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Haemorrhage after thrombectomy with adjuvant thrombolysis in unknown onset stroke depends on high early lesion water uptake

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Stroke & Vascular Neurology 2024年第4期9卷 390-398页

作者： Gabriel Broocks Lukas Meyer Uta Hanning Tobias Djamsched Faizy Matthias Bechstein Helge Kniep Noel Van Horn Gerhard Schön Ewgenia Barow Götz Thomalla Jens Fiehler Andre Kemmling Department of Diagnostic and Interventional Neuroradiology University Medical Center Hamburg-EppendorfHamburgGermany Department of Medical Biometry and Epidemiology University Medical Center Hamburg EppendorfHamburgGermany Department of Neurology University Medical Center Hamburg-EppendorfHamburgGermany Department of Neuroradiology University MarburgMarburgGermany

Background and purpose In wake-up stroke,CT-based quantitative net water uptake(NWU)might serve as an alternative tool to MRI to guide intravenous thrombolysis with alteplase(IVT).An important complication after IVT is symptomatic intracerebral haemorrhage(sICH).As NWU directly implies ischaemic lesion progression,reflecting blood-brain barrier injury,we hypothesised that NWU predicts sICH in patients who had a ischaemic stroke undergoing thrombectomy with unknown *** Consecutive analysis of all patients who had unknown onset anterior circulation ischaemic stroke who underwent CT at baseline and endovascular treatment between December 2016 and October *** NWU was assessed on baseline *** primary endpoint was *** association of NWU and other baseline parameters to sICH was investigated using inverse-probability weighting(IPW)*** A total of 88 patients were included,of which 46 patients(52.3%)received *** median NWU was 10.7%(IQR:5.1–17.7).The proportion of patients with any haemorrhage and sICH were 35.2%and 13.6%.NWU at baseline was significantly higher in patients with sICH(19.1%vs 9.6%,p<0.0001)and the median Alberta Stroke Program Early CT Score(ASPECTS)was lower(5 vs 8,p<0.0001).Following IPW,there was no association between IVT and sICH in unadjusted ***,after adjusting for ASPECTS and NWU,there was a significant association between IVT administration and sICH(14.6%,95%CI:3.3%to 25.6%,p<0.01).Conclusion In patients with ischaemic stroke with unknown onset,the combination of high NWU with IVT is directly linked to higher rates of *** ASPECTS for evaluating the extent of the early infarct lesion,quantitative NWU could be used as an imaging biomarker to assess the degree of blood-brain barrier damage in order to predict the risk of sICH in patients with wake up stroke.

关键词： throm thrombolysis high

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The emerging role of tranexamic acid and its principal target,plasminogen,in skeletal health

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Acta Pharmaceutica Sinica B 2024年第7期14卷 2869-2884页

作者： Weixin Xie Antonia Donat Shan Jiang Anke Baranowsky Johannes Keller Department of Trauma and Orthopedic Surgery University Medical Center Hamburg-EppendorfHamburg 20246Germany

The worldwide burden of skeletal diseases such as osteoporosis,degenerative joint disease and impaired fracture healing is steadily *** acid(TXA),a plasminogen inhibitor and anti-fibrinolytic agent,is used to reduce bleeding with high effectiveness and safety in major surgical *** its widespread clinical application,the effects of TXA beyond anti-fibrinolysis have been noticed and prompted renewed interest in its *** clinical trials have characterized the effects of TXA on reducing postoperative infection rates and regulating immune responses in patients undergoing ***,several animal studies suggest potential therapeutic effects of TXA on skeletal diseases such as osteoporosis and fracture *** a direct effect of TXA on the differentiation and function of bone cells in vitro was shown,few mechanisms of action have been ***,we summarize recent findings of the effects of TXA on skeletal diseases and discuss the underlying plasminogen-dependent and-independent mechanisms related to bone metabolism and the immune *** furthermore discuss potential novel indications for TXA application as a treatment strategy for skeletal diseases.

关键词： Tranexamic acid Osteoporosis Osteoarthritis Fracture healing Bone metabolism Inflammation Plasminogen Fibrinolysis

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Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management

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Asian Journal of Urology 2024年第1期11卷 42-47页

作者： Randi M.Pose Sophie Knipper Jonas Ekrutt Mara Kölker Pierre Tennstedt Hans Heinzer Derya Tilki Florian Langer Markus Graefen Martini-Klinik Prostate Cancer Centre University Hospital Hamburg-EppendorfGermany Department of Urology University Hospital Hamburg-EppendorfGermany Department of Hematology and Oncology University Medical Centre Hamburg-EppendorfHamburgGermany

Objective:To examine the perioperative impact of factor V Leiden mutation on thromboembolic events'risk in radical prostatectomy(RP)*** an incidence of about 5%,factor V Leiden mutation is the most common hereditary hypercoagulability among Caucasians and rarer in *** increased risk of thromboembolic events is three-to seven-fold in heterozygous and to 80-fold in homozygous ***:Within our prospectively collected database,we analysed 33006 prostate cancer patients treated with RP between December 2001 and December *** those,patients with factor V Leiden mutation were *** patients received individualised recommendation of haemostaseologists for perioperative *** complications(deep vein thrombosis and pulmonary embolism)were assessed during hospital stay,as well as according to patient reported outcomes within the first 3 months after ***:Overall,85(0.3%)patients with known factor V Leiden mutation were *** age was 65(interquartile range:61-68)*** was at least one thrombosis in 53(62.4%)patients and 31(36.5%)patients had at least one embolic event in their medical history before *** all 85 patients with factor V Leiden mutation,we experienced no thromboembolic complications within the first 3 months after ***:In our cohort of patients with factor V Leiden mutation,no thromboembolic events were observed after RP with an individualised perioperative coagulation management *** may reassure patients with this hereditary condition who are counselled for RP.

关键词： Prostatecancer Prostatectomy Factor V Leiden mutation Thromboembolism Thrombophilia

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Microglial complex I activity: a crucial factor for smoldering inflammation in the central nervouss system

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Signal Transduction and Targeted Therapy 2024年第8期9卷 3165-3166页

作者： Jana K.Sonner Christina Mayer Manuel A.Friese Institute of Neuroimmunology and Multiple Sclerosis University Medical Center Hamburg-EppendorfHamburgGermany

In their article published in Nature,Peruzotti-Jametta et *** metabolic reprogramming of microglia as a defining characteristic of their persistent and harmful activation during inflammatory neurodegeneration,which is observable in conditions like multiple sclerosis(MS).Subsequently,the authors demonstrate how mitigating mitochondrial dysregulation in microglia alleviates disease progression in an animal model of MS,thereby unveiling a potential novel target for the treatment of MS(Fig.1).

关键词： inflammation al. thereby

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Piezo1 expression in chondrocytes controls endochondral ossification and osteoarthritis development

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Bone Research 2024年第1期12卷 199-214页

作者： Laura J.Brylka Assil-Ramin Alimy Miriam E.A.Tschaffon-Müller Shan Jiang Tobias Malte Ballhause Anke Baranowsky Simon von Kroge Julian Delsmann Eva Pawlus Kian Eghbalian Klaus Püschel Astrid Schoppa Melanie Haffner-Luntzer David J.Beech Frank Timo Beil Michael Amling Johannes Keller Anita Ignatius Timur A.Yorgan Tim Rolvien Thorsten Schinke Department of Osteology and Biomechanics University Medical Center Hamburg-Eppendorf20246 HamburgGermany Department of Trauma and Orthopedic Surgery University Medical Center Hamburg-Eppendorf20246 HamburgGermany Institute of Orthopedic Research and Biomechanics University Medical Center UlmBadenWürttemberg89081 UlmGermany Department Legal Medicine University Medical Center Hamburg-Eppendorf20246 HamburgGermany Leeds Institute of Cardiovascular and Metabolic Medicine School of MedicineUniversity of LeedsLS29JT LeedsUK

Piezo proteins are mechanically activated ion channels,which are required for mechanosensing functions in a variety of cell *** we and others have previously demonstrated that the expression of Piezo1 in osteoblast lineage cells is essential for boneanabolic processes,there was only suggestive evidence indicating a role of Piezo1 and/or Piezo2 in *** we addressed the question if and how chondrocyte expression of the mechanosensitive proteins Piezo1 or Piezo2 controls physiological endochondral ossification and pathological osteoarthritis(OA)*** with chondrocyte-specific inactivation of Piezo1(Piezo1^(Col2a1Cre)),but not of Piezo2,developed a near absence of trabecular bone below the chondrogenic growth plate ***,all Piezo1^(Col2a1Cre) animals displayed multiple fractures of rib bones at 7 days of age,which were located close to the growth *** skeletal growth was only mildly affected in these mice,OA pathologies were markedly less pronounced compared to littermate controls at 60 weeks of ***,when OA was induced by anterior cruciate ligament transection,only the chondrocyte inactivation of Piezo1,not of Piezo2,resulted in attenuated articular cartilage ***,osteophyte formation and maturation were also reduced in Piezo1^(Col2a1Cre) *** further observed increased Piezo1 protein abundance in cartilaginous zones of human ***,we identified Ptgs2 and Ccn2 as potentially relevant Piezo1 downstream genes in ***,our data do not only demonstrate that Piezo1 is a critical regulator of physiological and pathological endochondral ossification processes,but also suggest that Piezo1 antagonists may be established as a novel approach to limit osteophyte formation in OA.

关键词： Piezo1 markedly ossification

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Fetal lung growth predicts the risk for early-life respiratory infections and childhood asthma

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World Journal of Pediatrics 2024年第5期20卷 481-495页

作者： Dimitra E.Zazara Olympia Giannou Steven Schepanski Mirja Pagenkemper Anastasios D.Giannou Maike Pincus Ioannis Belios Stefan Bonn Ania C.Muntau Kurt Hecher Anke Diemert Petra Clara Arck Division for Experimental Feto-Maternal Medicine Department of Obstetrics and Fetal MedicineUniversity Medical Center Hamburg-Eppendorf(UKE)Martinistraße 5220251HamburgGermany university Children’s Hospital UKEHamburgGermany Computer Engineering and Informatics Department Polytechnic SchoolUniversity of PatrasPatrasGreece Institute of Developmental Neurophysiology Center for Molecular Neurobiology Hamburg(ZMNH)UKEHamburgGermany Department of Obstetrics and Fetal Medicine UKEHamburgGermany Department of General Visceral and Thoracic SurgeryUKEHamburgGermany Section of Molecular Immunology and Gastroenterology Ⅰ.Department of MedicineUKEHamburgGermany Pediatrics and Pediatric Pneumology Practice BerlinGermany Institute of Medical Systems Biology ZMNHUKEHamburgGermany hamburg Center for Translational Immunology UKEHamburgGermany

Background Early-life respiratory infections and asthma are major health burdens during *** predicting an increased risk for early-life respiratory diseases are ***,we identified the predictive value of ultrasound-monitored fetal lung growth for the risk of early-life respiratory infections and *** Fetal lung size was serially assessed at standardized time points by transabdominal ultrasound in pregnant women participating in a pregnancy *** between fetal lung growth and respiratory infections in infancy or early-onset asthma at five years were ***-learning models relying on extreme gradient boosting regressor or classifier algorithms were developed to predict respiratory infection or asthma risk based on fetal lung *** model development and validation,study participants were randomly divided into a training and a testing group,respectively,by the employed *** Enhanced fetal lung growth throughout pregnancy predicted a lower early-life respiratory infection *** sex was associated with a higher risk for respiratory infections in *** lung growth could also predict the risk of asthma at five years of *** designed three machine-learning models to predict the risk and number of infections in infancy as well as the risk of early-onset *** models’R2 values were 0.92,0.90 and 0.93,respectively,underscoring a high accuracy and agreement between the actual and predicted *** variables included known risk factors and novel predictors,such as ultrasound-monitored fetal lung *** Sonographic monitoring of fetal lung growth allows to predict the risk for early-life respiratory infections and asthma.

关键词： Asthma Child risk Early-life respiratory infections Prenatal lung development Sexual dimorphism

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Calculation of ship motions in steep waves with restoring and Froude-Krylov forces on an adaptive panel mesh with Gauss and analytic integration methods

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Journal of Hydrodynamics 2024年第2期36卷 275-289页

作者： Malwin Wermbter Moustafa Abdel-Maksoud Institute for Fluid Dynamics and Ship Theory Hamburg University of TechnologyHamburgGermany

The impulse response method is a frequently used method to calculate ship seakeeping *** this paper,the restoring and Froude-Krylov calculation is conducted with constant evaluation of panel pressures as well as Gauss quadrature and an analytical *** applied panel grid is coarsened by an adaptive algorithm which is based on a normal vector *** comparison of methods is based on grid convergence studies which are followed by a verification of forces with computational fluid dynamics(CFD)results on the fixed duisburg test case in *** with experimental results in head,oblique and following waves show that all integration methods are *** exact integration is numerically sensitive in some *** quadrature is highly accurate;however,the additional effort is not beneficial since the geometrical accuracy has-stronger influence on the force amplitudes than the integration *** grid coarsening reduces the simulation time and is accurate up to a level,where the panel length comes close the *** added resistance at the investigated Froude number of 0.05 shows higher uncertainty levels,this applies to the results of both the numerical methods and model tests.

关键词： Ship hydrodynamics seakeeping impulse response method added resistance wave loads

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Empowerment in chronic wound care——exploring the scope for patient contribution

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Frontiers of Nursing 2024年第1期11卷 1-16页

作者： Benedikt Hackert Ewa Klara Stürmer Ulrich Weger Department of Psychology and Psychotherapy University of Witten/HerdeckeAlfred-Herrhausen-Straße 5058448 WittenGermany Department for Vascular Medicine University Heart and Vascular Center HamburgUniversity Medical Center Hamburg-EppendorfMartinistreet 5220246 HamburgGermany

Objective:In this study,we investigated the concept of empowerment in chronic wound care and propose to facilitate patient control by making use of degrees of freedom(DOF):that is,shaping of everyday wound care tasks initiated by patients and based on their wishes,mostly in terms of patients executing treatment steps,requesting or directing health care professionals to under take changes,or modifications of internal ***:As a first step,we conducted a systematic literature search,followed by an inductive form of qualitative content analysis,which resulted in the identification of 5 dimensions as main elements of empowerment:education and shared decision making,adherence to self-care behaviors,responsibility and control,general call for empowerment,and ***,the latter are noticeably absent in the *** investigate patients'freedom in shaping the wound care process,we conducted a second literature ***:A number of possibilities for patients to influence the wound care process could be identified,but experimental or clinical evidence about their effects is missing,their variety is limited,and they are only inadequately ***:However,DOF should be an indispensable aspect of genuine empowerment,since they allow patients to occupy the role of the agent in the treatment process and give rise to the subjective experience of feeling ***,in the third part,we develop a research proposal on how to investigate and include DOF in the clinical practice of wound ***,limitations about implementations are discussed(e.g.,patients being reluctant to overcome their passive role,resulting in frustration for health care professionals).

关键词： adherence chronic wounds control degrees of freedom empowerment shared decision making

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Septic shock due to Capnocytophaga canimorsus treated with IgM-enriched immunoglobulin as adjuvant therapy in an immunocompetent woman

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Journal of Intensive Medicine 2024年第2期4卷 265-268页

作者： Josephine Braunsteiner Stephanie Siedler Dominik Jarczak Stefan Kluge Axel Nierhaus Department of Intensive Care Medicine University Medical Centre Hamburg-EppendorfHamburgGermany

Background Capnocytophaga canimorsus(***)belongs to the family *** is a facultative anaerobic Gram-negative bacillus and belongs to the normal oral microbiota of some mammals,such as cats and *** to humans can occur through the skin after skin abrasion caused by a scratch or a bite.[1]Based on polymerase chain reaction(PCR)analysis,*** is present in saliva in 70%-74%of dogs and 55%-57%of cats.

关键词： belongs enriched scratch

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Enhancing 3D Reconstruction Accuracy of FIB Tomography Data Using Multi‑voltage Images and Multimodal Machine Learning

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Nanomanufacturing and Metrology 2024年第1期7卷 48-60页

作者： Trushal Sardhara Alexander Shkurmanov Yong Li Lukas Riedel Shan Shi Christian J.Cyron Roland C.Aydin Martin Ritter Institute for Continuum and Material Mechanics Hamburg University of TechnologyHamburgGermany Electron Microscopy Unit Hamburg University of TechnologyHamburgGermany Institute of Materials Physics and Technology Hamburg University of TechnologyHamburgGermany Institute of Materials Mechanics Helmholtz-Zentrum HereonGeesthachtGermany Research Group of Integrated Metallic Nanomaterials Systems Hamburg University of TechnologyHamburgGermany Institute of Material Systems Modeling Helmholtz-Zentrum HereonGeesthachtGermany

FIB-SEM tomography is a powerful technique that integrates a focused ion beam(FIB)and a scanning electron microscope(SEM)to capture high-resolution imaging data of *** approach involves collecting in-plane SEM imagesand using FIB to remove material layers for imaging subsequent planes,thereby producing image ***,theseimage stacks in FIB-SEM tomography are subject to the shine-through effect,which makes structures visible from theposterior regions of the current *** artifact introduces an ambiguity between image intensity and structures in thecurrent plane,making conventional segmentation methods such as thresholding or the k-means algorithm *** study,we propose a multimodal machine learning approach that combines intensity information obtained at differentelectron beam accelerating voltages to improve the three-dimensional(3D)reconstruction of *** treatingthe increased shine-through effect at higher accelerating voltages as a form of additional information,the proposed methodsignificantly improves segmentation accuracy and leads to more precise 3D reconstructions for real FIB tomography data.

关键词： Multimodal machine learning Multi-voltage images FIB-SEM Overdeterministic systems 3D reconstruction FIB tomography

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