TY - GEN A1 - Gehmert, Sangaa A1 - Lehoczky, Gyözöc A1 - Loibl, Markus A1 - Jung, Friedrich A1 - Prantl, Lukas A1 - Gehmert, Sebastian T1 - Interaction between extracellular cancer matrix and stromal breast cells T2 - Clinical Hemorheology and Microcirculation N2 - Stromal-epithelial interactions are fundamental for normal organ development and there is a multitude of evidence that the different components of the microenvironment are also necessary for the maintenance and promotion of the “tumor organ”. Deregulated tumor associated extracellular matrix (tECM) is a hallmark of cancer, causing an alteration in the amount and composition of the different components (i.e. proteins, proteoglycans, glycoproteins and polysaccharids) of the ECM. As epithelial-stromal interactions are reciprocal, it is possible that tECM itself is able to initiate tumor development. We therefore established a mouse model to examine the influence of tECM of murine breast cancer on developing breast tissue in mice. KW - Breast cancer KW - extracellular matrix KW - microenvironment KW - epithelial-stromal interaction Y1 - 2020 UR - https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch199234 U6 - https://doi.org/10.3233/CH-199234 SN - 1875-8622 SN - 1386-0291 VL - 74 IS - 1 SP - 45 EP - 52 ER - TY - GEN A1 - Diesch, S. T. A1 - Jung, Friedrich A1 - Prantl, Lukas A1 - Jung, Ernst Michael T1 - Surface imaging of breast implants using modern high-frequency ultrasound technology in comparison to high-end sonography with power analyses for B-scan optimization T2 - Clinical Hemorheology and Microcirculation Y1 - 2022 U6 - https://doi.org/10.3233/CH-219204 SN - 1875-8622 SN - 1386-0291 VL - 80 IS - 4 SP - 487 EP - 495 ER - TY - GEN A1 - Jung, Friedrich A1 - Lamby, Philipp A1 - Prantl, Lukas A1 - Wiggermann, P. A1 - Jung, Ernst Michael A1 - Krüger-Genge, Anne A1 - Franke, Ralf-Peter T1 - Post-mortem distribution of Iodinated Contrast Media (ICM) (iodixanol versus iopromide) in the porcine kidney after multiple bolus injections in vivo into the supra-renal aorta T2 - Clinical Hemorheology and Microcirculation Y1 - 2022 U6 - https://doi.org/10.3233/CH-229102 SN - 1875-8622 VL - 85(2023) IS - 3 SP - 289 EP - 295 ER - TY - GEN A1 - Biermann, Niklas A1 - Sommerauer, Laura A1 - Diesch, Sophia A1 - Koch, Christoph A1 - Jung, Friedrich A1 - Kehrer, Andreas A1 - Prantl, Lukas A1 - Taeger, Christian D. T1 - The influence of pulsed electromagnetic field therapy (PEMFT) on cutaneous blood flow in healthy volunteers T2 - Clinical Hemorheology and Microcirculation N2 - BACKGROUND: The biophysical interaction induced by low energy pulsed electromagnetic field therapy (PEMFT) on the capillary microcirculation is not well understood. Several studies indicate a significant effect of PEMFT in patients with chronic medical conditions. OBJECTIVE: The aim of this study was to evaluate the influence of PEMFT on skin microcirculation in healthy volunteers. METHODS: 15 healthy participants were included. Nine PEMF treatments were applied over three weeks in an 48-hour interval. The PEMFT system (BEMER) was placed beneath one of the participants’ leg with the contralateral side serving as a control. A forty-minute application period was preceded by a 10-minute resting phase. Measuring was done using two Laser Doppler probes (LEA) placed on each anterior lateral thigh. RESULTS: All outcome parameters including flow, mixed venous oxygen saturation and relative venous hemoglobin showed a significant increase during the experiment when compared to the baseline values of the resting phase in both groups (p < 0.01). Comparing both groups, the measurement values during the experiment did not differ (p > 0.05) except for higher flow values in the control group (P = 0.03). Over time, baseline values of both groups showed no significant difference (p > 0.05). CONCLUSION: We found a significant increase of all measurement parameters during the study compared to the baseline values with no difference between the PEMF and control group. KW - Pulsed electromagnetic field therapy (PEMFT) KW - microcirculation KW - cutaneous blood flow Y1 - 2021 UR - https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch209224 U6 - https://doi.org/10.3233/CH-209224 VL - 76 IS - 4 SP - 495 EP - 501 ER - TY - GEN A1 - Martina, Georgieva A1 - Kammerer, Sarah A1 - Prantl, Lukas A1 - Jung, Friedrich A1 - Stroszczynski, Christian A1 - Jung, Ernst Michael T1 - Imaging of breast implant and implant-associated complications: Capsular contracture and intraor extracapsular rupture T2 - Clinical Hemorheology and Microcirculation N2 - BACKGROUND: In recent years, follow-up after breast reconstruction with silicone implants and the detection of complications have been relieved by the possibility of improved diagnostic methods. METHODS: Between January 2015 and December 2019 a total of 40 patients (29–84 years) with silicone implants were included in this retrospective study. The implants were examined clinically and with modern imaging: general ultrasound imaging (US), magnetic resonance imaging (MRI), high resolution computed tomography (CT) and positron emission tomography –computed tomography (PET-CT). If necessary, a histological/cytological sample was taken. The breast implants were assessed by three radiologists specialized in breast imaging. The grade of capsular contracture was classified according to the Baker classification. RESULTS: All 40 women obtained a clinical examination and an US diagnostic to identify early and more common complications such as implant folding and capsular fibrosis. Depending on the clinical examination and ultrasound findings additional MRI (n = 10), CT (n = 9) and/or PET-CT (n = 2) were performed. 16 patients had implants folding proven with US (n = 16), MRI (n = 6) and CT (n = 1). The grade of capsular fibrosis was determined according to the Baker classification. The following results were obtained in our study: 25 breast implants with Baker grade I and eleven breast implants with Baker grade II, both proven with US; one breast implants with Baker grade III and one breast implant with Baker grade IV, proven with US (n = 2), MRI (n = 1) and CT (n = 1). One patient had intracapsular rupture and one patient had extracapsular rupture, both detected on CT and surgically proven. No patient had a silicone accumulation in the lymph nodes. One patient had pathologically enlarged axillary lymph nodes, which were evaluated as inflammatory changes in PET-CT. Long-term complications such as the development of malignant breast tumors could not be observed. CONCLUSION: To detect early complications after breast implant surgery, a regular clinical examination is indispensable. Imaging methods complement each other and if they are used multimodal, it is easier to identify early complications. Modern diagnostic modalities like ultrasound and magnetic resonance imaging expand the spectrum and improve diagnostic safety. KW - Breast implant KW - ultrasound KW - magnetic resonance imaging KW - capsular contracture Y1 - 2020 UR - https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch209218 U6 - https://doi.org/10.3233/CH-209218 SN - 1875-8622 SN - 1386-0291 VL - 76 IS - 2 SP - 221 EP - 231 ER - TY - GEN A1 - Lamby, Philipp A1 - Minkow, Alexander A1 - Handt, Stefan A1 - Falter, Johannes A1 - Schellenberg, Eva-Lotte A1 - Graf, Stefanie A1 - Hiebl, Bernhard A1 - Haerteis, Silke A1 - Gemeinhardt, Ole A1 - Krüger-Genge, Anne A1 - Klosterhalfen, Bernd A1 - Jung, Ernst Michael A1 - Franke, Ralf-Peter A1 - Momeni, Arash A1 - Prantl, Lukas A1 - Jung, Friedrich T1 - Histological and SEM assessment of blood stasis in kidney blood vessels after repeated intra-arterial application of radiographic contrast media T2 - Life N2 - Background: After application of iodinated contrast media (CM), a pronounced deterioration of the microcirculation in skin and myocardium was reported. Clinically, the repeated application of CM, especially, led to an increase of the renal resistance index (RRI). With respect to the transiency of the RRI increase, it is reasonable to assume that the deterioration of blood flow could be due to transient blood stasis caused by reversible morphologic cell alterations due to osmotic discrepancies between CM and human blood. Therefore, the hypothesis was investigated whether CM are able to induce in vivo such blood stasis and cell deformations in the renal vasculature of well-hydrated pigs. Methods: The in vivo study was performed as a prospective randomized examination to compare the effects of two different CM in 16 pigs (German Landrace). Pigs were randomized to receive either Iodixanol (n = 8), or Iopromide (n = 8). Each animal received 10 injections separated by 5-min intervals via the suprarenal aorta at a rate of 10 mL/s according to the usual procedure during a cardiac catheter examination. Finally, the kidneys were explanted and processed for histology (H & E staining and fibrin staining according to Weigert) as well as for scanning electron microscopy (SEM) with regards to morphologic correlates explaining the changes in the microcirculation. Results: In each of the predefined four categories of vascular diameters, blood stasis were found, but clearly more often after application of Iopromide than after application of Iodixanol (p < 0.001). In addition, Iopromide induced more blood stasis in all of the examined kidney regions compared to Iodixanol (p = 0.0001). There were no obstructive events in the middle cortex following the application of Iodixanol. Except for the region around a puncture channel of a placed-in catheter probe, no fibrin was detected in Weigert’s fibrin-stained samples, neither around the histologically assessed thrombi nor in vessels with blood stasis. Complementary SEM analyses revealed in a few cases only a slight generation of fibrin and thrombi and deformations, such as echinocyte and “box-like” deformations. Conclusions: According to previous in vitro studies, pathological erythrocyte deformations, such as echinocyte and box-like formation of erythrocytes, were observed also in vivo. In addition, blood stasis and/or thrombi could be detected in histological samples from explanted kidneys from young pigs after repeated in vivo administration of CM. In only a few cases, mural platelet aggregates within minimal fibrin meshes occurred only after the application of Iopromide. KW - acute kidney injury KW - nephrotoxicity KW - nephropathy KW - renal pathology KW - iodinated contrast media KW - electron microscopy KW - histopathology Y1 - 2020 UR - https://www.mdpi.com/2075-1729/10/9/167 U6 - https://doi.org/10.3390/life10090167 SN - 2075-1729 VL - 10 IS - 9 ER - TY - GEN A1 - Jung, Ernst Michael A1 - Hösl, Vanessa A1 - Fraunberg, Sarah von A1 - Jung, Friedrich A1 - Prantl, Lukas T1 - Ultrasound elastography for the detection of capsular fibrosis in breast implants: First results T2 - Clinical Hemorheology and Microcirculation N2 - BACKGROUND: Capsular contractures around breast implants usually develop leading to pain and aesthetically inadequate results and ultimately often requires the replacement of the implants. Textured silicone implants are the most commonly placed implant, but polyurethane-coated implants are increasingly being used in an attempt to ameliorate the long-term complications associated with implant insertion. AIM: Capsular contracture is traditionally classified using the Baker scale, a subjective classification system based upon clinical findings. Aim of this study was to evaluate the association between pain due capsular contraction, Baker Score and different techniques of US elastography. MATERIAL AND METHODS: Patients were contacted who had undergone an implant replacement due to capsular contracture. Inclusion criterion was the re-implantation of a PU-coated implant. In the third year after changing the implant a follow-up examination was performed in 16 patients with 23 implants. A conventional examination with anamnesis, tactile and visual findings to obtain a Baker score, and ultrasound examinations including shear wave elastography, ARFI and compound elastography were performed. In addition, pain was evaluated using a visual analogue scale (VAS). RESULTS: The pain data showed a significant improvement (before implant exchange: 4.1±2.8 score points) with significance in favor of the current state (1.7±1.0 pain score points; p = 0.002). All patients suffered from less or no pain three years after exchange of the implant. Pain values and elastography (ARFI values) correlated well (r = 0,873), with increasing Baker score the ARFI values increased. US elastography evaluations can locally determine tissue density but correlate only to a limited extent with the test findings according to Baker. US elastography values of mammary gland tissue without implant did not differ from mammary gland tissue around implants. CONCLUSION: Preoperative Baker scores prior to exchange and the current Baker scores at the follow-up showed significantly lower score points three years after exchange of the implants. Ultrasound elastography seems to be an objective classification of capsular fibrosis. These first results motivate to initiate a prospective multicenter investigation. KW - Capsular fibrosis KW - ultrasound examinations KW - elastography KW - ARFI KW - Baker score Y1 - 2020 UR - https://content.iospress.com/articles/clinical-hemorheology-and-microcirculation/ch200875 U6 - https://doi.org/10.3233/CH-200875 SN - 1386-0291 VL - 77(2021) IS - 3 SP - 247 EP - 257 ER -