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1.
Rev Sci Instrum ; 95(4)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38629924

RESUMO

We present an all-optical method to measure and compensate for residual magnetic fields present in a cloud of ultracold atoms trapped in an optical dipole trap. Our approach leverages the increased loss from the trapped atomic sample through electromagnetically induced absorption. Modulating the excitation laser provides coherent sidebands, resulting in a Λ-type pump-probe scheme. Scanning an additional magnetic offset field leads to pairs of sub-natural linewidth resonances, whose positions encode the magnetic field in all three spatial directions. Our measurement scheme is readily implemented in typical quantum gas experiments and has no particular hardware requirements.

2.
Eur J Cell Biol ; 103(2): 151412, 2024 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-38608422

RESUMO

Mesenchymal stromal cells (MSCs) that are promising for cartilage tissue engineering secrete high amounts of prostaglandin E2 (PGE2), an immunoactive mediator involved in endochondral bone development. This study aimed to identify drivers of PGE2 and its role in the inadvertent MSC misdifferentiation into hypertrophic chondrocytes. PGE2 release, which rose in the first three weeks of MSC chondrogenesis, was jointly stimulated by endogenous BMP, WNT, and hedgehog activity that supported the exogenous stimulation by TGF-ß1 and insulin to overcome the PGE2 inhibition by dexamethasone. Experiments with PGE2 treatment or the inhibitor celecoxib or specific receptor antagonists demonstrated that PGE2, although driven by prohypertrophic signals, exerted broad autocrine antihypertrophic effects. This chondroprotective effect makes PGE2 not only a promising option for future combinatorial approaches to direct MSC tissue engineering approaches into chondral instead of endochondral development but could potentially have implications for the use of COX-2-selective inhibitors in osteoarthritis pain management.

3.
Stem Cell Res Ther ; 15(1): 98, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38581019

RESUMO

BACKGROUND: In vitro chondrogenesis of mesenchymal stromal cells (MSCs) driven by the essential chondro-inducer transforming growth factor (TGF)-ß is instable and yields undesired hypertrophic cartilage predisposed to bone formation in vivo. TGF-ß can non-canonically activate bone morphogenetic protein-associated ALK1/2/3 receptors. These have been accused of driving hypertrophic MSC misdifferentiation, but data remained conflicting. We here tested the antihypertrophic capacity of two highly specific ALK1/2/3 inhibitors - compound A (CompA) and LDN-212854 (LDN21) - in order to reveal potential prohypertrophic contributions of these BMP/non-canonical TGF-ß receptors during MSC in vitro chondrogenesis. METHODS: Standard chondrogenic pellet cultures of human bone marrow-derived MSCs were treated with TGF-ß and CompA (500 nM) or LDN21 (500 nM). Daily 6-hour pulses of parathyroid hormone-related peptide (PTHrP[1-34], 2.5 nM, from day 7) served as potent antihypertrophic control treatment. Day 28 samples were subcutaneously implanted into immunodeficient mice. RESULTS: All groups underwent strong chondrogenesis, but GAG/DNA deposition and ACAN expression were slightly but significantly reduced by ALK inhibition compared to solvent controls along with a mild decrease of the hypertrophy markers IHH-, SPP1-mRNA, and Alkaline phosphatase (ALP) activity. When corrected for the degree of chondrogenesis (COL2A1 expression), only pulsed PTHrP but not ALK1/2/3 inhibition qualified as antihypertrophic treatment. In vivo, all subcutaneous cartilaginous implants mineralized within 8 weeks, but PTHrP pretreated samples formed less bone and attracted significantly less haematopoietic marrow than ALK1/2/3 inhibitor groups. CONCLUSIONS: Overall, our data show that BMP-ALK1/2/3 inhibition cannot program mesenchymal stromal cells toward stable chondrogenesis. BMP-ALK1/2/3 signalling is no driver of hypertrophic MSC misdifferentiation and BMP receptor induction is not an adverse prohypertrophic side effect of TGF-ß that leads to endochondral MSC misdifferentiation. Instead, the prohypertrophic network comprises misregulated PTHrP/hedgehog signalling and WNT activity, and a potential contribution of TGF-ß-ALK4/5-mediated SMAD1/5/9 signalling should be further investigated to decide about its postulated prohypertrophic activity. This will help to successfully engineer cartilage replacement tissues from MSCs in vitro and translate these into clinical cartilage regenerative therapies.


Assuntos
Células-Tronco Mesenquimais , Proteína Relacionada ao Hormônio Paratireóideo , Animais , Humanos , Camundongos , Células Cultivadas , Condrócitos/metabolismo , Condrogênese , Proteínas Hedgehog/genética , Hipertrofia/metabolismo , Células-Tronco Mesenquimais/metabolismo , Proteína Relacionada ao Hormônio Paratireóideo/farmacologia , Fator de Crescimento Transformador beta/metabolismo
4.
Biosensors (Basel) ; 13(12)2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-38131790

RESUMO

Despite remarkable progress in applied Surface Plasmon Resonance (SPR)-based methods, concise monitoring of kinetic properties for native biomarkers from patient samples is still lacking. Not only are low concentrations of native targets in patient samples, often in the pM range, a limiting and challenging factor, but body fluids as complex matrices furthermore complicate measurements. The here-described method enables the determination of kinetic constants and resulting affinities for native antigens from patients' cerebrospinal fluid (CSF) and sera binding to antibodies. Using a significantly extended target-enrichment step, we modified a common sandwich-assay protocol, based on a primary and secondary antibody. We successfully analyze antibody kinetics of native targets from a variety of origins, with consistent results, independent of their source. Moreover, native neurofilament light chain (NFL) was investigated as an exemplary biomarker. Obtained data reveal antibodies recognizing recombinant NFL with high affinities, while showing no, or only significantly weakened binding to native NFL. The indicated differences for recombinant vs. native material demonstrate another beneficial application. Our assay is highly suitable for gaining valuable insights into characteristics of native biomarkers, thus impacting on the binder development of diagnostic reagents or pharmaceutical drugs.


Assuntos
Antígenos , Ressonância de Plasmônio de Superfície , Humanos , Ressonância de Plasmônio de Superfície/métodos , Anticorpos , Biomarcadores
5.
Animals (Basel) ; 13(24)2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-38136794

RESUMO

The use of sensors to analyze behavior in sheep has gained increasing attention in scientific research. This systematic review aims to provide an overview of the sensors developed and used to detect rumination behavior in sheep in scientific research. Moreover, this overview provides details of the sensors that are currently commercially available and describes their suitability for sheep based on the information provided in the literature found. Furthermore, this overview lists the best sensor performances in terms of achieved accuracy, sensitivity, precision, and specificity in rumination detection, detailing, when applicable, the sensor position and epoch settings that were used to achieve the best results. Challenges and areas for future research and development are also identified. A search strategy was implemented in the databases PubMed, Web of Science, and Livivo, yielding a total of 935 articles. After reviewing the summaries of 57 articles remaining following filtration (exclusion) of repeated and unsuitable articles, 17 articles fully met the pre-established criteria (peer-reviewed; published between 2012 and 2023 in English or German; with a particular focus on sensors detecting rumination in sheep) and were included in this review. The guidelines outlined in the PRISMA 2020 methodology were followed. The results indicate that sensor-based systems have been utilized to monitor and analyze rumination behavior, among other behaviors. Notably, none of the sensors identified in this review were specifically designed for sheep. In order to meet the specific needs of sheep, a customized sensor solution is necessary. Additionally, further investigation of the optimal sensor position and epoch settings is necessary. Implications: The utilization of such sensors has significant implications for improving sheep welfare and enhancing our knowledge of their behavior in various contexts.

6.
Eur Spine J ; 32(10): 3370-3378, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37584698

RESUMO

PURPOSE: To outline clinical effectiveness of continuous epidural analgesia (CEA) in patients with failed back surgery syndrome (FBSS) or lumbar spinal stenosis (LSS) depending on severity of spinal degeneration. METHODS: In this retrospective cohort study, all patients with FBSS or LSS who underwent CEA within an inpatient rehabilitation program were evaluated. The pain reduction was measured by VAS on an hourly basis. Substantial pain reduction was defined as a minimal clinically important difference (MCID) > 50%. Severity of spinal degeneration, side effects and patient-specific characteristics were documented. RESULT: We included a total of 148 patients with 105 patients suffering from FBSS and 48 with LSS. The average pain reduction was - 37.6 ± 19.2 in FBSS and - 38.1 ± 17.8 in LSS group (p < .001 and p < .001, respectively). In the FBSS group, sensory deficits (p = .047) and numbness (p = .002), and in the LSS group, a severe disability measured by ODI (38.2 ± 15.4 vs. 57.3 ± 11.3, p < .001) significantly contributed to a worse outcome. The severity of the spinal degeneration and psychological disorders did not affect the pain reduction in terms of MCID. CONCLUSIONS: This study provides new evidence about CEA in the treatment of FBSS and LSS. CEA provides a significant pain reduction even under intensified physiotherapeutic exercising in patients with severe spinal degeneration and a broad variety of secondary diagnoses. Neurologic deficits in case of FBSS and severe disability in case of LSS may be risk factors for less favorable outcome.


Assuntos
Analgesia Epidural , Síndrome Pós-Laminectomia , Estenose Espinal , Humanos , Estudos Retrospectivos , Estenose Espinal/complicações , Estenose Espinal/cirurgia , Estenose Espinal/diagnóstico , Resultado do Tratamento , Vértebras Lombares/cirurgia
7.
Sensors (Basel) ; 23(4)2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36850796

RESUMO

Device-free localization (DFL) systems exploit changes in the radio frequency channel by measuring, for example, the channel impulse response (CIR), to detect and localize obstacles within a target area. However, due to a lack of well-defined interfaces, missing modularization, as well as complex system configuration, it is difficult to deploy DFL systems outside of laboratory setups. This paper focused on the system view and the challenges that come with setting up a DFL system in an indoor environment. We propose MA-RTI, a modular DFL system that is easy to set up, and which utilizes a multipath-assisted (MA) radio-tomographic imaging (RTI) algorithm. To achieve a modular DFL system, we proposed and implemented an architectural model for DFL systems. For minimizing the configuration overhead, we applied a 3D spatial model, that helps in placing the sensors and calculating the required calibration parameters. Therefore, we configured the system solely with idle measurements and a 3D spatial model. We deployed such a DFL system and evaluated it in a real-world office environment with four sensor nodes. The radio technology was ultra-wideband (UWB) and the corresponding signal measurements were CIRs. The DFL system operated with CIRs that provided a sub-nanosecond time-domain resolution. After pre-processing, the update rate was approximately 46 Hz and it provided a localization accuracy of 1.0 m in 50% of all cases and 1.8 m in 80% of all cases. MA fingerprinting approaches lead to higher localization accuracy, but require a labor-intensive training phase.

8.
J Neurol Surg A Cent Eur Neurosurg ; 84(1): 30-36, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33506474

RESUMO

BACKGROUND AND STUDY AIMS: The treatment of infections following a spine surgery continues to be a challenge. Negative pressure wound therapy (NPWT) has been an effective method in the context of infection therapy, and its use has gained popularity in recent decades. This study aims to analyze the impact of known risk factors for postoperative wound infection on the efficiency and length of NPWT therapy until healing. PATIENTS AND METHODS: We analyzed 50 cases of NPWT treatment for deep wound infection after posterior and posteroanterior spinal fusion from March 2010 to July 2014 retrospectively. We included 32 women and 18 men with a mean age of 69 years (range, 36-87 years). Individual risk factors for postoperative infection, such as age, gender, obesity, diabetes, immunosuppression, duration of surgery, intraoperative blood loss, and previous surgeries, as well as type and onset (early vs. late) of the infection were analyzed. We assessed the associations between these risk factors and the number of revisions until wound healing. RESULTS: In 42 patients (84%), bacterial pathogens were successfully detected by means of intraoperative swabs and tissue samples during first revision. A total of 19 different pathogens could be identified with a preponderance of Staphylococcus epidermidis (21.4%) and S. aureus (19.0%). Methicillin-resistant S. aureus (MRSA) was recorded in two patients (2.6%). An average of four NPWT revisions was required until the infection was cured. Patients with infections caused by mixed pathogens required a significantly higher number of revisions (5.3 vs. 3.3; p < 0.01) until definitive wound healing. For the risk factors, no significant differences in the number of revisions could be demonstrated when compared with the patients without the respective risk factor. CONCLUSION: NPWT was an effective therapy for the treatment of wound infections after spinal fusion. All patients in the study had their infections successfully cured, and all spinal implants could be retained. The number of revisions was similar to those reported in the published literature. The present study provides insights regarding the effectiveness of NPWT for the treatment of deep wound infection after spinal fusion. Further investigations on the impact of potential risk factors for postoperative wound healing disorders are required. Better knowledge on the impact of specific risk factors will contribute to a higher effectiveness of prophylaxis for postoperative wound infections considering the patient-specific situation.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Tratamento de Ferimentos com Pressão Negativa , Masculino , Humanos , Feminino , Idoso , Estudos Retrospectivos , Staphylococcus aureus , Tratamento de Ferimentos com Pressão Negativa/efeitos adversos , Tratamento de Ferimentos com Pressão Negativa/métodos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/terapia , Infecção da Ferida Cirúrgica/etiologia
9.
Am J Case Rep ; 23: e938506, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36504027

RESUMO

BACKGROUND Gastrobronchial fistulas mostly occur as a result of postoperative complications, including those of bariatric, esophageal, and spleno-pancreatic surgery. Other causes are pneumonia, neoplasm, gastric ulcer, and subphrenic abscess. Traumatic fistulous communications between the stomach and the lung tissue are rare, with only 8 cases reported in the English-language literature (PubMed search) until now. CASE REPORT We report a 49-year-old female patient with a gastrobronchial fistula secondary to diaphragm rupture 7 years prior, with intrathoracic herniation of the gastric fundus. She underwent thoracotomy for surgical repair. She presented in our Emergency Department with recurrent hemoptysis and painful cough. The diagnosis of the gastrobronchial fistula was confirmed by computed tomography and simultaneous bronchoscopy and esophagogastroscopy, with injection of toluidine blue. As a multidisciplinary team, we opted for surgical repair owing to the fistula extent and severity and the need of repair of the diaphragm hernia. The patient underwent left-sided thoracoscopy. However, owing to dense adhesions and chronic inflammation, we converted to an open procedure. The herniated gastric fundus was repaired by wedge resection. The affected lung tissue was debrided and reconstructed by suture repair. The diaphragmatic defect was closed by sutures with mesh augmentation. The patient's postoperative course was uncomplicated, and she was discharged in good clinical condition on postoperative day 7. CONCLUSIONS Owing to the scarcity of the disease, the management of a gastrobronchial fistula is not standardized. The establishment of the diagnosis of the disease is often challenging. Therapeutic options include conservative measures, endoscopic options, and surgical repair. Our case showed that a multidisciplinary workup is essential for successful treatment.


Assuntos
Fístula , Hérnias Diafragmáticas Congênitas , Feminino , Humanos , Pessoa de Meia-Idade , Estômago , Broncoscopia , Esofagoscopia
10.
Sensors (Basel) ; 22(16)2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-36016015

RESUMO

In radio-frequency (RF)-based device-free localization (DFL), the number of sensors acting as RF transmitters and receivers is crucial for accuracy and system costs. Two promising approaches for DFL have been identified in the past: radio tomographic imaging (RTI) and multi-static radar (MSR). RTI in its basic version requires many sensors for high accuracy, which increases the cost. In this paper, we show how RTI benefits from multipath propagation. By evaluating the direct and echo paths, we increase the coverage of the target area, and by utilizing UWB signals, the RTI system is less susceptible to multipath propagation. MSR maps reflections that occur within the target area to reflectors such as persons or other objects. MSR does not require that the person is located near a signal path. Both suggested methods exploit ultra-wideband (UWB) channel impulse response (CIR) measurements. CIR measurements and the modeling of multipath effects either increase the accuracy or reduce the required number of sensors for localization with RTI. We created a test setup and measure UWB CIRs at different positions with a commercially available off-the-shelf UWB radio chip, the Decawave DW1000. We compare the localization results of RTI, multipath-assisted (MA)-RTI, and MSR and investigate a combined approach. We show that RTI is improved by the analysis of multipath propagation; furthermore, MA-RTI results in a better performance compared to MSR: with 50% of all cases, the localization error is better than 0.82 m and in 80% of all cases 1.34 m. The combined approach results in the best localization result with 0.64 m in 50% of all cases.


Assuntos
Radar , Ondas de Rádio , Humanos
11.
Ther Apher Dial ; 26(6): 1289-1295, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35352478

RESUMO

BACKGROUND: Low-density lipoprotein apheresis is not specific to lipoproteins but removes immunoglobulins as well. It remains elusive, whether protective SARS-CoV-2 antibodies after vaccination from COVID-19 are eliminated as well. METHODS: A cross-sectional case-control study on 55 patients undergoing weekly lipoprotein apheresis and 21 patients with comparable comorbidities and epidemiology not undergoing apheresis. SARS-CoV-2 IgG was assessed in all patients prior to apheresis and in 38 patients both before and after apheresis. RESULTS: SARS-CoV-2 IgG concentrations before a session of lipoprotein apheresis were comparable to control patients not undergoing apheresis(1727 IU/ml, IQR 365-2500) vs. 1652 IU/ml,(IQR408.8-2500), p = 0.78). SARS-CoV-2 IgG concentrations were reduced by lipoprotein apheresis from 1656 IU/ml(IQR 540.5-2500) prior to 1305 IU/ml (IQR 449-2500) afterwards(p < 0.0001). CONCLUSION: Lipoprotein apheresis removes SARS-CoV-2 IgG. The average elimination rate was 21.2%. In the present population of patients undergoing apheresis once weekly, however, the elimination did not lead to inferior concentrations compared to patients not undergoing lipoprotein apheresis.


Assuntos
Remoção de Componentes Sanguíneos , COVID-19 , Humanos , SARS-CoV-2 , Estudos de Casos e Controles , Estudos Transversais , COVID-19/terapia , Lipoproteínas , Lipoproteínas LDL , Imunoglobulina G
12.
Cell Rep ; 38(9): 110457, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35235780

RESUMO

Bifurcation of cellular fates, a critical process in development, requires histone 3 lysine 27 methylation (H3K27me3) marks propagated by the polycomb repressive complex 2 (PRC2). However, precise chromatin loci of functional H3K27me3 marks are not yet known. Here, we identify critical PRC2 functional sites at high resolution. We fused a computationally designed protein, EED binder (EB), which competes with EZH2 and thereby inhibits PRC2 function, to dCas9 (EBdCas9) to allow for PRC2 inhibition at a precise locus using gRNA. Targeting EBdCas9 to four different genes (TBX18, p16, CDX2, and GATA3) results in precise H3K27me3 and EZH2 reduction, gene activation, and functional outcomes in the cell cycle (p16) or trophoblast transdifferentiation (CDX2 and GATA3). In the case of TBX18, we identify a PRC2-controlled, functional TATA box >500 bp upstream of the TBX18 transcription start site (TSS) using EBdCas9. Deletion of this TATA box eliminates EBdCas9-dependent TATA binding protein (TBP) recruitment and transcriptional activation. EBdCas9 technology may provide a broadly applicable tool for epigenomic control of gene regulation.


Assuntos
Histonas , Complexo Repressor Polycomb 2 , Cromatina , Computadores , Histonas/metabolismo , Complexo Repressor Polycomb 2/metabolismo , TATA Box
13.
Proc Natl Acad Sci U S A ; 119(9)2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35217606

RESUMO

Mutations in the gene coding for leucine-rich repeat kinase 2 (LRRK2) are a leading cause of the inherited form of Parkinson's disease (PD), while LRRK2 overactivation is also associated with the more common idiopathic form of PD. LRRK2 is a large multidomain protein, including a GTPase as well as a Ser/Thr protein kinase domain. Common, disease-causing mutations increase LRRK2 kinase activity, presenting LRRK2 as an attractive target for drug discovery. Currently, drug development has mainly focused on ATP-competitive kinase inhibitors. Here, we report the identification and characterization of a variety of nanobodies that bind to different LRRK2 domains and inhibit or activate LRRK2 in cells and in in vitro. Importantly, nanobodies were identified that inhibit LRRK2 kinase activity while binding to a site that is topographically distinct from the active site and thus act through an allosteric inhibitory mechanism that does not involve binding to the ATP pocket or even to the kinase domain. Moreover, while certain nanobodies completely inhibit the LRRK2 kinase activity, we also identified nanobodies that specifically inhibit the phosphorylation of Rab protein substrates. Finally, in contrast to current type I kinase inhibitors, the studied kinase-inhibitory nanobodies did not induce LRRK2 microtubule association. These comprehensively characterized nanobodies represent versatile tools to study the LRRK2 function and mechanism and can pave the way toward novel diagnostic and therapeutic strategies for PD.


Assuntos
Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/metabolismo , Doença de Parkinson/metabolismo , Anticorpos de Domínio Único , Trifosfato de Adenosina/metabolismo , Regulação Alostérica , Animais , Sítios de Ligação , Mapeamento de Epitopos , Células HEK293 , Humanos , Camundongos , Microtúbulos/metabolismo , Fosforilação , Ligação Proteica , Células RAW 264.7 , Proteínas rab de Ligação ao GTP/metabolismo
14.
PLoS Biol ; 20(2): e3001427, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35192607

RESUMO

The 2 major molecular switches in biology, kinases and GTPases, are both contained in the Parkinson disease-related leucine-rich repeat kinase 2 (LRRK2). Using hydrogen-deuterium exchange mass spectrometry (HDX-MS) and molecular dynamics (MD) simulations, we generated a comprehensive dynamic allosteric portrait of the C-terminal domains of LRRK2 (LRRK2RCKW). We identified 2 helices that shield the kinase domain and regulate LRRK2 conformation and function. One helix in COR-B (COR-B Helix) tethers the COR-B domain to the αC helix of the kinase domain and faces its activation loop, while the C-terminal helix (Ct-Helix) extends from the WD40 domain and interacts with both kinase lobes. The Ct-Helix and the N-terminus of the COR-B Helix create a "cap" that regulates the N-lobe of the kinase domain. Our analyses reveal allosteric sites for pharmacological intervention and confirm the kinase domain as the central hub for conformational control.


Assuntos
Domínio Catalítico , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/química , Simulação de Dinâmica Molecular , Conformação Proteica , Regulação Alostérica , Sítio Alostérico , Medição da Troca de Deutério/métodos , Humanos , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/genética , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/metabolismo , Espectrometria de Massas/métodos , Mutação , Ligação Proteica
15.
J Anesth ; 36(2): 246-253, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35044493

RESUMO

PURPOSE: The purpose of this study was to outline the feasibility of continuous epidural analgesia in the treatment of failed back surgery syndrome (FBSS) or spinal stenosis. METHODS: We queried our prospective collected institutional database to include all consecutive patients, who underwent continuous epidural analgesia with accompanying intensive physiotherapeutic exercise within a timeframe of 4 years. Patients suffered from FBSS or spinal stenosis; protocolled continuous epidural analgesia was planned for 4 days within the framework of an inpatient multimodal pain therapy concept. The instillation technique of the epidural catheter, the capability to attend in accompanying physiotherapy, and the peri-interventional complications were evaluated. RESULTS: 153 patients with an average age of 57.4 years (± 11.9) were enrolled in this study. 105 patients suffered from FBSS and 48 patients had spinal stenosis. Overall, 148 patients (96.7%) reported the pain reduction and were able to perform daily intensified physiotherapeutic exercise. There were no serious adverse events, neither infection nor bleeding, no cardiopulmonary complication or permanent neurological deficits. The most common side effect was neurological impairment, such as numbness, dysesthesia, or weakness of the lower limbs with complete regression after flow rate adjustment. Patients with FBSS were more likely to develop dysesthesia (p = 0.007). CONCLUSIONS: Continuous epidural analgesia is feasible in patients with FBSS or spinal stenosis. This treatment enables extensive physiotherapeutic treatment even in patients with severe pain conditions and can be considered as an alternative to epidural injections. An increased complication rate in comparison to short-term perioperative or perinatal application was not observed.


Assuntos
Analgesia Epidural , Síndrome Pós-Laminectomia , Estenose Espinal , Analgesia Epidural/efeitos adversos , Síndrome Pós-Laminectomia/etiologia , Síndrome Pós-Laminectomia/terapia , Estudos de Viabilidade , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Estenose Espinal/complicações , Estenose Espinal/cirurgia
16.
Ann Surg ; 275(6): 1130-1136, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33055589

RESUMO

OBJECTIVE: To assess the impact of surgical technique in regard to morbidity and mortality after neoadjuvant treatment for esophageal cancer. BACKGROUND: The SAKK trial 75/08 was a multicenter phase III trial (NCT01107639) comparing induction chemotherapy followed by chemoradiation and surgery in patients with locally advanced esophageal cancer. METHODS: Patients in the control arm received induction chemotherapy with cisplatin and docetaxel, followed by concomitant chemoradiation therapy with cisplatin, docetaxel, and 45Gy. In the experimental arm, the same regimen was used with addition of cetuximab. After completion of neoadjuvant treatment, patients underwent esophagectomy. The experimental arm received adjuvant cetuximab. Surgical outcomes and complications were prospectively recorded and analyzed. RESULTS: Total of 259 patients underwent esophagectomy. Overall complication rate was 56% and reoperation rate was 15% with no difference in complication rates for transthoracic versus transhiatal resections (56% vs 54%, P = 0.77), nor for video assisted thoracic surgeries (VATS) versus open transthoracic resections (67% vs 55%, P = 0.32). There was a trend to higher overall complication rates in squamous cell carcinoma versus adenocarcinoma (65% vs 51%, P = 0.035), and a significant difference in ARDS in squamous cell carcinoma with 14% versus 2% in adenocarcinoma (P = 0.0002). For patients with involved lymph nodes, a lymph node ratio of ≥0.1 was an independent predictor of PFS (HR 2.5, P = 0.01) and OS (HR 2.2, P = 0.03). CONCLUSIONS: This trial showed no difference in surgical complication rates between transthoracic and transhiatal resections. For patients with involved lymph nodes, lymph node ratio was an independent predictor of progression free survival and overall survival.


Assuntos
Adenocarcinoma , Carcinoma de Células Escamosas , Neoplasias Esofágicas , Adenocarcinoma/patologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Cetuximab/uso terapêutico , Cisplatino/uso terapêutico , Docetaxel/uso terapêutico , Esofagectomia/métodos , Humanos , Terapia Neoadjuvante/métodos , Estadiamento de Neoplasias , Taxa de Sobrevida , Resultado do Tratamento
17.
Int J Legal Med ; 135(6): 2335-2345, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34591186

RESUMO

Thorough postmortem investigations of fatalities following vaccination with coronavirus disease 2019 (COVID-19) vaccines are of great social significance. From 11.03.2021 to 09.06.2021, postmortem investigations of 18 deceased persons who recently received a vaccination against COVID-19 were performed. Vaxzevria was vaccinated in nine, Comirnaty in five, Spikevax in three, and Janssen in one person. In all cases, full autopsies, histopathological examinations, and virological analyses for the severe acute respiratory syndrome coronavirus 2 were carried out. Depending on the case, additional laboratory tests (anaphylaxis diagnostics, VITT [vaccine-induced immune thrombotic thrombocytopenia] diagnostics, glucose metabolism diagnostics) and neuropathological examinations were conducted. In 13 deceased, the cause of death was attributed to preexisting diseases while postmortem investigations did not indicate a causal relationship to the vaccination. In one case after vaccination with Comirnaty, myocarditis was found to be the cause of death. A causal relationship to vaccination was considered possible, but could not be proven beyond doubt. VITT was found in three deceased persons following vaccination with Vaxzevria and one deceased following vaccination with Janssen. Of those four cases with VITT, only one was diagnosed before death. The synopsis of the anamnestic data, the autopsy results, laboratory diagnostic examinations, and histopathological and neuropathological examinations revealed that VITT was the very likely cause of death in only two of the four cases. In the other two cases, no neuropathological correlate of VITT explaining death was found, while possible causes of death emerged that were not necessarily attributable to VITT. The results of our study demonstrate the necessity of postmortem investigations on all fatalities following vaccination with COVID-19 vaccines. In order to identify a possible causal relationship between vaccination and death, in most cases an autopsy and histopathological examinations have to be combined with additional investigations, such as laboratory tests and neuropathological examinations.


Assuntos
Vacinas contra COVID-19 , Medicina Legal , Vacinação/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anafilaxia/mortalidade , Autopsia , Causalidade , Causas de Morte , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/mortalidade , Púrpura Trombocitopênica Idiopática/mortalidade
18.
Biofabrication ; 13(4)2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34521078

RESUMO

Post-fabrication formation of a proper vasculature remains an unresolved challenge in bioprinting. Established strategies focus on the supply of the fabricated structure with nutrients and oxygen and either rely on the mere formation of a channel system using fugitive inks or additionally use mature endothelial cells and/or peri-endothelial cells such as smooth muscle cells for the formation of blood vesselsin vitro.Functional vessels, however, exhibit a hierarchical organization and multilayered wall structure that is important for their function. Human induced pluripotent stem cell-derived mesodermal progenitor cells (hiMPCs) have been shown to possess the capacity to form blood vesselsin vitro, but have so far not been assessed for their applicability in bioprinting processes. Here, we demonstrate that hiMPCs, after formulation into an alginate/collagen type I bioink and subsequent extrusion, retain their ability to give rise to the formation of complex vessels that display a hierarchical network in a process that mimics the embryonic steps of vessel formation during vasculogenesis. Histological evaluations at different time points of extrusion revealed the initial formation of spheres, followed by lumen formation and further structural maturation as evidenced by building a multilayered vessel wall and a vascular network. These findings are supported by immunostainings for endothelial and peri-endothelial cell markers as well as electron microscopic analyses at the ultrastructural level. Moreover, endothelial cells in capillary-like vessel structures deposited a basement membrane-like matrix at the basal side between the vessel wall and the alginate-collagen matrix. After transplantation of the printed constructs into the chicken chorioallantoic membrane (CAM) the printed vessels connected to the CAM blood vessels and get perfusedin vivo. These results evidence the applicability and great potential of hiMPCs for the bioprinting of vascular structures mimicking the basic morphogenetic steps ofde novovessel formation during embryogenesis.


Assuntos
Bioimpressão , Células-Tronco Pluripotentes Induzidas , Vasos Sanguíneos , Células Endoteliais , Humanos , Tinta , Tecidos Suporte
19.
Proc Natl Acad Sci U S A ; 118(23)2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34088839

RESUMO

To explore how pathogenic mutations of the multidomain leucine-rich repeat kinase 2 (LRRK2) hijack its finely tuned activation process and drive Parkinson's disease (PD), we used a multitiered approach. Most mutations mimic Rab-mediated activation by "unleashing" kinase activity, and many, like the kinase inhibitor MLi-2, trap LRRK2 onto microtubules. Here we mimic activation by simply deleting the inhibitory N-terminal domains and then characterize conformational changes induced by MLi-2 and PD mutations. After confirming that LRRK2RCKW retains full kinase activity, we used hydrogen-deuterium exchange mass spectrometry to capture breathing dynamics in the presence and absence of MLi-2. Solvent-accessible regions throughout the entire protein are reduced by MLi-2 binding. With molecular dynamics simulations, we created a dynamic portrait of LRRK2RCKW and demonstrate the consequences of kinase domain mutations. Although all domains contribute to regulating kinase activity, the kinase domain, driven by the DYGψ motif, is the allosteric hub that drives LRRK2 regulation.


Assuntos
Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/química , Simulação de Dinâmica Molecular , Motivos de Aminoácidos , Humanos , Espectrometria de Massa com Troca Hidrogênio-Deutério , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/genética , Domínios Proteicos , Transporte Proteico
20.
Sensors (Basel) ; 20(24)2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33322078

RESUMO

In this paper, we propose a multipath-assisted device-free localization (DFL) system that includes magnitude and phase information (MAMPI). The DFL system employs ultra-wideband (UWB) channel impulse response (CIR) measurements, enabling the extraction of several multipath components (MPCs) and thereby benefits from multipath propagation. We propose a radio propagation model that calculates the effect on the received signal based on the position of a person within a target area. Additionally, we propose a validated error model for the measurements and explain the creation of different feature vectors and extraction of the MPCs from Decawave DW1000 CIR measurements. We evaluate the system via simulations of the position error probability and a measurement setup in an indoor scenario. We compare the performance of MAMPI to a conventional DFL system based on four sensor nodes that measures radio signal strength values. The combination of the magnitude and phase differences for the feature vectors results in a position error probability that is comparable to a conventional system but requires only two sensor nodes.

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