TY - THES A1 - Lehnert, Teresa T1 - Biomechanische Eigenschaften von Knochenersatz und Schraubenosteosynthese in der Stabilisierung von Tibiakopffrakturen bei Osteoporose T1 - Biomechanical characteristics of bone substitute and screw osteosynthesis in stabilization of tibial depression fractures in osteoporotic bones N2 - Das Ziel dieser Arbeit war die Untersuchung eines neuen bohrbaren Kalziumphosphatzements (Norian drillable Synthes GmbH) sowohl als alleiniges Knochenersatzmaterial als auch in Kombination mit Schrauben, die in Jail-Technik angebracht wurden bei der Versorgung von lateralen Tibiakopfimpressionsfrakturen. Laterale Tibiakopfimpressionsfrakturen wurden dafür in einem biomechanischen Frakturmodell künstlich erzeugt. Die Präparate wurden mit Knochenersatzmaterial (Gruppe 1), Knochenersatzmaterial mit zusätzlichen vier Schrauben in Jail-Technik (Gruppe 2) oder lediglich mit vier Schrauben (Gruppe 3) stabilisiert. Anschließend wurde das Einsinken des Knochens (Displacement) unter zyklischer Belastung sowie Steifigkeit und Maximalbelastung in load-to-failure-Tests ermittelt. Die Gruppen, die mit Knochenersatzmaterial versorgt wurden, zeigten unter zyklischer Belastung ein geringeres Displacement und eine höhere Steifigkeit. Die Maximalbelastung, der die Knochen in der Load-to-failure-Testung standhielten, war indes höher für die Gruppen, die mit Schrauben versorgt wurden. Fazit: Die Kombination aus Unterfütterung mit Knochenersatzmaterial und Stabilisierung mit Schrauben bietet die umfangreichste Versorgung bei lateralen Tibiakopfimpressionsfrakturen. N2 - The aim of this study was to investigate a new drillable calcium phosphate cement (Norian drillable Synthes GmbH) as a bone substitute either alone or in combination with screws in the jail technique with regard to the primary stability in lateral tibial depression fractures. Lateral depression fractures of the tibial plateau were created in a biomechanical fracture model. After reduction they were stabilised with bone substitute (group one), bone substitute with additional four screws in the jail technique (group two) or four screws only (group three). Displacement under cyclic loading, stiffness and maximum load in load-to-failure tests were determined. The groups with the bone substitute showed a lower displacement of the depressed articular fragment under cyclical loading and a higher stiffness. The maximum load was higher for the groups with screws. Conclusions: Only the combination of bone substitute and screws prevented secondary loss of reduction and, at the same time, provided enough stability under maximum load. KW - Tibiaplateau KW - Tibiakopfbruch KW - Knochenzement KW - Tibiakopfimpressionsfraktur Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-98362 ER - TY - JOUR A1 - Prauße, Maria T. E. A1 - Lehnert, Teresa A1 - Timme, Sandra A1 - Hünniger, Kerstin A1 - Leonhardt, Ines A1 - Kurzai, Oliver A1 - Figge, Marc Thilo T1 - Predictive Virtual Infection Modeling of Fungal Immune Evasion in Human Whole Blood JF - Frontiers in Immunology N2 - Bloodstream infections by the human-pathogenic fungi Candida albicans and Candida glabrata increasingly occur in hospitalized patients and are associated with high mortality rates. The early immune response against these fungi in human blood comprises a concerted action of humoral and cellular components of the innate immune system. Upon entering the blood, the majority of fungal cells will be eliminated by innate immune cells, i.e., neutrophils and monocytes. However, recent studies identified a population of fungal cells that can evade the immune response and thereby may disseminate and cause organ dissemination, which is frequently observed during candidemia. In this study, we investigate the so far unresolved mechanism of fungal immune evasion in human whole blood by testing hypotheses with the help of mathematical modeling. We use a previously established state-based virtual infection model for whole-blood infection with C. albicans to quantify the immune response and identified the fungal immune-evasion mechanism. While this process was assumed to be spontaneous in the previous model, we now hypothesize that the immune-evasion process is mediated by host factors and incorporate such a mechanism in the model. In particular, we propose, based on previous studies that the fungal immune-evasion mechanism could possibly arise through modification of the fungal surface by as of yet unknown proteins that are assumed to be secreted by activated neutrophils. To validate or reject any of the immune-evasion mechanisms, we compared the simulation of both immune-evasion models for different infection scenarios, i.e., infection of whole blood with either C. albicans or C. glabrata under non-neutropenic and neutropenic conditions. We found that under non-neutropenic conditions, both immune-evasion models fit the experimental data from whole-blood infection with C. albicans and C. glabrata. However, differences between the immune-evasion models could be observed for the infection outcome under neutropenic conditions with respect to the distribution of fungal cells across the immune cells. Based on these predictions, we suggested specific experimental studies that might allow for the validation or rejection of the proposed immune-evasion mechanism. KW - immune evasion KW - state-based model KW - innate immune response KW - polymorphonuclear neutrophils KW - whole-blood infection assay Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-197493 SN - 1664-3224 VL - 9 IS - 560 ER -