@article{GuckenbergerMantelGersztenetal.2014, author = {Guckenberger, Matthias and Mantel, Frederick and Gerszten, Peter C. and Flickinger, John C. and Sahgal, Arjun and L{\´e}tourneau, Daniel and Grills, Inga S. and Jawad, Maha and Fahim, Daniel K. and Shin, John H. and Winey, Brian and Sheehan, Jason and Kersh, Ron}, title = {Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis}, doi = {10.1186/s13014-014-0226-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110638}, year = {2014}, abstract = {Purpose To evaluate patient selection criteria, methodology, safety and clinical outcomes of stereotactic body radiotherapy (SBRT) for treatment of vertebral metastases. Materials and methods Eight centers from the United States (n = 5), Canada (n = 2) and Germany (n = 1) participated in the retrospective study and analyzed 301 patients with 387 vertebral metastases. No patient had been exposed to prior radiation at the treatment site. All patients were treated with linac-based SBRT using cone-beam CT image-guidance and online correction of set-up errors in six degrees of freedom. Results 387 spinal metastases were treated and the median follow-up was 11.8 months. The median number of consecutive vertebrae treated in a single volume was one (range, 1-6), and the median total dose was 24 Gy (range 8-60 Gy) in 3 fractions (range 1-20). The median EQD210 was 38 Gy (range 12-81 Gy). Median overall survival (OS) was 19.5 months and local tumor control (LC) at two years was 83.9\%. On multivariate analysis for OS, male sex (p < 0.001; HR = 0.44), performance status <90 (p < 0.001; HR = 0.46), presence of visceral metastases (p = 0.007; HR = 0.50), uncontrolled systemic disease (p = 0.007; HR = 0.45), >1 vertebra treated with SBRT (p = 0.04; HR = 0.62) were correlated with worse outcomes. For LC, an interval between primary diagnosis of cancer and SBRT of ≤30 months (p = 0.01; HR = 0.27) and histology of primary disease (NSCLC, renal cell cancer, melanoma, other) (p = 0.01; HR = 0.21) were correlated with worse LC. Vertebral compression fractures progressed and developed de novo in 4.1\% and 3.6\%, respectively. Other adverse events were rare and no radiation induced myelopathy reported. Conclusions This multi-institutional cohort study reports high rates of efficacy with spine SBRT. At this time the optimal fractionation within high dose practice is unknown.}, language = {en} } @article{SchreierBinnsWu2014, author = {Schreier, Peter and Binns, Colin and Wu, Dayong}, title = {To surrender or to persevere?}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-101096}, year = {2014}, abstract = {Second Editorial of Open Access Journal "Nutrition and Medicine (NUME)" published by W{\"u}rzburg University Press: http://nume.de}, subject = {Wissenschaftliches Arbeiten}, language = {en} } @article{LutzSchlatter1993, author = {Lutz, Werner K. and Schlatter, Josef}, title = {The relative importance of mutagens and carcinogens in the diet.}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86311}, year = {1993}, abstract = {Known mutagens and carcinogens in the dict were compiled and the risk of cancer was estimated on the basis of average exposure Ievels in Switzerland and carcinogenic potencies from rodent bioassays. The analysis showed that, except for a1cohol, the sum of all known dietary carcinogens could only explain a few percent of the cancer deaths attributed by epidemiologists to dietary factors. The discrepancy was explained by a "carcinogenicity" of excess macronutrients. This hypothesis was based on an evaluation of dietary restriction experiments in rats and mice, where a dramatic reducing effect on spontaneaus tumour formation was seen. From these experiments, a "carcinogenic potency" was deduced for food in excess (TD50 approximately 16 g/kg per day). Ovemutrition in Switzerland was converted into excess food intake and the cancer risk estimated on the basis ofthe TD50 value. The resulting risk of60,000 cases per one million lives wou1d aJlow to explain by overnutrition almost all "diet-related" cancer deaths in humans.}, subject = {Medizin}, language = {en} } @article{BuschTschernitzThurneretal.2013, author = {Busch, Albert and Tschernitz, Sebastian and Thurner, Anette and Kellersmann, Richard and Lorenz, Udo}, title = {Fatal Paraneoplastic Embolisms in Both Circulations in a Patient with Poorly Differentiated Neuroendocrine Tumour}, series = {Case Reports in Vascular Medicine}, journal = {Case Reports in Vascular Medicine}, doi = {10.1155/2013/739427}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97335}, year = {2013}, abstract = {Arterial embolism with lower limb ischemia is a rare manifestation of paraneoplastic hypercoagulability in cancer patients. We report a unique case of fatal thromboembolism involving both circulations associated with a poorly differentiated neuroendocrine tumor of the lung with rapid progress despite high doses of unfractioned heparin and review the current literature on anticoagulative regimen in tumour patients.}, language = {en} } @article{SchusterJohannsenRoewer2013, author = {Schuster, Frank and Johannsen, Stephan and Roewer, Norbert}, title = {A Minimal-Invasive Metabolic Test Detects Malignant Hyperthermia Susceptibility in a Patient after Sevoflurane-Induced Metabolic Crisis}, series = {Case Reports in Anesthesiology}, journal = {Case Reports in Anesthesiology}, doi = {10.1155/2013/953859}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97080}, year = {2013}, abstract = {Malignant hyperthermia is a rare but life-threatening complication of general anesthesia in predisposed patients usually triggered by potent inhalation anesthetics and/or the depolarizing muscle relaxant succinylcholine. The authors present a case of delayed sevoflurane-induced malignant hyperthermia in a 21-year-old male patient that was sufficiently treated by discontinuation of trigger agent application and dantrolene infusion. After surviving an MH episode diagnostic procedures are indicated to increase patient safety. In the presented case, the use of a novel minimal-invasive metabolic test with intramuscular injection of halothane and caffeine successfully confirmed MH susceptibility and hence might be an alternative for invasive in vitro contracture testing in selected cases.}, language = {en} } @article{ReichertSchmalzlPrageretal.2013, author = {Reichert, Johannes and Schmalzl, Jonas and Prager, Patrick and Gilbert, Fabian and Quent, Verena M. C. and Steinert, Andre F. and Rudert, Maximilian and N{\"o}th, Ulrich}, title = {Synergistic effect of Indian hedgehog and bone morphogenetic protein-2 gene transfer to increase the osteogenic potential of human mesenchymal stem cells}, series = {Stem Cell Research \& Therapy}, journal = {Stem Cell Research \& Therapy}, doi = {10.1186/scrt316}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97010}, year = {2013}, abstract = {Introduction To stimulate healing of large bone defects research has concentrated on the application of mesenchymal stem cells (MSCs). Methods In the present study, we induced the overexpression of the growth factors bone morphogenetic protein 2 (BMP-2) and/or Indian hedgehog (IHH) in human MSCs by adenoviral transduction to increase their osteogenic potential. GFP and nontransduced MSCs served as controls. The influence of the respective genetic modification on cell metabolic activity, proliferation, alkaline phosphatase (ALP) activity, mineralization in cell culture, and osteogenic marker gene expression was investigated. Results Transduction had no negative influence on cell metabolic activity or proliferation. ALP activity showed a typical rise-and-fall pattern with a maximal activity at day 14 and 21 after osteogenic induction. Enzyme activity was significantly higher in groups cultured with osteogenic media. The overexpression of BMP-2 and especially IHH + BMP-2 resulted in a significantly higher mineralization after 28 days. This was in line with obtained quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) analyses, which showed a significant increase in osteopontin and osteocalcin expression for osteogenically induced BMP-2 and IHH + BMP-2 transduced cells when compared with the other groups. Moreover, an increase in runx2 expression was observed in all osteogenic groups toward day 21. It was again more pronounced for BMP-2 and IHH + BMP-2 transduced cells cultured in osteogenic media. Conclusions In summary, viral transduction did not negatively influence cell metabolic activity and proliferation. The overexpression of BMP-2 in combination with or without IHH resulted in an increased deposition of mineralized extracellular matrix, and expression of osteogenic marker genes. Viral transduction therefore represents a promising means to increase the osteogenic potential of MSCs and the combination of different transgenes may result in synergistic effects.}, language = {en} } @article{WestermaierStetterKunzeetal.2013, author = {Westermaier, Thomas and Stetter, Christian and Kunze, Ekkehard and Willner, Nadine and Raslan, Furat and Vince, Giles H. and Ernestus, Ralf-Ingo}, title = {Magnesium treatment for neuroprotection in ischemic diseases of the brain}, series = {Experimental and Translational Stroke Medicine}, journal = {Experimental and Translational Stroke Medicine}, doi = {10.1186/2040-7378-5-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96729}, year = {2013}, abstract = {This article reviews experimental and clinical data on the use of magnesium as a neuroprotective agent in various conditions of cerebral ischemia. Whereas magnesium has shown neuroprotective properties in animal models of global and focal cerebral ischemia, this effect could not be reproduced in a large human stroke trial. These conflicting results may be explained by the timing of treatment. While treatment can be started before or early after ischemia in experimental studies, there is an inevitable delay of treatment in human stroke. Magnesium administration to women at risk for preterm birth has been investigated in several randomized controlled trials and was found to reduce the risk of neurological deficits for the premature infant. Postnatal administration of magnesium to babies after perinatal asphyxia has been studied in a number of controlled clinical trials. The results are promising but the trials have, so far, been underpowered. In aneurysmal subarachnoid hemorrhage (SAH), cerebral ischemia arises with the onset of delayed cerebral vasospasm several days after aneurysm rupture. Similar to perinatal asphyxia in impending preterm delivery, treatment can be started prior to ischemia. The results of clinical trials are conflicting. Several clinical trials did not show an additive effect of magnesium with nimodipine, another calcium antagonist which is routinely administered to SAH patients in many centers. Other trials found a protective effect after magnesium therapy. Thus, it may still be a promising substance in the treatment of secondary cerebral ischemia after aneurysmal SAH. Future prospects of magnesium therapy are discussed.}, language = {en} } @article{FreyJansenDohtetal.2013, author = {Frey, S{\"o}nke Percy and Jansen, Hendrik and Doht, Stefanie and Filgueira, Luis and Zellweger, Rene}, title = {Immunohistochemical and Molecular Characterization of the Human Periosteum}, series = {The Scientific World Journal}, journal = {The Scientific World Journal}, doi = {10.1155/2013/341078}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96623}, year = {2013}, abstract = {Purpose. The aim of the present study was to characterize the cell of the human periosteum using immunohistological and molecular methods. Methods. Phenotypic properties and the distribution of the cells within the different layers were investigated with immunohistochemical staining techniques and RT-PCR, focussing on markers for stromal stem cells, osteoblasts, osteoclasts and immune cells. Results. Immunohistochemical results revealed that all stained cells were located in the cambium layer and that most cells were positive for vimentin. The majority of cells consisted of stromal stem cells and osteoblastic precursor cells. The density increased towards the deeper layers of the cambium. In addition, cells positive for markers of the osteoblast, chondrocyte, and osteoclast lineages were found. Interestingly, there were MHC class II-expressing immune cells suggesting the presence of dendritic cells. Using lineage-specific primer pairs RT-PCR confirmed the immunofluorescence microscopy results, supporting that human periosteum serves as a reservoir of stromal stem cells, as well as cells of the osteoblastic, and the chondroblastic lineage, osteoclasts, and dendritic cells. Conclusion. Our work elucidates the role of periosteum as a source of cells with a high regenerative capacity. Undifferentiated stromal stem cells as well as osteoblastic precursor cells are dominating in the cambium layer. A new outlook is given towards an immune response coming from the periosteum as MHC II positive immune cells were detected.}, language = {en} } @article{GunrebenGeisKleinschnitz2013, author = {Gunreben, Ignaz and Geis, Christian and Kleinschnitz, Christoph}, title = {Acute tetraparesis secondary to bilateral precentral gyral cerebral ischemia: a case report}, series = {Journal of Medical Case Reports}, journal = {Journal of Medical Case Reports}, doi = {10.1186/1752-1947-7-61}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96179}, year = {2013}, abstract = {Introduction Sudden tetraparesis represents a neurological emergency and is most often caused by traumatic spinal cord injury, spinal epidural bleeding or brainstem ischemia and less frequently by medial disc herniation or spinal ischemia. Case presentation Here we report the rare case of an 82-year-old Caucasian man who developed severe tetraparesis four days after radical cystoprostatectomy. An emergency diagnostic study for spinal cord affection was normal. Brain magnetic resonance imaging revealed acute bilateral ischemic strokes in the precentral gyri as the underlying cause. Conclusions This case report underlines the need to also consider unusual causes of tetraparesis in an emergency situation apart from spinal cord or brain stem injury in order not to leave severe symptomatology unclear and possibly miss therapeutic options.}, language = {en} } @article{StoeberFranzekBeckmann1993, author = {St{\"o}ber, Gerald and Franzek, E. and Beckmann, H.}, title = {Die selbstqu{\"a}lerische Depression: eine Form monopolarer endogener Depression}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78454}, year = {1993}, abstract = {Anhand von drei exemplarischen f{\"a}llen wird. das Krankheitsbild der selbstqu{\"a}lerischen Depression, eine Form der reinen Depressionen Leonhards, dargestellt. Im Zentrum stehen die Ideen der Selbsterniedrigung und Selbstentwertung und der sich daran entwickelnde {\"a}ngstlich-depressive Affekt. Charakteristisch ist auch die Angst um die n{\"a}chsten Angeh{\"o}rigen. In ihren Selbstanklagen erwarten und fordern die Patienten f{\"u}r sich die schrecklichsten Strafen. Diese wenigen Leitsymptome kehren in jeder Krankheitsphase gleichf{\"o}rmig wieder. Andere depressive Symptome wie Denkhemmung und psychomotorische Hemmung treten dagegen v{\"o}llig in den Hintergrund. Der Krankheitsverlauf ist streng monopolar. Die Dauer der Krankheitsphasen wurde von Leonhard mit durchschnittlich 5,8 Monaten angegeben. Sie betrug bei unseren Patienten durchschnittlich 4,1 Monate. Das klinische Erscheinungsbild ist durch moderne Behandlungsstrategien nicht wesentlich zu beeinflussen. Eine famili{\"a}re Belastung mit affektiven Psychosen findet sich nur sehr selten.}, subject = {Medizin}, language = {de} } @article{Stoeber1994, author = {St{\"o}ber, Gerald}, title = {Schwangerschaftsinfektionen bei M{\"u}ttern von chronisch Schizophrenen: die Bedeutung einer differenzierten Nosologie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78438}, year = {1994}, abstract = {In einer retrospektiven Untersuchung erinnerten 16 von 80 M{\"u}ttern von chronisch Schizophrenen eine schwere Infektionserkrankung in der Schwangerschaft. Im zweiten Trimenon waren geh{\"a}uft Infektionen aufgetreten. Zehn von 80 M{\"u}ttern von Kontrollpersonen erinnerten ebenfalls eine Infektion. Im Vergleich zu den Kontrollen halfen M{\"u}tter Schizophrener im 5. Schwangerschaftsmonat h{\"a}ufiger Infektionen als in den anderen Gestationsmonaten (p < 0,05). Bei "famili{\"a}ren" und "sporadischen" Schizophrenen gem{\"a}ß DSM III-R kamen im Vergleich zu Kontrollen Infektionen in gleicher H{\"a}ufigkeit vor. Wurden hingegen in der Diagnostik schizophrener Psychosen die Definitionen von Leonhard zugrunde gelegt, ergaben sich signifikante Unterschiede! Bei den systematischen Schizophrenen (denen nach Leonhard keine erbliche Disposition zugrunde liegt) waren Infektionen geh{\"a}uft im 2. Schwangerschaftsdrittel aufgetreten, sowohl im Vergleich zu Kontrollen (p < 0,01) als auch im Vergleich zu den unsystematischen Schizophrenen, die haupts{\"a}chlich genetisch bedingt zu sein scheinen (p < 0,001). Infektionserkrankungen im 5. Schwangerschaftsmonat waren ausschließlich bei den M{\"u}ttern von systematischen Schizophrenen vorgekommen. Bei diesen Krankheitsformen scheinen Infektionen im 2. Schwangerschaftstrimenon und insbesondere im 5. Schwangerschaftsmonat wichtige {\"a}tiologische Faktoren zu sein und k{\"o}nnten miturs{\"a}chlich sein f{\"u}r die beschriebenen zytoarchitektonischen Aberrationen im Zentralnervensystem von chronisch Schizophrenen.}, subject = {Medizin}, language = {de} } @article{BeckerSchmidtkeStoeberetal.1994, author = {Becker, T. and Schmidtke, A. and St{\"o}ber, Gerald and Franzek, E. and Teichmann, E. and Hofmann, E.}, title = {Hyperintense Marklagerl{\"a}sionen bei psychiatrischen Patienten: r{\"a}umliche Verteilung und psychopathologische Symptome}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78288}, year = {1994}, abstract = {In einem Kollektiv von 130 MR-tomographisch untersuchten psychiatrischen Patienten (axiale T2-SE-Sequenz) wurden Zahl und r{\"a}umliche Verteilung von hyperintensen Marklagerl{\"a}sionen ("white matter lesions"; WM L) erfaßt und die Ventricle-to-brain-Ratio (VBR) bestimmt. Eine Konfigurationsfrequenzanalyse auf der Grundlage der r{\"a}umlichen WMLVerteilung erlaubte die Abgrenzung von vier Patientengruppen: 1. keine WML (n = 35), 2. WML rechts frontotemporal (n = 23), 3. WML bifrontal (n = 12), 4. WML ubiquit{\"a}r (n = 16). Die w{\"a}hrend 3 Jahren beobachteten psychopathologischen Symptome dieser Patienten wurden retrospektiv nach dem AMDP-Systemdokumentiert. In der Gruppe mit ubiquit{\"a}ren WML {\"u}berwogen organisch-psychopathologische Ttems, die VER war gr{\"o}ßer als in den anderen Gruppen (ANOVA;p < 0,001). Die r{\"a}umliche W M L- Verteilung erkl{\"a}rte 10,24 \% der Gesamtvarianz psychopathologischer M erkmalsverteilung in den Gruppen. Das Patientenalter (MANCOVA; p < 0,021), nicht aber die VER hattesignifikanten Einfluß auf das psychopathologische Symptomprofil. Nach Ausblendung der Patientengruppe mit ubiquit{\"a}ren WMLblieb der Einfluß der WML-Verteilung auf die psychopathologische Symptomatiksignifikantc (p <0,05). Bifrontale WML waren mit Denkst{\"o}rung, rechts frontotemporale WML mit affektiven Symptomen assoziiert. Die Befunde sprechen f{\"u}r einen Einfluß der r{\"a}umlichen Verteilung unspezifischer Marklagerl{\"a}sionen auf die psychopathologische Symptomatik.}, subject = {Medizin}, language = {de} } @article{SchickIsbaryStueberetal.2012, author = {Schick, Martin Alexander and Isbary, Jobst Tobias and Stueber, Tanja and Brugger, Juergen and Stumpner, Jan and Schlegel, Nicolas and Roewer, Norbert and Eichelbroenner, Otto and Wunder, Christian}, title = {Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-78151}, year = {2012}, abstract = {Background: Septic acute liver and intestinal failure is associated with a high mortality. We therefore investigated the influence of volume resuscitation with different crystalloid or colloid solutions on liver and intestine injury and microcirculation in septic rodents. Methods: Sepsis was induced by cecal ligation and puncture (CLP) in 77 male rats. Animals were treated with different crystalloids (NaCl 0.9\% (NaCl), Ringer's acetate (RA)) or colloids (Gelafundin 4\% (Gel), 6\% HES 130/0.4 (HES)). After 24 h animals were re-anesthetized and intestinal (n = 6/group) and liver microcirculation (n = 6/group) were obtained using intravital microscopy, as well as macrohemodynamic parameters were measured. Blood assays and organs were harvested to determine organ function and injury. Results: HES improved liver microcirculation, cardiac index and DO2-I, but significantly increased IL-1β, IL-6 and TNF-α levels and resulted in a mortality rate of 33\%. Gel infused animals revealed significant reduction of liver and intestine microcirculation with severe side effects on coagulation (significantly increased PTT and INR, decreased haemoglobin and platelet count). Furthermore Gel showed severe hypoglycemia, acidosis and significantly increased ALT and IL-6 with a lethality of 29\%. RA exhibited no derangements in liver microcirculation when compared to sham and HES. RA showed no intestinal microcirculation disturbance compared to sham, but significantly improved the number of intestinal capillaries with flow compared to HES. All RA treated animals survided and showed no severe side effects on coagulation, liver, macrohemodynamic or metabolic state. Conclusions: Gelatine 4\% revealed devastated hepatic and intestinal microcirculation and severe side effects in CLP induced septic rats, whereas the balanced crystalloid solution showed stabilization of macro- and microhemodynamics with improved survival. HES improved liver microcirculation, but exhibited significantly increased pro-inflammatory cytokine levels. Crystalloid infusion revealed best results in mortality and microcirculation, when compared with colloid infusion.}, subject = {Medizin}, language = {en} } @article{KniesSchusterAmezianeetal.2012, author = {Knies, Kerstin and Schuster, Beatrice and Ameziane, Najim and Rooimans, Martin and Bettecken, Thomas and de Winter, Johan and Schindler, Detlev}, title = {Genotyping of Fanconi Anemia Patients by Whole Exome Sequencing: Advantages and Challenges}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77985}, year = {2012}, abstract = {Fanconi anemia (FA) is a rare genomic instability syndrome. Disease-causing are biallelic mutations in any one of at least 15 genes encoding members of the FA/BRCA pathway of DNA-interstrand crosslink repair. Patients are diagnosed based upon phenotypical manifestationsand the diagnosis of FA is confirmed by the hypersensitivity of cells to DNA interstrand crosslinking agents. Customary molecular diagnostics has become increasingly cumbersome, time-consuming and expensive the more FA genes have been identified. We performed Whole Exome Sequencing (WES) in four FA patients in order to investigate the potential of this method for FA genotyping. In search of an optimal WES methodology we explored different enrichment and sequencing techniques. In each case we were able to identify the pathogenic mutations so that WES provided both, complementation group assignment and mutation detection in a single approach. The mutations included homozygous and heterozygous single base pair substitutions and a two-base-pair duplication in FANCJ, -D1, or - D2. Different WES strategies had no critical influence on the individual outcome. However, database errors and in particular pseudogenes impose obstacles that may prevent correct data perception and interpretation, and thus cause pitfalls. With these difficulties in mind, our results show that WES is a valuable tool for the molecular diagnosis of FA and a sufficiently safe technique, capable of engaging increasingly in competition with classical genetic approaches.}, subject = {Medizin}, language = {en} } @article{RiedelMottokBredeetal.2012, author = {Riedel, Simone S. and Mottok, Anja and Brede, Christian and B{\"a}uerlein, Carina A. and Jord{\´a}n Garrote, Ana Laura and Ritz, Miriam and Mattenheimer, Katharina and Rosenwald, Andreas and Einsele, Hermann and Bogen, Bjarne and Beilhack, Andreas}, title = {Non-Invasive Imaging Provides Spatiotemporal Information on Disease Progression and Response to Therapy in a Murine Model of Multiple Myeloma}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77978}, year = {2012}, abstract = {Background: Multiple myeloma (MM) is a B-cell malignancy, where malignant plasma cells clonally expand in the bone marrow of older people, causing significant morbidity and mortality. Typical clinical symptoms include increased serum calcium levels, renal insufficiency, anemia, and bone lesions. With standard therapies, MM remains incurable; therefore, the development of new drugs or immune cell-based therapies is desirable. To advance the goal of finding a more effective treatment for MM, we aimed to develop a reliable preclinical MM mouse model applying sensitive and reproducible methods for monitoring of tumor growth and metastasis in response to therapy. Material and Methods: A mouse model was created by intravenously injecting bone marrow-homing mouse myeloma cells (MOPC-315.BM) that expressed luciferase into BALB/c wild type mice. The luciferase in the myeloma cells allowed in vivo tracking before and after melphalan treatment with bioluminescence imaging (BLI). Homing of MOPC-315.BM luciferase+ myeloma cells to specific tissues was examined by flow cytometry. Idiotype-specific myeloma protein serum levels were measured by ELISA. In vivo measurements were validated with histopathology. Results: Strong bone marrow tropism and subsequent dissemination of MOPC-315.BM luciferase+ cells in vivo closely mimicked the human disease. In vivo BLI and later histopathological analysis revealed that 12 days of melphalan treatment slowed tumor progression and reduced MM dissemination compared to untreated controls. MOPC-315.BM luciferase+ cells expressed CXCR4 and high levels of CD44 and a4b1 in vitro which could explain the strong bone marrow tropism. The results showed that MOPC-315.BM cells dynamically regulated homing receptor expression and depended on interactions with surrounding cells. Conclusions: This study described a novel MM mouse model that facilitated convenient, reliable, and sensitive tracking of myeloma cells with whole body BLI in living animals. This model is highly suitable for monitoring the effects of different treatment regimens.}, subject = {Medizin}, language = {en} } @article{FehrholzBersaniKrameretal.2012, author = {Fehrholz, Markus and Bersani, Iliana and Kramer, Boris W. and Speer, Christian P. and Kunzmann, Steffen}, title = {Synergistic Effect of Caffeine and Glucocorticoids on Expression of Surfactant Protein B (SP-B) mRNA}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77927}, year = {2012}, abstract = {Administration of glucocorticoids and caffeine is a common therapeutic intervention in the neonatal period, but possible interactions between these substances are still unclear. The present study investigated the effect of caffeine and different glucocorticoids on expression of surfactant protein (SP)-B, crucial for the physiological function of pulmonary surfactant. We measured expression levels of SP-B, various SP-B transcription factors including erythroblastic leukemia viral oncogene homolog 4 (ErbB4) and thyroid transcription factor-1 (TTF-1), as well as the glucocorticoid receptor (GR) after administering different doses of glucocorticoids, caffeine, cAMP, or the phosphodiesterase-4 inhibitor rolipram in the human airway epithelial cell line NCI-H441. Administration of dexamethasone (1 mM) or caffeine (5 mM) stimulated SP-B mRNA expression with a maximal of 38.8611.1-fold and 5.261.4-fold increase, respectively. Synergistic induction was achieved after coadministration of dexamethasone (1 mM) in combination with caffeine (10 mM) (206659.7-fold increase, p,0.0001) or cAMP (1 mM) (2136111-fold increase, p = 0.0108). SP-B mRNA was synergistically induced also by administration of caffeine with hydrocortisone (87.9639.0), prednisolone (154666.8), and betamethasone (12366.4). Rolipram also induced SP-B mRNA (64.9621.0-fold increase). We detected a higher expression of ErbB4 and GR mRNA (7.0- and 1.7-fold increase, respectively), whereas TTF-1, Jun B, c-Jun, SP1, SP3, and HNF-3a mRNA expression was predominantly unchanged. In accordance with mRNA data, mature SP-B was induced significantly by dexamethasone with caffeine (13.869.0-fold increase, p = 0.0134). We found a synergistic upregulation of SP-B mRNA expression induced by co-administration of various glucocorticoids and caffeine, achieved by accumulation of intracellular cAMP. This effect was mediated by a caffeinedependent phosphodiesterase inhibition and by upregulation of both ErbB4 and the GR. These results suggested that caffeine is able to induce the expression of SP-transcription factors and affects the signaling pathways of glucocorticoids, amplifying their effects. Co-administration of caffeine and corticosteroids may therefore be of benefit in surfactant homeostasis.}, subject = {Medizin}, language = {en} } @article{BenkertDietzHartmannetal.2012, author = {Benkert, Thomas F. and Dietz, Lena and Hartmann, Elena M. and Leich, Ellen and Rosenwald, Andreas and Serfling, Edgar and Buttmann, Mathias and Berberich-Siebelt, Friederike}, title = {Natalizumab Exerts Direct Signaling Capacity and Supports a Pro-Inflammatory Phenotype in Some Patients with Multiple Sclerosis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77905}, year = {2012}, abstract = {Natalizumab is a recombinant monoclonal antibody raised against integrin alpha-4 (CD49d). It is approved for the treatment of patients with multiple sclerosis (MS), a chronic inflammatory autoimmune disease of the CNS. While having shown high therapeutic efficacy, treatment by natalizumab has been linked to progressive multifocal leukoencephalopathy (PML) as a serious adverse effect. Furthermore, drug cessation sometimes induces rebound disease activity of unknown etiology. Here we investigated whether binding of this adhesion-blocking antibody to T lymphocytes could modulate their phenotype by direct induction of intracellular signaling events. Primary CD4+ T lymphocytes either from healthy donors and treated with natalizumab in vitro or from MS patients receiving their very first dose of natalizumab were analyzed. Natalizumab induced a mild upregulation of IL-2, IFN-c and IL-17 expression in activated primary human CD4+ T cells propagated ex vivo from healthy donors, consistent with a pro-inflammatory costimulatory effect on lymphokine expression. Along with this, natalizumab binding triggered rapid MAPK/ERK phosphorylation. Furthermore, it decreased CD49d surface expression on effector cells within a few hours. Sustained CD49d downregulation could be attributed to integrin internalization and degradation. Importantly, also CD4+ T cells from some MS patients receiving their very first dose of natalizumab produced more IL-2, IFN-c and IL-17 already 24 h after infusion. Together these data indicate that in addition to its adhesion-blocking mode of action natalizumab possesses mild direct signaling capacities, which can support a pro-inflammatory phenotype of peripheral blood T lymphocytes. This might explain why a rebound of disease activity or IRIS is observed in some MS patients after natalizumab cessation.}, subject = {Medizin}, language = {en} } @article{MatlachSloboddaGrehnetal.2012, author = {Matlach, Juliane and Slobodda, Joerg and Grehn, Franz and Klink, Thomas}, title = {Pars plana vitrectomy for malignant glaucoma in non-glaucomatous and in filtered glaucomatous eyes}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-76375}, year = {2012}, abstract = {Purpose: To assess the outcomes of pars plana vitrectomy for the treatment of malignant glaucoma in patients with and without previous filtration surgery. Patients and methods: Data of 15 patients developing malignant glaucoma after trabeculectomy (60\%) or following ophthalmic interventions other than filtration surgery (40\%) were recorded retrospectively. Pars plana vitrectomy was performed in case of failed medical or laser treatment recreating the normal pathway of aqueous humor. The main outcome measures were the postoperative intraocular pressure (IOP), the frequency of complications, and success rate based on the following criteria: IOP reduction by \$20\% and to \#21 mmHg (definition one) or an IOP , 18 mmHg (definition two) with (qualified success) and without (complete success) glaucoma medication. Results: Vitrectomy reduced IOP from baseline in eyes with and without previous trabeculectomy during a median follow-up of 16.4 months (range 7 days to 58 months); although the majority of patients required glaucoma medication to reach desired IOP. The complete success rates were 11\% (both definitions) for patients with filtering blebs and none of the patients without previous trabeculectomy had complete success at the 12-month visit. Complications were few and included transient shallowing of the anterior chamber, choroidal detachment, corneal decompensation, filtering bleb failure, and need for further IOP-lowering procedures. Conclusion: Pars plana vitrectomy is equally effective for malignant glaucoma caused by trabeculectomy or interventions other than filtration surgery, although IOP-lowering medication is necessary in nearly all cases to maintain target IOP.}, subject = {Medizin}, language = {en} } @article{SchulteWestermannVogel2012, author = {Schulte, Leon N. and Westermann, Alexander J. and Vogel, J{\"o}rg}, title = {Differential activation and functional specialization of miR-146 and miR-155 in innate immune sensing}, edition = {Advance Access}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-76365}, year = {2012}, abstract = {Many microRNAs (miRNAs) are co-regulated during the same physiological process but the underlying cellular logic is often little understood. The conserved, immunomodulatory miRNAs miR-146 and miR-155, for instance, are co-induced in many cell types in response to microbial lipopolysaccharide (LPS) to feedback-repress LPS signalling through Toll-like receptor TLR4. Here, we report that these seemingly co-induced regulatory RNAs dramatically differ in their induction behaviour under various stimuli strengths and act non-redundantly through functional specialization; although miR-146 expression saturates at sub-inflammatory doses of LPS that do not trigger the messengers of inflammation markers, miR-155 remains tightly associated with the pro-inflammatory transcriptional programmes. Consequently, we found that both miRNAs control distinct mRNA target profiles; although miR-146 targets the messengers of LPS signal transduction components and thus downregulates cellular LPS sensitivity, miR-155 targets the mRNAs of genes pervasively involved in pro-inflammatory transcriptional programmes. Thus, miR-155 acts as a broad limiter of pro-inflammatory gene expression once the miR-146 dependent barrier to LPS triggered inflammation has been breached. Importantly, we also report alternative miR-155 activation by the sensing of bacterial peptidoglycan through cytoplasmic NOD-like receptor, NOD2. We predict that dosedependent responses to environmental stimuli may involve functional specialization of seemingly coinduced miRNAs in other cellular circuitries as well.}, subject = {Medizin}, language = {en} } @article{ZellerDangWeiseetal.2012, author = {Zeller, Daniel and Dang, Su-Yin and Weise, David and Rieckmann, Peter and Toyka, Klaus V. and Classen, Joseph}, title = {Excitability decreasing central motor plasticity is retained in multiple sclerosis patients}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-76333}, year = {2012}, abstract = {Background: Compensation of brain injury in multiple sclerosis (MS) may in part work through mechanisms involving neuronal plasticity on local and interregional scales. Mechanisms limiting excessive neuronal activity may have special significance for retention and (re-)acquisition of lost motor skills in brain injury. However, previous neurophysiological studies of plasticity in MS have investigated only excitability enhancing plasticity and results from neuroimaging are ambiguous. Thus, the aim of this study was to probe long-term depression-like central motor plasticity utilizing continuous theta-burst stimulation (cTBS), a non-invasive brain stimulation protocol. Because cTBS also may trigger behavioral effects through local interference with neuronal circuits, this approach also permitted investigating the functional role of the primary motor cortex (M1) in force control in patients with MS. Methods: We used cTBS and force recordings to examine long-term depression-like central motor plasticity and behavioral consequences of a M1 lesion in 14 patients with stable mild-to-moderate MS (median EDSS 1.5, range 0 to 3.5) and 14 age-matched healthy controls. cTBS consisted of bursts (50 Hz) of three subthreshold biphasic magnetic stimuli repeated at 5 Hz for 40 s over the hand area of the left M1. Corticospinal excitability was probed via motor-evoked potentials (MEP) in the abductor pollicis brevis muscle over M1 before and after cTBS. Force production performance was assessed in an isometric right thumb abduction task by recording the number of hits into a predefined force window. Results: cTBS reduced MEP amplitudes in the contralateral abductor pollicis brevis muscle to a comparable extent in control subjects (69 ± 22\% of baseline amplitude, p < 0.001) and in MS patients (69 ± 18\%, p < 0.001). In contrast, postcTBS force production performance was only impaired in controls (2.2 ± 2.8, p = 0.011), but not in MS patients (2.0 ± 4.4, p = 0.108). The decline in force production performance following cTBS correlated with corticomuscular latencies (CML) in MS patients, but did not correlate with MEP amplitude reduction in patients or controls. Conclusions: Long-term depression-like plasticity remains largely intact in mild-to-moderate MS. Increasing brain injury may render the neuronal networks less responsive toward lesion-induction by cTBS.}, subject = {Medizin}, language = {en} }