@article{JakubietzMeffertSchmidtetal.2017, author = {Jakubietz, Michael G. and Meffert, Rainer H. and Schmidt, Karsten and Gruenert, Joerg G. and Jakubietz, Rafael G.}, title = {Acute A4 Pulley Reconstruction with a First Extensor Compartment Onlay Graft}, series = {Plastic and Reconstructive Surgery Global Open}, volume = {5}, journal = {Plastic and Reconstructive Surgery Global Open}, number = {6}, doi = {10.1097/GOX.0000000000001361}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158057}, pages = {e1361}, year = {2017}, abstract = {Background: The integrity of the flexor tendon pulley apparatus is crucial for unimpaired function of the digits. Although secondary reconstruction is an established procedure in multi-pulley injuries, acute reconstruction of isolated, closed pulley ruptures is a rare occurrence. There are 3 factors influencing the functional outcome of a reconstruction: gapping distance between tendon and bone (E-space), bulkiness of the reconstruction, and stability. As direct repair is rarely done, grafts are used to reinforce the pulley. An advantage of the first extensor retinaculum graft is the synovial coating providing the possibility to be used both as a direct graft with synovial coating or as an onlay graft after removal of the synovia when the native synovial layer is present. Methods: A graft from the first dorsal extensor compartment is used as an onlay graft to reinforce the sutured A4 pulley. This technique allows reconstruction of the original dimensions of the pulley system while stability is ensured by anchoring the onlay graft to the bony insertions of the pulley. Results: Anatomical reconstruction can be achieved with this method. The measured E-space remained 0 mm throughout the recovery, while the graft incorporated as a slim reinforcement of the pulley, displaying no bulkiness. Conclusions: The ideal reconstruction should provide synovial coating and sufficient strength with minimal bulk. Early reconstruction using an onlay graft offers these options. The native synovial lining is preserved and the graft is used to reinforce the pulley.}, language = {en} } @article{JordanBittrichFehskeetal.2017, author = {Jordan, Martin C. and Bittrich, Leonie A. and Fehske, Kai and Meffert, Rainer H. and Jansen, Hendrik}, title = {A rare case of Hoffa fracture combined with lateral patellar dislocation}, series = {Trauma Case Reports}, volume = {9}, journal = {Trauma Case Reports}, doi = {10.1016/j.tcr.2017.05.001}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158315}, pages = {13-16}, year = {2017}, abstract = {The coronal unicondylar fracture of the distal femur (AO 33-B3) is a rare intraarticular injury within the weight bearing area of the knee, initially described by Albert Hoffa in 1904. We report an unusual combination of a Hoffa fracture with lateral patellar dislocation in a young adult. Our patient sustained the injury by a sudden twist of his leg during sports. He presented clinically with knee swelling, dislocation of the patella, and localized tenderness; unable to bare weight. After plane radiograph confirmed the injury, manual reduction of the patella was done by hyperextension of the knee and medialward pressure. Afterwards, a CT scan and MRI were conducted. The injury was surgically treated with lag-screws, locking-plate and MPFL-reconstruction.}, language = {en} } @article{BornKunzSperlich2017, author = {Born, Dennis-Peter and Kunz, Philipp and Sperlich, Billy}, title = {Reliability and validity of an agility-like incremental exercise test with multidirectional change-of-direction movements in response to a visual stimulus}, series = {Physiological Reports}, volume = {5}, journal = {Physiological Reports}, number = {9}, doi = {10.14814/phy2.13275}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158265}, pages = {e13275}, year = {2017}, abstract = {The aim of the study was to evaluate the reliability and validity of cardiorespiratory and metabolic variables, that is, peak oxygen uptake (V'O\(_{2peak}\)) and heart rate (HR\(_{peak}\)), obtained from an agility-like incremental exercise test for team sport athletes. To investigate the test-retest reliability, 25 team sport athletes (age: 22 ± 3 years, body mass: 75 ± 7 kg, height: 182 ± 6 cm) performed an agility-like incremental exercise test on the SpeedCourt (SC) system incorporating multidirectional change-of-direction (COD) movements twice. For each step of the incremental SC test, the athletes covered a 40-m distance interspersed with a 10-sec rest period. Each 40 m distance was split into short sprints (2.25-6.36 m) separated by multidirectional COD movements (0°-180°), which were performed in response to an external visual stimulus. All performance and physiological data were validated with variables obtained from a ramp-like treadmill and Yo-Yo intermittent recovery level 2 test (Yo-Yo IR2). The incremental SC test revealed high test-retest reliability for the time to exhaustion (ICC = 0.85, typical error [TE] = 0.44, and CV\% = 3.88), V'O\(_{2peak}\), HR\(_{peak}\), ventilation, and breathing frequency (ICC = 0.84, 0.72, 0.89, 0.77, respectively). The time to exhaustion (r = 0.50, 0.74) of the incremental SC test as well as the peak values for V'O\(_{2}\) (r = 0.59, 0.52), HR (r = 0.75, 0.78), ventilation (r = 0.57, 0.57), and breathing frequency (r = 0.68, 0.68) were significantly correlated (P ≤ 0.01) with the ramp-like treadmill test and the Yo-Yo IR2, respectively. The incremental SC test represents a reliable and valid method to assess peak values for V'O\(_{2}\) and HR with respect to the specific demand of team sport match play by incorporating multidirectional COD movements, decision making, and cognitive components.}, language = {en} } @article{HillmannWiedmannRueckeretal.2017, author = {Hillmann, Steffi and Wiedmann, Silke and R{\"u}cker, Viktoria and Berger, Klaus and Nabavi, Darius and Bruder, Ingo and Koennecke, Hans-Christian and Seidel, G{\"u}nter and Misselwitz, Bj{\"o}rn and Janssen, Alfred and Burmeister, Christoph and Matthis, Christine and Busse, Otto and Hermanek, Peter and Heuschmann, Peter Ulrich}, title = {Stroke unit care in Germany: the German stroke registers study group (ADSR)}, series = {BMC Neurology}, volume = {17}, journal = {BMC Neurology}, number = {49}, doi = {10.1186/s12883-017-0819-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159447}, year = {2017}, abstract = {Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4\% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low.}, language = {en} } @article{BeningHamoudaOezkuretal.2017, author = {Bening, Constanze and Hamouda, Khaled and Oezkur, Mehmet and Schimmer, Christoph and Schade, Ina and Gorski, Armin and Aleksic, Ivan and Leyh, Rainer}, title = {Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy}, series = {Journal of Cardiothoracic Surgery}, volume = {12}, journal = {Journal of Cardiothoracic Surgery}, number = {27}, doi = {10.1186/s13019-017-0598-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159439}, year = {2017}, abstract = {Background: There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT. Methods: Sixty-eight patients (mean age 76 ± 6 years, 32\% females) underwent RAT-AVR between 9/2013 and 7/2015. According to the valve type implanted the patients were divided into two groups. In 43 patients (R-group; mean age 74.1 ± 6.6 years) a rapid deployment valve system (Edwards Intuity, Edwards Lifesciences Corp; Irvine, Calif) and in 25 patients (C-group; mean age 74.2 ± 6.6 years) a conventional stented biological aortic valve was implanted. Results: Aortic cross-clamp (42.1 ± 12 min vs. 68.3 ± 20.3 min; p < 0.001) and bypass time (80.4 ± 39.3 min vs. 106.6 ± 23.2 min; p = 0.001) were shorter in the rapid deployment group (R-group). We observed no differences in clinical outcome. Postoperative gradients (R-group: max gradient, 14.3 ± 8 mmHg vs. 15.5 ± 5 mmHg (C-group), mean gradient, 9.2 ± 1.7 mmHg (R-group) vs. 9.1 ± 2.3 mmHg (C-group) revealed no differences. However, larger prostheses were implanted in C-group (25 mm; IQR 23-27 mm vs. 23 mm; IQR 21-25; p = 0.009). Conclusions: Our data suggest that the rapid deployment aortic valve system reduced cross clamp and bypass time in patients undergoing RAT-AVR with similar hemodynamics as with larger size stented prosthesis. However, larger studies and long-term follow-up are mandatory to confirm our findings.}, language = {en} } @article{DuekingHolmbergSperlich2017, author = {D{\"u}king, Peter and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Instant Biofeedback Provided by Wearable Sensor Technology Can Help to Optimize Exercise and Prevent Injury and Overuse}, series = {Frontiers in Physiology}, volume = {8}, journal = {Frontiers in Physiology}, number = {167}, doi = {10.3389/fphys.2017.00167}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158044}, year = {2017}, language = {en} } @article{HelmprobstLillesaarStigloher2017, author = {Helmprobst, Frederik and Lillesaar, Christina and Stigloher, Christian}, title = {Expression of sept3, sept5a and sept5b in the Developing and Adult Nervous System of the Zebrafish (Danio rerio)}, series = {Frontiers in Neuroanatomy}, volume = {11}, journal = {Frontiers in Neuroanatomy}, number = {6}, doi = {10.3389/fnana.2017.00006}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157625}, year = {2017}, abstract = {Septins are a highly conserved family of small GTPases that form cytoskeletal filaments. Their cellular functions, especially in the nervous system, still remain largely enigmatic, but there are accumulating lines of evidence that septins play important roles in neuronal physiology and pathology. In order to further dissect septin function in the nervous system a detailed temporal resolved analysis in the genetically well tractable model vertebrate zebrafish (Danio rerio) is crucially necessary. To close this knowledge gap we here provide a reference dataset describing the expression of selected septins (sept3, sept5a and sept5b) in the zebrafish central nervous system. Strikingly, proliferation zones are devoid of expression of all three septins investigated, suggesting that they have a role in post-mitotic neural cells. Our finding that three septins are mainly expressed in non-proliferative regions was further confirmed by double-stainings with a proliferative marker. Our RNA in situ hybridization (ISH) study, detecting sept3, sept5a and sept5b mRNAs, shows that all three septins are expressed in largely overlapping regions of the developing brain. However, the expression of sept5a is much more confined compared to sept3 and sept5b. In contrast, the expression of all the three analyzed septins is largely similar in the adult brain.}, language = {en} } @article{LillaFuellgrafStetteretal.2017, author = {Lilla, Nadine and F{\"u}llgraf, Hannah and Stetter, Christian and K{\"o}hler, Stefan and Ernestus, Ralf-Ingo and Westermaier, Thomas}, title = {First Description of Reduced Pyruvate Dehydrogenase Enzyme Activity Following Subarachnoid Hemorrhage (SAH)}, series = {Frontiers in Neuroscience}, volume = {11}, journal = {Frontiers in Neuroscience}, number = {37}, doi = {10.3389/fnins.2017.00037}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157636}, year = {2017}, abstract = {Object: Several previous studies reported metabolic derangements and an accumulation of metabolic products in the early phase of experimental subarachnoid hemorrhage (SAH), which may contribute to secondary brain damage. This may be a result of deranged oxygen utilization due to enzymatic dysfunction in aerobic glucose metabolism. This study was performed to investigate, if pyruvate dehydrogenase enzyme (PDH) is affected in its activity giving further hints for a derangement of oxidative metabolism. Methods: Eighteen male Sprague-Dawley rats were randomly assigned to one of two experimental groups (n = 9): (1) SAH induced by the endovascular filament model and (2) sham-operated controls. Mean arterial blood pressure (MABP), intracranial pressure (ICP), and local cerebral blood flow (LCBF; laser-Doppler flowmetry) were continuously monitored from 30 min before until 3 h after SAH. Thereafter, the animals were sacrificed and PDH activity was measured by ELISA. Results: PDH activity was significantly reduced in animals subjected to SAH compared to controls. Conclusion: The results of this study demonstrate for the first time a reduction of PDH activity following SAH, independent of supply of substrates and may be an independent factor contributing to a derangement of oxidative metabolism, failure of oxygen utilization, and secondary brain damage.}, language = {en} } @article{DombertBalkLueningschroeretal.2017, author = {Dombert, Benjamin and Balk, Stefanie and L{\"u}ningschr{\"o}r, Patrick and Moradi, Mehri and Sivadasan, Rajeeve and Saal-Bauernschubert, Lena and Jablonka, Sibylle}, title = {BDNF/trkB induction of calcium transients through Ca\(_{v}\)2.2 calcium channels in motoneurons corresponds to F-actin assembly and growth cone formation on β2-chain laminin (221)}, series = {Frontiers in Molecular Neuroscience}, volume = {10}, journal = {Frontiers in Molecular Neuroscience}, number = {346}, doi = {10.3389/fnmol.2017.00346}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159094}, year = {2017}, abstract = {Spontaneous Ca\(^{2+}\) transients and actin dynamics in primary motoneurons correspond to cellular differentiation such as axon elongation and growth cone formation. Brain-derived neurotrophic factor (BDNF) and its receptor trkB support both motoneuron survival and synaptic differentiation. However, in motoneurons effects of BDNF/trkB signaling on spontaneous Ca\(^{2+}\) influx and actin dynamics at axonal growth cones are not fully unraveled. In our study we addressed the question how neurotrophic factor signaling corresponds to cell autonomous excitability and growth cone formation. Primary motoneurons from mouse embryos were cultured on the synapse specific, β2-chain containing laminin isoform (221) regulating axon elongation through spontaneous Ca\(^{2+}\) transients that are in turn induced by enhanced clustering of N-type specific voltage-gated Ca\(^{2+}\) channels (Ca\(_{v}\)2.2) in axonal growth cones. TrkB-deficient (trkBTK\(^{-/-}\)) mouse motoneurons which express no full-length trkB receptor and wildtype motoneurons cultured without BDNF exhibited reduced spontaneous Ca\(^{2+}\) transients that corresponded to altered axon elongation and defects in growth cone morphology which was accompanied by changes in the local actin cytoskeleton. Vice versa, the acute application of BDNF resulted in the induction of spontaneous Ca\(^{2+}\) transients and Ca\(_{v}\)2.2 clustering in motor growth cones, as well as the activation of trkB downstream signaling cascades which promoted the stabilization of β-actin via the LIM kinase pathway and phosphorylation of profilin at Tyr129. Finally, we identified a mutual regulation of neuronal excitability and actin dynamics in axonal growth cones of embryonic motoneurons cultured on laminin-221/211. Impaired excitability resulted in dysregulated axon extension and local actin cytoskeleton, whereas upon β-actin knockdown Ca\(_{v}\)2.2 clustering was affected. We conclude from our data that in embryonic motoneurons BDNF/trkB signaling contributes to axon elongation and growth cone formation through changes in the local actin cytoskeleton accompanied by increased Ca\(_{v}\)2.2 clustering and local calcium transients. These findings may help to explore cellular mechanisms which might be dysregulated during maturation of embryonic motoneurons leading to motoneuron disease.}, language = {en} } @article{FehrholzGlaserSpeeretal.2017, author = {Fehrholz, Markus and Glaser, Kirsten and Speer, Christian P. and Seidenspinner, Silvia and Ottensmeier, Barbara and Kunzmann, Steffen}, title = {Caffeine modulates glucocorticoid-induced expression of CTGF in lung epithelial cells and fibroblasts}, series = {Respiratory Research}, volume = {18}, journal = {Respiratory Research}, number = {51}, doi = {10.1186/s12931-017-0535-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157672}, year = {2017}, abstract = {Background: Although caffeine and glucocorticoids are frequently used to treat chronic lung disease in preterm neonates, potential interactions are largely unknown. While anti-inflammatory effects of glucocorticoids are well defined, their impact on airway remodeling is less characterized. Caffeine has been ascribed to positive effects on airway inflammation as well as remodeling. Connective tissue growth factor (CTGF, CCN2) plays a key role in airway remodeling and has been implicated in the pathogenesis of chronic lung diseases such as bronchopulmonary dysplasia (BPD) in preterm infants. The current study addressed the impact of glucocorticoids on the regulation of CTGF in the presence of caffeine using human lung epithelial and fibroblast cells. Methods: The human airway epithelial cell line H441 and the fetal lung fibroblast strain IMR-90 were exposed to different glucocorticoids (dexamethasone, budesonide, betamethasone, prednisolone, hydrocortisone) and caffeine. mRNA and protein expression of CTGF, TGF-β1-3, and TNF-α were determined by means of quantitative real-time PCR and immunoblotting. H441 cells were additionally treated with cAMP, the adenylyl cyclase activator forskolin, and the selective phosphodiesterase (PDE)-4 inhibitor cilomilast to mimic caffeine-mediated PDE inhibition. Results: Treatment with different glucocorticoids (1 μM) significantly increased CTGF mRNA levels in H441 (p < 0.0001) and IMR-90 cells (p < 0.01). Upon simultaneous exposure to caffeine (10 mM), both glucocorticoid-induced mRNA and protein expression were significantly reduced in IMR-90 cells (p < 0.0001). Of note, 24 h exposure to caffeine alone significantly suppressed basal expression of CTGF mRNA and protein in IMR-90 cells. Caffeine-induced reduction of CTGF mRNA expression seemed to be independent of cAMP levels, adenylyl cyclase activation, or PDE-4 inhibition. While dexamethasone or caffeine treatment did not affect TGF-β1 mRNA in H441 cells, increased expression of TGF-β2 and TGF-β3 mRNA was detected upon exposure to dexamethasone or dexamethasone and caffeine, respectively. Moreover, caffeine increased TNF-α mRNA in H441 cells (6.5 ± 2.2-fold, p < 0.05) which has been described as potent inhibitor of CTGF expression. Conclusions: In addition to well-known anti-inflammatory features, glucocorticoids may have adverse effects on long-term remodeling by TGF-β1-independent induction of CTGF in lung cells. Simultaneous treatment with caffeine may attenuate glucocorticoid-induced expression of CTGF, thereby promoting restoration of lung homeostasis.}, language = {en} } @article{SchindlerRichterEysser2017, author = {Schindler, Julia and Richter, Tobias and Eyßer, Carolin}, title = {Mood moderates the effect of self-generation during learning}, series = {Frontline Learning Research}, volume = {5}, journal = {Frontline Learning Research}, number = {4}, doi = {10.14786/flr.v5i4.296}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159282}, pages = {76-88}, year = {2017}, abstract = {Generating information, compared to reading, improves learning and enhances long-term retention of the learned content. This so-called generation effect has been demonstrated repeatedly for recall and recognition of single words. However, before adopting generating as a learning strategy in educational contexts, conditions moderating the effect need to be identified. This study investigated the impact of positive and negative mood states on the generation effect with short expository texts. According to the dual-force framework (Fiedler, Nickel, Asbeck, \& Pagel, 2003), positive mood should facilitate generation by enhancing creative knowledge-based top-down processing (assimilation). Negative mood, however, should facilitate learning in the read-condition by enhancing critical stimulus-driven bottom-up processing (accommodation). In contrast to our expectations, we found no general generation effect but an overall learning advantage of read compared to generated texts. However, a significant interaction of learning condition and mood indicates that learners in a better mood recall generated texts better than learners in a more negative mood, whereas no mood effect was found when the texts were read. The results of the present study partially support the predictions of the dual-force framework and are discussed in the context of recent theoretical approaches to the generation effect.}, language = {en} } @article{KelmSeyfriedReimeretal.2017, author = {Kelm, M. and Seyfried, F. and Reimer, S. and Krajinovic, K. and Miras, A. D. and Jurowich, C. and Germer, C. T. and Brand, M.}, title = {Proximal jejunal stoma as ultima ratio in case of traumatic distal duodenal perforation facilitating successful EndoVAC\(^{®}\) treatment: a case report}, series = {International Journal of Surgery Case Reports}, volume = {41}, journal = {International Journal of Surgery Case Reports}, doi = {10.1016/j.ijscr.2017.11.022}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159292}, pages = {401-403}, year = {2017}, abstract = {Introduction: During damage control surgery for blunt abdominal traumata simultaneous duodenal perforations can be missed making secondary sufficient surgical treatment challenging. Endoluminal vacuum (EndoVAC™) therapy has been shown to be a revolutionary option but has anatomical and technical limits. Presentation of the case: A 59-year old man with hemorrhagic shock due to rupture of the mesenteric root after blunt abdominal trauma received damage control treatment. Within a scheduled second-look, perforation of the posterior duodenal wall was identified. Due to local and systemic conditions, further surgical treatment was limited. Decision for endoscopic treatment was made but proved to be difficult due to the distal location. Finally, double-barreled jejunal stoma was created for transstomal EndoVAC™ treatment. Complete leakage healing was achieved and jejunostomy reversal followed subsequently. Discussion: During damage control surgery simultaneous bowel injuries can be missed leading to life-threatening complications with limited surgical options. EndoVAC™ treatment is an option for gastrointestinal perforations but has anatomical limitations that can be sufficiently shifted by a transstomal approach for intestinal leakage. Conclusion: In trauma related laparotomy complete mobilization of the duodenum is crucial. As ultima ratio, transstomal EndoVAC™ is a safe and feasible option and can be considered for similar cases.}, language = {en} } @article{LapaKircherHaenscheidetal.2018, author = {Lapa, Constantin and Kircher, Malte and H{\"a}nscheid, Heribert and Schirbel, Andreas and Grigoleit, G{\"o}tz Ulrich and Klinker, Erdwine and B{\"o}ck, Markus and Samnick, Samuel and Pelzer, Theo and Buck, Andreas K}, title = {Peptide receptor radionuclide therapy as a new tool in treatment-refractory sarcoidosis - initial experience in two patients}, series = {Theranostics}, volume = {8}, journal = {Theranostics}, number = {3}, doi = {10.7150/thno.22161}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158983}, pages = {644-649}, year = {2018}, abstract = {Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that can involve virtually all organ systems. Whereas most patients present without symptoms, progressive and disabling organ failure can occur in up to 10\% of subjects. Somatostatin receptor (SSTR)-directed peptide receptor radionuclide therapy (PRRT) has recently received market authorization for treatment of SSTR-positive neuroendocrine tumors. Methods: We describe the first case series comprising two patients with refractory multi-organ involvement of sarcoidosis who received 4 cycles of PRRT. Results: PRRT was well-tolerated without any acute adverse effects. No relevant toxicities could be recorded during follow-up. Therapy resulted in partial response accompanied by a pronounced reduction in pain (patient \#1) and stable disease regarding morphology as well as disease activity (patient \#2), respectively. Conclusion: Peptide receptor radionuclide therapy in sarcoidosis is feasible and might be a new valuable tool in patients with otherwise treatment-refractory disease. Given the long experience with and good tolerability of PRRT, further evaluation of this new treatment option for otherwise treatment-refractory sarcoidosis in larger patient cohorts is warranted.}, language = {en} } @article{SchuhmannGuthmannStolletal.2017, author = {Schuhmann, Michael K. and Guthmann, Josua and Stoll, Guido and Nieswandt, Bernhard and Kraft, Peter and Kleinschnitz, Christoph}, title = {Blocking of platelet glycoprotein receptor Ib reduces "thrombo-inflammation" in mice with acute ischemic stroke}, series = {Journal of Neuroinflammation}, volume = {14}, journal = {Journal of Neuroinflammation}, number = {18}, doi = {10.1186/s12974-017-0792-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157582}, year = {2017}, abstract = {Background: Ischemic stroke causes a strong inflammatory response that includes T cells, monocytes/macrophages, and neutrophils. Interaction of these immune cells with platelets and endothelial cells facilitates microvascular dysfunction and leads to secondary infarct growth. We recently showed that blocking of platelet glycoprotein (GP) receptor Ib improves stroke outcome without increasing the risk of intracerebral hemorrhage. Until now, it has been unclear whether GPIb only mediates thrombus formation or also contributes to the pathophysiology of local inflammation. Methods: Focal cerebral ischemia was induced in C57BL/6 mice by a 60-min transient middle cerebral artery occlusion (tMCAO). Animals were treated with antigen-binding fragments (Fab) against the platelet surface molecules GPIb (p0p/B Fab). Rat immunoglobulin G (IgG) Fab was used as control treatment. Stroke outcome, including infarct size and functional deficits as well as the local inflammatory response, was assessed on day 1 after tMCAO. Results: Blocking of GPIb reduced stroke size and improved functional outcome on day 1 after tMCAO without increasing the risk of intracerebral hemorrhage. As expected, disruption of GPIb-mediated pathways in platelets significantly reduced thrombus burden in the cerebral microvasculature. In addition, inhibition of GPIb limited the local inflammatory response in the ischemic brain as indicated by lower numbers of infiltrating T cells and macrophages and lower expression levels of inflammatory cytokines compared with rat IgG Fab-treated controls. Conclusion: In acute ischemic stroke, thrombus formation and inflammation are closely intertwined ("thrombo-inflammation"). Blocking of platelet GPIb can ameliorate thrombo-inflammation.}, language = {en} } @article{SperlichBeckerHothoetal.2017, author = {Sperlich, Billy and Becker, Martin and Hotho, Andreas and Wallmann-Sperlich, Birgit and Sareban, Mahdi and Winkert, Kay and Steinacker, J{\"u}rgen M. and Treff, Gunnar}, title = {Sedentary behavior among national elite rowers during off-training — a pilot study}, series = {Frontiers in Physiology}, volume = {8}, journal = {Frontiers in Physiology}, number = {655}, doi = {10.3389/fphys.2017.00655}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158753}, year = {2017}, abstract = {The aim of this pilot study was to analyze the off-training physical activity (PA) profile in national elite German U23 rowers during 31 days of their preparation period. The hours spent in each PA category (i.e., sedentary: <1.5 metabolic equivalents (MET); light physical activity: 1.5-3 MET; moderate physical activity: 3-6 MET and vigorous intense physical activity: >6 MET) were calculated for every valid day (i.e., >480 min of wear time). The off-training PA during 21 weekdays and 10 weekend days of the final 11-week preparation period was assessed by the wrist-worn multisensory device Microsoft Band II (MSBII). A total of 11 rowers provided valid data (i.e., >480 min/day) for 11.6 week days and 4.8 weekend days during the 31 days observation period. The average sedentary time was 11.63 ± 1.25 h per day during the week and 12.49 ± 1.10 h per day on the weekend, with a tendency to be higher on the weekend compared to weekdays (p = 0.06; d = 0.73). The average time in light, moderate and vigorous PA during the weekdays was 1.27 ± 1.15, 0.76 ± 0.37, 0.51 ± 0.44 h per day, and 0.67 ± 0.43, 0.59 ± 0.37, 0.53 ± 0.32 h per weekend day. Light physical activity was higher during weekdays compared to the weekend (p = 0.04; d = 0.69). Based on our pilot study of 11 national elite rowers we conclude that rowers display a considerable sedentary off-training behavior of more than 11.5 h/day.}, language = {en} } @article{WeistePedrottiSelvanayagametal.2017, author = {Weiste, Christoph and Pedrotti, Lorenzo and Selvanayagam, Jebasingh and Muralidhara, Prathibha and Fr{\"o}schel, Christian and Nov{\´a}k, Ondřej and Ljung, Karin and Hanson, Johannes and Dr{\"o}ge-Laser, Wolfgang}, title = {The Arabidopsis bZIP11 transcription factor links low-energy signalling to auxin-mediated control of primary root growth}, series = {PLoS Genetics}, volume = {13}, journal = {PLoS Genetics}, number = {2}, doi = {10.1371/journal.pgen.1006607}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157742}, pages = {e1006607}, year = {2017}, abstract = {Plants have to tightly control their energy homeostasis to ensure survival and fitness under constantly changing environmental conditions. Thus, it is stringently required that energy-consuming stress-adaptation and growth-related processes are dynamically tuned according to the prevailing energy availability. The evolutionary conserved SUCROSE NON-FERMENTING1 RELATED KINASES1 (SnRK1) and the downstream group C/S\(_{1}\) basic leucine zipper (bZIP) transcription factors (TFs) are well-characterised central players in plants' low-energy management. Nevertheless, mechanistic insights into plant growth control under energy deprived conditions remains largely elusive. In this work, we disclose the novel function of the low-energy activated group S\(_{1}\) bZIP11-related TFs as regulators of auxin-mediated primary root growth. Whereas transgenic gain-of-function approaches of these bZIPs interfere with the activity of the root apical meristem and result in root growth repression, root growth of loss-of-function plants show a pronounced insensitivity to low-energy conditions. Based on ensuing molecular and biochemical analyses, we propose a mechanistic model, in which bZIP11-related TFs gain control over the root meristem by directly activating IAA3/SHY2 transcription. IAA3/SHY2 is a pivotal negative regulator of root growth, which has been demonstrated to efficiently repress transcription of major auxin transport facilitators of the PIN-FORMED (PIN) gene family, thereby restricting polar auxin transport to the root tip and in consequence auxin-driven primary root growth. Taken together, our results disclose the central low-energy activated SnRK1-C/S\(_{1}\)-bZIP signalling module as gateway to integrate information on the plant's energy status into root meristem control, thereby balancing plant growth and cellular energy resources.}, language = {en} } @article{MoschallDenkErkelenzetal.2017, author = {Moschall, Rebecca and Denk, Sarah and Erkelenz, Steffen and Schenk, Christian and Schaal, Heiner and Bodem, Jochen}, title = {A purine-rich element in foamy virus pol regulates env splicing and gag/pol expression}, series = {Retrovirology}, volume = {14}, journal = {Retrovirology}, number = {10}, doi = {10.1186/s12977-017-0337-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157614}, year = {2017}, abstract = {Background: The foamy viral genome encodes four central purine-rich elements localized in the integrase-coding region of pol. Previously, we have shown that the first two of these RNA elements (A and B) are required for protease dimerization and activation. The D element functions as internal polypurine tract during reverse transcription. Peters et al., described the third element (C) as essential for gag expression suggesting that it might serve as an RNA export element for the unspliced genomic transcript. Results: Here, we analysed env splicing and demonstrate that the described C element composed of three GAA repeats known to bind SR proteins regulates env splicing, thus balancing the amount of gag/pol mRNAs. Deletion of the C element effectively promotes a splice site switch from a newly identified env splice acceptor to the intrinsically strong downstream localised env 3′ splice acceptor permitting complete splicing of almost all LTR derived transcripts. We provide evidence that repression of this env splice acceptor is a prerequisite for gag expression. This repression is achieved by the C element, resulting in impaired branch point recognition and SF1/mBBP binding. Separating the branch point from the overlapping purine-rich C element, by insertion of only 20 nucleotides, liberated repression and fully restored splicing to the intrinsically strong env 3′ splice site. This indicated that the cis-acting element might repress splicing by blocking the recognition of essential splice site signals. Conclusions: The foamy viral purine-rich C element regulates splicing by suppressing the branch point recognition of the strongest env splice acceptor. It is essential for the formation of unspliced gag and singly spliced pol transcripts.}, language = {en} } @article{WiegeringRiegelWagneretal.2017, author = {Wiegering, Armin and Riegel, Johannes and Wagner, Johanna and Kunzmann, Volker and Baur, Johannes and Walles, Thorsten and Dietz, Ulrich and Loeb, Stefan and Germer, Christoph-Thomas and Steger, Ulrich and Klein, Ingo}, title = {The impact of pulmonary metastasectomy in patients with previously resected colorectal cancer liver metastases}, series = {PLoS ONE}, volume = {12}, journal = {PLoS ONE}, number = {3}, doi = {10.1371/journal.pone.0173933}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158036}, pages = {e0173933}, year = {2017}, abstract = {Background 40-50\% of patients with colorectal cancer (CRC) will develop liver metastases (CRLM) during the course of the disease. One third of these patients will additionally develop pulmonary metastases. Methods 137 consecutive patients with CRLM, were analyzed regarding survival data, clinical, histological data and treatment. Results were stratified according to the occurrence of pulmonary metastases and metastases resection. Results 39\% of all patients with liver resection due to CRLM developed additional lung metastases. 44\% of these patients underwent subsequent pulmonary resection. Patients undergoing pulmonary metastasectomy showed a significantly better five-year survival compared to patients not qualified for curative resection (5-year survival 71.2\% vs. 28.0\%; p = 0.001). Interestingly, the 5-year survival of these patients was even superior to all patients with CRLM, who did not develop pulmonary metastases (77.5\% vs. 63.5\%; p = 0.015). Patients, whose pulmonary metastases were not resected, were more likely to redevelop liver metastases (50.0\% vs 78.6\%; p = 0.034). However, the rate of distant metastases did not differ between both groups (54.5 vs.53.6; p = 0.945). Conclusion The occurrence of colorectal lung metastases after curative liver resection does not impact patient survival if pulmonary metastasectomy is feasible. Those patients clearly benefit from repeated resections of the liver and the lung metastases.}, language = {en} } @article{HagemannStrengKraemeretal.2017, author = {Hagemann, Christine and Streng, Andrea and Kraemer, Alexander and Liese, Johannes G.}, title = {Heterogeneity in coverage for measles and varicella vaccination in toddlers - analysis of factors influencing parental acceptance}, series = {BMC Public Health}, volume = {17}, journal = {BMC Public Health}, number = {724}, doi = {10.1186/s12889-017-4725-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157827}, year = {2017}, abstract = {Background: In 2004, routine varicella vaccination was introduced in Germany for children aged 11-14 months. Routine measles vaccination had already been introduced in 1973 for the same age group, but coverage is still too low (<95\%) in some areas to eliminate measles. The present study assessed varicella and measles vaccination coverage and determinants of parental acceptance in two study regions, situated in Northern and Southern Bavaria (Germany). Methods: From 2009 to 2011, annual cross-sectional parent surveys were performed on random samples of 600 children aged 18-36 months in the Bavarian regions of both Munich and W{\"u}rzburg. Logistic regression models were used to identify factors associated with varicella and measles vaccination. Results: In 2009, 2010 and 2011, vaccination coverage was lower in Munich than in W{\"u}rzburg, for both varicella (Munich 53\%, 67\%, 69\% vs. W{\"u}rzburg 72\%, 81\%, 83\%) and for measles (Munich 88\%, 89\%, 91\% vs. W{\"u}rzburg 92\%, 93\%, 95\%). Recommendation by the physician was the main independent factor associated with varicella vaccination in both regions (adjusted odd ratios (OR) with 95\% confidence interval (CI): Munich OR 19.7, CI 13.6-28.6; W{\"u}rzburg OR 34.7, CI 22.6-53.2). Attendance at a childcare unit was positively associated with a higher acceptance of varicella vaccination in Munich (OR 1.5, CI 1.1-2.2). Regarding measles vaccination, attendance at a childcare unit was positively associated in both regions (Munich OR 2.0; CI 1.3-3.0; W{\"u}rzburg OR 1.8; CI 1.1-3.1), and a higher level of parental school education was negatively associated in W{\"u}rzburg (OR 0.5, CI 0.3-0.9). Conclusions: Vaccination rates differed between regions, with rates constantly higher in W{\"u}rzburg. Within each region, vaccination rates were lower for varicella than for measles. Measles vaccination status was mainly dependent upon socio-demographic factors (attendance at a childcare unit, parental school education), whereas for the more recently introduced varicella vaccination recommendation by the physician had the strongest impact. Hence, different strategies are needed to further improve vaccination rates for both diseases.}, language = {en} } @article{RichterWeickKriegeretal.2017, author = {Richter, Anne and Weick, Stefan and Krieger, Thomas and Exner, Florian and Kellner, Sonja and Polat, B{\"u}lent and Flentje, Michael}, title = {Evaluation of a software module for adaptive treatment planning and re-irradiation}, series = {Radiation Oncology}, volume = {12}, journal = {Radiation Oncology}, number = {205}, doi = {10.1186/s13014-017-0943-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158711}, year = {2017}, abstract = {Background: The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. Methods: The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. Results: The Dynamic Planning Tool was used in 20\% of treated patients per year for both approaches nearly equally (42\% plan adaptation and 58\% re-irradiation). Most cases were assessed for the thoracic body region (51\%) followed by pelvis (21\%) and head and neck cases (10\%). The sub-group evaluation showed that unintended plan adaptation was performed in 38\% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4-35 days) was observed. PTV changed by 12 ± 12\% on average (maximum change 42\%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. Conclusion: The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to consider the pretreatment dose, to adapt the actual treatment schema more specifically and to review the accumulated dose.}, language = {en} }