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Background: Numerous cases of swine-origin 2009 H1N1 influenza A virus (H1N1)-associated acute respiratory distress syndrome (ARDS) bridged by extracorporeal membrane oxygenation (ECMO) therapy have been reported; however, complication rates are high. We present our experience with H1N1-associated ARDS and successful bridging of lung function using superimposed high-frequency jet ventilation (SHFJV) in combination with continuous positive airway pressure/assisted spontaneous breathing (CPAP/ASB).
Methods: We admitted five patients with H1N1 infection and ARDS to our intensive care unit. Although all patients required pure oxygen and controlled ventilation, oxygenation was insufficient. We applied SHFJV/CPAP/ASB to improve oxygenation.
Results: Initial PaO2/FiO2 ratio prior SHFJV was 58-79 mmHg. In all patients, successful oxygenation was achieved by SHFJV (PaO2/FiO2 ratio 105-306 mmHg within 24 h). Spontaneous breathing was set during first hours after admission. SHFJV could be stopped after 39, 40, 72, 100, or 240 h. Concomitant pulmonary herpes simplex virus (HSV) infection was observed in all patients. Two patients were successfully discharged. The other three patients relapsed and died within 7 weeks mainly due to combined HSV infection and in two cases reoccurring H1N1 infection.
Conclusions: SHFJV represents an alternative to bridge lung function successfully and improve oxygenation in the critically ill.
Background: The most common spinocerebellar ataxias (SCA)—SCA1, SCA2, SCA3, and SCA6—are caused by (CAG)n repeat expansion. While the number of repeats of the coding (CAG)n expansions is correlated with the age at onset, there are no appropriate models that include both affected and preclinical carriers allowing for the prediction of age at onset.
Methods: We combined data from two major European cohorts of SCA1, SCA2, SCA3, and SCA6 mutation carriers: 1187 affected individuals from the EUROSCA registry and 123 preclinical individuals from the RISCA cohort. For each SCA genotype, a regression model was fitted using a log-normal distribution for age at onset with the repeat length of the alleles as covariates. From these models, we calculated expected age at onset from birth and conditionally that this age is greater than the current age.
Results: For SCA2 and SCA3 genotypes, the expanded allele was a significant predictor of age at onset (−0.105±0.005 and −0.056±0.003) while for SCA1 and SCA6 genotypes both the size of the expanded and normal alleles were significant (expanded: −0.049±0.002 and −0.090±0.009, respectively; normal: +0.013±0.005 and −0.029±0.010, respectively). According to the model, we indicated the median values (90% critical region) and the expectancy (SD) of the predicted age at onset for each SCA genotype according to the CAG repeat size and current age.
Conclusions: These estimations can be valuable in clinical and research. However, results need to be confirmed in other independent cohorts and in future longitudinal studies.
The concept of culturomics was born out of the availability of massive amounts of textual data and the interest to make sense of cultural and language phenomena over time. Thus far however, culturomics has only made use of, and shown the great potential of, statistical methods. In this paper, we present a vision for a knowledge-based culturomics that complements traditional culturomics. We discuss the possibilities and challenges of combining knowledge-based methods with statistical methods and address major challenges that arise due to the nature of the data; diversity of sources, changes in language over time as well as temporal dynamics of information in general. We address all layers needed for knowledge-based culturomics, from natural language processing and relations to summaries and opinions.
Tumor–endothelial cell interactions represent an essential mechanism in spinal metastasis. Ephrin-B2–EphB4 communication induces tumor cell repulsion from the endothelium in metastatic melanoma, reducing spinal bone metastasis formation. To shed further light on the Ephrin-B2–EphB4 signaling mechanism, we researched the effects of pharmacological EphB4 receptor stimulation and inhibition in a ligand-dependent/independent context. We chose a preventative and a post-diagnostic therapeutic window. EphB4 stimulation during tumor cell seeding led to an increase in spinal metastatic loci and number of disseminated melanoma cells, as well as earlier locomotion deficits in the presence of endothelial Ephrin-B2. In the absence of endothelial Ephrin-B2, reduction of metastatic loci with a later manifestation of locomotion deficits occurred. Thus, EphB4 receptor stimulation affects metastatic dissemination depending on the presence/absence of endothelial Ephrin-B2. After the manifestation of solid metastasis, EphB4 kinase inhibition resulted in significantly earlier manifestation of locomotion deficits in the presence of the ligand. No post-diagnostic treatment effect was found in the absence of endothelial Ephrin-B2. For solid metastasis treatment, EphB4 kinase inhibition induced prometastatic effects in the presence of endothelial Ephrin-B2. In the absence of endothelial Ephrin-B2, both therapies showed no effect on the growth of solid metastasis.
Genotoxicity assessment is of high relevance for crude and refined petroleum products, since oil compounds are known to cause DNA damage with severe consequences for aquatic biota as demonstrated in long-term monitoring studies. This study aimed at the optimization and evaluation of small-scale higher-throughput assays (Ames fluctuation, micronucleus, Nrf2-CALUX®) covering different mechanistic endpoints as first screening tools for genotoxicity assessment of oils. Cells were exposed to native and chemically dispersed water-accommodated fractions (WAFs) of three oil types varying in their processing degree. Independent of an exogenous metabolic activation system, WAF compounds induced neither base exchange nor frame shift mutations in bacterial strains. However, significantly increased chromosomal aberrations in zebrafish liver (ZF-L) cells were observed. Oxidative stress was indicated for some treatments and was not correlated with observed DNA damage. Application of a chemical dispersant increased the genotoxic potential rather by the increased bioavailability of dissolved and particulate oil compounds. Nonetheless, the dispersant induced a clear oxidative stress response, indicating a relevance for general toxic stress. Results showed that the combination of different in vitro assays is important for a reliable genotoxicity assessment. Especially, the ZF-L capable of active metabolism and DNA repair seems to be a promising model for WAF testing.
Schriftenschau
(2008)
Targeting key angiogenic pathways with a bispecific CrossMAb optimized for neovascular eye diseases
(2016)
Anti-angiogenic therapies using biological molecules that neutralize vascular endothelial growth factor-A (VEGF-A) have revolutionized treatment of retinal vascular diseases including age-related macular degeneration (AMD). This study reports preclinical assessment of a strategy to enhance anti-VEGF-A monotherapy efficacy by targeting both VEGF-A and angiopoietin-2 (ANG-2), a factor strongly upregulated in vitreous fluids of patients with retinal vascular disease and exerting some of its activities in concert with VEGF-A. Simultaneous VEGF-A and ANG-2 inhibition was found to reduce vessel lesion number, permeability, retinal edema, and neuron loss more effectively than either agent alone in a spontaneous choroidal neovascularization (CNV) model. We describe the generation of a bispecific domain-exchanged (crossed) monoclonal antibody (CrossMAb; RG7716) capable of binding, neutralizing, and depleting VEGF-A and ANG-2. RG7716 showed greater efficacy than anti-VEGF-A alone in a non-human primate laser-induced CNV model after intravitreal delivery. Modification of RG7716’s FcRn and FccR binding sites disabled the antibodies’ Fc-mediated effector functions. This resulted in increased systemic, but not ocular, clearance. These properties make RG7716 a potential nextgeneration therapy for neovascular indications of the eye.
Poster presentation: Twenty Second Annual Computational Neuroscience Meeting: CNS*2013. Paris, France. 13-18 July 2013.
Neuronal death and subsequent denervation of target areas is a major feature of several neurological conditions such as brain trauma, ischemia or neurodegeneration. The denervation-induced axonal loss results in reorganization of the dendritic tree of denervated neurons. Dendritic reorganization of denervated neurons has been previously studied using entorhinal cortex lesion (ECL).
ECL leads to shortening and loss of dendritic segments in the denervated outer molecular layer of the dentate gyrus [1]. However, the functional importance of these long-term dendritic alterations is not yet understood and their impact on neuronal electrical properties remains unclear. Therefore, in this study we analyzed what happens to the electrotonic structure and excitability of dentate granule cells after denervation-induced alterations of their dendritic morphology, assuming all other parameters remain equal.
To perform comparative electrotonic analysis we used computer simulations in anatomically and biophysically realistic compartmental models of 3D-reconstructed healthy and denervated granule cells. Our results show that somatofugal and somatopetal voltage attenuation due to passive cable properties was strongly reduced in denervated granule cells. In line with these predictions, the attenuation of simulated backpropagating action potentials and forward propagating EPSPs was significantly reduced in dendrites of denervated neurons. In addition, simulations of somatic and dendritic frequency-current (f-I) curves revealed increased excitability in deafferentated granule cells.
Taken together, our results indicate that unless counterbalanced by a compensatory adjustment of passive and/or active membrane properties, the plastic remodeling of dendrites following lesion of entorhinal cortex inputs to granule cells will boost their electrotonic compactness and excitability.
Throughout mankind’s history, the need to secure and protect the home settlement was an essential one. This holds especially true for the city of Ainos (modern Enez) in Turkish Thrace. Due to its continuous settlement history since the 7th/6th century BC, several different types of city walls were built—sometimes even on top of each other—several of which have been preserved over time. To decipher the construction style, the course and the age of a buried city wall segment in the southern part of the former city, a geoscientific multi-proxy approach including magnetic gradiometer (MG) and electrical resistivity tomography (ERT) measurements in combination with granulometrical, sedimentological and microfaunistical investigations on sediment cores was applied. We were able to (1) present reasonable arguments for its Hellenistic age; (2) reveal the course of this wall segment and extrapolate it further north into a less studied area; and (3) demonstrate that in this near-coastal area, the former swampy terrain had been consolidated for constructing the wall. Our multi-proxy approach serves as a valuable example for investigating buried structures in archaeological contexts, avoiding a less-economical, time-consuming, or even forbidden excavation.
Die elektrokardiographische (EKG) Diagnostik stellt auch heute noch eine nicht zu ersetzende Methode zur Erkennung wichtiger Erkrankungen der Inneren Medizin dar. Das Wissen um diese Methodik konnte in den letzten Jahren deutlich erweitert werden. Mehr Detailwissen verleiht der elektrokardiographischen Diagnostik höhere Präzision, stellt aber auch höhere Anforderungen an die Motivation der Studierenden und an die Qualität der Lehre. Im Rahmen dieser Doktorarbeit wurde diese Problematik vertieft. Mittels einer umfassenden Recherche und eines Fragebogens wurden die verschiedenen Fortbildungsmethoden zur elektrokardiographischen Diagnostik (Bücher, Kurse, praktische Fälle) auf ihren Aufbau, ihre Vor- und Nachteile und ihre Beliebtheit bei Studenten untersucht. In einem zweiten Teil wurde ein Lehrbuch aus einem EKGSeminar an der Universität Frankfurt am Main entwickelt und einem Test unterzogen. Hierzu wurden 30 Teststudenten in zwei Gruppen unterteilt. Gruppe 1 („Verumgruppe“) erhielt das "Selbstlernprogramm" zur Durcharbeitung, Gruppe 2 („Kontrollgruppe“) erhielt keine zusätzliche Fortbildung. Beide Gruppen führten zwei schriftliche Prüfungen durch und die Test-Ergebnisse wurden verglichen. Es fand sich ein Trend zu einer Verbesserung des Test-Ergebnisses (p (x1<x2) = 0,0733) durch das Selbstlernprogramm im Wilcoxon-Mann-Whitney-Test. Im Hodges-Lehmann-Schätzer wurde ein Unterschied von 18 Punkten ermittelt, bei einer Maximalpunktzahl von 150 pro Prüfung. Die Auswertung des Fragebogens ergab eine hohe Beliebtheit von Kursen und praktischen Fällen, eine geringere Beliebtheit von Lehrbüchern und eine niedrige Beliebtheit von Internetquellen zur Fortbildung. Das angewandte Fortbildungskonzept und auch das Selbstlernprogramm an sich wurden als gut strukturiert und sinnvoll eingeschätzt. Die Fortbildung "Entwicklung eines Konzepts zu einem EKG-Selbstlernprogramm" soll als Anregung dienen, die Qualität der Lehre zu verbessern. Sie soll als Beispiel dienen, auf welche Weise Qualitätskontrollen im Bereich der Lehre erfolgen könnten.