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    Keywords: Germany ; VOLUME ; PATIENT ; LESIONS ; REPAIR ; COLOR DOPPLER ; cardiac surgery ; CARDIOMYOPATHY ; coronary artery disease ; ischemic mitral regurgitation ; OVINE MODEL ; REPLACEMENT ; VALVE RECONSTRUCTION ; annuloplasty ; GEOMETRY ; ischernic mitral regurgitation ; left ventricular geometry ; three-dimensional echocardiography
    Abstract: Background: The aim of this study was to investigate the relationship between LV geometry, annular shape and the amount of regurgitation in patients with ischernic mitral regurgitation (group 1, n = 30) compared to patients with primary mitral valve lesions (group 2, n = 30). Methods: LV geometry was assessed by the sphericity index, i.e., LV volume divided by the volume of a sphere with a diameter equal to the longest axis. Annular geometry was evaluated by diameters, areas and their percentual shortening. The degree of mitral regurgitation was assessed as jet volumes by 3D-echocardiography. Results: Group I showed significantly larger longitudinal (54.3 +/- 3.1 vs. 40.9 +/- 2.6 mm) and antero-posterior (32.2 +/- 3.3 vs. 27.1 +/- 2.9 mm) annulus diameters and areas (993.3 +/- 66.6 vs. 702.1 +/- 47.9 mm(2)) than group 2. No asymmetric annular enlargement was found in either group. Annular enlargement correlated to the degree of mitral regurgitation in group I but not in group 2. Annular area shortening was significantly impaired in group 2 and the sphericity index was larger in group 1 than in group 2. In group 1, the sphericity index was significantly correlated to the degree of mitral regurgitation (r = 0.87; p 〈 0.001). Conclusions: These findings suggest that ischemic mitral regurgitation was mostly associated with a global left ventricular enlargement, in which annulus dilatation and its reduced contraction play a significant role
    Type of Publication: Journal article published
    PubMed ID: 17089311
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  • 3
    Keywords: CANCER ; CELLS ; EXPRESSION ; GROWTH ; GROWTH-FACTOR ; SURVIVAL ; tumor ; TUMOR-CELLS ; carcinoma ; CELL ; evaluation ; Germany ; SYSTEM ; SYSTEMS ; HISTORY ; GENES ; SURGERY ; TIME ; PATIENT ; murine ; FAMILY ; MARKER ; IMPACT ; ANTIGEN ; STAGE ; IDENTIFICATION ; LESIONS ; PROGRESSION ; AGE ; WOMEN ; METASTASIS ; colorectal cancer ; MEN ; COLORECTAL-CANCER ; metastases ; MARKERS ; MELANOMA ; PROGNOSTIC-FACTORS ; RESECTION ; PARAMETERS ; ONCOGENE ; INVOLVEMENT ; PROGNOSTIC FACTORS ; SELECTION ; SERUM ; SUBSET ; COLORECTAL-CARCINOMA ; PATIENT SURVIVAL ; MAGE ; lung metastases ; PROGNOSTIC-FACTOR ; LEVEL ; PROGNOSTIC MARKER ; FOS ; EVENTS ; vascular endothelial growth factor ; colorectal ; PROMOTES ; colorectal carcinoma ; growth factor ; PULMONARY METASTASES ; metastasectomy ; OPINION ; thoracic surgery ; TUMOR LYMPHANGIOGENESIS
    Abstract: Background: Although aggressive resection of pulmonary metastases prolongs the survival of patients with metastatic colorectal cancer, there is a need for predictive pathologic parameters to understand the key molecular events of metastatic progression. The aim of this study was to verify immunohistochemical markers in addition to established clinical parameters after surgery. Methods: From our subset of patients undergoing resection of pulmonary metastases from metastatic colorectal carcinoma, we analyzed 39 patients (23 men and 16 women) between 2003 and 2007. Only patients who met the criteria for a potentially curative operation were included. All patients were analyzed with regard to age and sex, primary tumor location, stage of the primary tumor, history of hepatic metastases, number of pulmonary metastases, pre-thoracotomy carcinoembryonic (CEA) serum antigen level, and the presence of thoracic lymph node metastasis. Furthermore, we immunohistochemically investigated the expression of vascular endothelial growth factor (VEGF)-D, FBJ murine osteosarcoma viral oncogene homolog B (FOS-B), and melanoma antigen (MAGE)-A in the Surgical specimens of pulmonary metastatic lesions. Results: The overall 3-year survival was 50.6%. A significantly longer survival was observed with multivariate analysis in patients with a pre-thoracotomy serum carcinoembryonic antigen level of no more than 4.2 ng/mL (p=0.001), and Dukes stage A or B primary tumor (p=0.001). A significantly longer recurrence-free survival was observed with multivariate analysis in patients without thoracic lymph node involvement compared to patients with pulmonary and/or mediastinal lymph node metastases (p=0.006). The stage of the primary tumor remained significant (p=0.029), and FOS-B expression in tumor cells showed a trend towards favorable recurrence-free survival after pulmonary metastasectomy (p=0.059). No statistically significant difference was found in the overall survival rate or recurrence-free survival rate of patients with expression of VEGF-D or MAGE-A antigen in pulmonary metastatic tumor cells. Conclusions: Our results suggest that in addition to clinically prognostic factors, FOS-B expression has a debatable impact on patient Survival. We conclude that the evaluation of molecular and clinical prognostic parameters at the time of pulmonary metastasectomy offers a greater understanding of the metastatic process and provides important information for patient selection
    Type of Publication: Journal article published
    PubMed ID: 19795327
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    Abstract: The results of a research project aiming to visualize cardiac anatomy in a 3-dimensional form for surgical planning are presented. Based on electronic data processing within a local area network environment, serial slices of CT- and MRI-machines were used to construct a 3-dimensional data cube that was illuminated by calculated sources of light. Light rays were traced through the entire "data volume". Mathematically following each pathway of light through the space, the intensity of changes along this path were calculated. The results of applying this "Heidelberg Ray-tracing Technique" to cardiac anatomy are 3-dimensional "computer movies" that appear on any workstation within a computer network. Using special software, the surgeon can "walk" in any direction through the heart or he can break it into two or more parts in order to analyze regions of interest in detail. Even small structures such as papillary muscles, bifurcations, coronary arteries and cusps of cardiac valves become visible. This new technique may enable the surgeon to open the heart prior to surgery on the computer monitor working with a visualized model that corresponds to the visual experience of his daily intraoperative practice.
    Type of Publication: Journal article published
    PubMed ID: 1803630
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    Keywords: DISEASE ; METABOLITES ; PROSTACYCLIN ; THROMBOXANE
    Abstract: BACKGROUND: Pulmonary arterial hypertension (PAH) is a cause of morbidity in patients with congenital heart disease (CHD). It has been hypothesized that prostanoides participate in the development of PAH. The aim of this study was to show the potential expression of cyclooxygenase-2 (COX-2) in patients with CHD and PAH. PATIENTS AND METHODS: We included patients with isolated left-to-right shunts undergoing lung biopsy before or concomitantly with cardiac surgery between 2004 and 2009.For determination of COX-2 expression, histological and immunohistochemistry analyses as well as quantitative polymerase chain reaction (qPCR) were performed. RESULTS: We were able to show COX-2 protein overexpression in the lung tissue of children with CHD and PAH. Furthermore, we showed an increase in COX-1 gene expression and an even stronger induction of COX-2 by using qPCR and immunohistochemistry. CONCLUSIONS: We examined the expression of COX-2 in lung tissue from patients with CHD and PAH. We showed that COX-2 is expressed in diseased lung tissue, indicating a relationship between COX-2 and vascular remodeling in pulmonary arteries in CHD.
    Type of Publication: Journal article published
    PubMed ID: 23681850
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