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1.
Rev Sci Instrum ; 94(10)2023 Oct 01.
Article in English | MEDLINE | ID: mdl-37787626

ABSTRACT

Time-resolved optical pump-probe experiments enable the study of complex light-matter interactions on ultrafast timescales, provided that they reach sufficient sensitivity. For instance, with pump-induced ultrafast photoacoustics, probing the typically small changes in optical properties requires a high signal-to-noise ratio. Asynchronous optical sampling (ASOPS), using two separate pulsed lasers at slightly different repetition rates, can be effective at removing noise by averaging many rapidly acquired traces. However, the pump-probe delay scan with ASOPS is always as long as the pump pulse interval, which is inefficient if the delay-time range of interest is shorter. Here, we demonstrate two modified ASOPS schemes that optimize measurement efficiency by only scanning the range of interest. The modification based on frequency modulated ASOPS (MASOPS) is most efficient, especially in the presence of low-frequency flicker noise. We provide a proof-of-concept measurement of ultrafast photoacoustics in which we use MASOPS to scan a time delay of 1/20 of the pump pulse interval. The resulting noise floor is 20 times lower compared to conventional ASOPS, allowing for 20 times faster measurements. Furthermore, we show that by taking experimental noise characteristics into account, more traditional pump-probe methods can also be optimized.

2.
Opt Express ; 29(3): 4475-4487, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33771025

ABSTRACT

An experimental study of laser-produced plasmas is performed by irradiating a planar tin target by laser pulses, of 4.8 ns duration, produced from a KTP-based 2-µm-wavelength master oscillator power amplifier. Comparative spectroscopic investigations are performed for plasmas driven by 1-µm- and 2-µm-wavelength pulsed lasers, over a wide range of laser intensities spanning 0.5 - 5 × 1011 W/cm 2. Similar extreme ultraviolet (EUV) spectra in the 5.5-25.5 nm wavelength range and underlying plasma ionicities are obtained when the intensity ratio is kept fixed at I1µm/I2µm = 2.4(7). Crucially, the conversion efficiency (CE) of 2-µm-laser energy into radiation within a 2% bandwidth centered at 13.5 nm relevant for industrial applications is found to be a factor of two larger, at a 60 degree observation angle, than in the case of the denser 1-µm-laser-driven plasma. Our findings regarding the scaling of the optimum laser intensity for efficient EUV generation and CE with drive laser wavelength are extended to other laser wavelengths using available literature data.

3.
J Opt Soc Am A Opt Image Sci Vis ; 37(6): 914-924, 2020 Jun 01.
Article in English | MEDLINE | ID: mdl-32543591

ABSTRACT

Diffractive shearing interferometry (DSI) is a method that has recently been developed to perform lensless imaging using extreme ultraviolet radiation generated by high-harmonic generation. In this paper, we investigate the uniqueness of the DSI solution and the requirements for the support constraint size. We find that there can be multiple solutions to the DSI problem that consist of displaced copies of the actual object. These alternative solutions can be eliminated by enforcing a sufficiently tight support constraint, or by introducing additional synthetic constraints. We furthermore propose a new DSI algorithm inspired by the analogy with coherent diffractive imaging (CDI) algorithms: the original DSI algorithm is in a way analogous to the hybrid input-output algorithm as used in CDI, and we propose a new algorithm that is more analogous to the error reduction algorithm as used in CDI. We find that the newly proposed algorithm is suitable for final refinement of the reconstruction.

4.
Nat Commun ; 11(1): 2334, 2020 May 11.
Article in English | MEDLINE | ID: mdl-32393789

ABSTRACT

Extreme ultraviolet (EUV) lithography is currently entering high-volume manufacturing to enable the continued miniaturization of semiconductor devices. The required EUV light, at 13.5 nm wavelength, is produced in a hot and dense laser-driven tin plasma. The atomic origins of this light are demonstrably poorly understood. Here we calculate detailed tin opacity spectra using the Los Alamos atomic physics suite ATOMIC and validate these calculations with experimental comparisons. Our key finding is that EUV light largely originates from transitions between multiply-excited states, and not from the singly-excited states decaying to the ground state as is the current paradigm. Moreover, we find that transitions between these multiply-excited states also contribute in the same narrow window around 13.5 nm as those originating from singly-excited states, and this striking property holds over a wide range of charge states. We thus reveal the doubly magic behavior of tin and the origins of the EUV light.

5.
Opt Express ; 28(4): 5257-5266, 2020 Feb 17.
Article in English | MEDLINE | ID: mdl-32121750

ABSTRACT

We report on a method that allows microscopic image reconstruction from extreme-ultraviolet diffraction patterns without the need for object support constraints or other prior knowledge about the object structure. This is achieved by introducing additional diversity through rotation of an object in a rotationally asymmetric probe beam, produced by the spatial interference between two phase-coherent high-harmonic beams. With this rotational diffractive shearing interferometry method, we demonstrate robust image reconstruction of microscopic objects at wavelengths around 30 nm, using images recorded at only three to five different object rotations.

6.
Opt Lett ; 44(15): 3625-3628, 2019 Aug 01.
Article in English | MEDLINE | ID: mdl-31368928

ABSTRACT

We demonstrate direct dispersion measurements of various thin films at extreme ultraviolet (EUV) wavelengths, using a table-top laser-driven high-harmonic generation (HHG) source. In this method, spatially separated identical EUV pulses are generated through HHG with a pair of phase-locked infrared pulses. The EUV pulses are re-imaged to a sample plane using a single toroidal mirror, such that one pulse illuminates the target thin film, while the other pulse passes through a reference aperture. By comparing the EUV interference with and without a sample, we are able to extract the dispersion properties of the sample, integrated over the full film thickness. We have measured thin films of titanium, nickel, copper, and silicon nitride, demonstrating that this technique can be applied to a wide range of materials, only requiring a film thin, enough for sufficient EUV transmission.

7.
J Dairy Sci ; 102(8): 7522-7535, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31155243

ABSTRACT

The liver becomes resistant to growth hormone before parturition in dairy cows (uncoupling of the somatotropic axis). However, the mechanism of growth hormone insensitivity has not been fully described. The aim of the present study was to improve a previous model of adult bovine hepatocytes in a sandwich culture system to ensure growth hormone receptor (GHR) expression. First, we modified the protocol for hepatocyte retrieval and tested the effect of short (18 min) and long (up to 30 min) warm ischemia on hepatocyte viability. Second, we used medium additives that affect GHR expression in vivo-insulin (INS), dexamethasone (DEX), both (INS+DEX), or no hormone additives (CTRL)-to ensure the functionality of hepatocytes, as measured by lactate dehydrogenase activity and urea concentration in the medium. We also used reverse transcriptase PCR of hepatocytes to evaluate expression of albumin (ALB), hepatocyte nuclear factor 4α (HNF4A), nuclear factor-κ-B-inhibitor α (NFKBIA), cytosolic phosphoenolpyruvate carboxykinase (PCK1), and vimentin (VIM) mRNA. Moreover, we analyzed the expression of GHRtot (GHR), GHR1A, insulin-like growth factor-1 (IGF1), and IGF binding protein-2 (IGFBP2) in response to exposure to media with the different compositions. Modification of the protocol (changes in rinsing and perfusion times, buffer composition, and the volume and standardization of collagenase) led to increased cell counts and cell viability. Short warm ischemia with the modified protocol significantly increased cell count (4.7 × 107 ± 1.9 × 107 vs. 3.5 × 106 ± 1.5 × 106 vital cells/g of liver) and viability (79.1 ± 8.4 vs. 37.1 ± 8.9%). Therefore, we gathered hepatocytes from the liver after short warm ischemia with the modified protocol. For these hepatocytes, lactate dehydrogenase activity was lower in media with INS and with DEX than in media with INS+DEX or CTRL; urea concentrations were highest at d 4 for INS+DEX. As well, HNF4A and ALB were more highly expressed in hepatocytes cultured with INS and INS+DEX than in those cultured with DEX or CTRL, and the substitution of DEX suppressed VIM and NFKBIA expression but increased PCK1 expression. The expression of GHR, GHR1A, and IGF1 was suppressed by dexamethasone (DEX and INS+DEX), whereas INS distinctly increased GHR, GHR1A, and IGF1 mRNA expression. Hepatocytes in a sandwich culture showed influenceable GHR expression; this study provides a model that can be used in studies examining factors that influence the expression and signal transduction of GHR in dairy cows.


Subject(s)
Cattle/genetics , Hepatocytes/metabolism , Liver/cytology , Receptors, Somatotropin/genetics , Animals , Cattle/metabolism , Cells, Cultured , Dexamethasone/pharmacology , Female , Growth Hormone/pharmacology , Hepatocytes/cytology , Hepatocytes/drug effects , Insulin/metabolism , Insulin-Like Growth Factor I/analogs & derivatives , Insulin-Like Growth Factor I/genetics , Insulin-Like Growth Factor I/metabolism , Liver/drug effects , Liver/metabolism , Pregnancy , Primary Cell Culture , Receptors, Somatotropin/metabolism , Vimentin/genetics , Vimentin/metabolism
8.
Opt Express ; 26(18): 23380-23396, 2018 Sep 03.
Article in English | MEDLINE | ID: mdl-30184840

ABSTRACT

We report on femtosecond optical pump-probe measurements of ultrafast electron dynamics to detect the presence of gratings buried underneath optically opaque gold layers. Electron energy diffusion and cooling are found to be strongly affected by the presence and type of metal buried below the gold layer. As a result, the spatially periodic buried grating is encoded on the electron temperature near the top surface, leading to a spatially periodic modulation of the optical properties near the gold surface from which a delayed probe pulse can be diffracted. Our measurements show that these effects may be useful for optical detection and alignment applications in semiconductor device manufacturing.

9.
Opt Express ; 26(10): 12479-12489, 2018 May 14.
Article in English | MEDLINE | ID: mdl-29801285

ABSTRACT

We demonstrate a novel imaging approach and associated reconstruction algorithm for far-field coherent diffractive imaging, based on the measurement of a pair of laterally sheared diffraction patterns. The differential phase profile retrieved from such a measurement leads to improved reconstruction accuracy, increased robustness against noise, and faster convergence compared to traditional coherent diffractive imaging methods. We measure laterally sheared diffraction patterns using Fourier-transform spectroscopy with two phase-locked pulse pairs from a high-harmonic source. Using this approach, we demonstrate spectrally resolved imaging at extreme ultraviolet wavelengths between 28 and 35 nm.

10.
Hernia ; 22(4): 627-635, 2018 08.
Article in English | MEDLINE | ID: mdl-29721629

ABSTRACT

PURPOSE: Transversus abdominis plane (TAP) blockade with long-acting anesthetic can be used during open ventral hernia repair (VHR) with posterior component separation (PCS). TAP block can be performed under ultrasound guidance (US-TAP) or under direct visualization (DV-TAP). We hypothesized that US-TAP and DV-TAP provide equivalent postoperative analgesia following open VHR. METHODS: A retrospective review of patients undergoing open VHR with PCS who received TAP blocks with 266 mg of liposomal bupivacaine was performed. Data included demographics, comorbidities, length of stay (LOS), average postoperative day (POD) pain scores, and narcotic requirements (normalized to mg oral morphine). Statistical analysis utilized Student's t test and Fisher's exact test. RESULTS: Thirty-nine patients were identified (22 DV-TAP). There were no differences between the groups with respect to demographics, comorbidities, pre-operative pain medication usage (narcotic and non-narcotic) or herniorrhaphy-related data. The average POD0 pain score was lower for the DV-TAP group (2.35 vs 4.18; p = 0.019). Narcotic requirements on POD0 (48.0 vs 103.76 mg; p = 0.02), POD1 (128.45 vs 273.82 mg; p = 0.03), POD4 (54.29 vs 160.75 mg; p = 0.042), and during the complete hospitalization (408.52 vs 860.92 mg; p = 0.013) were lower in the DV-TAP group. There were no differences between initiation of diet or LOS. During the study, no changes were made to the VHR enhanced recovery pathway. CONCLUSIONS: DV-TAP blocks appear to provide superior analgesia in the immediate postoperative period. To achieve similar post-operative pain scores, patients in the US-TAP group required significantly more narcotic administration during their hospitalization. The study highlights DV-TAP as a valuable addition to VHR recovery pathways.


Subject(s)
Abdominal Muscles/innervation , Abdominal Muscles/surgery , Hernia, Ventral/surgery , Herniorrhaphy/methods , Nerve Block/methods , Pain, Postoperative/drug therapy , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Female , Humans , Liposomes/administration & dosage , Male , Middle Aged , Narcotics/administration & dosage , Pain Management , Retrospective Studies , Ultrasonography, Interventional
11.
Opt Express ; 26(6): 6860-6871, 2018 Mar 19.
Article in English | MEDLINE | ID: mdl-29609373

ABSTRACT

Wavefront sensors are an important tool to characterize coherent beams of extreme ultraviolet radiation. However, conventional Hartmann-type sensors do not allow for independent wavefront characterization of different spectral components that may be present in a beam, which limits their applicability for intrinsically broadband high-harmonic generation (HHG) sources. Here we introduce a wavefront sensor that measures the wavefronts of all the harmonics in a HHG beam in a single camera exposure. By replacing the mask apertures with transmission gratings at different orientations, we simultaneously detect harmonic wavefronts and spectra, and obtain sensitivity to spatiotemporal structure such as pulse front tilt as well. We demonstrate the capabilities of the sensor through a parallel measurement of the wavefronts of 9 harmonics in a wavelength range between 25 and 49 nm, with up to λ/32 precision.

12.
Opt Lett ; 42(14): 2758-2761, 2017 Jul 15.
Article in English | MEDLINE | ID: mdl-28708162

ABSTRACT

We report on a laser system capable of generating high-energy (>270 mJ) temporally shaped pulses at 1064 nm with 0.43-ns shaping resolution. The pulses are generated by modulation of a continuous-wave seed laser and subsequent amplification by a dual-stage grazing-incidence Nd:YVO4 "bounce" amplifier and a Nd:YAG power amplifier (all quasi-continuous diode-pumped). The system produces pulses with a high-quality top-hat spatial beam profile with up to 0.6 GW of peak power and 44 W of average power, a power stability of 0.22% rms, and fully programmable complex temporal shapes.

13.
Vet J ; 216: 157-63, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27687944

ABSTRACT

Superficial digital flexor (SDF) tendonitis is a common injury in Thoroughbred racehorses. Injuries require prolonged rehabilitation, with unpredictable outcomes and a high incidence of re-injury. This observational case-control study aimed to compare race outcomes after commonly advocated treatments for tendon healing. Clinical and racing records were evaluated for 127 National Hunt racehorses treated between 2007 and 2011 for an SDF tendon injury. Two age- and sex-matched control horses were selected for each case horse to analyse the effect on post-injury racing outcomes of pre-injury data, lesion severity and treatment group [controlled exercise alone, bar firing, intralesional platelet-rich plasma (PRP), tendon splitting, tendon splitting combined with bar firing]. Control horses raced more often than case horses, with higher maximum racing post rating (RPRmax) and longer racing distances. Pre-injury racing performance was not associated with treatment group. Rate of return to racing was not associated with lesion severity or treatment group. Number of races, total distance raced post-injury and RPRmax were not associated with lesion severity or treatment group. Controlled exercise alone offered similar post-injury racing outcomes in National Hunt racehorses with SDF tendonitis to the other treatment options examined. Bar firing, either alone or in conjunction with tendon splitting, provided no additional benefit in rate of return to racing and race performance.


Subject(s)
Horse Diseases/therapy , Physical Conditioning, Animal , Tendinopathy/veterinary , Animals , Case-Control Studies , Female , Horse Diseases/etiology , Horses , Hot Temperature , Ireland , Male , Platelet-Rich Plasma , Sports , Tendinopathy/etiology , Tendinopathy/therapy
14.
Equine Vet J ; 48(4): 509-16, 2016 Jul.
Article in English | MEDLINE | ID: mdl-25919410

ABSTRACT

REASONS FOR PERFORMING STUDY: The diagnosis of equine back disorders is challenging. Objectively determining movement of the vertebral column may therefore be of value in a clinical setting. OBJECTIVES: To establish whether surface-mounted inertial measurement units (IMUs) can be used to establish normal values for range of motion (ROM) of the vertebral column in a uniform population of horses trotting under different conditions. STUDY DESIGN: Vertebral ROM was established in Franches-Montagnes stallions and a general population of horses and the variability in measurements compared between the two groups. Repeatability and the influence of specific exercise condition (on ROM) were assessed. Finally, attempts were made to explain the findings of the study through the evaluation of factors that might influence ROM. METHODS: Dorsoventral (DV) and mediolateral (ML) vertebral ROM was measured at a trot under different exercise conditions in 27 Franches-Montagnes stallions and six general population horses using IMUs distributed over the vertebral column. RESULTS: Variability in the ROM measurements was significantly higher for general population horses than for Franches-Montagnes stallions (both DV and ML ROM). Repeatability was strong to very strong for DV measurements and moderate for ML measurements. Trotting under saddle significantly reduced the ROM, with sitting trot resulting in a significantly lower ROM than rising trot. Age is unlikely to explain the low variability in vertebral ROM recorded in the Franches-Montagnes horses, while this may be associated with conformational factors. CONCLUSIONS: It was possible to establish a normal vertebral ROM for a group of Franches-Montagnes stallions. While within-breed variation was low in this population, further studies are necessary to determine variation in vertebral ROM for other breeds and to assess their utility for diagnosis of equine back disorders.


Subject(s)
Horses/physiology , Range of Motion, Articular/physiology , Spine/physiology , Aging , Animals
15.
Phys Chem Chem Phys ; 17(30): 19895-900, 2015 Aug 14.
Article in English | MEDLINE | ID: mdl-26165172

ABSTRACT

A large number of scientific contributions is dedicated to syntheses, characterization and applications of metal nanoparticles. In contrast, only few studies on their formation mechanisms have been reported. In general, concepts to describe particle growth processes are rare. Commonly used models are not able to explain the influences of reaction parameters on the growth and the final particle size. In this contribution it is shown how the growth of colloidal metal nanoparticles can be illustrated using an approach based on colloidal stability. In the first part, investigations of various syntheses of colloidal nanoparticles (including Rh, Pd, Pt, Cu, Ag and Au) show that growth due to aggregation and coalescence is the governing principle of nanoparticle formation if the monomer supply is faster than the actual growth. In the second part of this contribution, the influences of various parameters on the growth of Au nanoparticles are studied and it is demonstrated how the colloidal stability approach can illustrate the impact of synthesis parameters on the final particle size.

16.
Clin Pharmacol Ther ; 97(4): 411-8, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25669933

ABSTRACT

Determining the efficacy contribution of an investigational drug as part of a novel combination regimen that also includes a previously untested dose of a standard treatment is challenging, particularly when "placebo control" data (combination regimen minus the investigational drug) is not available for comparison. This situation was encountered in a phase III trial that tested the combination of the investigational drug everolimus with a dose of tacrolimus lower than used in standard liver transplantation therapy. The challenge was addressed by predicting the efficacy of the placebo control from the study data using a pharmacometric-based exposure-response analysis, selected to account for features specific to the transplant setting: systematic change in drug exposure over time and sparse pharmacokinetic sampling. The efficacy contribution of everolimus was then demonstrated by comparing this prediction to the efficacy of the combination regimen. This pharmacometrics-based approach may contribute to characterization of therapeutic agents in real-world settings.


Subject(s)
Graft Rejection/prevention & control , Immunosuppressive Agents/pharmacokinetics , Immunosuppressive Agents/therapeutic use , Liver Transplantation/methods , Sirolimus/analogs & derivatives , Tacrolimus/pharmacokinetics , Tacrolimus/therapeutic use , Adult , Aged , Drug Therapy, Combination , Everolimus , Female , Humans , Infant, Newborn , Male , Middle Aged , Sirolimus/pharmacokinetics , Sirolimus/therapeutic use
17.
Transpl Infect Dis ; 15(2): 150-62, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23013440

ABSTRACT

BACKGROUND: Cytomegalovirus (CMV) causes several complications following cardiac transplantation including cardiac allograft vasculopathy. Previous studies suggested that immunosuppressive treatment based on everolimus might reduce CMV infection. Aiming to better characterize the action of everolimus on CMV and its interplay with patient/recipient serology and anti-CMV prophylaxis, we analyzed data from 3 large randomized studies comparing various everolimus regimens with azathioprine (AZA)- and mycophenolate mofetil (MMF)-based regimens. METHODS: CMV data were analyzed from 1009 patients in 3 trials of de novo cardiac transplant recipients who were randomized to everolimus 1.5 mg/day, everolimus 3 mg/day, or AZA 1-3 mg/kg/day, plus standard-dose (SD) cyclosporine (CsA; study B253, n = 634); everolimus 1.5 mg/day plus SD- or reduced-dose (RD)-CsA (study A2403, n = 199); and everolimus 1.5 mg/day plus RD-CsA or MMF plus SD-CsA (study A2411, n = 176). RESULTS: In study B253, patients allocated to everolimus experienced almost a 70% reduction in odds of experiencing CMV infection compared with AZA (P < 0.001). In study A2403, CMV infection was low in both everolimus arms, irrespective of CsA dosing, and in study A2411, patients allocated to everolimus experienced an 80% reduction in odds of experiencing CMV infection, compared with MMF (P < 0.001). CMV syndrome/disease was rare and less frequent in everolimus-treated patients. Subgroup analyses showed that the benefit everolimus provides, in terms of CMV events, is retained in CMV-naïve recipients and is independent of anti-CMV prophylaxis or preemptive approaches. CONCLUSIONS: Everolimus is associated with a lower incidence of CMV infection compared with AZA and MMF, which combined with its immunosuppressive efficacy and antiproliferative effects may positively impact long-term outcomes.


Subject(s)
Cytomegalovirus Infections/prevention & control , Heart Transplantation , Immunosuppressive Agents/therapeutic use , Sirolimus/analogs & derivatives , Adolescent , Adult , Aged , Azathioprine/therapeutic use , Cyclosporine/therapeutic use , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/epidemiology , Drug Therapy, Combination , Everolimus , Female , Humans , Incidence , Male , Middle Aged , Postoperative Complications/prevention & control , Sirolimus/therapeutic use , Statistics as Topic
18.
Am J Transplant ; 12(11): 3008-20, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22882750

ABSTRACT

In a prospective, multicenter, open-label study, de novo liver transplant patients were randomized at day 30±5 to (i) everolimus initiation with tacrolimus elimination (TAC Elimination) (ii) everolimus initiation with reduced-exposure tacrolimus (EVR+Reduced TAC) or (iii) standard-exposure tacrolimus (TAC Control). Randomization to TAC Elimination was terminated prematurely due to a higher rate of treated biopsy-proven acute rejection (tBPAR). EVR+Reduced TAC was noninferior to TAC Control for the primary efficacy endpoint (tBPAR, graft loss or death at 12 months posttransplantation): 6.7% versus 9.7% (-3.0%; 95% CI -8.7, 2.6%; p<0.001 for noninferiority [12% margin]). tBPAR occurred in 2.9% of EVR+Reduced TAC patients versus 7.0% of TAC Controls (p = 0.035). The change in adjusted estimated GFR from randomization to month 12 was superior with EVR+Reduced TAC versus TAC Control (difference 8.50 mL/min/1.73 m(2) , 97.5% CI 3.74, 13.27 mL/min/1.73 m(2) , p<0.001 for superiority). Drug discontinuation for adverse events occurred in 25.7% of EVR+Reduced TAC and 14.1% of TAC Controls (relative risk 1.82, 95% CI 1.25, 2.66). Relative risk of serious infections between the EVR+Reduced TAC group versus TAC Controls was 1.76 (95% CI 1.03, 3.00). Everolimus facilitates early tacrolimus minimization with comparable efficacy and superior renal function, compared to a standard tacrolimus exposure regimen 12 months after liver transplantation.


Subject(s)
Immunosuppressive Agents/administration & dosage , Liver Transplantation/immunology , Sirolimus/analogs & derivatives , Tacrolimus/administration & dosage , Adolescent , Adult , Aged , Confidence Intervals , Cross-Over Studies , Dose-Response Relationship, Drug , Drug Administration Schedule , Everolimus , Follow-Up Studies , Glomerular Filtration Rate/drug effects , Graft Rejection , Graft Survival , Humans , Immunosuppressive Agents/adverse effects , Kaplan-Meier Estimate , Kidney/drug effects , Kidney Function Tests , Liver Failure/surgery , Liver Transplantation/methods , Liver Transplantation/mortality , Male , Middle Aged , Prospective Studies , Risk Assessment , Sirolimus/administration & dosage , Survival Analysis , Time Factors , Transplantation Immunology/physiology , Treatment Outcome , Young Adult
19.
Parkinsonism Relat Disord ; 18(4): 370-6, 2012 May.
Article in English | MEDLINE | ID: mdl-22316635

ABSTRACT

AIMS: To determine the efficacy and safety of pardoprunox in levodopa-treated patients with Parkinson's disease (PD) experiencing motor fluctuations. METHODS: Patients were randomized to pardoprunox (up to 42 mg/day, n = 150) or placebo (n = 144). Pardoprunox was titrated to an optimal dose over 7 weeks, followed by a 12-week stable dose period. The primary efficacy variable was the change from baseline to study endpoint in total daily OFF time, based on patient diaries. Secondary analyses included the change in ON time without troublesome dyskinesias, UPDRS-ADL + Motor ON, UPDRS-ADL OFF and PDQ-39. Subgroup analyses explored the impact of pardoprunox on dyskinesias (UPDRS items 32 + 33), depression (Hospital Anxiety Depression Scale) and pain (Visual Analogue Scale). RESULTS: Pardoprunox significantly reduced OFF time versus placebo (-1.62 h/day versus -0.92 h/day, respectively, p = 0.0215). Compared to placebo, pardoprunox improved ON time without troublesome dyskinesias (p = 0.0386), UPDRS-ADL + Motor ON (p = 0.0003), and UPDRS-ADL OFF (p < 0.0001), while no significant difference was observed on PDQ-39. A high drop-out rate due to adverse events (AEs) (pardoprunox, 37%; placebo, 12%) suggested that the selected dose range may have been too high, and/or titration was too rapid. CONCLUSIONS: Pardoprunox decreased OFF time and increased ON time without troublesome dyskinesias in levodopa-treated PD patients. The high drop-out rate at the selected doses justifies the investigation of lower doses. The impact of pardoprunox on dyskinesias and non-motor symptoms deserves further investigation.


Subject(s)
Benzoxazoles/therapeutic use , Dyskinesia, Drug-Induced/prevention & control , Parkinson Disease/drug therapy , Parkinson Disease/physiopathology , Piperazines/therapeutic use , Adult , Aged , Antiparkinson Agents/adverse effects , Double-Blind Method , Drug Administration Schedule , Dyskinesia, Drug-Induced/etiology , Female , Follow-Up Studies , Humans , Levodopa/adverse effects , Male , Middle Aged , Pain Measurement , Severity of Illness Index , Time Factors , Treatment Outcome
20.
Am J Transplant ; 11(7): 1444-55, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21564523

ABSTRACT

Sotrastaurin, a selective protein-kinase-C inhibitor, blocks early T-cell activation through a calcineurin-independent mechanism. In this study, de novo renal transplant recipients with immediate graft function were randomized 1:2 to tacrolimus (control, n = 44) or sotrastaurin (300 mg b.i.d.; n = 81). All patients received basiliximab, mycophenolic acid (MPA) and steroids. The primary endpoint was the composite of treated biopsy-proven acute rejection (BPAR), graft loss, death or lost to follow-up at month 3. The main safety assessment was estimated glomerular filtration rate (eGFR); modification of diet in renal disease (MDRD) at month 3. Composite efficacy failure at month 3 was higher for the sotrastaurin versus control regimen (25.7% vs. 4.5%, p = 0.001), driven by higher BPAR rates (23.6% vs. 4.5%, p = 0.003), which led to early study termination. Median (± standard deviation [SD]) eGFR was higher for sotrastaurin versus control at all timepoints from day 7 (month 3: 59.0 ± 22.3 vs. 49.5 ± 17.7 mL/min/1.73 m(2) , p = 0.006). The most common adverse events were gastrointestinal disorders (control: 63.6%; sotrastaurin: 88.9%) which led to study-medication discontinuation in two sotrastaurin patients. This study demonstrated a lower degree of efficacy but better renal function with the calcineurin-inhibitor-free regimen of sotrastaurin+MPA versus the tacrolimus-based control. Ongoing studies are evaluating alternative sotrastaurin regimens.


Subject(s)
Kidney Transplantation/physiology , Protein Kinase C/antagonists & inhibitors , Pyrroles/therapeutic use , Quinazolines/therapeutic use , Adult , Calcineurin Inhibitors , Female , Humans , Male , Mycophenolic Acid/therapeutic use , Tacrolimus/therapeutic use
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