Grönemeyer Institute for MicroTherapy

Purpose To estimate the extent in which coronary artery calcium (CAC) score and incident lung cancer diagnosis are associated and determine if use of CAC score to predict lung cancer could improve lung cancer screening (LCS). Materials and Methods This retrospective analysis analyzed data from an ongoing, prospective, population-based cohort study (Heinz Nixdorf Recall study) in which participants aged 45-75 years underwent electron-beam CT of the heart. The association between CAC score and incident lung cancer was assessed using Cox proportional hazard regression models adjusted for potential confounders. The area under the receiver operating characteristic curve (AUC) was used to assess predictive performance of CAC score for lung cancer in all participants, eligible participants, and ineligible participants for LCS. Results The study included 4605 participants (mean age, 59.7 [SD, 7.8] years; 2328 female). During a median follow-up time of 15.2 years, incident lung cancer was diagnosed in 111 participants. CAC score as a continuous variable (log CAC+1) was associated with incident lung cancer (hazard ratio [HR] in the fully adjusted model: 1.21 [95% CI: 1.10, 1.32]). A CAC score of 400 or higher versus 0 was associated with a more than fourfold higher risk of lung cancer (adjusted HR: 4.31 [95% CI: 2.19, 8.51]). CAC score alone showed poor performance for predicting lung cancer in the total study sample (AUC, 0.63) and subgroups of participants eligible (AUC, 0.56) and ineligible (AUC, 0.61) for LCS. Conclusion CAC score was associated with incident lung cancer but did not demonstrate potential to improve the efficiency of LCS. Keywords: Epidemiology, Screening, Arteriosclerosis, Cardiac, Thorax, CT, Lung Cancer Supplemental material is available for this article. © RSNA, 2025.

Beim Prostatakarzinom, dem häufigsten malignen Tumor des Mannes, beruhte die Diagnostik lange Zeit auf der digitalen rektalen Untersuchung, der Bestimmung des prostataspezifischen Antigens (PSA) und der transrektal sonografisch geführten Biopsie (TRUS-Biopsie). Gemäß den Guidelines der European Association of Urology wird eine multiparametrische MRT der Prostata bereits vor der ersten Biopsie empfohlen und somit zur Klärung einer Biopsie-Indikation eingesetzt (Mottet N et al. European urology 2020 in press). Weitere Indikationen sind die Detektion vor Sekundärbiopsie, die aktive Überwachung beim Prostatakarzinom, das lokale Staging, die präoperative Planung und die Rezidivdiagnostik.

This 2019 focused update to the American Heart Association neonatal resuscitation guidelines is based on 2 evidence reviews recently completed under the direction of the International Liaison Committee on Resuscitation Neonatal Life Support Task Force. The International Liaison Committee on Resuscitation Expert Systematic Reviewer and content experts performed comprehensive reviews of the scientific literature on the appropriate initial oxygen concentration for use during neonatal resuscitation in 2 groups: term and late-preterm newborns (≥35 weeks of gestation) and preterm newborns (<35 weeks of gestation). This article summarizes those evidence reviews and presents recommendations. The recommendations for neonatal resuscitation are as follows: In term and late-preterm newborns (≥35 weeks of gestation) receiving respiratory support at birth, the initial use of 21% oxygen is reasonable. One hundred percent oxygen should not be used to initiate resuscitation because it is associated with excess mortality. In preterm newborns (<35 weeks of gestation) receiving respiratory support at birth, it may be reasonable to begin with 21% to 30% oxygen and to base subsequent oxygen titration on oxygen saturation targets. These guidelines require no change in the Neonatal Resuscitation Algorithm-2015 Update.

The amiloride-sensitive epithelial sodium channel (ENaC) localizes to the apical membrane of epithelial cells in distal nephron, playing an important role in regulating whole-body Na + homeostasis and blood pressure. We were the first to describe the presence of αENaC in human renal proximal tubule cells (hRPTC). Gene variants in αENaC have been shown to be associated with salt sensitivity of blood pressure (SS) . We also verified that the specific gene variant rs4764586 was significantly associated with SS (χ 2 =9.67, P=0.046). In our salt sensitivity clinical study, 11% participants (N=27/240) had a paradoxical increase in blood pressure (BP) (≥7-mm Hg) on a low NaCl diet, defined as inverse salt sensitive ( ISS ) as compared to salt resistant ( SR , 72%) and salt sensitive ( SS , 17%). The incidence of the minor allele αENaC rs4764586 in the ISS group was 2-fold of that in SR or SS ( ISS , 14.8%; SR , 7.0%; SS , 7.1%). Expression of αENaC protein in urine derived hRPTCs was significantly lower in ISS than in SR ( ISS , 0.55±0.01, n=3; SR, 0.97±0.12, n=3; SS, 0.87±0.12, n=3; one-way ANOVA, ISS vs SR p&lt;0.05), with the lowest in the homozygous variants (HV) of rs4764586 and highest in wild type. The heterozygous variant containing hRPTCs had an intermediate expression of αENaC (WT, 0.94±0.11, n=4; Heterozygous, 0.72±0.11, n=4; HV, 0.53, n=1). ENaC-like channels were demonstrated in hRPTCs using single-channel patch-clamp electrophysiology with a conductance of 10.5±0.7 pS and E rev 39.2±5.5 mV vs 10.3±0.8 pS in SR and ISS lines, respectively. However, in ISS baseline ENaC-like channel activity was too low to be recorded without trypsin in the pipette (Po = open probability), unlike SR . In contrast, ISS cells demonstrated a higher Po than SR cells in response to trypsin both immediately and after 4 minutes of activation, even though the number of channels recorded at 4 min after GigaOhm seal formation was lower in the ISS line compared to SR line (4.7±1.7 vs 1.75±0.5, p=0.042 in SR vs ISS lines). These results suggest that ISS phenotype may be related to impaired ENaC activity in the renal proximal tubule. The long-term physiologic consequences of the ISS phenotype remain to be determined

Clozapine (CLZ), a potent D 4 R antagonist that is an effective antipsychotic drug for the treatment of schizophrenia, is associated with hypertension. The hypertensive side effect of CLZ may be through inhibition of the D 4 R because germline deletion of D 4 R in mice causes hypertension. The hypertension caused by germline deletion of D 4 R may, in part, be due to increased renal expression of the angiotensin type 1 receptor (AT 1 R) and renal expression of sodium exchangers, transporters, and pumps, e.g., NHE3, NKCC2, NCC, and Na + K + /ATPase, α subunit. CLZ administered subcutaneously (20mg/kg/day/x3 days, n=5) in mice induced hypertension, shifted the pressure-natriuresis plot to the right, and increased the renal expressions of NCC and Na + K + /ATPase, α subunit, relative to vehicle-treated mice (n=5). Activation of D 4 R decreased AT 1 R expression and Na + K + /ATPase activity in rat renal proximal tubule cells (RPTCs). Therefore, we studied two groups: subjects 18 to 75 years old with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder treated with CLZ for &gt;2 months (CLZ, N=32) and untreated healthy controls ( HC , N=20) without psychiatric illness. There were no significant differences in blood pressure (BP) between the two groups since more than half of the CLZ participants received antihypertensive medication. We studied RPTCs cultured from the participant’s urine (CLZ, N=18; HC, N=9) and treated those cells with 100 nM CLZ. CLZ decreased D 4 R expression in both HC and CLZ groups ( HC , VEH 1.04±0.17 vs CLZ 0.73±0.09, n=9, paired t-test, P&lt;0.05; CLZ, VEH 1.02±0.09 vs CLZ 0.75±0.06, n=16, paired t-test, P&lt;0.01). CLZ also increased reactive oxygen species (Rosstar550 assay) in the HC but not CLZ-treated group ( HC , VEH 0.92±0.07 vs CLZ 1.02±0.09, n=8, paired t-test , P&lt;0.05; CLZ VEH 1.09±0.18 vs CLZ 1.07±0.18, n=14). The density of plasma membrane AT 1 R tended to be higher in CLZ-treated hypertensive (CLX HP) than the CLZ-treated normotensive participants (CLZ NP): ( HC , 0.28±0.08 n=8; CLZ NP, 0.10±0.02 n=4; CLZ HP, 0.81±0.31 n=7). Thus, CLZ may induce hypertension through a D 4 R/AT 1 R-mediated mechanism similar to that reported in D 4 R knockout mice. Additional studies will determine if CLZ increases sodium transport in human RPTCs.

A fast greedy sparse (FGS) method of cardiac equivalent current sources reconstruction is developed for non-invasive detection and quantitative analysis of individual left ventricular torsion. The cardiac magnetic field inverse problem is solved based on a distributed source model. The analysis of real 61-channel magnetocardiogram (MCG) data demonstrates that one or two dominant current source with larger strength can be identified efficiently by the FGS algorithm. Then, the left ventricle torsion during systole is examined on the basis of x, y and z coordination curves and angle change of reconstructed dominant current sources. The advantages of this method are non-invasive, visible, with higher sensitivity and resolution. It may enable the clinical detection of cardiac systolic and ejection dysfunction.

Article Relation between neonatal behavioral states and heart rate variability was published on August 30, 2012 in the journal Biomedical Engineering / Biomedizinische Technik (volume 57, issue SI-1-Track-F).