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1.
Phys Rev E ; 109(2-2): 025201, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38491621

RESUMO

Proton bunches with maximum energies between 12 and 22 MeV were emitted from submicrometer-thin plastic foils upon irradiation by laser pulses with peak intensity of 4×10^{20}W/cm^{2}. The images of the protons by a magnetic quadrupole doublet on a screen remained consistently larger by a factor of 10 compared to expectations drawn from the ultralow transverse emittance values reported for thick foil targets. Analytic estimates and particle-in-cell simulations attribute this drastically increased emittance to formerly excluded Coulomb collisions between charged particles. The presence of carbon ions and significant transparency likely play a decisive role. This observation is highly relevant because such thin, partially transparent foils are considered ideal for optimizing maximum proton energies.

2.
Phys Med Biol ; 68(10)2023 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-37011627

RESUMO

Objectives.The energy deposited in a medium by a pulsed proton beam results in the emission of thermoacoustic waves, also called ionoacoustics (IA). The proton beam stopping position (Bragg peak) can be retrieved from a time-of-flight analysis (ToF) of IA signals acquired at different sensor locations (multilateration). This work aimed to assess the robustness of multilateration methods in proton beams at pre-clinical energies for the development of a small animal irradiator.Approach.The accuracy of multilateration performed using different algorithms; namely, time of arrival and time difference of arrival, was investigatedin-silicofor ideal point sources in the presence of realistic uncertainties on the ToF estimation and ionoacoustic signals generated by a 20 MeV pulsed proton beam stopped in a homogeneous water phantom. The localisation accuracy was further investigated experimentally based on two different measurements with pulsed monoenergetic proton beams at energies of 20 and 22 MeV.Main results.It was found that the localisation accuracy mainly depends on the position of the acoustic detectors relative to the proton beam due to spatial variation of the error on the ToF estimation. By optimally positioning the sensors to reduce the ToF error, the Bragg peak could be locatedin-silicowith an accuracy better than 90µm (2% error). Localisation errors going up to 1 mm were observed experimentally due to inaccurate knowledge of the sensor positions and noisy ionoacoustic signals.Significance.This study gives a first overview of the implementation of different multilateration methods for ionoacoustics-based Bragg peak localisation in two- and three-dimensions at pre-clinical energies. Different sources of uncertainty were investigated, and their impact on the localisation accuracy was quantifiedin-silicoand experimentally.


Assuntos
Terapia com Prótons , Radioatividade , Prótons , Terapia com Prótons/métodos , Água , Acústica , Método de Monte Carlo , Dosagem Radioterapêutica
3.
Z Med Phys ; 32(1): 109-119, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32532553

RESUMO

Laser-accelerated proton bunches with kinetic energies up to several tens of MeV and at repetition rates in the order of Hz are nowadays achievable at several research centres housing high-power laser system. The unique features of such ultra-short bunches are also arousing interest in the field of radiological and biomedical applications. For many of these applications, accurate positioning of the biological target is crucial, raising the need for on-site imaging. One convenient option is proton radiography, which can exploit the polyenergetic spectrum of laser-accelerated proton bunches. We present a Monte Carlo (MC) feasibility study to assess the applicability and potential of laser-driven proton radiography of millimetre to centimetre sized objects. Our radiography setup consists of a thin time-of-flight spectrometer operated in transmission prior to the object and a pixelated silicon detector for imaging. Proton bunches with kinetic energies up to 20MeV and up to 100MeV were investigated. The water equivalent thickness (WET) of the traversed material is calculated from the energy deposition inside an imaging detector, using an online generated calibration curve that is based on a MC generated look-up table and the reconstructed proton energy distribution. With a dose of 43mGy for a 1mm thin object imaged with protons up to 20MeV, the reconstructed WET of defined regions-of-interest was within 1.5% of the ground truth values. The spatial resolution, which strongly depends on the gap between object and imaging detector, was 2.5lpmm-1 for a realistic distance of 5mm. Due to this relatively high imaging dose, our proposed setup for laser-driven proton radiography is currently limited to objects with low radio-sensitivity, but possibilities for further dose reduction are presented and discussed.


Assuntos
Terapia com Prótons , Prótons , Estudos de Viabilidade , Lasers , Método de Monte Carlo , Imagens de Fantasmas , Radiografia
4.
J Radiol Prot ; 40(4)2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32702682

RESUMO

The 'Centre for Advanced Laser Applications' (CALA) is a new research institute for laser-based acceleration of electron beams for brilliant x-ray generation, laser-driven sub-nanosecond bunches of protons and heavy ions for biomedical applications like imaging and tumour therapy as well as for nuclear and high-field physics.The radiation sources emerging from experiments using the up to 2.5 petawatt laser pulses with 25 femtosecond duration will be mixed particle-species of high intensity, high energy and pulsed, thus posing new challenges compared to conventional radiation protection. Such worldwide pioneering laser experiments result in source characteristics that require careful a-priori radiation safety simulations.The FLUKA Monte-Carlo code was used to model the five CALA experimental caves, including the corridors, halls and air spaces surrounding the caves. Beams of electrons (<5 GeV), protons (<200 MeV),12C (<400MeV/u) and197Au (<10MeV/u) ions were simulated using spectra, divergences and bunch-charges based on expectations from recent scientific progress.Simulated dose rates locally can exceed 1.5 kSv h-1inside beam dumps. Vacuum pipes in the cave walls for laser transport and extraction channels for the generated x-rays result in small dose leakage to neighboring areas. Secondary neutrons contribute to most of the prompt dose rate outside caves into which the beam is delivered. This secondary radiation component causes non-negligible dose rates to occur behind walls to which large fluences of secondary particles are directed.By employing adequate beam dumps matched to beam-divergence, magnets, passive shielding and laser pulse repetition limits, average dose rates in- and outside the experimental building stay below design specifications (<0.5µSv h-1) for unclassified areas,<2.5µSv h-1for supervised areas,<7.5µSv h-1maximum local dose rate) and regulatory limits (<1mSv a-1for unclassified areas).


Assuntos
Proteção Radiológica , Lasers , Método de Monte Carlo , Aceleradores de Partículas , Prótons , Proteção Radiológica/métodos , Raios X
5.
Rev Sci Instrum ; 91(6): 063303, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32611048

RESUMO

The development from single shot basic laser plasma interaction research toward experiments in which repetition rated laser-driven ion sources can be applied requires technological improvements. For example, in the case of radio-biological experiments, irradiation duration and reproducible controlled conditions are important for performing studies with a large number of samples. We present important technological advancements of recent years at the ATLAS 300 laser in Garching near Munich since our last radiation biology experiment. Improvements range from target positioning over proton transport and diagnostics to specimen handling. Exemplarily, we show the current capabilities by performing an application oriented experiment employing the zebrafish embryo model as a living vertebrate organism for laser-driven proton irradiation. The size, intensity, and energy of the laser-driven proton bunches resulted in evaluable partial body changes in the small (<1 mm) embryos, confirming the feasibility of the experimental system. The outcomes of this first study show both the appropriateness of the current capabilities and the required improvements of our laser-driven proton source for in vivo biological experiments, in particular the need for accurate, spatially resolved single bunch dosimetry and image guidance.


Assuntos
Aceleração , Embrião não Mamífero/efeitos da radiação , Lasers , Prótons , Radiobiologia/métodos , Peixe-Zebra/embriologia , Animais , Estudos de Viabilidade
6.
Acta Oncol ; 58(10): 1470-1475, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31271091

RESUMO

Background: Precision small animal radiotherapy research is a young emerging field aiming to provide new experimental insights into tumor and normal tissue models in different microenvironments, to unravel complex mechanisms of radiation damage in target and non-target tissues and assess efficacy of novel therapeutic strategies. For photon therapy, modern small animal radiotherapy research platforms have been developed over the last years and are meanwhile commercially available. Conversely, for proton therapy, which holds potential for an even superior outcome than photon therapy, no commercial system exists yet. Material and methods: The project SIRMIO (Small Animal Proton Irradiator for Research in Molecular Image-guided Radiation-Oncology) aims at realizing and demonstrating an innovative portable prototype system for precision image-guided small animal proton irradiation, suitable for installation at existing clinical treatment facilities. The proposed design combines precise dose application with in situ multi-modal anatomical image guidance and in vivo verification of the actual treatment delivery. Results and conclusions: This manuscript describes the status of the different components under development, featuring a dedicated beamline for degradation and focusing of clinical proton beams, along with novel detector systems for in situimaging and range verification. The foreseen workflow includes pre-treatment proton transmission imaging, complemented by ultrasonic tumor localization, for treatment planning and position verification, followed by image-guided delivery with on site range verification by means of ionoacoustics (for pulsed beams) and positron-emission-tomography (PET, for continuous beams). The proposed compact and cost-effective system promises to open a new era in small animal proton therapy research, contributing to the basic understanding of in vivo radiation action to identify areas of potential breakthroughs for future translation into innovative clinical strategies.


Assuntos
Modelos Animais , Terapia com Prótons/instrumentação , Radioterapia Guiada por Imagem/instrumentação , Animais , Camundongos , Tomografia por Emissão de Pósitrons , Terapia com Prótons/métodos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Radioterapia Guiada por Imagem/métodos
7.
Sci Rep ; 9(1): 6714, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040311

RESUMO

The shape of a wave carries all information about the spatial and temporal structure of its source, given that the medium and its properties are known. Most modern imaging methods seek to utilize this nature of waves originating from Huygens' principle. We discuss the retrieval of the complete kinetic energy distribution from the acoustic trace that is recorded when a short ion bunch deposits its energy in water. This novel method, which we refer to as Ion-Bunch Energy Acoustic Tracing (I-BEAT), is a refinement of the ionoacoustic approach. With its capability of completely monitoring a single, focused proton bunch with prompt readout and high repetition rate, I-BEAT is a promising approach to meet future requirements of experiments and applications in the field of laser-based ion acceleration. We demonstrate its functionality at two laser-driven ion sources for quantitative online determination of the kinetic energy distribution in the focus of single proton bunches.

8.
Sci Rep ; 9(1): 7697, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118430

RESUMO

Today's high-power laser systems are capable of reaching photon intensities up to 1022 W cm-2, generating plasmas when interacting with material. The high intensity and ultrashort laser pulse duration (fs) make direct observation of plasma dynamics a challenging task. In the field of laser-plasma physics and especially for the acceleration of ions, the spatio-temporal intensity distribution is one of the most critical aspects. We describe a novel method based on a single-shot (i.e. single laser pulse) chirped probing scheme, taking nine sequential frames at frame rates up to THz. This technique, to which we refer as temporally resolved intensity contouring (TRIC) enables single-shot measurement of laser-plasma dynamics. Using TRIC, we demonstrate the reconstruction of the complete spatio-temporal intensity distribution of a high-power laser pulse in the focal plane at full pulse energy with sub-picosecond resolution.

10.
Radiat Prot Dosimetry ; 180(1-4): 291-295, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-29415243

RESUMO

We report on a scintillator-based online detection system for the spectral characterization of polychromatic proton bunches. Using up to nine stacked layers of radiation hard polysiloxane scintillators, coupled to and readout edge-on by a large area pixelated CMOS detector, impinging polychromatic proton bunches were characterized. The energy spectra were reconstructed using calibration data and simulated using Monte-Carlo simulations. Despite the scintillator stack showed some problems like thickness inhomogeneities and unequal layer coupling, the prototype allows to obtain a first estimate of the energy spectrum of proton beams.


Assuntos
Lasers , Sistemas On-Line , Prótons , Contagem de Cintilação/instrumentação , Calibragem , Simulação por Computador , Ciclotrons , Luz , Método de Monte Carlo , Fótons , Raios X
11.
Rev Sci Instrum ; 89(12): 123302, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30599609

RESUMO

A common approach for spectrum determination of polyenergetic proton bunches from laser-ion acceleration experiments is based on the time-of-flight (TOF) method. However, spectra obtained using this method are typically given in relative units or are estimated based on some prior assumptions on the energy distribution of the accelerated ions. In this work, we present a new approach using the TOF method that allows for an absolute energy spectrum reconstruction from a current signal acquired with a sub-nanosecond fast and 10 µm thin silicon detector. The reconstruction is based on solving a linear least-squares problem, taking into account the response function of the detection system. The general principle of signal generation and spectrum reconstruction by setting up an appropriate system response matrix is presented. Proof-of-principle experiments at a 12 MV Tandem accelerator using different nanosecond-short (quasi-)monoenergetic and polyenergetic proton bunches at energies up to 20 MeV were successfully performed. Within the experimental uncertainties of 2.4% and 12.1% for energy and particle number, respectively, reconstructed energy distributions were found in excellent agreement with the spectra calculated using Monte Carlo simulations and measured by a magnetic spectrometer. This TOF method can hence be used for absolute online spectrometry of laser-accelerated particle bunches.

12.
PLoS One ; 8(10): e76903, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24146943

RESUMO

Activity-dependent gene expression is central for sculpting neuronal connectivity in the brain. Despite the importance for synaptic plasticity, a comprehensive analysis of the temporal changes in the transcriptomic response to neuronal activity is lacking. In a genome wide survey we identified genes that were induced at 1, 4, 8, or 24 hours following neuronal activity in the hippocampus. According to their distinct expression kinetics we assigned these genes to five clusters, each containing approximately 200 genes. Using in situ hybridizations the regulated expression of 24 genes was validated. Apart from known activity-dependent genes our study reveals a large number of unknown induced genes with distinct expression kinetics. Among these we identified several genes with complex temporal expression patterns. Furthermore, our study provides examples for activity-induced exon switching in the coding region of genes and activity-induced alternative splicing of the 3'-UTR. One example is Zwint. In contrast to the constitutively expressed variant, the induced Zwint transcript harbors multiple regulatory elements in the 3'-UTR. Taken together, our study provides a comprehensive analysis of the transcriptomic response to neuronal activity and sheds new light on expression kinetics and alternative splicing events.


Assuntos
Perfilação da Expressão Gênica , Estudo de Associação Genômica Ampla , Hipocampo/metabolismo , Transcriptoma , Regiões 3' não Traduzidas , Processamento Alternativo , Animais , Sítios de Ligação , Análise por Conglomerados , Éxons , Regulação da Expressão Gênica , Masculino , Camundongos , Anotação de Sequência Molecular , Ligação Proteica , Reprodutibilidade dos Testes , Fatores de Transcrição/metabolismo , Transcrição Gênica
13.
J Clin Invest ; 123(11): 4836-48, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24084739

RESUMO

The molecular mechanisms that control innate immune cell trafficking during chronic infection and inflammation, such as in tuberculosis (TB), are incompletely understood. During active TB, myeloid cells infiltrate the lung and sustain local inflammation. While the chemoattractants that orchestrate these processes are increasingly recognized, the posttranscriptional events that dictate their availability are unclear. We identified microRNA-223 (miR-223) as an upregulated small noncoding RNA in blood and lung parenchyma of TB patients and during murine TB. Deletion of miR-223 rendered TB-resistant mice highly susceptible to acute lung infection. The lethality of miR-223(­/­) mice was apparently not due to defects in antimycobacterial T cell responses. Exacerbated TB in miR-223(­/­) animals could be partially reversed by neutralization of CXCL2, CCL3, and IL-6, by mAb depletion of neutrophils, and by genetic deletion of Cxcr2. We found that miR-223 controlled lung recruitment of myeloid cells, and consequently, neutrophil-driven lethal inflammation. We conclude that miR-223 directly targets the chemoattractants CXCL2, CCL3, and IL-6 in myeloid cells. Our study not only reveals an essential role for a single miRNA in TB, it also identifies new targets for, and assigns biological functions to, miR-223. By regulating leukocyte chemotaxis via chemoattractants, miR-223 is critical for the control of TB and potentially other chronic inflammatory diseases.


Assuntos
MicroRNAs/genética , MicroRNAs/imunologia , Infiltração de Neutrófilos/genética , Tuberculose Pulmonar/genética , Animais , Quimiocina CCL3/metabolismo , Quimiocina CXCL2/metabolismo , Suscetibilidade a Doenças , Humanos , Imunidade Inata/genética , Interleucina-6/metabolismo , Pulmão/imunologia , Pulmão/patologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , MicroRNAs/sangue , Infiltração de Neutrófilos/imunologia , Receptores de Interleucina-8B/deficiência , Receptores de Interleucina-8B/genética , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/patologia , Regulação para Cima
14.
PLoS One ; 7(4): e35345, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22532850

RESUMO

Despite the importance of microRNAs (miRs) for regulation of the delicate balance between cell proliferation and death, evidence for their specific involvement during death receptor (DR)-mediated apoptosis is scarce. Transfection with miR-133b rendered resistant HeLa cells sensitive to tumor necrosis factor-alpha (TNFα)-induced cell death. Similarly, miR-133b caused exacerbated proapoptotic responses to TNF-related apoptosis-inducing ligand (TRAIL) or an activating antibody to Fas/CD95. Comprehensive analysis, encompassing global RNA or protein expression profiling performed by microarray experiments and pulsed stable isotope labeling with amino acids in cell culture (pSILAC), led to the discovery of the antiapoptotic protein Fas apoptosis inhibitory molecule (FAIM) as immediate miR-133b target. Moreover, miR-133b impaired the expression of the detoxifying protein glutathione-S-transferase pi (GSTP1). Expression of miR-133b in tumor specimens of prostate cancer patients was significantly downregulated in 75% of the cases, when compared with matched healthy tissue. Furthermore, introduction of synthetic miR-133b into an ex-vivo model of prostate cancer resulted in impaired proliferation and cellular metabolic activity. PC3 cells were also sensitized to apoptotic stimuli after transfection with miR-133b similar to HeLa cells. These data reveal the ability of a single miR to influence major apoptosis pathways, suggesting an essential role for this molecule during cellular transformation, tumorigenesis and tissue homeostasis.


Assuntos
Apoptose/genética , MicroRNAs/genética , Receptores de Morte Celular/genética , Ligante Indutor de Apoptose Relacionado a TNF/genética , Adenocarcinoma/genética , Adenocarcinoma/patologia , Apoptose/efeitos dos fármacos , Proteínas Reguladoras de Apoptose/genética , Glutationa Transferase/genética , Células HeLa , Humanos , Masculino , MicroRNAs/metabolismo , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Transfecção , Células Tumorais Cultivadas , Fator de Necrose Tumoral alfa/farmacologia
15.
Cell Host Microbe ; 3(2): 97-103, 2008 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-18312844

RESUMO

Attenuated strains of mycobacteria can be exploited to determine genes essential for their pathogenesis and persistence. To this goal, we sequenced the genome of H37Ra, an attenuated variant of Mycobacterium tuberculosis H37Rv strain. Comparison with H37Rv revealed three unique coding region polymorphisms. One polymorphism was located in the DNA-binding domain of the transcriptional regulator PhoP, causing the protein's diminished DNA-binding capacity. Temporal gene expression profiles showed that several genes with reduced expression in H37Ra were also repressed in an H37Rv phoP knockout strain. At later time points, genes of the dormancy regulon, typically expressed in a state of nonreplicating persistence, were upregulated in H37Ra. Complementation of H37Ra with H37Rv phoP partially restored its persistence in a murine macrophage infection model. Our approach demonstrates the feasibility of identifying minute but distinct differences between isogenic strains and illustrates the consequences of single point mutations on the survival stratagem of M. tuberculosis.


Assuntos
Proteínas de Bactérias/genética , Mycobacterium tuberculosis/química , Mycobacterium tuberculosis/patogenicidade , Fatores de Transcrição/genética , Sequência de Aminoácidos , Animais , Proteínas de Bactérias/química , Células Cultivadas , Teste de Complementação Genética , Macrófagos/microbiologia , Camundongos , Dados de Sequência Molecular , Mutação Puntual , Polimorfismo Genético , Estrutura Terciária de Proteína/genética , Alinhamento de Sequência , Fatores de Transcrição/química , Virulência
16.
Science ; 303(5662): 1378-81, 2004 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-14988562

RESUMO

The transcriptional regulatory networks that specify and maintain human tissue diversity are largely uncharted. To gain insight into this circuitry, we used chromatin immunoprecipitation combined with promoter microarrays to identify systematically the genes occupied by the transcriptional regulators HNF1alpha, HNF4alpha, and HNF6, together with RNA polymerase II, in human liver and pancreatic islets. We identified tissue-specific regulatory circuits formed by HNF1alpha, HNF4alpha, and HNF6 with other transcription factors, revealing how these factors function as master regulators of hepatocyte and islet transcription. Our results suggest how misregulation of HNF4alpha can contribute to type 2 diabetes.


Assuntos
Proteínas de Ligação a DNA , Regulação da Expressão Gênica , Hepatócitos/metabolismo , Proteínas de Homeodomínio/metabolismo , Ilhotas Pancreáticas/metabolismo , Proteínas Nucleares , Fosfoproteínas/metabolismo , Transativadores/metabolismo , Fatores de Transcrição/metabolismo , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos , Metabolismo dos Carboidratos , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/genética , Perfilação da Expressão Gênica , Genoma Humano , Gluconeogênese , Fator 1 Nuclear de Hepatócito , Fator 1-alfa Nuclear de Hepatócito , Fator 1-beta Nuclear de Hepatócito , Fator 4 Nuclear de Hepatócito , Fator 6 Nuclear de Hepatócito , Humanos , Metabolismo dos Lipídeos , Análise de Sequência com Séries de Oligonucleotídeos , Testes de Precipitina , Regiões Promotoras Genéticas , RNA Polimerase II/metabolismo , Transcrição Gênica
17.
FEBS Lett ; 528(1-3): 95-100, 2002 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-12297286

RESUMO

Glial cells missing (GCM) proteins form a small family of transcriptional regulators involved in different developmental processes. They contain a DNA-binding domain that is highly conserved from flies to mice and humans and consists of approximately 150 residues. The GCM domain of the mouse GCM homolog a was expressed in bacteria. Extended X-ray absorption fine structure and particle-induced X-ray emission analysis techniques showed the presence of two Zn atoms with four-fold coordination and cysteine/histidine residues as ligands. Zn atoms can be removed from the GCM domain by the Zn chelator phenanthroline only under denaturating conditions. This suggests that the Zn ions are buried in the interior of the GCM domain and that their removal abolishes DNA-binding because it impairs the structure of the GCM domain. Our results define the GCM domain as a new type of Zn-coordinating, sequence-specific DNA-binding domain.


Assuntos
Proteínas de Ligação a DNA/química , Neuropeptídeos/química , Transativadores/química , Sequência de Aminoácidos , Animais , Sítios de Ligação , Sequência Conservada , Cristalografia por Raios X , Proteínas de Ligação a DNA/genética , Escherichia coli/genética , Humanos , Camundongos , Dados de Sequência Molecular , Neuropeptídeos/genética , Estrutura Terciária de Proteína , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Homologia de Sequência de Aminoácidos , Espectrometria por Raios X , Análise Espectral , Transativadores/genética , Raios X , Zinco/química
18.
Semin Thromb Hemost ; 28(2): 203-14, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11992243

RESUMO

Fourteen patients with different types of von Willebrand disease (vWD) having acute bleeds or elective surgery were treated with Immunate(sound recording copyright sign), a double-virus inactivated factor VIII/von Willebrand factor (FVIII/vWF) concentrate. The concentrate was applied as a bolus or via continuous infusion. FVIII activity (FVIIIc), vWF antigen (vWF:Ag), ristocetin cofactor activity (vWF:RCo), collagen binding activity (vWF:CB), activated partial thromboplastin time (aPTT), and von Willebrand multimers (vW-multimers) were monitored for 48 hours. Pharmacokinetic analyses were performed. The clinical efficacy was rated excellent or good. Bleeding complications occurred in 3 patients due to an additional FXIII deficiency in one patient, to a surgically induced bleed in another patient, and a rather short substitution period in the third patient. There were no serious adverse experiences. One patient showed a phlebitic reaction at the site of venous access after more than 100 hours of continuous infusion, requiring a change to application via bolus.


Assuntos
Fator VIII/administração & dosagem , Doenças de von Willebrand/tratamento farmacológico , Fator de von Willebrand/administração & dosagem , Técnicas de Laboratório Clínico , Dimerização , Combinação de Medicamentos , Monitoramento de Medicamentos/métodos , Fator VIII/farmacocinética , Feminino , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Humanos , Masculino , Assistência Perioperatória/métodos , Esterilização , Resultado do Tratamento , Doenças de von Willebrand/complicações , Doenças de von Willebrand/diagnóstico , Fator de von Willebrand/farmacocinética
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