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1.
Front Pharmacol ; 15: 1334233, 2024.
Article in English | MEDLINE | ID: mdl-38444946

ABSTRACT

Targeted chemotherapy and immune checkpoint inhibitors (ICPi) have expanded the spectrum of therapies for patients with relapsed/refractory (r/r) Hodgkin's disease and significantly improved the proportion of patients with long-term disease control. However, there is no standardized therapeutic option in case of further progression. Recently, we demonstrated that therapy with MEPED (metronomic chemotherapy, everolimus, pioglitazone, etoricoxib, dexamethasone) is highly effective in patients with r/r Hodgkin's disease. The benefit after pre-treatment with ICPi has not been studied, yet. Here, we report a patient with progressive Hodgkin's disease on Pembrolizumab for the first time who achieved sustained complete remission (CR) after initiation of MEPED therapy. A 57-year-old patient was pre-treated with brentuximab vedotin for relapsed advanced Hodgkin's disease and had received Pembrolizumab for progression from November 2020 to July 2022. Due to further progression, MEPED therapy was started in August 2022 and continued until May 2023. It consisted of a strictly oral daily (28-day cycle) application of low-dose treosulfan 250 mg, everolimus 15 mg, pioglitazone 45 mg, etoricoxib 60 mg, and dexamethasone 0.5 mg. Treatment response was evaluated by F-18 FDG-PET/CT (PET/CT). CR was defined by a negative Deauville score (DS) of 1-3. Already 3 months after starting MEPED, a CR (DS: 3) was confirmed by PET/CT in November 2022. The next follow-up in May 2023 continued to show CR (DS: 3). The therapy was very well tolerated. No hematological or other organ toxicity was observed. However, in May 2023 the patient presented with leg edema and weight gain, most likely due to pioglitazone and the PET/CT revealed suspected everolimus-induced pneumonitis, so MEPED was discontinued and diuretic therapy and treatment with prednisolone was started with gradual dose reduction. This resulted in a rapid complete resolution of the symptoms. The next PET-CT in July 2023 continued to show CR (DS: 3) without evidence of pneumonitis. Currently, therapy with MEPED has not been resumed. In conclusion, we demonstrate for the first time that MEPED therapy is highly effective in a patient with Hodgkin's disease who has been refractory to ICPi. Sustained CR was achieved over 11 months after initiation of MEPED therapy. Further studies on a larger patient cohort should be performed.

2.
Arch Gynecol Obstet ; 307(4): 1155-1162, 2023 04.
Article in English | MEDLINE | ID: mdl-36127525

ABSTRACT

INTRODUCTION: The intention of this study was to evaluate the level of anxiety and depression of malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) survivors and to identify possible alterable cofactors. METHODS: CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO Studygroup. Women who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete the Hospital Anxiety and Depression Scale (HADS) to evaluate distress. Predictors of distress (type of surgery, chemotherapy, time since diagnosis, recurrence, second tumor, pain) were investigated using multivariate linear regression analysis. RESULTS: 150 MOGCT and SCST patients with confirmed histological diagnosis completed the questionnaire median seven years after diagnosis. They had a HADS total score ≥ 13 indicating severe mental distress in 34% of cases. Patients after fertility-conserving surgery had lower probability of severe mental distress than those without fertility-conserving treatment (ß = - 3.1, p = 0.04). Pain was associated with the level of distress in uni- and multivariate analysis (coef 0.1, p < 0.01, coef. Beta 0.5). DISCUSSION: Severe mental distress was frequent in patients with MOGCT and SCST and the level of pain was associated with the level of distress. Fertility conserving therapy, however, was associated with less mental distress. Screening and treatment of pain and depression is required to improve mental well-being in survivors of MOGCT and SCST.


Subject(s)
Neoplasms, Germ Cell and Embryonal , Ovarian Neoplasms , Sex Cord-Gonadal Stromal Tumors , Humans , Female , Ovarian Neoplasms/pathology , Retrospective Studies , Prospective Studies , Sex Cord-Gonadal Stromal Tumors/epidemiology , Sex Cord-Gonadal Stromal Tumors/pathology , Sex Cord-Gonadal Stromal Tumors/surgery , Pain , Anxiety/epidemiology , Anxiety/etiology , Germ Cells/pathology , Neoplasms, Germ Cell and Embryonal/complications , Neoplasms, Germ Cell and Embryonal/therapy
3.
Fungal Syst Evol ; 9: 161-200, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35978986

ABSTRACT

Seven Fusarium species complexes are treated, namely F. aywerte species complex (FASC) (two species), F. buharicum species complex (FBSC) (five species), F. burgessii species complex (FBURSC) (three species), F. camptoceras species complex (FCAMSC) (three species), F. chlamydosporum species complex (FCSC) (eight species), F. citricola species complex (FCCSC) (five species) and the F. concolor species complex (FCOSC) (four species). New species include Fusicolla elongata from soil (Zimbabwe), and Neocosmospora geoasparagicola from soil associated with Asparagus officinalis (Netherlands). New combinations include Neocosmospora akasia, N. awan, N. drepaniformis, N. duplosperma, N. geoasparagicola, N. mekan, N. papillata, N. variasi and N. warna. Newly validated taxa include Longinectria gen. nov., L. lagenoides, L. verticilliforme, Fusicolla gigas and Fusicolla guangxiensis. Furthermore, Fusarium rosicola is reduced to synonymy under N. brevis. Finally, the genome assemblies of Fusarium secorum (CBS 175.32), Microcera coccophila (CBS 310.34), Rectifusarium robinianum (CBS 430.91), Rugonectria rugulosa (CBS 126565), and Thelonectria blattea (CBS 952.68) are also announced here. Citation: Crous PW, Sandoval-Denis M, Costa MM, Groenewald JZ, van Iperen AL, Starink-Willemse M, Hernández-Restrepo M, Kandemir H, Ulaszewski B, de Boer W, Abdel-Azeem AM, Abdollahzadeh J, Akulov A, Bakhshi M, Bezerra JDP, Bhunjun CS, Câmara MPS, Chaverri P, Vieira WAS, Decock CA, Gaya E, Gené J, Guarro J, Gramaje D, Grube M, Gupta VK, Guarnaccia V, Hill R, Hirooka Y, Hyde KD, Jayawardena RS, Jeewon R, Jurjevic Z, Korsten L, Lamprecht SC, Lombard L, Maharachchikumbura SSN, Polizzi G, Rajeshkumar KC, Salgado-Salazar C, Shang Q-J, Shivas RG, Summerbell RC, Sun GY, Swart WJ, Tan YP, Vizzini A, Xia JW, Zare R, González CD, Iturriaga T, Savary O, Coton M, Coton E, Jany J-L, Liu C, Zeng Z-Q, Zhuang W-Y, Yu Z-H, Thines M (2022). Fusarium and allied fusarioid taxa (FUSA). 1. Fungal Systematics and Evolution 9: 161-200. doi: 10.3114/fuse.2022.09.08.

4.
Proc Biol Sci ; 287(1922): 20192862, 2020 03 11.
Article in English | MEDLINE | ID: mdl-32156209

ABSTRACT

Characterizing functional trait variation and covariation, and its drivers, is critical to understand the response of species to changing environmental conditions. Evolutionary and environmental factors determine how traits vary among and within species at multiple scales. However, disentangling their relative contribution is challenging and a comprehensive trait-environment framework addressing such questions is missing in lichens. We investigated the variation in nine traits related to photosynthetic performance, water use and nutrient acquisition applying phylogenetic comparative analyses in lichen epiphytic communities on beech across Europe. These poikilohydric organisms offer a valuable model owing to their inherent limitations to buffer contrasting environmental conditions. Photobiont type and growth form captured differences in certain physiological traits whose variation was largely determined by evolutionary processes (i.e. phylogenetic history), although the intraspecific component was non-negligible. Seasonal temperature fluctuations also had an impact on trait variation, while nitrogen content depended on photobiont type rather than nitrogen deposition. The inconsistency of trait covariation among and within species prevented establishing major resource use strategies in lichens. However, we did identify a general pattern related to the water-use strategy. Thus, to robustly unveil lichen responses under different climatic scenarios, it is necessary to incorporate both among and within-species trait variation and covariation.


Subject(s)
Lichens , Phenotype , Biodiversity , Climate Change , Europe , Nitrogen , Photosynthesis , Phylogeny
5.
Equine Vet J ; 50(4): 525-531, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29239016

ABSTRACT

BACKGROUND: Standard treatment of foals with severe abscessing lung infection caused by Rhodococcus equi using rifampicin and a macrolide antibiotic can be compromised by extensive inhibition and/or induction of drug metabolising enzymes (e.g. CYP3A4) and transport proteins (e.g. P-glycoprotein), as has been shown for rifampicin and clarithromycin. The combination of rifampicin with the new, poorly metabolised gamithromycin, a long-acting analogue of azithromycin and tulathromycin with lower pharmacokinetic interaction potential, might be a suitable alternative. OBJECTIVES: To evaluate the pharmacokinetic interactions and pulmonary distribution of rifampicin and gamithromycin in healthy foals, and to investigate the cellular uptake of gamithromycin in vitro. STUDY DESIGN: Controlled, four-period, consecutive, single-dose and multiple-dose study. METHODS: Pharmacokinetics and lung distribution of rifampicin (10 mg/kg) and gamithromycin (6 mg/kg) were measured in nine healthy foals using LC-MS/MS. Enzyme induction was confirmed using the 4ß-OH-cholesterol/cholesterol ratio. Affinity of gamithromycin to drug transport proteins was evaluated in vitro using equine hepatocytes and MDCKII-cells stably transfected with human OATP1B1, OATP1B3 and OATP2B1. RESULTS: Rifampicin significantly (P<0.05) increased the plasma exposure of gamithromycin (16.2 ± 4.77 vs. 8.57 ± 3.10 µg × h/mL) by decreasing the total body clearance. Otherwise, gamithromycin significantly lowered plasma exposure of single- and multiple-dose rifampicin (83.8 ± 35.3 and 112 ± 43.1 vs. 164 ± 96.7 µg × h/mL) without a change in metabolic ratio and half-life. Gamithromycin was identified as an inhibitor of human OATP1B1, OATP1B3 and OATP2B1 and as a substrate of OATP2B1. In addition, it was extracted by equine hepatocytes via a mechanism which could be inhibited by rifampicin. MAIN LIMITATIONS: Influence of gamithromycin on pulmonary distribution of rifampicin was not evaluated. CONCLUSION: The plasma exposure of gamithromycin is significantly increased by co-administration of rifampicin which is most likely caused by inhibition of hepatic elimination.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Horses/blood , Macrolides/pharmacokinetics , Rifampin/pharmacokinetics , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/blood , Area Under Curve , Biomarkers , Dogs , Drug Administration Schedule , Drug Interactions , Female , Half-Life , Macrolides/administration & dosage , Macrolides/blood , Madin Darby Canine Kidney Cells , Male , Rifampin/administration & dosage , Rifampin/blood
6.
Nat Commun ; 8(1): 2154, 2017 12 18.
Article in English | MEDLINE | ID: mdl-29255275

ABSTRACT

Perception relies on the integration of sensory information and prior expectations. Here we show that selective neurodegeneration of human frontal speech regions results in delayed reconciliation of predictions in temporal cortex. These temporal regions were not atrophic, displayed normal evoked magnetic and electrical power, and preserved neural sensitivity to manipulations of sensory detail. Frontal neurodegeneration does not prevent the perceptual effects of contextual information; instead, prior expectations are applied inflexibly. The precision of predictions correlates with beta power, in line with theoretical models of the neural instantiation of predictive coding. Fronto-temporal interactions are enhanced while participants reconcile prior predictions with degraded sensory signals. Excessively precise predictions can explain several challenging phenomena in frontal aphasias, including agrammatism and subjective difficulties with speech perception. This work demonstrates that higher-level frontal mechanisms for cognitive and behavioural flexibility make a causal functional contribution to the hierarchical generative models underlying speech perception.


Subject(s)
Frontal Lobe/physiopathology , Primary Progressive Nonfluent Aphasia/physiopathology , Speech Perception/physiology , Temporal Lobe/physiopathology , Acoustic Stimulation , Aged , Brain Mapping , Electroencephalography , Female , Humans , Magnetoencephalography , Male , Nerve Net/physiopathology , Speech/physiology
7.
J Vet Pharmacol Ther ; 40(4): 406-410, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28317153

ABSTRACT

The long-acting azalide antibiotic gamithromycin is marketed for intramuscular treatment of bovine and swine infections. Off-label use in foals leads to severe local lesions likely caused by hyperosmolality of the injected solution. We provide evidence from a pharmacokinetic study in 10 warm-blooded healthy foals for intravenous bolus injection of gamithromycin diluted in distilled water to be a safe and well tolerated alternative. By intravenous dosing, markedly higher plasma exposure and better penetration into bronchoalveolar lavage cells but lower distribution into epithelial lining fluid are achieved as after intramuscular or subcutaneous administration. Intravenously injected gamithromycin was tolerated without any adverse drug reactions. The protocols for treatment of equine pulmonary infections caused by Rhodococcus equi should be revised accordingly.


Subject(s)
Actinomycetales Infections/veterinary , Horse Diseases/drug therapy , Horses/metabolism , Infusions, Intravenous/veterinary , Macrolides/pharmacokinetics , Rhodococcus equi , Actinomycetales Infections/drug therapy , Animals , Cattle , Lung/metabolism , Macrolides/administration & dosage
8.
Equine Vet J ; 49(5): 618-623, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28063154

ABSTRACT

BACKGROUND: The treatment of equine lung infections by Rhodococcus equi with rifampicin is empirically based because pharmacokinetic/pharmacodynamic (PK/PD) indices and pivotal clinical outcome data are not available. OBJECTIVES: To evaluate the pharmacokinetics and pulmonary distribution of rifampicin into epithelial lining fluid (ELF) and bronchoalveolar lavage cells (BALC) to predict antimicrobial activity in the lung using PK/PD indices. STUDY DESIGN: Controlled, randomised, two-period, crossover, repeated-dose study with an initial arm to measure disposition after i.v. administration of rifampicin. METHODS: Pharmacokinetics and lung distribution were evaluated in six healthy foals treated with 10 mg/kg bwt rifampicin i.v. (initial arm) and with repeated oral doses of rifampicin at 10 mg/kg bwt and 20 mg/kg bwt once per day for 10 days (crossover arms). ELF and BALC were sampled by bronchoalveolar lavage 24 h after the last oral dosing. Rifampicin and 25-O-desacetyl rifampicin were quantified using liquid chromatography tandem-mass spectrometry. Enzyme induction by rifampicin was confirmed by evaluation of plasma 4ß-OH-cholesterol:cholesterol ratios. RESULTS: The distribution volume of rifampicin administered i.v. was ~0.85 L/kg. Terminal elimination half-life was ~11 h. Orally given rifampicin was slowly absorbed (Tmax , range: 2.5-8.0 h) and eliminated with apparent half-lives of ~6-8 h. Trough concentrations in ELF and BALC were 1.01 ± 0.20 µg/mL and 1.25 ± 0.29 µg/mL, respectively, after 10 mg/kg bwt rifampicin and 2.71 ± 1.25 µg/mL and 3.09 ± 1.63 µg/mL, respectively, after 20 mg/kg bwt rifampicin. The average ratios of area under the plasma concentration time curve during an administration interval of 24 h (AUC0-24 h ) to minimum inhibitory concentration (MIC) were 145 and 322 h, respectively, for less susceptible strains of R. equi (MIC90 : 0.5 µg/mL). MAIN LIMITATIONS: The clearance and bioavailability of rifampicin after repeated oral dosing were not evaluated. CONCLUSIONS: Treatment with rifampicin at 10 mg/kg bwt administered once per day is suitable to generate drug concentrations above the MIC90 in the ELF and BALC of foals. Future clinical studies with rifampicin in combination with macrolide antibiotics with low drug interaction potential are required to translate the PK/PD indices into protocols for the treatment of R. equi lung infections.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Lung/metabolism , Rifampin/pharmacokinetics , Administration, Oral , Animals , Area Under Curve , Half-Life , Horses , Random Allocation
9.
Ophthalmologe ; 114(3): 262-265, 2017 Mar.
Article in German | MEDLINE | ID: mdl-27364634

ABSTRACT

The POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) is a rare paraneoplastic syndrome based on a clonal plasma cell disorder. Optic disc edema (ODE) is a frequent ocular sign in POEMS syndrome. The cause of the ODE has not yet been entirely clarified. This article reports the case of a 62-year-old male suffering from POEMS syndrome with a bilateral ODE.


Subject(s)
POEMS Syndrome/complications , POEMS Syndrome/diagnosis , Papilledema/diagnosis , Papilledema/etiology , Diagnosis, Differential , Humans , Male , Middle Aged , POEMS Syndrome/therapy , Papilledema/therapy , Rare Diseases/complications , Rare Diseases/diagnosis , Rare Diseases/therapy
11.
Chem Biol Interact ; 220: 200-7, 2014 Sep 05.
Article in English | MEDLINE | ID: mdl-25016077

ABSTRACT

UNLABELLED: The ability to intercalate between DNA strands determines the cytotoxic activity of numerous anticancer drugs. Strikingly, intercalating activity was also reported for some compounds considered to be antimutagenic. The aim of this study was to determine the mode of interaction of DNA with the antimutagenic and DNA repair-stimulating dihydropyridine (DHP) AV-153. DNA and AV-153 interactions were studied by means of UV/VIS spectroscopy, fluorimetry and infrared spectroscopy. Compound AV-153 is a 1,4 dihydropyridine with ethoxycarbonyl groups in positions 3 and 5. Computer modeling of AV-153 and DNA interactions suggested an ability of the compound to dock between DNA strands at a single strand break site in the vicinity of two pyrimidines, which was confirmed in the present study. AV-153 evidently interacted with DNA, as addition of DNA to AV-153 solutions resulted in pronounced hyperchromic and bathochromic effects on the spectra. Base modification in a plasmid by peroxynitrite only minimally changed binding affinity of the compound; however, induction of single-strand breaks using Fenton's reaction greatly increased binding affinity. The affinity did not change when the ionic strength of the solution was changed from 5 to 150 mM NaCl, although it increased somewhat at 300 mM. Neither was it influenced by temperature changes from 25 to 40°C, however, it decreased when the pH of the solution was changed from 7.4 to 4.7. AV-153 competed with EBr for intercalation sites in DNA: 116 mM of the compound caused a two-fold decrease in fluorescence intensity. FT-IR spectral data analyses indicated formation of complexes between DNA and AV-153. The second derivative spectra analyses indicated interaction of AV-153 with guanine, cytosine and thymine bases, but no interaction with adenine was detected. CONCLUSIONS: The antimutagenic substance AV-153 appears to intercalate between the DNA strands at the site of a DNA nick in the vicinity of two pyrimidines.


Subject(s)
Antimutagenic Agents/chemistry , DNA/chemistry , Dihydropyridines/chemistry , Niacin/analogs & derivatives , Animals , Antimutagenic Agents/metabolism , Binding Sites , DNA/metabolism , DNA Repair/drug effects , Dihydropyridines/metabolism , Dihydropyridines/pharmacology , Liver/chemistry , Molecular Structure , Niacin/chemistry , Niacin/metabolism , Niacin/pharmacology , Rats , Spectroscopy, Fourier Transform Infrared
12.
Nervenarzt ; 85(11): 1390-401, 2014 Nov.
Article in German | MEDLINE | ID: mdl-24796707

ABSTRACT

BACKGROUND: Psychosocial stress and psychopathological abnormalities are expected in cancer patients at a frequency of 30-60%. Apart from decreased quality of life psychological factors may cause a negative impact on treatment compliance and on the subsequent biological course of tumor development. MATERIALS AND METHODS: This study examined the association of different psychiatric and psychotherapeutic interventions in liaison-consultation psychiatry with the four psychopathological dimensions derived by factor analysis based on the items of psycho-oncological basic documentation in a group of 141 breast cancer patients without pre-existing mental disorders who were inpatients of a gynecologic cancer centre. In addition information concerning subjective stress experience was collected with the distress thermometer. RESULTS: The plausible fit of the various psychiatric and psychotherapeutic interventions due to the psychopathological dimensions and due to the subjective experience of stress could be demonstrated. Those intervention variables that were associated with an improvement of the psychological state could be described as well. The findings showed that improvement or at least stability of the psychological state was regularly associated with completion of oncological treatment in the relevant index inpatient stay. In addition it was found that the interventions offered could contribute to improved psychological well-being in the subgroup of patients without mental disorders particularly in normal grief reactions. CONCLUSION: Despite methodological limitations this investigation contributes to describing relevant psychopathological syndromes in a group of breast cancer patients without pre-existing mental disorders and the goodness of fit of the different psychiatric and psychotherapeutic interventions. Finally the study confirmed the assumption that stabilization of the mental state may help to avoid treatment interruptions in an oncological inpatient setting and therefore decrease the likelihood that reduced psychological well-being can negatively impact the biological course of tumor development.


Subject(s)
Breast Neoplasms/psychology , Breast Neoplasms/therapy , Mental Disorders/psychology , Mental Disorders/therapy , Psychotherapy/statistics & numerical data , Referral and Consultation/statistics & numerical data , Adult , Aged , Aged, 80 and over , Breast Neoplasms/epidemiology , Female , Germany/epidemiology , Hospitalization/statistics & numerical data , Humans , Mental Disorders/epidemiology , Middle Aged , Prevalence , Quality of Life/psychology , Risk Factors , Treatment Outcome
13.
Internist (Berl) ; 53(4): 467-73, 2012 Apr.
Article in German | MEDLINE | ID: mdl-22274304

ABSTRACT

We report on a 72-year-old female patient with multiple myeloma who presented with alopecia and eye-catching alterations of the skin and the nails. A biopsy of the skin could confirm the diagnosis of immunoglobulin light chain (AL) amyloidosis, which was also suspected of having affected other organs. After six cycles of a cytoreductive therapy with bortezomib and dexamethasone a very good partial response of the multiple myeloma was seen and an improvement in the skin and nail alterations could be achieved.


Subject(s)
Amyloidosis/drug therapy , Amyloidosis/etiology , Multiple Myeloma/complications , Multiple Myeloma/drug therapy , Skin Diseases/drug therapy , Skin Diseases/etiology , Aged , Amyloidosis/diagnosis , Antineoplastic Agents/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Boronic Acids/administration & dosage , Bortezomib , Dexamethasone/administration & dosage , Diagnosis, Differential , Female , Humans , Multiple Myeloma/diagnosis , Pyrazines/administration & dosage , Skin Diseases/diagnosis , Treatment Outcome
14.
Nervenarzt ; 83(1): 49-51, 54-6, 2012 Jan.
Article in German | MEDLINE | ID: mdl-21301800

ABSTRACT

BACKGROUND: The aim of this study was to investigate characteristics of migrants facing imminent deportation in comparison with migrants with guaranteed residence status. The occurrence of psychoreactive disorders in both groups was examined. PATIENTS AND METHODS: In a case-control study 82 migrants recorded as inpatients facing imminent deportation were compared to a control group of 93 migrants with guaranteed residence status. RESULTS: Migrants facing imminent deportation more frequently suffered from psychoreactive disorders, compared to migrants with guaranteed residence status. In this subgroup psychoreactive disorders were associated with reported traumatisations. Imminent deportation within the next month was associated with the diagnosis of psychoreactive disorder as well. CONCLUSION: Psychoreactive disorders appeared more frequently in immigrant inpatients facing imminent deportation. Additionally a history of traumatisations is associated with the progression of psychoreactive disorders.


Subject(s)
Emigration and Immigration/statistics & numerical data , Mental Disorders/epidemiology , Mental Disorders/psychology , Adolescent , Adult , Aged , Child , Female , Germany/epidemiology , Humans , Male , Prevalence , Retrospective Studies , Risk Assessment , Risk Factors , Young Adult
16.
Br J Anaesth ; 105(2): 172-8, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20587537

ABSTRACT

BACKGROUND: The patient state index (PSI) and the bispectral index (BIS) quantify anaesthetic depth based on the EEG using different algorithms. We compared both indices with regard to the prediction of the depth of propofol anaesthesia. METHODS: In 17 patients, propofol was infused until burst suppression occurred and stopped thereafter until BIS recovered to values above 60. This was repeated; afterwards, patients were intubated, for subsequent surgery. Without surgical stimulus, PSI and BIS were measured simultaneously and compared with the estimated effect-site concentrations of propofol. These were derived from simultaneous pharmacokinetic and -dynamic modelling in an individual two-stage and a population-based NONMEM approach. RESULTS: A close sigmoid relationship was observed between the propofol effect-site concentration and both PSI [coefficient of determination rho(2)=0.91 (sd 0.05)] and BIS [rho(2)=0.92 (0.03)], which was significantly steeper for PSI [gamma=2.2 (0.6)] than for BIS [gamma=1.8 (0.4)], and reached significantly lower values for PSI [E(max)=0.3 (1.1)] than for BIS [E(max)=5.3 (6.7)] at maximal propofol concentrations. A significantly smaller k(e0) was obtained for PSI [0.09 (0.03) min(-1)] compared with BIS [0.10 (0.02) min(-1)]. PSI and BIS correlated significantly with each other (rho(2)=0.866) and predicted propofol effect-site concentration with a comparable probability [P(K)=0.87 (0.05) and 0.86 (0.05), respectively]. NONMEM revealed E(0)=89.3 and 92.3, E(max)=1.9 and 8.6, C(e50)=1.38 and 1.92 microg ml(-1), gamma=1.6 and 1.48, and k(e0)=0.103 and 0.131 min(-1) as typical values for PSI and BIS, respectively. CONCLUSIONS: The PSI and the BIS monitors performed equally well in predicting depth of propofol anaesthesia. However, PSI was lower than BIS by approximately 10-15 points at high propofol concentrations.


Subject(s)
Anesthetics, Intravenous/pharmacology , Electroencephalography/drug effects , Monitoring, Intraoperative/methods , Propofol/pharmacology , Signal Processing, Computer-Assisted , Adolescent , Adult , Aged , Anesthetics, Intravenous/administration & dosage , Anesthetics, Intravenous/blood , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Otorhinolaryngologic Surgical Procedures , Propofol/administration & dosage , Propofol/blood , Reproducibility of Results , Young Adult
17.
Stud Mycol ; 64: 1-15S10, 2009.
Article in English | MEDLINE | ID: mdl-20169021

ABSTRACT

We present a comprehensive phylogeny derived from 5 genes, nucSSU, nucLSU rDNA, TEF1, RPB1 and RPB2, for 356 isolates and 41 families (six newly described in this volume) in Dothideomycetes. All currently accepted orders in the class are represented for the first time in addition to numerous previously unplaced lineages. Subclass Pleosporomycetidae is expanded to include the aquatic order Jahnulales. An ancestral reconstruction of basic nutritional modes supports numerous transitions from saprobic life histories to plant associated and lichenised modes and a transition from terrestrial to aquatic habitats are confirmed. Finally, a genomic comparison of 6 dothideomycete genomes with other fungi finds a high level of unique protein associated with the class, supporting its delineation as a separate taxon.

18.
Stud Mycol ; 64: 135-144S4, 2009.
Article in English | MEDLINE | ID: mdl-20169027

ABSTRACT

We present a revised phylogeny of lichenised Dothideomyceta (Arthoniomycetes and Dothideomycetes) based on a combined data set of nuclear large subunit (nuLSU) and mitochondrial small subunit (mtSSU) rDNA data. Dothideomyceta is supported as monophyletic with monophyletic classes Arthoniomycetes and Dothideomycetes; the latter, however, lacking support in this study. The phylogeny of lichenised Arthoniomycetes supports the current division into three families: Chrysothrichaceae (Chrysothrix), Arthoniaceae (Arthonia s. l., Cryptothecia, Herpothallon), and Roccellaceae (Chiodecton, Combea, Dendrographa, Dichosporidium, Enterographa, Erythrodecton, Lecanactis, Opegrapha, Roccella, Roccellographa, Schismatomma, Simonyella). The widespread and common Arthonia caesia is strongly supported as a (non-pigmented) member of Chrysothrix. Monoblastiaceae, Strigulaceae, and Trypetheliaceae are recovered as unrelated, monophyletic clades within Dothideomycetes. Also, the genera Arthopyrenia (Arthopyreniaceae) and Cystocoleus and Racodium (Capnodiales) are confirmed as Dothideomycetes but unrelated to each other. Mycomicrothelia is shown to be unrelated to Arthopyrenia s.str., but is supported as a monophyletic clade sister to Trypetheliaceae, which is supported by hamathecium characters. The generic concept in several groups is in need of revision, as indicated by non-monophyly of genera, such as Arthonia, Astrothelium, Cryptothecia, Cryptothelium, Enterographa, Opegrapha, and Trypethelium in our analyses.

19.
Stud Mycol ; 64: 123-133S7, 2009.
Article in English | MEDLINE | ID: mdl-20169026

ABSTRACT

The class Dothideomycetes (along with Eurotiomycetes) includes numerous rock-inhabiting fungi (RIF), a group of ascomycetes that tolerates surprisingly well harsh conditions prevailing on rock surfaces. Despite their convergent morphology and physiology, RIF are phylogenetically highly diverse in Dothideomycetes. However, the positions of main groups of RIF in this class remain unclear due to the lack of a strong phylogenetic framework. Moreover, connections between rock-dwelling habit and other lifestyles found in Dothideomycetes such as plant pathogens, saprobes and lichen-forming fungi are still unexplored. Based on multigene phylogenetic analyses, we report that RIF belong to Capnodiales (particularly to the family Teratosphaeriaceae s.l.), Dothideales, Pleosporales, and Myriangiales, as well as some uncharacterised groups with affinities to Dothideomycetes. Moreover, one lineage consisting exclusively of RIF proved to be closely related to Arthoniomycetes, the sister class of Dothideomycetes. The broad phylogenetic amplitude of RIF in Dothideomycetes suggests that total species richness in this class remains underestimated. Composition of some RIF-rich lineages suggests that rock surfaces are reservoirs for plant-associated fungi or saprobes, although other data also agree with rocks as a primary substrate for ancient fungal lineages. According to the current sampling, long distance dispersal seems to be common for RIF. Dothideomycetes lineages comprising lichens also include RIF, suggesting a possible link between rock-dwelling habit and lichenisation.

20.
Stud Mycol ; 61: 83-90, 2008.
Article in English | MEDLINE | ID: mdl-19287530

ABSTRACT

We present a phylogenetic study of black fungi in lichens, primarily focusing on saxicolous samples from seasonally arid habitats in Armenia, but also with examples from other sites. Culturable strains of lichen-associated black fungi were obtained by isolation from surface-washed lichen material. Determination is based on ITS rDNA sequence data and comparison with published sequences from other sources. The genera Capnobotryella, Cladophialophora, Coniosporium, Mycosphaerella, and Rhinocladiella were found in different lichen species, which showed no pathogenic symptoms. A clade of predominantly lichen-associated strains is present only in Rhinocladiella, whereas samples of the remaining genera were grouped more clearly in clades with species from other sources. The ecology of most-closely related strains indicates that Capnobotryella and Coniosporium, and perhaps also Rhinocladiella strains opportunistically colonise lichens. In contrast, high sequence divergence in strains assigned to Mycosphaerella could indicate the presence of several lichen-specific species with unknown range of hosts or habitats, which are distantly related to plant-inhabitants. Similar applies to Cladophialophora strains, where the closest relatives of the strains from lichens are serious human pathogens.

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