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  • 1
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pacing threshold is affected by many factors. A pacing system able to confirm capture at each beat and automatically adjust its output close to the actual pacing threshold is highly desirable. This study evaluates the safety and efficacy of the Autocapture function of the Pacesetter Microny SR+. One hundred thirteen patients were recruited from 16 centers in 7 European countries and followed up for 1 year. All pacemakers were implanted with Pacesetter's low polarization, bipolar leads. The key feature of Autocapture is the immediate delivery of a 4.5 V safety backup pulse 62.5 ms after any ineffective ongoing low output pulse. Holter recordings confirmed total reliability of this feature without any exit block. The measured evoked response (ER) signal was stable over time. Acute and chronic pacing thresholds measured by VARIO and Autocapture tests correlated (r 〉 0.79) over the period of the study. The incidence of backup pulses was 1.1% during pacing. With Autocapture programmed ON, the overall total current consumption was 4.1 μA for VVI and 5.0 μA for VVIR pacing. Tbis study proved that the Autocapture safely and reliably regulates the pacemaker's output according to the prevailing threshold thus providing maximum patient safety and prolonging service life.
    Type of Medium: Electronic Resource
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  • 2
    Publication Date: 2013-02-20
    Description: Background: Alternatively polarized macrophages (MΦ) shape the microenvironment of hepatocellular carcinoma (HCC) and temper anti-cancer immune responses. We investigated if Sorafenib alters the HCC microenvironment by restoring classical macrophage polarization and triggering tumor-directed NK cell responses. Methods: In vivo experiments were conducted with Sorafenib (25 mg/kg) treated C57BL/6 wild-type as well as HBV and lymphotoxin transgenic mice with and without HCC. Monocyte derived MΦ or tumor-associated macrophages (TAM) isolated from HCC tissue were treated with Sorafenib (0.07-5.0 µg/ml) and co-cultured with autologous NK cells. MΦ and NK cell activation was analyzed by flow cytometry and killing assays, respectively. Cytokine and growth factor release was measured by ELISA. Results: Short-term administration of Sorafenib triggered activation of hepatic NK cells in wild-type and tumor bearing mice. In vitro, Sorafenib sensitized MΦ to LPS reverting alternative MΦ polarization and enhanced IL12 secretion ( P =0.0133). NK cells activated by Sorafenib-treated MΦ showed increased degranulation (15.3±0.2% vs. 32.0±0.9%, P 〈0.0001) and IFNγ secretion (2.1±0.2% vs. 8.0±0.2%, P 〈0.0001) upon target cell contact. Sorafenib-triggered NK cell activation was verified by co-culture experiments using TAM. Sorafenib-treated MΦ increased cytolytic NK cell function against K562, Raji and HepG2 target cells in a dose-dependent manner. Neutralization of IL12 or IL18 as well as inhibition of the NFκB pathway reversed NK cell activation in MΦ/NK co-cultures. Conclusion: Sorafenib triggers pro-inflammatory activity of TAM and subsequently induces anti-tumoral NK cell responses in a cytokine and NFĸB-dependent fashion. This observation is relevant for HCC therapy, as Sorafenib is a compound in clinical use, which reverses alternative polarization of TAM in HCC. (H EPATOLOGY 2013.)
    Print ISSN: 0270-9139
    Electronic ISSN: 1527-3350
    Topics: Medicine
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