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1.
Haematologica ; 105(2): 435-447, 2020.
Article in English | MEDLINE | ID: mdl-31123029

ABSTRACT

Recurrent gain-of-function mutations in the transcription factors STAT5A and much more in STAT5B were found in hematopoietic malignancies with the highest proportion in mature T- and natural killer-cell neoplasms (peripheral T-cell lymphoma, PTCL). No targeted therapy exists for these heterogeneous and often aggressive diseases. Given the shortage of models for PTCL, we mimicked graded STAT5A or STAT5B activity by expressing hyperactive Stat5a or STAT5B variants at low or high levels in the hematopoietic system of transgenic mice. Only mice with high activity levels developed a lethal disease resembling human PTCL. Neoplasia displayed massive expansion of CD8+ T cells and destructive organ infiltration. T cells were cytokine-hypersensitive with activated memory CD8+ T-lymphocyte characteristics. Histopathology and mRNA expression profiles revealed close correlation with distinct subtypes of PTCL. Pronounced STAT5 expression and activity in samples from patients with different subsets underline the relevance of JAK/STAT as a therapeutic target. JAK inhibitors or a selective STAT5 SH2 domain inhibitor induced cell death and ruxolitinib blocked T-cell neoplasia in vivo We conclude that enhanced STAT5A or STAT5B action both drive PTCL development, defining both STAT5 molecules as targets for therapeutic intervention.


Subject(s)
Leukemia , Lymphoma, T-Cell, Peripheral , Animals , CD8-Positive T-Lymphocytes/metabolism , Cytokines , Humans , Lymphoma, T-Cell, Peripheral/genetics , Mice , STAT5 Transcription Factor/genetics , STAT5 Transcription Factor/metabolism , Tumor Suppressor Proteins
2.
PLoS One ; 13(8): e0201416, 2018.
Article in English | MEDLINE | ID: mdl-30080886

ABSTRACT

OBJECTIVES: This matched-cohort retrospective study investigated the long-term (9-year) safety and efficacy outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and primary percutaneous coronary intervention (pPCI) with Genous (n = 102) versus TAXUS Liberté (n = 101) stents in 2006-2008. BACKGROUND: In the era of off-label use of drug-eluting stents for pPCI in patients with STEMI, the use of first-generation Genous stents (endothelial progenitor cell capture stents that have a passive coating and accelerate re-endothelialization) was proposed. METHODS: The primary endpoint was 9-year major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, re-infarction, target vessel revascularization (TVR), and stroke. The secondary endpoints were the separate primary endpoint events at pre-defined time-points (in-hospital, 6 months, and yearly) and stent thrombosis. Time-dependent 9-year composite MACCE, all-cause death, and TVR were compared using Kaplan-Meier estimates and multivariate Cox regression models. RESULTS: Propensity score analysis confirmed the comparability of the groups. Patients in the Genous and TAXUS groups had 7 and 1 acute definitive stent thrombosis events, respectively (p<0.001). There was a trend towards higher in-hospital MACCE in the Genous group (10.8%) versus the TAXUS group (4.0%). Kaplan-Meier analysis showed that 9-year MACCE was significantly worse in the Genous than in the TAXUS group. The in-hospital, 6-month, 1-year, and 9-year mortality rates were 7.8%, 8.8%, 9.8%, and 23.5% in the Genous group and 2.0%, 3.0%, 4.0%, and 16.8% in the TAXUS group. CONCLUSIONS: Higher peri-procedural, in-hospital, and short-term mortality led to worse outcomes for first-generation Genous stents versus TAXUS Liberté stents for pPCI in STEMI. TAXUS Liberté stents had more favorable 9-year clinical outcomes.


Subject(s)
Coated Materials, Biocompatible/adverse effects , Hospital Mortality , Percutaneous Coronary Intervention , Postoperative Complications/mortality , ST Elevation Myocardial Infarction , Stents/adverse effects , Thrombosis , Aged , Disease-Free Survival , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , ST Elevation Myocardial Infarction/mortality , ST Elevation Myocardial Infarction/surgery , Survival Rate , Thrombosis/etiology , Thrombosis/mortality
3.
J Cardiovasc Magn Reson ; 20(1): 16, 2018 03 08.
Article in English | MEDLINE | ID: mdl-29514708

ABSTRACT

BACKGROUND: Dark rim artifacts in first-pass cardiovascular magnetic resonance (CMR) perfusion images can mimic perfusion defects and affect diagnostic accuracy for coronary artery disease (CAD). We evaluated whether quantitative myocardial blood flow (MBF) can differentiate dark rim artifacts from true perfusion defects in CMR perfusion. METHODS: Regadenoson perfusion CMR was performed at 1.5 T in 76 patients. Significant CAD was defined by quantitative invasive coronary angiography (QCA) ≥ 50% diameter stenosis. Non-significant CAD (NonCAD) was defined as stenosis by QCA < 50% diameter stenosis or computed tomographic coronary angiography (CTA) < 30% in all major epicardial arteries. Dark rim artifacts had study specific and guideline-based definitions for comparison purposes. MBF was quantified at the pixel-level and sector-level. RESULTS: In a NonCAD subgroup with dark rim artifacts, stress MBF was lower in the subendocardial than midmyocardial and epicardial layers (2.17 ± 0.61 vs. 3.06 ± 0.75 vs. 3.24 ± 0.80 mL/min/g, both p < 0.001) and was also 30% lower than in remote regions (2.17 ± 0.61 vs. 2.83 ± 0.67 mL/min/g, p < 0.001). However, subendocardial stress MBF in dark rim artifacts was 37-56% higher than in true perfusion defects (2.17 ± 0.61 vs. 0.95 ± 0.43 mL/min/g, p < 0.001). Absolute stress MBF differentiated CAD from NonCAD with an accuracy ranging from 86 to 89% (all p < 0.001) using pixel-level analyses. Similar results were seen at a sector level. CONCLUSION: Quantitative stress MBF is lower in dark rim artifacts than remote myocardium but significantly higher than in true perfusion defects. If confirmed in larger series, this approach may aid the interpretation of clinical stress perfusion exams. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00027170 ; first posted 11/28/2001; updated 11/27/2017.


Subject(s)
Artifacts , Coronary Artery Disease/diagnostic imaging , Coronary Circulation , Coronary Stenosis/diagnostic imaging , Coronary Vessels/diagnostic imaging , Image Interpretation, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Myocardial Perfusion Imaging/methods , Adult , Aged , Blood Flow Velocity , Coronary Angiography , Coronary Artery Disease/physiopathology , Coronary Stenosis/physiopathology , Coronary Vessels/physiopathology , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Purines/administration & dosage , Pyrazoles/administration & dosage , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Vasodilator Agents/administration & dosage
4.
JACC Cardiovasc Imaging ; 11(5): 697-707, 2018 05.
Article in English | MEDLINE | ID: mdl-29454767

ABSTRACT

OBJECTIVES: The authors developed a fully automated framework to quantify myocardial blood flow (MBF) from contrast-enhanced cardiac magnetic resonance (CMR) perfusion imaging and evaluated its diagnostic performance in patients. BACKGROUND: Fully quantitative CMR perfusion pixel maps were previously validated with microsphere MBF measurements and showed potential in clinical applications, but the methods required laborious manual processes and were excessively time-consuming. METHODS: CMR perfusion imaging was performed on 80 patients with known or suspected coronary artery disease (CAD) and 17 healthy volunteers. Significant CAD was defined by quantitative coronary angiography (QCA) as ≥70% stenosis. Nonsignificant CAD was defined by: 1) QCA as <70% stenosis; or 2) coronary computed tomography angiography as <30% stenosis and a calcium score of 0 in all vessels. Automatically generated MBF maps were compared with manual quantification on healthy volunteers. Diagnostic performance of the automated MBF pixel maps was analyzed on patients using absolute MBF, myocardial perfusion reserve (MPR), and relative measurements of MBF and MPR. RESULTS: The correlation between automated and manual quantification was excellent (r = 0.96). Stress MBF and MPR in the ischemic zone were lower than those in the remote myocardium in patients with significant CAD (both p < 0.001). Stress MBF and MPR in the remote zone of the patients were lower than those in the normal volunteers (both p < 0.001). All quantitative metrics had good area under the curve (0.864 to 0.926), sensitivity (82.9% to 91.4%), and specificity (75.6% to 91.1%) on per-patient analysis. On a per-vessel analysis of the quantitative metrics, area under the curve (0.837 to 0.864), sensitivity (75.0% to 82.7%), and specificity (71.8% to 80.9%) were good. CONCLUSIONS: Fully quantitative CMR MBF pixel maps can be generated automatically, and the results agree well with manual quantification. These methods can discriminate regional perfusion variations and have high diagnostic performance for detecting significant CAD. (Technical Development of Cardiovascular Magnetic Resonance Imaging; NCT00027170).


Subject(s)
Coronary Artery Disease/diagnostic imaging , Coronary Circulation , Coronary Stenosis/diagnostic imaging , Image Interpretation, Computer-Assisted , Magnetic Resonance Imaging/methods , Myocardial Perfusion Imaging/methods , Automation , Blood Flow Velocity , Case-Control Studies , Coronary Artery Disease/physiopathology , Coronary Stenosis/physiopathology , Humans , Predictive Value of Tests , Reproducibility of Results , Severity of Illness Index
5.
PLoS One ; 12(2): e0171542, 2017.
Article in English | MEDLINE | ID: mdl-28199339

ABSTRACT

BACKGROUND: Diastolic dysfunction of the left ventricle is common but frequently under-diagnosed. Particularly in advanced stages affected patients may present with significant functional tricuspid regurgitation (TR) as the most prominent sign on echocardiography. The underlying left ventricular pathology may eventually be missed and symptoms of heart failure are attributed to TR, with respective therapeutic consequences. The aim of the present study was to determine prevalence and mechanisms underlying TR evolution in heart failure with preserved ejection fraction (HFpEF). METHODS AND RESULTS: Consecutive HFpEF patients were enrolled in this prospective, observational study. Confirmatory diagnostic tests including echocardiography and invasive hemodynamic assessments were performed. Of the 175 patients registered between 2010 and 2014, 51% had significant (moderate or severe) TR without structural abnormalities of the tricuspid valve. Significant hemodynamic differences between patients with and without relevant TR were encountered. These included elevated pulmonary vascular resistance (p = 0.038), reduced pulmonary arterial compliance (PAC, p = 0.005), and elevated left ventricular filling pressures (p = 0.039) in the TR group. Multivariable binary logistic regression analysis revealed diastolic pulmonary artery pressure (p = 0.029) and PAC (p = 0.048) as independent determinants of TR. Patients were followed for 18.1±14.1 months, during which 32% had a cardiac event. While TR was associated with outcome in the univariable analysis, it failed to predict event-free survival in the multivariable model. CONCLUSIONS: The presence of ´isolated´ functional TR should prompt the suspicion of HFpEF. Our data show that significant TR is a marker of advanced HFpEF but neither an isolated entity nor independently associated with event-free survival.


Subject(s)
Heart Failure/diagnosis , Tricuspid Valve Insufficiency/diagnosis , Aged , Disease-Free Survival , Echocardiography , Female , Heart/diagnostic imaging , Heart Failure/etiology , Heart Ventricles/diagnostic imaging , Heart Ventricles/physiopathology , Hemodynamics , Humans , Logistic Models , Male , Middle Aged , Natriuretic Peptide, Brain/analysis , Peptide Fragments/analysis , Proportional Hazards Models , Prospective Studies , Pulmonary Artery/physiology , Stroke Volume , Survival Rate , Tricuspid Valve/physiopathology , Tricuspid Valve Insufficiency/complications , Tricuspid Valve Insufficiency/mortality
6.
J Cardiovasc Magn Reson ; 17: 11, 2015 Feb 11.
Article in English | MEDLINE | ID: mdl-25827156

ABSTRACT

BACKGROUND: Surface coil-related field inhomogeneity potentially confounds pixel-wise quantitative analysis of perfusion CMR images. This study assessed the effect of surface coil-related field inhomogeneity on the spatial variation of pixel-wise myocardial blood flow (MBF), and assessed its impact on the ability of MBF quantification to differentiate ischaemic from remote coronary territories. Two surface coil intensity correction (SCIC) techniques were evaluated: 1) a proton density-based technique (PD-SCIC) and; 2) a saturation recovery steady-state free precession-based technique (SSFP-SCIC). METHODS: 26 subjects (18 with significant CAD and 8 healthy volunteers) underwent stress perfusion CMR using a motion-corrected, saturation recovery SSFP dual-sequence protocol. A proton density (PD)-weighted image was acquired at the beginning of the sequence. Surface coil-related field inhomogeneity was approximated using a third-order surface fit to the PD image or a pre-contrast saturation prepared SSFP image. The estimated intensity bias field was subsequently applied to the image series. Pixel-wise MBF was measured from mid-ventricular stress images using the two SCIC approaches and compared to measurements made without SCIC. RESULTS: MBF heterogeneity in healthy volunteers was higher using SSFP-SCIC (24.8 ± 4.1%) compared to PD-SCIC (20.8 ± 3.0%; p = 0.009), however heterogeneity was significantly lower using either SCIC technique compared to analysis performed without SCIC (36.2 ± 6.3%). In CAD patients, the difference in MBF between remote and ischaemic territories was minimal when analysis was performed without SCIC (0.06 ± 0.91 mL/min/kg), and was substantially lower than with either PD-SCIC (0.50 ± 0.63 mL/min/kg; p = 0.013) or with SSFP-SCIC (0.63 ± 0.89 mL/min/kg; p = 0.005). In 6 patients, MBF quantified without SCIC was artifactually higher in the stenosed coronary territory compared to the remote territory. PD-SCIC and SSFP-SCIC had similar differences in MBF between remote and ischaemic territories (p = 0.145). CONCLUSIONS: This study demonstrates that surface coil-related field inhomogeneity can confound pixel-wise MBF quantification. Whilst a PD-based SCIC led to a more homogenous correction than a saturation recovery SSFP-based technique, this did not result in an appreciable difference in the differentiation of ischaemic from remote coronary territories and thus either method could be applied.


Subject(s)
Coronary Artery Disease/diagnosis , Coronary Circulation , Coronary Vessels/physiopathology , Image Interpretation, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Myocardial Perfusion Imaging/methods , Aged , Artifacts , Case-Control Studies , Coronary Artery Disease/physiopathology , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Reproducibility of Results
7.
Brain Lang ; 127(3): 377-87, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24267487

ABSTRACT

Complex grammatical structures are mastered late in language acquisition. We studied age-effects on performance in object topicalization in 48 typically developing German-speaking participants (aged 8-30years) and in five patients (children and adolescents) with lesion-induced atypical language representation. Production was tested by a sentence repetition task, comprehension by an acting out task. Three topicalized conditions with differing disambiguation (agreement, case, and case plus agreement) were contrasted with canonical control sentences. Children's (aged 8-13years) performance was significantly below that of adolescents and adults in all topicalized conditions. All participants made most mistakes in the agreement condition. Patients showed remarkable difficulties as compared with age-appropriate control groups in all topicalization conditions and across age-groups. Despite the small sample size, the consistency of these difficulties might hint to the importance of an intact typical neural language substrate for processing complex grammatical structures even in very early brain lesions.


Subject(s)
Language Development , Adolescent , Adult , Child , Comprehension/physiology , Female , Humans , Language , Male , Speech Perception/physiology , Young Adult
9.
Brain Lang ; 127(3): 366-76, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23273501

ABSTRACT

Individual differences in second language (L2) aptitude have been assumed to depend upon a variety of cognitive and personality factors. Especially, the cognitive factor phonological working memory has been conceptualised as language learning device. However, strong associations between phonological working memory and L2 aptitude have been previously found in early-stage learners only, not in advanced learners. The current study aimed at investigating the behavioural and neurobiological predictors of advanced L2 learning. Our behavioural results showed that phonetic coding ability and empathy, but not phonological working memory, predict L2 pronunciation aptitude in advanced learners. Second, functional neuroimaging revealed this behavioural trait to be correlated with hemodynamic responses of the cerebral network of speech motor control and auditory-perceptual areas. We suggest that the acquisition of L2 pronunciation aptitude is a dynamic process, requiring a variety of neural resources at different processing stages over time.


Subject(s)
Brain Mapping , Brain/physiology , Language , Learning/physiology , Multilingualism , Adult , Auditory Perception/physiology , Empathy/physiology , Female , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Motor Skills/physiology , Personality/physiology , Young Adult
10.
Cancer Med ; 2(6): 862-71, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24403259

ABSTRACT

Everolimus is an orally administrated mammalian target of rapamycin (mTOR) inhibitor. Several large-scale randomized controlled trials (RCTs) have demonstrated the survival benefits of everolimus at the dose of 10 mg/day for solid cancers. Furthermore, mTOR-inhibitor-based immunosuppression is associated with survival benefits for patients with hepatocellular carcinoma (HCC) who have received liver transplantation. However, a low rate of tumor reduction and some adverse events have been pointed out. This review summarizes the antitumor effects and adverse events of everolimus and evaluates its possible application in advanced HCC. For the meta-analysis of adverse events, we used the RCTs for solid cancers. The odds ratios of adverse events were calculated using the Peto method. Manypreclinical studies demonstrated that everolimus had antitumor effects such as antiproliferation and antiangiogenesis. However, some differences in the effects were observed among in vivo animal studies for HCC treatment. Meanwhile, clinical studies demonstrated that the response rate of single-agent everolimus was low, though survival benefits could be expected. The meta-analysis revealed the odds ratios (95% confidence interval [CI]) of stomatitis: 5.42 [4.31-6.73], hyperglycemia: 3.22 [2.37-4.39], anemia: 3.34 [2.37-4.67], pneumonitis: 6.02 [3.95-9.16], aspartate aminotransferase levels: 2.22 [1.37-3.62], and serum alanine aminotransferase levels: 2.94 [1.72-5.02], respectively. Everolimus at the dose of 10 mg/day significantly increased the risk of the adverse events. In order to enable its application to the standard conventional therapies of HCC, further studies are required to enhance the antitumor effects and manage the adverse events of everolimus.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Liver Neoplasms/drug therapy , Sirolimus/analogs & derivatives , Animals , Antineoplastic Agents/adverse effects , Everolimus , Humans , Sirolimus/adverse effects , Sirolimus/therapeutic use , TOR Serine-Threonine Kinases/antagonists & inhibitors
11.
Clin Linguist Phon ; 26(2): 135-47, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21787139

ABSTRACT

Language functions are generally represented in the left cerebral hemisphere. After early (prenatally acquired or perinatally acquired) left hemispheric brain damage language functions may be salvaged by reorganization into the right hemisphere. This is different from brain lesions acquired in adulthood which normally lead to aphasia. Right hemispheric reorganized language (RL) is not associated with obvious language deficits. In this pilot study we compared a group of German-speaking patients with left hemispheric brain damage and RL with a group of matched healthy controls. The novel combination of reliable language lateralization as assessed by neuroimaging (functional magnetic resonance imaging) and specific linguistic tasks revealed significant differences between patients with RL and healthy controls in both language comprehension and production. Our results provide evidence for the hypothesis that RL is significantly different from normal left hemispheric language. This knowledge can be used to improve counselling of parents and to develop specific therapeutic approaches.


Subject(s)
Cerebral Palsy/complications , Dominance, Cerebral/physiology , Language Development , Language Disorders/diagnosis , Language Disorders/etiology , Linguistics , Adolescent , Adult , Cerebral Cortex/physiopathology , Cerebral Palsy/physiopathology , Child , Female , Germany , Humans , Language Disorders/physiopathology , Magnetic Resonance Imaging , Male , Pilot Projects , Young Adult
12.
Front Psychol ; 2: 271, 2011.
Article in English | MEDLINE | ID: mdl-22059077

ABSTRACT

An unanswered question in adult language learning or late bi and multilingualism is why individuals show marked differences in their ability to imitate foreign accents. While recent research acknowledges that more adults than previously assumed can still acquire a "native" foreign accent, very little is known about the neuro-cognitive correlates of this special ability. We investigated 140 German-speaking individuals displaying varying degrees of "mimicking" capacity, based on natural language text, sentence, and word imitations either in their second language English or in Hindi and Tamil, languages they had never been exposed to. The large subject pool was strictly controlled for previous language experience prior to magnetic resonance imaging. The late-onset (around 10 years) bilinguals showed significant individual differences as to how they employed their left-hemisphere speech areas: higher hemodynamic activation in a distinct fronto-parietal network accompanied low ability, while high ability paralleled enhanced gray matter volume in these areas concomitant with decreased hemodynamic responses. Finally and unexpectedly, males were found to be more talented foreign speech mimics.

13.
Am J Emerg Med ; 29(6): 650-5, 2011 Jul.
Article in English | MEDLINE | ID: mdl-20825868

ABSTRACT

PURPOSES: The objective of this study was to evaluate improvement opportunities in the emergency department for timely ST-segment elevation myocardial infarction management and evaluated the new process flow. BASIC PROCEDURES: In a prospective study, we compared time from door to cath laboratory before and after implementation of a new ST-segment elevation myocardial infarction (STEMI) protocol. The new protocol included a blend of strategies to reduce door to cath laboratory time. MAIN FINDINGS: We included 55 patients. After implementing a new STEMI protocol, we included 54 patients. Time to cath laboratory was 21 (interquartile range, 9-40) minutes before and 10 (interquartile range 5-25) minutes after initiation of the new protocol (P = .02). A door to cath laboratory time less than 15 minutes was reached in 36% of our patients in phase 1 and in 61% in phase 2 (odds ratio; 0.36, 95% confidence interval, 0.16-0.81; P = .01). PRINCIPAL CONCLUSION: Simple changes in organizational strategies resulted in a significantly faster care for patients with acute uncomplicated STEMI.


Subject(s)
Emergency Service, Hospital/organization & administration , Myocardial Infarction/therapy , Aged , Cardiac Catheterization , Efficiency, Organizational , Electrocardiography , Female , Humans , Male , Middle Aged , Prospective Studies , Statistics, Nonparametric , Time Factors
14.
Thromb Haemost ; 102(3): 564-72, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19718478

ABSTRACT

Atherosclerotic plaque rupture with subsequent mural thrombus formation is considered the main event compromising epicardial flow in acute myocardial infarction (AMI). However, the precise mechanisms underlying acute coronary occlusion are unknown. We compared the proteomic profiles of systemic plasma and plasma derived from the site of thrombus formation of patients with AMI by two-dimensional gel electrophoresis and ELISA. We identified a local activation of the complement system, with selective accumulation of the complement activator C-reactive protein (CRP) and the downstream complement effectors C3a and C5a. CRP in coronary thrombus co-localised with C1q and C3 immunoreactivities, suggesting classical complement activation. In vitro, coronary thrombus derived plasma enhanced neutrophil chemotaxis in a C5a dependent fashion. In vivo, neutrophil accumulation at the site of thrombus formation paralleled the time delay from symptom onset to first balloon inflation or aspiration, and was correlated with C5a and enzymatic infarct size. We present the first direct evidence for localised complement activation in acute coronary thrombi. Our data indicate that local complement effectors amplify the vascular occlusion process in AMI by enhanced neutrophil recruitment.


Subject(s)
Complement Activation , Myocardial Infarction/blood , Neutrophils/cytology , Thrombosis/pathology , Aged , Chemotaxis , Complement C3a/chemistry , Complement C5a/chemistry , Complement System Proteins , Electrophoresis, Gel, Two-Dimensional , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Models, Biological , Myocardial Infarction/pathology , Neutrophils/metabolism , Proteomics/methods
16.
JACC Cardiovasc Interv ; 2(8): 718-27, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19695539

ABSTRACT

OBJECTIVES: The multicenter AUTAX (Austrian Multivessel TAXUS-Stent) registry investigated the 2-year clinical/angiographic outcomes of patients with multivessel coronary artery disease after implantation of TAXUS Express stents (Boston Scientific, Natick, Massachusetts), in a "real-world" setting. BACKGROUND: The AUTAX registry included patients with 2- or 3-vessel disease, with/without previous percutaneous coronary intervention (PCI) and concomitant surgery. METHODS: Patients (n = 441, 64 +/- 12 years, 78% men) (n = 1,080 lesions) with possible complete revascularization by PCI were prospectively included. Median clinical follow-up was 753 (quartiles 728 to 775) days after PCI in 95.7%, with control angiography of 78% at 6 months. The primary end point was the composite of major adverse cardiac (nonfatal acute myocardial infarction [AMI], all-cause mortality, target lesion revascularization [TLR]) and cerebrovascular events (MACCE). Potential risk factor effects on 2-year MACCE were evaluated using Cox regression. RESULTS: Complete revascularization was successful in 90.5%, with left main PCI of 6.8%. Rates of acute, subacute, and late stent thrombosis were 0.7%, 0.5%, and 0.5%. Two-year follow-up identified AMI (1.4%), death (3.6%), stroke (0.2%), and TLR (13.1%), for a composite MACCE of 18.3%. The binary restenosis rate was 10.8%. The median of cumulative SYNTAX score was 23.0 (range 12.0 to 56.5). The SYNTAX score did not predict TLR or MACCE, due to lack of scoring of restenotic or bypass stenoses (29.8%). Age (hazard ratio [HR]: 1.03, p = 0.019) and acute coronary syndrome (HR: 2.1, p = 0.001) were significant predictors of 2-year MACCE. Incomplete revascularization predicted death or AMI (HR: 3.84, p = 0.002). CONCLUSIONS: With the aim of complete revascularization, TAXUS stent implantations can be safe for patients with multivessel disease. The AUTAX registry including patients with post-PCI lesions provides additional information to the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) study. (Austrian Multivessel TAXUS-Stent Registry; NCT00738686).


Subject(s)
Angioplasty, Balloon, Coronary/instrumentation , Coronary Artery Bypass , Coronary Artery Disease/therapy , Drug-Eluting Stents , Aged , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/mortality , Austria , Coronary Angiography , Coronary Artery Bypass/adverse effects , Coronary Artery Bypass/mortality , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/mortality , Coronary Artery Disease/surgery , Coronary Restenosis/etiology , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Infarction/etiology , Odds Ratio , Platelet Aggregation Inhibitors/therapeutic use , Proportional Hazards Models , Prospective Studies , Prosthesis Design , Registries , Risk Assessment , Risk Factors , Severity of Illness Index , Stroke/etiology , Thrombosis/etiology , Time Factors , Treatment Outcome
17.
BMC Cancer ; 8: 240, 2008 Aug 15.
Article in English | MEDLINE | ID: mdl-18706092

ABSTRACT

BACKGROUND: Prostate cancer is a frequent finding in man. In dogs, malignant disease of the prostate is also of clinical relevance, although it is a less common diagnosis. Even though there are numerous differences in origin and development of the disease, man and dog share many similarities in the pathological presentation. For this reason, the dog might be a useful animal model for prostate malignancies in man.Although prostate cancer is of great importance in veterinary medicine as well as in comparative medicine, there are only few cell lines available. Thus, it was the aim of the present study to determine whether the formerly established prostate carcinoma cell line CT1258 is a suitable tool for in vivo testing, and to distinguish the growth pattern of the induced tumours. METHODS: For characterisation of the in vivo behaviour of the in vitro established canine prostate carcinoma cell line CT1258, cells were inoculated in 19 NOD.CB17-PrkdcScid/J (in the following: NOD-Scid) mice, either subcutaneously or intraperitoneally. After sacrifice, the obtained specimens were examined histologically and compared to the pattern of the original tumour in the donor. Cytogenetic investigation was performed. RESULTS: The cell line CT 1258 not only showed to be highly tumourigenic after subcutaneous as well as intraperitoneal inoculation, but also mimicked the behaviour of the original tumour. CONCLUSION: Tumours induced by inoculation of the cell line CT1258 resemble the situation in naturally occurring prostate carcinoma in the dog, and thus could be used as in vivo model for future studies.


Subject(s)
Dog Diseases/pathology , Prostatic Neoplasms/pathology , Animals , Cell Line, Tumor , Dogs , Female , Male , Mice , Mice, Inbred NOD , Mice, SCID , Mitotic Index , Neoplasm Transplantation/pathology , Transplantation, Heterologous/pathology
18.
BMC Genet ; 9: 49, 2008 Jul 23.
Article in English | MEDLINE | ID: mdl-18651940

ABSTRACT

BACKGROUND: The high mobility group A1 proteins (HMGA1a/HMGA1b) are highly conserved between mammalian species and widely described as participating in various cellular processes. By inducing DNA conformation changes the HMGA1 proteins indirectly influence the binding of various transcription factors and therefore effect the transcription regulation. In humans chromosomal aberrations affecting the HMGA1 gene locus on HSA 6p21 were described to be the cause for various benign mesenchymal tumours while high titres of HMGA1 proteins were shown to be associated with the neoplastic potential of various types of cancer. Interestingly, the absence of HMGA1 proteins was shown to cause insulin resistance and diabetes in humans and mice. Due to the various similarities in biology and presentation of human and canine cancers the dog has joined the common rodent animal model for therapeutic and preclinical studies. Accordingly, the canine genome was sequenced completely twice but unfortunately this could not solve the structure of canine HMGA1 gene. RESULTS: Herein we report the characterisation of the genomic structure of the canine HMGA1 gene consisting of 7 exons and 6 introns spanning in total 9524 bp, the in vivo localisation of the HMGA1 protein to the nucleus, and a chromosomal assignment of the gene by FISH to CFA12q11. Additionally, we evaluated a described canine HMGA1 exon 6 SNP in 55 Dachshunds. CONCLUSION: The performed characterisations will make comparative analyses of aberrations affecting the human and canine gene and proteins possible, thereby providing a basis for revealing mechanisms involved in HMGA1 related pathogenesis in both species.


Subject(s)
Chromosomes, Mammalian/genetics , Dogs/genetics , HMGA1a Protein/genetics , Animals , Cell Nucleus/genetics , Chromosome Mapping , Chromosomes, Artificial, Bacterial , DNA/genetics , Exons , In Situ Hybridization, Fluorescence , Point Mutation , Polymerase Chain Reaction , Polymorphism, Single Nucleotide
19.
Mol Cytogenet ; 1: 11, 2008 06 03.
Article in English | MEDLINE | ID: mdl-18522714

ABSTRACT

BACKGROUND: Chromosomal translocations affecting the chromosome 2p21 cluster in a 450 kb breakpoint region are frequently observed in human benign thyroid adenomas. THADA (thyroid adenoma associated) was identified as the affected gene within this breakpoint region. In contrast to man tumours of the thyroid gland of dogs (Canis lupus familiaris) constitute mainly as follicular cell carcinomas, with malignant thyroid tumours being more frequent than benign thyroid adenomas. In order to elucidate if the THADA gene is also a target of chromosomal rearrangements in thyroid adenomas of the dog we have physically mapped the canine THADA gene to canine chromosome 10.A PCR was established to screen a canine genome library for a BAC clone containing the gene sequence of canine THADA. Further PCR reactions were done using the identified BAC clone as a template in order to verify the corresponding PCR product by sequencing.Canine whole blood was incubated with colcemid in order to arrest the cultured cells in metaphases. The verified BAC DNA was digoxigenin labeled and used as a probe in fluorescence in situ hybridization (FISH). Ten well spread metaphases were examined indicating a signal on canine chromosome 10 on both chromatids. A detailed fine mapping was performed indicating the canine THADA gene locus on the q-arm of chromosome 10. RESULTS: The canine THADA gene locus was mapped on chromosome 10q25. Our mapping results obtained in this study following the previously described nomenclature for the canine karyotype. CONCLUSION: We analysed whether the THADA gene locus is a hotspot of canine chromosomal rearrangements in canine neoplastic lesions of the thyroid and in addition might play a role as a candidate gene for a possible malignant transformation of canine thyroid adenomas. Although the available cytogenetic data of canine thyroid adenomas are still insufficient the chromosomal region to which the canine THADA has been mapped seems to be no hotspot of chromosomal aberrations seen in canine thyroid adenomas.

20.
Cancer Genet Cytogenet ; 177(2): 98-102, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17854662

ABSTRACT

Prostate cancer is the most prevalent cancer in western countries, being the third leading cause of male cancer death. To check its possible significance as a prognostic marker, allowing a better prognosis of the tumor, we analyzed the high-mobility group protein-A2 gene (HMGA2) expression level because HMGA2 overexpression has been shown to correlate with the malignant potential of various neoplasias. Aside from man, the dog is the only mammalian species that shows spontaneously occurring prostate carcinoma with striking similarities to prostate cancer growth and progression in man, making it an adequate animal model for this neoplasia. We used real-time quantitative reverse-transcription polymerase chain reaction for HMGA2 expression analyses in a subset of canine prostate tissue samples. Our investigations reveal that HMGA2 expression levels in all carcinomas were higher than those of any of the nonmalignant tissues. Thus, canine prostate cancer represents a spontaneously occurring model to test therapeutic effects resulting from reduced expression of HMGA2.


Subject(s)
Adenocarcinoma/genetics , Disease Models, Animal , HMGA2 Protein/genetics , Prostatic Hyperplasia/genetics , Prostatic Neoplasms/genetics , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Animals , Disease Progression , Dogs , Gene Expression Regulation, Neoplastic , HMGA2 Protein/metabolism , Male , Neoplasm Invasiveness/pathology , Prostate/metabolism , Prostate/pathology , Prostatic Hyperplasia/metabolism , Prostatic Hyperplasia/pathology , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/pathology , RNA, Messenger/genetics , RNA, Messenger/metabolism , Reverse Transcriptase Polymerase Chain Reaction
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