TY - JOUR A1 - Busch, Albert A1 - Tschernitz, Sebastian A1 - Thurner, Anette A1 - Kellersmann, Richard A1 - Lorenz, Udo T1 - Fatal Paraneoplastic Embolisms in Both Circulations in a Patient with Poorly Differentiated Neuroendocrine Tumour JF - Case Reports in Vascular Medicine N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-97335 ER - TY - JOUR A1 - Schuster, Frank A1 - Johannsen, Stephan A1 - Roewer, Norbert T1 - A Minimal-Invasive Metabolic Test Detects Malignant Hyperthermia Susceptibility in a Patient after Sevoflurane-Induced Metabolic Crisis JF - Case Reports in Anesthesiology N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-97080 ER - TY - JOUR A1 - Reichert, Johannes A1 - Schmalzl, Jonas A1 - Prager, Patrick A1 - Gilbert, Fabian A1 - Quent, Verena M. C. A1 - Steinert, Andre F. A1 - Rudert, Maximilian A1 - Nöth, Ulrich T1 - Synergistic effect of Indian hedgehog and bone morphogenetic protein-2 gene transfer to increase the osteogenic potential of human mesenchymal stem cells JF - Stem Cell Research & Therapy N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-97010 UR - http://stemcellres.com/content/4/5/105 ER - TY - JOUR A1 - Westermaier, Thomas A1 - Stetter, Christian A1 - Kunze, Ekkehard A1 - Willner, Nadine A1 - Raslan, Furat A1 - Vince, Giles H. A1 - Ernestus, Ralf-Ingo T1 - Magnesium treatment for neuroprotection in ischemic diseases of the brain JF - Experimental and Translational Stroke Medicine N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-96729 UR - http://www.etsmjournal.com/content/5/1/6 ER - TY - JOUR A1 - Frey, Sönke Percy A1 - Jansen, Hendrik A1 - Doht, Stefanie A1 - Filgueira, Luis A1 - Zellweger, Rene T1 - Immunohistochemical and Molecular Characterization of the Human Periosteum JF - The Scientific World Journal N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-96623 ER - TY - JOUR A1 - Gunreben, Ignaz A1 - Geis, Christian A1 - Kleinschnitz, Christoph T1 - Acute tetraparesis secondary to bilateral precentral gyral cerebral ischemia: a case report JF - Journal of Medical Case Reports N2 - 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. KW - Medizin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-96179 UR - http://www.jmedicalcasereports.com/content/7/1/61 ER - TY - THES A1 - Kunkel, Sabine T1 - Veränderungen innerhalb der Schnittentbindung, ein Vergleich der Jahre 1995 und 2005. Eine retrospektive Analyse geburtshilflicher Parameter T1 - Developments in caesarean section, a comparison of the years 1995 and 2005. A retrospective analysis of obstetric parameters N2 - In der Abteilung für Gynäkologie und Geburtshilfe der Missionsärztlichen Klinik Würzburg wurden 1995 120 und 2005 312 Schnittentbindungen durchgeführt. In der vorliegenden retrospektiven Arbeit interessierte, ob sich zwischen 1995 und 2005 ein signifikanter Wandel der geburtshilflichen Parameter innerhalb dieser Schnittentbindungen abgezeichnet hat. Die Sectio-Frequenz stieg im untersuchten Zeitraum höchst signifikant von 11,4 % auf 24,7 %. Es wurden pro Schnittentbindung ein bis maximal fünf Indikationen, die zu einer Sectio führten, angegeben. 1995 gab es 31 und 2005 34 verschiedene Indikationen. Bezüglich der sieben häufigsten Indikationsangaben hat sich in diesen 10 Jahren nichts verändert. Statistisch signifikant waren nur zwei Veränderungen. Die Indikation Missverhältnis erfuhr eine signifikante Steigerung von 21,6 % auf 33,4 % und war damit 2005 die meistgenannte Indikation. Die Indikation frustrane Geburtseinleitung ging von 9,9 % auf 3,3 % zurück. Die häufigste Indikationsangabe 1995 war der Geburtsstillstand/protrahierte Eröffnungsperiode (33,3%). Höchst signifikante Unterschiede gab es bei den Anästhesieverfahren. 1995 wurde zu 67,7 % eine Intubationsnarkose durchgeführt, 2005 waren es nur noch 12,1 %. Im Gegensatz dazu stieg der Anteil an der Spinalanästhesie von 27 % auf 75,7 %. Das durchschnittliche Geburtsgewicht der Sectio-Geborenen lag 1995 bei 3235,6 Gramm gegenüber 3387,9 Gramm 2005. Dieser Unterschied war statistisch signifikant. Das niedrigere Geburtsgewicht 1995 liegt sicherlich auch daran, dass in diesem Jahr mehr Frühgeborene durch Kaiserschnitt zur Welt kamen. Bei der Betrachtung des Fetal Outcome der Sectiokinder zeigten sich folgende Ergebnisse. Der 1-Minuten-APGAR-Mittelwert war 2005 mit 8,9 statistisch höchst signifikant besser als 1995 mit 8,4. Der 5-Minuten- und 10 Minuten-APGAR-Mittelwert zeigte keine signifikanten Unterschiede. 1995 hatten weniger Neugeborene einen 1-Minuten-APGAR-Wert > 8 als 2005 und dafür mehr Kinder Werte < 7 (10,2 % 1995 zu 2,9 % 2005). Dies ist ebenfalls auf die höhere Frühgeburtenrate 1995 zurückzuführen. Beim Nabelarterien-pH-Mittelwert gab es keinen signifikanten Unterschied. 1995 gab es sechs Kinder mit einem pH-Wert kleiner 7,1 (dies entspricht 5,7 %) und 2005 fünf Kinder (1,7 %). Es wurde die Abhängigkeit der Indikationsstellung Missverhältnis/Geburtsstillstand von Geburtsgewicht, BMI und der untersuchten Jahre 1995 und 2005 untersucht. Hierbei zeigte sich, dass das Geburtsgewicht ein höchst signifikanter Risikofaktor für die Indikationsstellung Missverhältnis oder Geburtsstillstand darstellt. Ein Effekt des BMI oder der untersuchten Jahre konnte nicht nachgewiesen werden. Keine signifikanten Unterschiede gab es bei der Untersuchung der primären Sectiones, Re-Sectiones, Erstgebärenden, Alter der Mütter, BMI-Werte oder Komplikationen im Wochenbett. N2 - In the Department of Obstetrics and Gynecology at Medical Missionary Clinic in Würzburg (Missionsärztliche Klinik Würzburg) 120 caesarean sections took place in 1995 compared to 312 in 2005. Aim of this retrospective study is to find if there is a significant change in obstetric parameters of these caesarean sections in the years from 1995 to 2005. The sectio frequency increased highly significantly from 11.4% to 24.7% in the investigation period. Per caesarean section up to a maximum of five indications that led to a section have been specified. There were 31 different indications in 1995, in 2005 there were 34. No changes occurred regarding the seven most frequent indications in those ten years. Statistically significant were only two changes. The indication cephalopelvic disproportion rose significantly from 21.6% to 33.4% and as the most stated indication in 2005. The indication failure to induce labour fell from 9.9% to 3.3%. In 1995 the most common indication was failure to progress in labour (33.3%). Highly significant differences became apparent in the anaesthetic procedures. In 1995 an general anesthesia had been carried out in 67.7% of cases, in 2005 the number fell to only 12.1%. By contrast, the rate of spinal anesthesia rose from 27% to 75.7%. The average birth weight of the children born by caesarean section lay by 3235.6 gram in 1995 and 3387.9 gram in 2005. This difference is statistically significant. The lower 1995 birth weight is certainly down to the fact that more premature babies were delivered by caesarean section that year. The results of a consideration of the Fetal Outcome of the children born by caesarean section were as follows: the 1 minute APGAR score was 8.9 in 2005 and therefore statistically highly significantly better than in 1995 when the score was 8.4. The 5 and 10 minute APGAR score shows no significant difference. In 1995 fewer newborns had a 1 minute APGAR score of >8 than in 2005 and more children had scores <7 (10.2% in 1995 compared to 2.9% in 2005). This is also due to the higher preterm birth rate of 1995. There was no significant difference regarding the umbilical arteries pH score. In 1995 there were six children with a pH score below 7.1 (representing 5.7%) and five children (representing 1.7%) in 2005. The dependence of the indication cephalopelvic disproportion/failure to progress in labour on birth weight, BMI and the investigation years 1995 and 2005 was analysed. It showed that the birth weight is a highly significant risk factor for the indication cephalopelvic disproportion or failure to progress in labour. There has been no evidence for an effect of the BMI or the year in question. The study of primary sections, previous sections, nulliparous women, maternal age, BMI scores or complications in childbed resulted in no significant difference. KW - Medizin KW - Gynäkologie KW - Geburtshilfe KW - Schnittentbindung KW - Sectio caesarea KW - Kaiserschnitt KW - Indikationen KW - retrospektive Analyse KW - geburtshilflicher Parameter KW - caesarean section KW - retrospective analysis KW - obstetric parameters Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-82342 ER - TY - THES A1 - Schneider-Schaulies, Sibylle T1 - Molekularbiologische Charakterisierung der Masernvirusreplikation in zentralen Nervensystem von Lewis- und BN-Ratten N2 - Einleitung: Das Masernvirus (MV) ist ein hochkontagiöser, primatenpathogener Erreger, der für die bekannte Masernerkrankung verantwortlich ist... N2 - No abstract available. KW - Medizin KW - Masernvirus KW - Immunbiologie KW - Masern KW - Medicine Y1 - 1988 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-78465 ER - TY - JOUR A1 - Stöber, Gerald A1 - Franzek, E. A1 - Beckmann, H. T1 - Die selbstquälerische Depression: eine Form monopolarer endogener Depression N2 - Anhand von drei exemplarischen fällen wird. das Krankheitsbild der selbstquälerischen Depression, eine Form der reinen Depressionen Leonhards, dargestellt. Im Zentrum stehen die Ideen der Selbsterniedrigung und Selbstentwertung und der sich daran entwickelnde ängstlich-depressive Affekt. Charakteristisch ist auch die Angst um die nächsten Angehörigen. In ihren Selbstanklagen erwarten und fordern die Patienten für sich die schrecklichsten Strafen. Diese wenigen Leitsymptome kehren in jeder Krankheitsphase gleichförmig wieder. Andere depressive Symptome wie Denkhemmung und psychomotorische Hemmung treten dagegen völlig 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 familiäre Belastung mit affektiven Psychosen findet sich nur sehr selten. N2 - Three ease reports will be used to describe the self-torturing depression, one form of Leonhard's monopolar depressive disorders. The main symptomatology consists of marked feelings of guilt, as weil as ideas of self-abasement and self-depreciation. The severe anxious-depressive affect developes on the grounds of these symptoms. Worries of the patients about their family are also characteristic. Excessive self-reproach results in the expectation of and demand for heaviest punishment. These symptoms repeatedly occur during each episode. Other depressive symptoms like inhibited thinking and motor retardation are lacking. The course of the disease is strictly monopolar. In Leonhard's original description the mean duration of the episodes was found to be 5.8 months. We noticed a mean duration of 25 episodes of 4.1 months. The clinical manifestation of the episodes can only insignificantly be influenced by modern therapy. There is little evidence for familial loading with affective psychoses. KW - Medizin KW - Psychopathologie KW - monopolare endogene Depression KW - Leonhard-Klassifikation KW - Affective psychoses KW - psychopathology KW - monopolar depressive disorders KW - Leonhard classification Y1 - 1993 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-78454 ER - TY - JOUR A1 - Stöber, Gerald T1 - Schwangerschaftsinfektionen bei Müttern von chronisch Schizophrenen: die Bedeutung einer differenzierten Nosologie N2 - In einer retrospektiven Untersuchung erinnerten 16 von 80 Müttern von chronisch Schizophrenen eine schwere Infektionserkrankung in der Schwangerschaft. Im zweiten Trimenon waren gehäuft Infektionen aufgetreten. Zehn von 80 Müttern von Kontrollpersonen erinnerten ebenfalls eine Infektion. Im Vergleich zu den Kontrollen halfen Mütter Schizophrener im 5. Schwangerschaftsmonat häufiger Infektionen als in den anderen Gestationsmonaten (p < 0,05). Bei "familiären" und "sporadischen" Schizophrenen gemäß DSM III-R kamen im Vergleich zu Kontrollen Infektionen in gleicher Häufigkeit 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 gehäuft im 2. Schwangerschaftsdrittel aufgetreten, sowohl im Vergleich zu Kontrollen (p < 0,01) als auch im Vergleich zu den unsystematischen Schizophrenen, die hauptsächlich genetisch bedingt zu sein scheinen (p < 0,001). Infektionserkrankungen im 5. Schwangerschaftsmonat waren ausschließlich bei den Müttern von systematischen Schizophrenen vorgekommen. Bei diesen Krankheitsformen scheinen Infektionen im 2. Schwangerschaftstrimenon und insbesondere im 5. Schwangerschaftsmonat wichtige ätiologische Faktoren zu sein und könnten mitursächlich sein für die beschriebenen zytoarchitektonischen Aberrationen im Zentralnervensystem von chronisch Schizophrenen. N2 - In a retrospective study, 16 of 80 mothers of chronic DSM III-R schizophrenics reported having had a serious infectious disease during pregnancy. Eleven of the infections had occurred during the second trimester. Influenza and the common cold with fever were frequent. Ten of 80 female controls also recalled having had an infectious illness during pregnancy. Compared to the controls, mothers of schizophrenics reported more infectious illness during pregnancy, particularly during the fifth month ofgestation (p < 0.05). Mothers of familial and of sporadic DSM III-R schizophrenics reported equal frequencies of infections in pregnancy. In contrast, when Leonhard's classification of psychoses was applied, significant differences appeared. Infections during pregnancy were scarcely found in unsystematic schizophrenics (mainly genetically determined according to Leonhard). In systematicschizophrenics (mainly exogenously determined according to Leonhard), a significantly higher frequency of infectious diseases was reported for the second trimester as compared both to controls (p < 0.01) and to unsystematic schizophrenics (p < 0.001). Infections during the fifth month of gestation were exclusively reported in systematic schizophrenics. Thus, in the systematic forms of schizophrenia infections during the second trimester and particularly during the fifth montb ofgestation seem to play an important role in the etiology and seem to be of causal importance for the various cytoarchitectural abnormalities detected in the central nervous system of schizophrenics. KW - Medizin KW - Psychologie KW - Schizophrenie KW - Schwangerschaftsinfektion KW - "Familiär-sporadisch"- Konzept KW - Leonhard-Klassifikation KW - Schizophrenia KW - Maternal infections KW - Pregnancy KW - Familial/sporadic concept KW - Leonhard classification Y1 - 1994 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-78438 ER -