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Pötzsch C, Kurch L, Naumann S, Georgi TW, Sabri O, Stoevesandt D, Cepelova M, Körholz D, Mauz-Körholz C, Hasenclever D, Kluge R. Prevention of activated brown adipose tissue on 18F-FDG-PET scans of young lymphoma patients: results of an ancillary study within the EuroNet-PHL-C2 trial. Sci Rep 2023; 13:21944. [PMID: 38081864 PMCID: PMC10713612 DOI: 10.1038/s41598-023-48871-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Activated brown fat (aBAT) is known to affect the evaluation of 18F-FDG PET scans, especially in young patients. The aim of this study was to determine factors influencing the occurrence of aBAT, and to investigate the effectiveness of the two preventive measures, warming and beta-blocker (propranolol) administration. Five-hundred-twenty-eight 18F-FDG-PET scans of 241 EuroNet-PHL-C2 trial patients from 41 nuclear medicine departments in Germany and Czech Republic were screened for aBAT. The occurrence of aBAT was analyzed with patient characteristics (age, sex, body mass index, predisposition to aBAT), weather data at the day of 18F-FDG PET scanning as well as the preventive measures taken. Potentially important factors from univariate analyses were included into a logistic regression model. Warming as a preventive measure was used in 243 18F-FDG-PET scans, propranolol was administered in 36, warming and propranolol were combined in 84, and no preventive measures were taken in 165 scans. Whereas age, sex and body mass index had no clear impact, there was an individual predisposition to aBAT. Logistic regression model revealed that the frequency of aBAT mainly depends on the outside temperature (p = 0.005) and can be effectively reduced by warming (p = 0.004), the administration of unselective beta-blocker or the combination of both. Warming is a simple, cheap and non-invasive method to reduce the frequency of aBAT. However, the effect of warming decreases with increasing outside temperatures. Administration of propranolol seems to be equally effective and provides advantages whenever the positive effect of warming is compromised. The combination of both preventive measures could have an additive effect.
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Affiliation(s)
- C Pötzsch
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany.
| | - S Naumann
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - T W Georgi
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - D Stoevesandt
- Department of Radiology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - M Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - D Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University Giessen, Giessen, Germany
| | - C Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University Giessen, Giessen, Germany
| | - D Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - R Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
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Roschke E, Kluge T, Stallkamp F, Roth A, Zajonz D, Hoffmann KT, Sabri O, Kluge R, Ghanem M. Use of PET-CT in diagnostic workup of periprosthetic infection of hip and knee joints: significance in detecting additional infectious focus. Int Orthop 2021; 46:523-529. [PMID: 34618195 PMCID: PMC8840933 DOI: 10.1007/s00264-021-05218-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022]
Abstract
Introduction The diagnosis and management of periprosthetic knee and hip infections as well as the identification and management of possible additional infectious foci is of great importance for successful therapy. This study analyses the importance of 18F deoxyglucose PET-CT (PET-CT) in the identification of additional infectious focus and subsequent impact on management of periprosthetic infection (PPI). Material and methods A retrospective analysis of the clinical data and findings in the period from January 2008 to December 2018 was carried out. One hundred and four patients with in-hospital treatment due to PPI of a hip or knee joint were identified and included in this study. All patients underwent a standardized clinical examination and further surgical and antibiotic therapy. The reevaluation of performed PET-CTs was specifically carried out with regard to the local PPI or detection of secondary foci. Results PET-CT successfully verified the PPI in 84.2% of the patients. A total of 78 possible additional foci were detected in PET-CT in 56 (53.8%) of the examined patients. Predilection sites for possible secondary foci were joints (42.3%), pulmonary (15.4%), ear-nose-throat (15.4%), spine (11.5%), and the musculocutaneous tissues (11.5%). Fifty-four positive PET-CT findings were confirmed clinically with need of additional adequate treatment. Conclusion PET-CT is a valuable diagnostic tool to confirm periprosthetic joint infection. At the same time, the whole-body PET/CT may detect additional foci of infection with impact on subsequent treatment strategy. PET was of special value in detecting infections at distant locations far from the primary infected joint in significant number. These distant infection locations can be potential cause of a re-infection. This clearly reflects the need of their diagnosis.
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Affiliation(s)
- E Roschke
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - T Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - F Stallkamp
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - A Roth
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - D Zajonz
- Klinik Für Orthopädie, Unfallchirurgie Und Wiederherstellungschirurgie, Zeißigwaldkliniken Bethanien Chemnitz, Chemnitz, Germany
| | - K T Hoffmann
- Klinik Und Poliklinik Für Diagnostische Und Interventionelle Radiologie, Institut Für Neuroradiologie, Leipzig, Germany
| | - O Sabri
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - R Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - M Ghanem
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
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Kurch L, Kluge R, Sabri O, Fischer L, Wendt S, Graf Einsiedel H, Starke S, Kühl JS, Christiansen H, Hirsch FW, Sorge I, Roth C. Whole-body [ 18F]-FDG-PET/MRI for staging of pediatric non-Hodgkin lymphoma: first results from a single-center evaluation. EJNMMI Res 2021; 11:62. [PMID: 34216300 PMCID: PMC8254839 DOI: 10.1186/s13550-021-00804-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
Aim In 2015, the revised International Pediatric Non-Hodgkin Lymphoma Staging System was published. It mentions [18F]-FDG-PET/MRI as the latest method to perform whole-body imaging. However, supporting data are pending. Our aim was to investigate the performance of whole-body [18F]-FDG-PET/MRI in pediatric non-Hodgkin lymphoma patients by using a limited number of MRI sequences. Materials and methods Ten pediatric patients with histologically proven non-Hodgkin lymphoma underwent whole-body [18F]-FDG-PET/MRI at staging. The retrospective analysis included three steps: First, [18F]-FDG-PET and MR scans were evaluated separately by a nuclear medicine physician and a pediatric radiologist. Nineteen nodal and two extranodal regions as well as six organs were checked for involvement. Second, discrepant findings were reviewed together in order to reach consensus. Third, [18F]-FDG-PET/MRI findings were correlated with the results of other clinical investigations. Results Of the 190 lymph node regions evaluated, four were rated controversial. Consensus was reached by considering metabolic, functional and morphologic information combined. Concordantly, [18F]-FDG-PET and MRI detected Waldeyer’s ring involvement in two patients whose Waldeyer’s ring was negative on clinical assessment. In four patients MRI showed pleural effusion. However, in only two of them an increased glucose metabolism as a reliable sign of pleural involvement was detectable. In six patients [18F]-FDG-PET and MRI detected skeletal lesions although bone marrow biopsy was positive in only one of them. Conclusion Despite the small number of cases evaluated, whole-body [18F]-FDG-PET turned out to be a valuable tool for staging of pediatric non-Hodgkin lymphoma.
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Affiliation(s)
- L Kurch
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
| | - R Kluge
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - L Fischer
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - S Wendt
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - H Graf Einsiedel
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - S Starke
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - J-S Kühl
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - H Christiansen
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - F W Hirsch
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
| | - I Sorge
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
| | - C Roth
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
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Dralle H, Kluge R, Kaiser GM, Schlitt HJ. [Complicated course after cecal injury during laparoscopic salpingectomy]. Chirurg 2019; 90:671-673. [PMID: 31263911 DOI: 10.1007/s00104-019-0996-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Dralle
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
| | - R Kluge
- Gutachterstelle für Arzthaftpflichtfragen, Sächsische Landesärztekammer, Schützenhöhe 16, 01099, Dresden, Deutschland.
| | - G M Kaiser
- Klinik für Allgemein- und Viszeralchirurgie, St. Bernhard-Hospital Kamp-Lintfort GmbH, Bürgermeister-Schmelzing-Str. 90, 47475, Kamp-Lintfort, Deutschland.
| | - H J Schlitt
- Klinik und Poliklinik für Chirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
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Flerlage J, Mauz-Körholz C, Kelly K, McCarten K, Punnett A, Kaste S, Dieckmann K, Marks L, Seelisch J, Drachtman R, Lewis J, Beishuzen A, Kluge R, Kurch L, Stroevesandt D, Metzger M. INCLUSION OF A PEDIATRIC PERSPECTIVE INTO RECOMMENDATIONS FOR THE INITIAL EVALUATION AND STAGING OF HODGKIN LYMPHOMA: A CALL TO ACTION FROM THE INTERNATIONAL SEARCH WORKING GROUP. Hematol Oncol 2019. [DOI: 10.1002/hon.24_2629] [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)
- J. Flerlage
- Oncology; St. Jude Children's Research Hospital; Memphis United States
| | - C. Mauz-Körholz
- Pediatric Hematology and Oncology; Martin-Luther-University; Giessen Germany
| | - K. Kelly
- Hematology/Oncology; Roswell Park Comprehensive Cancer Center; Buffalo United States
| | - K. McCarten
- Diagnostic Imaging; 13Rhode Island Hospital/Warren Alpert Medical School at Brown University; Providence United States
| | - A. Punnett
- Pediatrics; Sickkids Hospital; Toronto Ontario Canada
| | - S. Kaste
- Oncology; St. Jude Children's Research Hospital; Memphis United States
| | - K. Dieckmann
- Radiotherapy; Medizinische Universität Wien; Vienna Austria
| | - L. Marks
- Pediatric Hematology/Oncology; Stanford; Palo Alto United States
| | - J. Seelisch
- Hematology/Oncology; Children's Hospital, London Health Sciences Centre; London Ontario Canada
| | - R. Drachtman
- Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - J. Lewis
- Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | | | - R. Kluge
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - L. Kurch
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | | | - M. Metzger
- Oncology; St. Jude Children's Research Hospital; Memphis United States
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Metzger M, Mauz-Körholz C, Flerlage J, Bartelt J, Billett A, Choi J, Ehrhardt M, Georgi T, Hasenclever D, Wang F, Zhang H, Kaste S, Kluge R, Körholz D, Kurch L, Link M, Stoevesandt D, Hudson M, Krasin M. SAFETY AND RESPONSE AFTER 2 CYCLES OF BRENTUXIMAB VEDOTIN SUBSTITUTING VINCRISTINE IN THE OEPA/COPDAC REGIMEN FOR HIGH RISK PEDIATRIC HODGKIN LYMPHOMA (HL). Hematol Oncol 2019. [DOI: 10.1002/hon.25_2629] [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)
- M. Metzger
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - C. Mauz-Körholz
- Pediatric Hematology Oncology; Justus Liebig Universität; Giessen Germany
| | - J. Flerlage
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - J. Bartelt
- Clinic of Radiology; Martin Luther University; Halle (Saale) Germany
| | - A. Billett
- Blood Disorders Center; Dana-Farber/Boston Children's Hospital; Boston United States
| | - J.K. Choi
- Pathology; St Jude Children's Research Hospital; Memphis United States
| | - M. Ehrhardt
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - T. Georgi
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - D. Hasenclever
- Institut for Medical Informatics; University of Leipzig; Leipzig Germany
| | - F. Wang
- Biostatistics; St Jude Children's Research Hospital; Memphis United States
| | - H. Zhang
- Biostatistics; St Jude Children's Research Hospital; Memphis United States
| | - S.C. Kaste
- Diagnostic Imaging; St Jude Children's Research Hospital; Memphis United States
| | - R. Kluge
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - D. Körholz
- Pediatric Hematology Oncology; Justus Liebig Universität; Giessen Germany
| | - L. Kurch
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - M. Link
- Pediatric Hematology Oncology; Stanford University Medical Center; Palo Alto United States
| | - D. Stoevesandt
- Clinic of Radiology; Martin Luther University; Halle (Saale) Germany
| | - M.M. Hudson
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - M. Krasin
- Radiation Oncology; St Jude Children's Research Hospital; Memphis United States
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Kurch L, Hasenclever D, Kluge R, Georgi T, Tchavdarova L, Golombeck M, Sabri O, Eggert A, Brenner W, Sykora KW, Bengel FM, Rossig C, Körholz D, Schäfers M, Feuchtinger T, Bartenstein P, Ammann RA, Krause T, Urban C, Aigner R, Gattenlöhner S, Klapper W, Mauz-Körholz C. Only strongly enhanced residual FDG uptake in early response PET (Deauville 5 or qPET ≥ 2) is prognostic in pediatric Hodgkin lymphoma: Results of the GPOH-HD2002 trial. Pediatr Blood Cancer 2019; 66:e27539. [PMID: 30426671 DOI: 10.1002/pbc.27539] [Citation(s) in RCA: 9] [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: 04/23/2018] [Revised: 10/11/2018] [Accepted: 10/14/2018] [Indexed: 11/06/2022]
Abstract
PURPOSE In 2014, we published the qPET method to quantify fluorodeoxyglucose positron emission tomography (FDG-PET) responses. Analysis of the distribution of the quantified signals suggested that a clearly abnormal FDG-PET response corresponds to a visual Deauville score (vDS) of 5 and high qPET values ≥ 2. Evaluation in long-term outcome data is still pending. Therefore, we analyzed progression-free survival (PFS) by early FDG-PET response in a subset of the GPOH-HD2002 trial for pediatric Hodgkin lymphoma (PHL). PATIENTS/METHODS Pairwise FDG-PET scans for initial staging and early response assessment after two cycles of chemotherapy were available in 93 PHL patients. vDS and qPET measurement were performed and related to PFS. RESULTS Patients with a qPET value ≥ 2.0 or vDS of 5 had 5-year PFS rates of 44%, respectively 50%. Those with qPET values < 2.0 or vDS 1 to 4 had 5-year PFS rates of 90%, respectively 80%. The positive predictive value of FDG-PET response assessment increased from 18% (9%; 33%) using a qPET threshold of 0.95 (vDS ≤ 3) to 30% (13%; 54%) for a qPET threshold of 1.3 (vDS ≤ 4) and to 56% (23%; 85%) when the qPET threshold was ≥ 2.0 (vDS 5). The negative predictive values remained stable at ≥92% (CI: 82%; 98%). CONCLUSION Only strongly enhanced residual FDG uptake in early response PET (vDS 5 or qPET ≥ 2, respectively) seems to be markedly prognostic in PHL when treatment according to the GPOH-HD-2002 protocol is given.
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Affiliation(s)
- L Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - D Hasenclever
- Institute of Medical Statistics, Informatics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - R Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - T Georgi
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - L Tchavdarova
- Clinic of Nuclear Medicine, National Hospital for Active Treatment in Oncology, Sofia, Bulgaria
| | - M Golombeck
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - A Eggert
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Charité Berlin, Berlin, Germany
| | - W Brenner
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K W Sykora
- Department of Pediatric Hematology and Oncology, Medizinische Hochschule Hannover, Hannover, Germany
| | - F M Bengel
- Department of Nuclear Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - C Rossig
- University Children's Hospital Münster, Pediatric Hematology and Oncology, Münster, Germany
| | - D Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Giessen, Germany
| | - M Schäfers
- Department of Nuclear Medicine, University Hospital of Münster, Münster, Germany
| | - T Feuchtinger
- Dr. von Hauner University Children's Hospital, LMU Munich, Munich, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, LMU Munich, Munich, Germany
| | - R A Ammann
- Division of Pediatric Hematology and Oncology, Department of Pediatrics (Inselspital) Bern University Hospital, University of Bern, Bern, Switzerland
| | - T Krause
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Urban
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Graz, Graz, Austria
| | - R Aigner
- Department of Radiology, Medical University Graz, Graz, Austria
| | - S Gattenlöhner
- Department of Pathology, Justus-Liebig University of Giessen, Giessen, Germany
| | - W Klapper
- Department of Pathology, University Hospital of Kiel, Kiel, Germany
| | - C Mauz-Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Giessen, Germany.,Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
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Kämpfer I, Seese A, Dannenberg C, Kluge R, Burchert W, Knapp WH, Barthel H. Improvement of Brain SPECT by Stabilization of Tc-99m-HMPAO with Methylene Blue or Cobalt Chloride. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: This present study was carried out to investigate whether stabilization of Tc-99m-HMPAO with methylene blue (MB) or cobalt chloride (CC) causes a sensible improvement in image quality and how cerebral to noncerebral activity ratios compare with those of Tc-99m-ECD. Methods: 30 minutes after preparation 400-600 MBq unstabilized Tc-99m-HMPAO (N = 35 patients), Tc-99m-HMPAO added with MB (N = 24 patients), added with CC (N = 30 patients) or Tc-99m-ECD (N = 28 patients) were injected. Radiochemical stability was measured in vitro with three chromatographical methods. Image quality was assessed quantitatively using two ratios, one of them determined by count densities of brain/scalp (QS), the other one by count densities of brain/ nose (QN). In addition, image quality (0 = bad, 3 = excellent) and background activity (0 = high, 3 = no) were visually assessed by three independent observers. Results: In contrast to unstabilized Tc-99m-HMPAO the integrity of the complexes of MB-Tc-99m-HMPAO, CC-Tc-99m-HMPAO and Tc-99m-ECD decreased only by a few percent during a period of 2 hours after reconstitution (66.8 ± 9.9 vs. 93.0 ± 2.5, 91.8 ± 1.9 and 96.9 ± 1.4%, p <0.001). Qs and Qn (m.v. ± SD) differed significantly between studies using unstabilized Tc-99m-HMPAO (3.0 ± 0.4 and 2.1 ± 0.3), MB-Tc-99m-HMPAO (3.4 ± 0.4 and 2.3 ± 0.3), CC-Tc-99m-H M PAO (3.6 ± 0.6 and 2.6 ± 0.4) and those using Tc-99m-ECD (4.3 ± 0.7 and 4.8 ± 1.4; p <0.05 and <0.001). Stabilization with CC or MB resulted in significant higher scoring of image quality and lower scoring of background activity in comparison to that of unstabilized Tc-99m-HMPAO, without reaching the scores obtained with Tc-99m-ECD. Conclusions: It is concluded that stabilization of Tc-99m-HMPAO with MB or CC definitely improves image quality in rCBF-SPECT, without reaching that of Tc-99m-ECD. Improvement of image quality results from the reduction of the amount of decomposition products that contribute to considerable extracerebral activity.
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Abstract
Summary
Aim: This study deals with the effect of the non-uniform attenuation correction method on myocardial tomograms of normal subjects. Method: A total of 35 patients (20 female, 15 male) without evidence of cardiac disease underwent SPET with and without attenuation correction using a dual head camera and transmission data obtained by two scanning Gd-153 line sources after administration of 400 MBq Tc-99m-tetrofosmin. Results: In non-corrected (NC) stress studies the lowest count rates were found in the inferior segments with mean differences in count rates between maxima and minima of 35.8 ± 10.8%. In attenuation corrected (AC) images the respective segmental differences averaged only 20.9 ± 3.3% and the images did not show significant count deficiency in the inferior segments. The effects of correction revealed to be sex dependent, but independent of body mass on average. Conclusion: AC using the above technique significantly reduces the variability of count rate distribution in normal subjects and improves the preconditions for accurate diagnostic evaluation of coronary artery disease using SPET.
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Bengel F, Büll U, Burchert W, Kies P, Kluge R, Krause BJ, Lindner O, Nienaber C, Nowak B, Schäfer W, Schober O, Schwaiger M, Silber S, Stegger L, vom Dahl J, Zimmermann R, Schäfers M. Position paper nuclear cardiology: Update 2008. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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
SummaryNuclear cardiology is well established in clinical diagnostic algorithms for many years. This is an update 2008 of the first common position paper of the German Association of Nuclear Medicine and the German Association of Cardiology, Heart and Circulation Research published in 2001 aiming at an overview of state-of-the-art scintigraphic methods.
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Burchert W, Bengel FM, Zimmermann R, vom Dahl J, Schäfer W, Büll U, Schober O, Schwaiger M, Kluge R, Schäfers M, Lindner O. Myocardial perfusion scintigraphy in Germany. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1621023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: A questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (>75%) was performed with 99mTc-MIBI or tetrofosmin. 201Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: In Germany, MPS is predominantly performed with 99mTc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization.
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Dietlein M, Mauz-Körholz C, Engert A, Borchmann P, Sabri O, Schober O, Schicha H, Kluge R, Kobe C. FDG-PET in Hodgkin lymphoma. Nuklearmedizin 2018; 47:235-8; quiz N75-6. [DOI: 10.3413/nukmed-0216] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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
SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.
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Burchert W, Bengel FM, Zimmermann R, vom Dahl J, Schäfer W, Schober O, Kluge R, Schäfers M, Lindner O. Myocardial perfusion scintigraphy 2006 in Germany. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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
SummaryAim: This second survey was to deliver further information on myocardial perfusion scintigraphy (MPS) in Germany in 2006. Method: 351 questionnaires were evaluated: 207 private practices (PP), 117 hospitals (HO), 27 from university hospitals (UH). Results: MPS of 106 331 patients were reported, 85% were investigated with 99mTc-perfusion tracers. 74% [2005=72%] were performed in PP, 17% [2005=15%] in HO and 9% [2005=13%] in UH. PP, which participated in 2005 and 2006, demonstrated an increase by 3,9% (HO 0%, UH –13,0%). The type of stress was pharmacological in 27% [2005=22%]; 54% adenosine (of these 29% with exercise), 37% dipyridamole (of these 56% with exercise), and 9% dobutamine. Gated SPECT was performed in 42% [2005=36%] of all restand in 39% [2005=32%] of all stress MPS. An attenuation correction was used by 69 [2005=78] institutions. 40% of all MPS were performed in patients suspected to have CAD. 24% of all institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2006 despite competing methods. Gated SPECT has experienced more acceptance. Suspicion of CAD is an important indication of MPS. In order to tap the full potential of MPS a gated SPECT should be performed routinely.
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Mozet C, Kuhnt T, Sattler B, Remmele J, Thome U, Stepan H, Kluge R, Dietz A, Knoedler M. [Head and Neck Cancer in Pregnancy - Recommendations for Diagnosis and Therapy With Case Report]. Laryngorhinootologie 2016; 95:674-683. [PMID: 27764854 DOI: 10.1055/s-0042-114987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The diagnosis of cancer in pregnancy is rare, but might become more relevant even for head and neck cancer patients due to a shift of age of primipara towards the last third of reproductive years. Unsureness exists about the risk and benefit of diagnostic and therapeutic cancer modalities for the unborn and established recommendations are still missing. But, according to recent data, even multimodal therapeutic approaches (e. g. surgery, radiation, chemotherapy) seem possible in face of pregnancy and should be traded against the risk of prematurity. Material and Methods: Our findings are discussed on the basis of a case report of a pregnant woman with advanced carcinoma of the outer ear canal and therapy options are formulated. Results: Sufficient performed diagnostic modalities do not reach imperilling uterus dosages. A growing number of case reports und studies did not detect any developmental disadvantage of children of prenatal exposed mothers by radiation or chemotherapy, whereas long-term impairments of premature infants are proven. Conclusion: In cancer in pregnancy, an immediate start of well-established therapy modalities like surgery and/or cisplatin-based chemoradiation seems to be possible without unjustifiable risks for the unborn.
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Affiliation(s)
- C Mozet
- ENT, Schwarzwald-Baar-Klinikum Villingen-Schwenningen, Villingen-Schwenningen
| | - T Kuhnt
- Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Leipzig
| | - B Sattler
- Medizinphysik, Klinik und Poliklinik für Nuklearmedizin Leipzig, Leipzig
| | - J Remmele
- Klinik für Strahlentherapie und Radioonklogie, Universitatsklinikum Leipzig, Leipzig
| | - U Thome
- Neonatologie, Universität Leipzig, Leipzig
| | - H Stepan
- Geburtsmedizin, Universitatsklinikum Leipzig, Leipzig
| | - R Kluge
- Nuklearmedizin, Universitatsklinikum Leipzig, Leipzig
| | - A Dietz
- Plastische Operationen, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität Leipzig, Leipzig
| | - M Knoedler
- Krebszentrm (UCCL),Universitatsklinikum Leipzig, Leipzig
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15
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Brandmaier P, Purz S, Bremicker K, Höckel M, Barthel H, Kluge R, Kahn T, Sabri O, Stumpp P. Simultaneous [18F]FDG-PET/MRI: Correlation of Apparent Diffusion Coefficient (ADC) and Standardized Uptake Value (SUV) in Primary and Recurrent Cervical Cancer. PLoS One 2015; 10:e0141684. [PMID: 26551527 PMCID: PMC4638340 DOI: 10.1371/journal.pone.0141684] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 10/12/2015] [Indexed: 01/18/2023] Open
Abstract
Objectives Previous non–simultaneous PET/MR studies have shown heterogeneous results about the correlation between standardized uptake values (SUVs) and apparent diffusion coefficients (ADCs). The aim of this study was to investigate correlations in patients with primary and recurrent tumors using a simultaneous PET/MRI system which could lead to a better understanding of tumor biology and might play a role in early response assessment. Methods We included 31 patients with histologically confirmed primary (n = 14) or recurrent cervical cancer (n = 17) who underwent simultaneous whole-body 18F-FDG-PET/MRI comprising DWI. Image analysis was performed by a radiologist and a nuclear physician who identified tumor margins and quantified ADC and SUV. Pearson correlations were calculated to investigate the association between ADC and SUV. Results 92 lesions were detected. We found a significant inverse correlation between SUVmax and ADCmin (r = -0.532, p = 0.05) in primary tumors as well as in primary metastases (r = -0.362, p = 0.05) and between SUVmean and ADCmin (r = -0.403, p = 0.03). In recurrent local tumors we found correlations for SUVmax and ADCmin (r = -0.747, p = 0.002) and SUVmean and ADCmin (r = -0.773, p = 0.001). Associations for recurrent metastases were not significant (p>0.05). Conclusions Our study demonstrates the feasibility of fast and reliable measurement of SUV and ADC with simultaneous PET/MRI. In patients with cervical cancer we found significant inverse correlations for SUV and ADC which could play a major role for further tumor characterization and therapy decisions.
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Affiliation(s)
- P. Brandmaier
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
- * E-mail:
| | - S. Purz
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - K. Bremicker
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - M. Höckel
- Department of Gynecology and Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - H. Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - R. Kluge
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - T. Kahn
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - O. Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - P. Stumpp
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
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Mauz-Körholz C, Lange T, Hasenclever D, Burkhardt B, Feller A, Dörffel W, Kluge R, Vordermark D, Körholz D. Pediatric Nodular Lymphocyte-predominant Hodgkin Lymphoma: Treatment Recommendations of the GPOH-HD Study Group. Klin Padiatr 2015; 227:314-21. [DOI: 10.1055/s-0035-1559664] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Mauz-Körholz
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
| | - T. Lange
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
| | - D. Hasenclever
- Institut für Medizinische Informatik, Statistik & Epidemiologie (IMISE), Universität Leipzig, Leipzig, Germany
| | - B. Burkhardt
- Clinic for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - A. Feller
- Institute for Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - W. Dörffel
- Clinic for Pediatric and Youth Medicine, Helios Hospital Berlin-Buch, Berlin, Germany
| | - R. Kluge
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - D. Vordermark
- Clinic and Policlinic for Radiation Therapy, University Hospital Halle (Saale), Halle (Saale), Germany
| | - D. Körholz
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
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17
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Kramell A, Porbeck F, Kluge R, Wiesner A, Csuk R. A fast and reliable detection of indigo in historic and prehistoric textile samples. J Mass Spectrom 2015; 50:ii. [PMID: 28338255 DOI: 10.1002/jms.3493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Across all cultures and over all time periods, as early as the third millennium BC, indigo, a very intense blue vat dye, has been used to dye textiles. Even today, indigo is regarded as one of the most popular blue colorants in items such as blue jeans. While synthetic indigo is used to color textiles today, throughout history, a variety of plants have provided indigo. In this special feature article, René Csuk and co-authors propose to use atmospheric solids analysis probe mass spectrometry (ASAP-MS) to very rapidly and reliably identify indigo colorants tiny amounts in ancient historic fabrics without any sample preparation. The ionization in ASAP experiments is effected by Penning ionization or by the transfer of protons originating from protonated clusters of water. Dr. René Csuk is Professor of organic bioorganic chemistry at the Martin-Luther Universität Halle-Wittenberg (Halle, Germany). His main research interests are in organic and medicinal chemistry, chemical biology and phytochemistry. Graphical Abstract: Historical samples can be investigated conveniently using ASAP®-MS experiments. ASAP®-MS allowed for rapid direct sampling without any preparation of the sample prior to its measurements, and reliable results were generated in less than 1 minute. As demonstrated for indigoid-type dyes, the efficacy of ASAP®-MS analysis is independent of the type of fiber, the age of the sample, the workmanship, and the state of preservation.
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Kamitz A, Hallahan N, Burkhardt R, Schulze G, Jähnert M, Arends D, Kluge R, Joost HG, Schürmann A. Identification of a quantitative trait locus effecting liver fat content and blood glucose in an NZOxB6 backcross. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549625] [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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Körholz D, Mauz-Körholz C, Vordermark D, Kluge R, Dieckmann K. Increased relapse rates in early stage hodgkin lymphoma (HL) patients without radiotherapy: the German Society of Radiooncology (DEGRO) advises to treat all early stage HL patients with radiotherapy. Klin Padiatr 2014; 226:307-8. [PMID: 25431863 DOI: 10.1055/s-0034-1389928] [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: 10/24/2022]
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20
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Pichler M, Staffler A, Bonometti N, Messner H, Deluca J, Thuile T, Kluge R, Schmuth M, Eisendle K. Premature newborns with fatal intrauterine herpes simplex virus-1 infection: first report of twins and review of the literature. J Eur Acad Dermatol Venereol 2014; 29:1216-20. [DOI: 10.1111/jdv.12583] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
- M. Pichler
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - A. Staffler
- Neonatal Intensive Care Unit; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - N. Bonometti
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - H. Messner
- Neonatal Intensive Care Unit; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - J. Deluca
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - T. Thuile
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - R. Kluge
- Department of Pathology; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - M. Schmuth
- Department of Dermatology; Innsbruck Medical University; Innsbruck Austria
| | - K. Eisendle
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
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Kamitz A, Hallahan N, Burkhardt R, Schulze G, Jähnert M, Kluge R, Jonas W, Joost HG, Schürmann A. Novel diabetes QTL on chromosomes 1, 9, 11 and 13 identified in an NZOxC57BL/6J backcross population. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374968] [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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22
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Kurch L, Hasenclever D, Tchavdarova L, Georgi T, Stoevesandt D, Pelz T, Vordermark D, Sabri O, Mauz-Körholz C, Körholz D, Kluge R. Impact of Non-FDG-Avid Areas Inside a Tumour Mass in Paediatric Hodgkin Lymphoma (PHL) Patients. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pichler M, Carriere C, Mazzoleni G, Kluge R, Eisendle K. Acne inversa-like lesions associated with the multi-kinase inhibitor sorafenib. Clin Exp Dermatol 2013; 39:232-3. [PMID: 24330088 DOI: 10.1111/ced.12257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M Pichler
- Department of Dermatology, Central Teaching Hospital of Bolzano, Bolzano/Bozen, Italy.
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Kurch L, Mauz-Körholz C, Bertling S, Wallinder M, Kaminska M, Marwede D, Tchavdarova L, Georgi TW, Elsner A, Barthel A, Stoevesandt D, Hasenclever D, Sattler B, Sabri O, Körholz D, Kluge R. The EuroNet paediatric hodgkin network - modern imaging data management for real time central review in multicentre trials. Klin Padiatr 2013; 225:357-61. [PMID: 24166093 DOI: 10.1055/s-0033-1354416] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Since 2007, children and adolescents with Hodgkin lymphomas are treated in the Europe-wide EuroNet-PHL trials. A real time central review process for stratification of the patients enhances quality control and efficient therapy management. This process includes reading of all cross-sectional-images. Since reference evaluation is time critical, a fast, easy to handle and safe data transfer is important. In addition, immediate and constant access to all the data has to be guaranteed in case of queries and for regulatory reasons. To meet the mentioned requirements the EuroNet Paediatric Hodgkin Data Network (funded by the European Union - Project Number: 2007108) was established between 2008 and 2011. A respective tailored data protection plan was formulated. The aim of this article is to describe the networks' mode of operation and the advantages for multi-centre trials that include centralized image review.
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Affiliation(s)
- L Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, Germany
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Vogel H, Mirhashemi F, Liehl B, Taugner F, Kluth O, Kluge R, Joost HG, Schürmann A. Estrogen deficiency aggravates insulin resistance and induces β-cell loss and diabetes in female New Zealand obese mice. Horm Metab Res 2013; 45:430-5. [PMID: 23322514 DOI: 10.1055/s-0032-1331700] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [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: 10/27/2022]
Abstract
In several rodent strains such as the New Zealand Obese (NZO) mouse, the incidence of obesity-associated diabetes mellitus is much higher in males than in females. In the present study, we investigated the effects of ovariectomy on glucose homeostasis in female NZO mice in order to elucidate the mechanism of their diabetes resistance. NZO females were ovariectomized at the age of 4 weeks, received a high-fat diet and body weight, body fat, glucose and insulin tolerance were investigated in comparison to sham-operated mice. In a second experiment, operated mice were fed a carbohydrate-free diet up to the age of 19 weeks before they received the high-fat diet. In comparison with a sham-operated control group, ovariectomized female NZO mice exhibited similar body weights, a reduced glucose tolerance, developed significantly higher blood glucose levels, lost insulin producing β-cells, which finally resulted in a diabetes prevalence of 73% at the age of 16 weeks vs. 25% in controls. Similar to male NZO mice, ovariectomized females presented a more severe insulin resistance in the insulin tolerance test than sham-operated controls. Furthermore, the more severe insulin resistance in ovariectomized mice preceded the development of diabetes and pancreatic insulin depletion that was caused by a dietary regimen of carbohydrate restriction and subsequent re-exposure. In summary our data demonstrate that estrogen protects NZO females from β-cell loss and obesity-associated diabetes mellitus. This effect is due to a reduced insulin resistance and possibly also to a reduced sensitivity of β-cells to glucolipotoxic conditions.
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Affiliation(s)
- H Vogel
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
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Stumpp P, Kubiessa K, Purz S, Gawlitza M, Kühn A, Fuchs J, Steinhoff KG, Boehm A, Kluge R, Sabri O, Kahn T. Erste klinische Ergebnisse der simultanen 18F-FDG-PET/MRT im Vergleich zur 18F-FDG-PET/CT bei Patienten mit Kopf-Hals-Tumoren. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346268] [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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Haase R, Vilser C, Mauz-Körholz C, Hasenclever D, Kluge R, Ruschke K, Borkhardt A, Seeger K, Lehrnbecher T, Kulozik A, Rößler J, Burdach S, Jürgens H, Körholz D. Evaluation of the prognostic meaning of C-reactive protein (CRP) in children and adolescents with classical Hodgkin's lymphoma (HL). Klin Padiatr 2012; 224:377-81. [PMID: 23047832 DOI: 10.1055/s-0032-1323824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND In adult cancer patients the negative predictive value of elevated CRP levels has been described for several malignancies. Only few studies have analyzed the prognostic role of CRP in children and adolescents with classical HL. In these studies elevated CRP levels correlate with the presence of classical risk factors and adverse outcome. PATIENTS AND METHODS The prognostic role of CRP for patients with classical HL admitted to the GPOH-HD-2002 study was analyzed retrospectively. RESULTS CRP levels were documented for 369 of 573 patients. Significant (p<0.05) increased median CRP levels were found in the presence of B-Symptoms (25.7 vs. 5.1 mg/l), extranodal involvement (21.5 vs. 7.5 mg/l), elevated erythrocyte sedimentation rate (ESR, 13.0 vs. 1.0 mg/l) and stage III/IV disease (15.5 vs. 5.3 mg/l). 83.9% of patients with elevated and 45.8% of patients with normal CRP had an ESR >30 mm/h. CONCLUSION Elevated CRP levels were associated with classical risk factors of HL. CRP and ESR may reflect different biological processes. CRP was prognostic within early stage TG-1 patients treated with reduced treatment, but not within advanced stage TG-2+3.
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Affiliation(s)
- R Haase
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle Wittenberg, Halle/Saale, Germany.
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Kluge R. Nuklearmedizin - Standard in der Funktionsdiagnostik. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1310697] [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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29
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Vogel H, Kanzleiter T, Scherneck S, Benz V, Kluge R, Blüher M, Montag D, Joost HG, Schürmann A. A microdeletion within a QTL hotspot on distal mouse chromosome 1 disrupts the Ifi202b gene and modulates metabolic and neuronal phenotypes. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314516] [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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Schulz N, Vogel H, Kluge R, Joost HG, Schürmann A. Einfluss einer Kohlenhydrat-freien Diät auf Körpergewicht und Glucosehomöostase SCHAD-defizienter Mäuse. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314531] [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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31
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Kluth O, Mirhashemi F, Kaiser D, Kluge R, Scherneck S, Joost HG, Schürmann A. Konträre Effekte gluco-lipotoxischer Bedingungen auf Inseln von Diabetes-suszeptiblen und -resistenten Mausstämmen. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314540] [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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Körholz D, Mauz-Körholz C, Kluge R, Bernig T, Staege MS, Vordermark D, Hasenclever D. Konzept der Langzeitnachsorge für in Deutschland behandelte Patienten der GPOH-HD2002 und EuroNet-PHL-C1 Studien. Klin Padiatr 2012. [DOI: 10.1055/s-0032-1306252] [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: 10/28/2022]
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Abstract
The paediatric Hodgkin lymphoma treatment optimisation concepts aim at reduction of treatment intensity with preservation of the high cure rates. A negative interim FDG-PET result after 2 cycles of chemotherapy is associated with a good prognosis. In the current EuroNet-PHL-C1 study radiotherapy is being omitted, if interim PET becomes negative. In addition to the early interim PET after 2 cycles of chemotherapy, all patients undergo an initial PET investigation which is part of the staging processs and plays an essential role for the interpretation of the interim PET. Skeletal involvement can be detected by a typical FDG-PET uptake pattern with high sensitivity and specifity. Therefore, in the forthcoming EuroNet-PHL-C2 study bone marrow biopsy and bone scintigraphy will no longer be part of the staging algorithm.
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Affiliation(s)
- R Kluge
- Universitätsklinikum Leipzig.
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Ruschke K, Stoevesandt D, Kluge R, Hasenclever D, Koerholz D. Lungenbefallsmuster bei Hodgkin Lymphom im Kindes- und Jugendalter – EuroNet- PHL-C1 Studie. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286221] [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: 10/17/2022]
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Schulz N, Scherneck S, Kaiser D, Vogel H, Himmelbauer H, Wanders R, Houten S, Kluge R, Joost HG, Schürmann A. Einfluss der Oxidation kurzkettiger Fettsäuren auf Körpergewicht und Glucosetoleranz. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Scherneck S, Mirhashemi F, Kluth O, Kaiser D, Schulz N, Vogel H, Kluge R, Joost HG, Schürmann A. Eine unzureichende Proliferation der β-Zellen trägt zur Diabetesempfindlichkeit der New Zealand Obese (NZO)-Maus bei. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Braunschweig R, Bergert H, Kluge R, Tiemann AH. [Imaging diagnostics of osteitis, osteomyelitis and joint infections]. Z Orthop Unfall 2011; 149:436-48. [PMID: 21534185 DOI: 10.1055/s-0030-1270953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Imaging diagnostics and surgical treatment of bone and joint infections are of paramount interest. The main purpose of our survey is to give a detailed overview about methods, indications, image criteria and efficiency of imaging diagnostics as a state of the art presentation. In conclusion we attempt to give some recommendations for clinical scenarios and diagnostic procedures concerning bone and joint infections. This paper has been prepared under the patronage of the AG Septische Chirurgie of the Deutsche Gesellschaft für Unfallchirurgie in Germany. It is our aim to update the paper with respect to the technical and clinical improvements and to publish it again after a number of years.
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Affiliation(s)
- R Braunschweig
- Klinik für bildgebende Diagnostik und Interventionsradiologie, BG Kliniken Bergmannstrost Halle, Merseburger Straße 165, Halle/Saale.
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Kluth O, Mirhashemi F, Scherneck S, Kaiser D, Kluge R, Neschen S, Joost HG, Schürmann A. Dissociation of lipotoxicity and glucotoxicity in a mouse model of obesity associated diabetes: role of forkhead box O1 (FOXO1) in glucose-induced beta cell failure. Diabetologia 2011; 54:605-16. [PMID: 21107520 PMCID: PMC3034032 DOI: 10.1007/s00125-010-1973-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 10/20/2010] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS Carbohydrate-free diet prevents hyperglycaemia and beta cell destruction in the New Zealand Obese (NZO) mouse model. Here we have used a sequential dietary regimen to dissociate the effects of obesity and hyperglycaemia on beta cell function and integrity, and to study glucose-induced alterations of key transcription factors over 16 days. METHODS Mice were rendered obese by feeding a carbohydrate-free diet for 18 weeks. Thereafter, a carbohydrate-containing diet was given. Plasma glucose, plasma insulin and total pancreatic insulin were determined, and forkhead box O1 protein (FOXO1) phosphorylation and the transcription factors pancreatic and duodenal homeobox 1 (PDX1), NK6 homeobox 1 protein (NKX6.1) and v-maf musculoaponeurotic fibrosarcoma oncogene family, protein A (avian) (MAFA) were monitored by immunohistochemistry for 16 days. RESULTS Dietary carbohydrates produced a rapid and continuous increase in plasma glucose in NZO mice between day 2 and 16 after the dietary challenge. Hyperglycaemia caused a dramatic dephosphorylation of FOXO1 at day 2, followed by a progressive depletion of insulin stores. The loss of beta cells was triggered by apoptosis (detectable at day 8), associated with reduction of crucial transcription factors (PDX1, NKX6.1 and MAFA). Incubation of isolated islets from carbohydrate-restricted NZO mice or MIN6 cells with palmitate and glucose for 48 h resulted in a dephosphorylation of FOXO1 and thymoma viral proto-oncogene 1 (AKT) without changing the protein levels of both proteins. CONCLUSIONS/INTERPRETATION The dietary regimen dissociates the effects of obesity (lipotoxicity) from those of hyperglycaemia (glucotoxicity) in NZO mice. Obese NZO mice are unable to compensate for the carbohydrate challenge by increasing insulin secretion or synthesising adequate amounts of insulin. In response to the hyperglycaemia, FOXO1 is dephosphorylated, leading to reduced levels of beta cell-specific transcription factors and to apoptosis of the cells.
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Affiliation(s)
- O. Kluth
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - F. Mirhashemi
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - S. Scherneck
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - D. Kaiser
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - R. Kluge
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - S. Neschen
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - H.-G. Joost
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - A. Schürmann
- Departments of Pharmacology and Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
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Csuk R, Tamba MG, Kluge R. Locking Out Ants - Synthesis and Biological Evaluation of Some Fluorinated Repellents. Z Naturforsch B 2011. [DOI: 10.5560/znb.2011.66b1069] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Csuk R, Schwarz S, Siewert B, Kluge R, Ströhl D. Synthesis and Antitumor Activity of Ring A-modified Glycyrrhetinic Acid Derivatives. Z Naturforsch B 2011. [DOI: 10.5560/znb.2011.66b0521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mirhashemi F, Scherneck S, Kluth O, Kaiser D, Vogel H, Kluge R, Schürmann A, Neschen S, Joost HG. Diet dependence of diabetes in the New Zealand Obese (NZO) mouse: total fat, but not fat quality or sucrose accelerates and aggravates diabetes. Exp Clin Endocrinol Diabetes 2010; 119:167-71. [PMID: 20827663 DOI: 10.1055/s-0030-1263127] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Obesity and diabetes in mice can be modified by dietary variables. Here we systematically analysed the effect of the sucrose and fat content and of the fat quality in New Zealand Obese mice, a mouse model of the metabolic syndrome. RESULTS Male NZO mice fed a semi-purified diet with sucrose exhibited an identical weight gain and diabetes incidence as controls without sucrose. In contrast, mice on a chow diet gained weight more slowly and developed diabetes approximately 10 weeks later than those on the semi-purified diet (energy density 3.05 vs. 3.85 kcal/g; fibre content 12.9 vs. 4.7%). In a second experimental series, neither the fat content (10 vs. 40% of the total energy) nor the quality of the fat (lard, safflower oil, or fish oil) of semi-purified diets modified weight gain. However, diabetes started approximately 2 weeks earlier and appeared more severe (blood glucose 30 vs. 20 mmol/l at week 13) in the high-fat diet group (energy density 4.58 kcal/g; fibre content 5.7%). CONCLUSIONS Obesity in NZO mice develops independent of the dietary sucrose or fat content, and of the fat quality. However, the dietary fat content accelerates the onset of diabetes without enhancing adiposity. In contrast, chow diet exerts an anti-adipogenic/anti-diabetogenic effect that appears to be due to its lower caloric density and/or its higher fibre content.
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Affiliation(s)
- F Mirhashemi
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Pharmacology, Nuthetal, Germany
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Franzius C, Stauss J, Pfluger T, Juergens KU, Kluge R, Amthauer H, Juergens H, Henze G, Stoever B, Hahn K. [Procedure guidelines for whole-body 18F-FDG PET and PET/CT in children with malignant diseases]. Nuklearmedizin 2010; 49:225-33; quiz N60-1. [PMID: 20617279 DOI: 10.3413/nukmed-0322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 05/04/2010] [Indexed: 11/20/2022]
Abstract
The purpose of these guidelines is to offer the nuclear medicine and the appropriate interdisciplinary team a framework for performing and reporting positron emission tomography (PET) and the combination with computed tomography (PET/CT) in children with malignant diseases mainly using the radiopharmaceutical 18F-fluorodeoxy-glucose (FDG). These guidelines are based on the recent guidelines of the Paediatric Committee of the European Association of Nuclear Medicine (EANM) (57) and have been translated and adapted to the current conditions in Germany. The adaptation of CT-parameters using PET/CT in children is covered in a more detailed way than in the EANM guideline taking into account that in Germany already a good portion of PET examinations is performed using an integrated PET/CT-scanner. Furthermore, a CT-scan without adoption of the CT acquisition parameters would result in a not tolerably high radiation exposition of the child. There are excellent guidelines for FDG PET and PET/CT in oncology published by the German Society of Nuclear Medicine (Deutsche Gesellschaft für Nuklearmedizin, DGN) (42) and EANM (4). These guidelines aim at providing additional information on issues particularly relevant to PET and PET/CT imaging in children. These guidelines should be taken in the context of local and national current standards of quality and rules.
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Affiliation(s)
- C Franzius
- Nuklearmedizin- und PET/CT-Zentrum Bremen Mitte, St. Jürgen Straße 1, 28177 Bremen, Germany.
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Hesse D, Hommel A, Jaschke A, Völker W, Engel T, Chadt A, Blüher M, Ruschke K, Kluge R, Joost HG, Schürmann A. Durch eine Beeinträchtigung der Lipidtropfenbildung und eine erhöhte Lipolyse resultiert die Deletion der GTPase Arfrp1 im Fettgewebe in einem lipodystrophen Phänotyp. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schulz N, Himmelbauer H, Scherneck S, Vogel H, Augustin R, Kluge R, Joost HG, Schürmann A. Adp3 – ein möglicher Regulator des Körpergewichts und der Insulinsekretion. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kluth O, Mirhashemi F, Kaiser D, Kluge R, Neschen S, Scherneck S, Joost HG, Schürmann A. Dissoziation von Glucotoxizität und Lipotoxizität in einem Mausmodell für Adipositas und Typ 2 Diabetes. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vogel H, Kryvych S, Scherneck S, Benz V, Block MD, Kluge R, Joost HG, Schürmann A. Identifizierung einer Genvariante für Adipositas und Hyperglykämie im Suszeptibilitätslocus Nob3. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mirhashemi F, Kaiser D, Scherneck S, Kluth O, Vogel H, Kluge R, Joost HG, Schürmann A. Einfluss des Fettgehaltes der Diät auf die Diabetesentstehung der NZO-Maus. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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49
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Scherneck S, Vogel H, Nestler M, Blüher M, Urbanski S, Schulz N, Kluge R, Schürmann A, Joost HG. Identifizierung des Transkriptionsfaktors Zfp69 als potentielles Kandidatengen für Typ-2-Diabetes. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Marwede D, Kahn T, Kluge R, Sabri O. RadLex: Motivation, Stuktur und Einsatzmöglichkeiten für eine standardisierte Terminologie. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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