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Ruschil C, Dubois E, Stefanou MI, Kowarik MC, Ziemann U, Schittenhelm M, Krumbholz M, Bischof F. Treatment of progressive multiple sclerosis with high-dose all-trans retinoic acid - no clear evidence of positive disease modifying effects. Neurol Res Pract 2021; 3:25. [PMID: 33966627 PMCID: PMC8108354 DOI: 10.1186/s42466-021-00121-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/23/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND All-trans retinoic acid (ATRA) is an acid derivative of vitamin A which is discussed as a promising candidate to ameliorate the disease course of multiple sclerosis (MS) by immunomodulation or even by promoting regeneration in progressive MS. Here we report a patient who significantly improved for MS related disability following administration of chemotherapy including ATRA for mitoxantrone-related acute promyelocytic leukemia and assess the effect of high-dose ATRA in three additional patients with progressive MS. METHODS Patients with progressive MS who had failed previous therapies were treated with high-dose ATRA. Patients underwent clinical and routine laboratory monitoring. Additionally, PBMCs were analyzed by flow cytometry for lymphocyte subsets. RESULTS ATRA was well tolerated and no pathological laboratory abnormalities were observed. After initial mild (not statistically significant) improvement of EDSS and mean MSFC z-score, ongoing disease progression was observed. One patient subacutely experienced severe cognitive and motor worsening. Cerebral MRI revealed persistent gadolinium-enhancing lesions. Flow cytometric alterations of peripheral blood naïve, central memory and effector memory CD4 and CD8 T cells, B lymphocytes, plasma cells, memory B cells, plasmablasts and natural killer (NK) cells did not reach statistical significance. CONCLUSIONS Stand-alone therapy with ATRA did not ameliorate progressive MS in our limited cohort and we did not observe consistent alterations of T and B cell subsets. Intriguingly, application of ATRA may have caused marked disease exacerbation in one patient.
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Affiliation(s)
- Christoph Ruschil
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany.
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany.
| | - Evelyn Dubois
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Maria-Ioanna Stefanou
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Markus Christian Kowarik
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Marcus Schittenhelm
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Eberhard-Karls University, Tübingen, Germany
- Department of Oncology/Hematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Markus Krumbholz
- Department of Neurology & Stroke, Eberhard-Karls University, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Felix Bischof
- Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
- Nervenärztliche Gemeinschaftspraxis, Konrad-Zuse-Str. 14, Böblingen, Germany
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Bischof F, Kampermann H, Bruß D. Resource Theory of Coherence Based on Positive-Operator-Valued Measures. Phys Rev Lett 2019; 123:110402. [PMID: 31573233 DOI: 10.1103/physrevlett.123.110402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 05/07/2019] [Indexed: 06/10/2023]
Abstract
Quantum coherence is a fundamental feature of quantum mechanics and an underlying requirement for most quantum information tasks. In the resource theory of coherence, incoherent states are diagonal with respect to a fixed orthonormal basis; i.e., they can be seen as arising from a von Neumann measurement. Here, we introduce and study a generalization to a resource theory of coherence defined with respect to the most general quantum measurements, i.e., to arbitrary positive-operator-valued measures (POVMs). We establish POVM-based coherence measures and POVM-incoherent operations that coincide for the case of von Neumann measurements with their counterparts in standard coherence theory. We provide a semidefinite program that allows us to characterize interconversion properties of resource states and exemplify our framework by means of the qubit trine POVM, for which we also show analytical results.
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Affiliation(s)
- Felix Bischof
- Institut für Theoretische Physik III, Heinrich-Heine-Universität Düsseldorf, Universitätsstraße 1, D-40225 Düsseldorf, Germany
| | - Hermann Kampermann
- Institut für Theoretische Physik III, Heinrich-Heine-Universität Düsseldorf, Universitätsstraße 1, D-40225 Düsseldorf, Germany
| | - Dagmar Bruß
- Institut für Theoretische Physik III, Heinrich-Heine-Universität Düsseldorf, Universitätsstraße 1, D-40225 Düsseldorf, Germany
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Meyerhoff C, Bischof F, Mennel F, Sternberg F, Pfeiffer E. Use of the Microdialysis Technique in the Monitoring of Subcutaneous Tissue Glucose Concentration. Int J Artif Organs 2018. [DOI: 10.1177/039139889301600507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For some time the subcutaneous (s.c.) tissue has been the target for continuous glucose measurement. The microdialysis technique permits an extracellular region approach, which has been used for about two decades for measuring various metabolites in dialysates obtained from different body regions. By connecting a s.c. implanted microdialysis probe to a flow chamber of an amperometric glucose sensor, the procedure of glucose sensing was transferred to ex vivo. Using this device it was possible to obtain, for up to 24 hours, s.c. tissue glucose profiles of healthy and diabetic people. The microdialysis theory, the calibration process and other microdialysis technique applications are discussed in this paper. Although the combination of the microdialysis technique and amperometric glucose sensing requires certain technical equipment, the combination of microdialysis and glucose sensor seems to be a promising approach to a continuously functioning glucose sensing system.
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Affiliation(s)
- C. Meyerhoff
- Institut für Diabetes Technologie an der Universität Ulm, Ulm - Germany
| | - F. Bischof
- Institut für Diabetes Technologie an der Universität Ulm, Ulm - Germany
| | - F.J. Mennel
- Institut für Diabetes Technologie an der Universität Ulm, Ulm - Germany
| | - F. Sternberg
- Institut für Diabetes Technologie an der Universität Ulm, Ulm - Germany
| | - E.F. Pfeiffer
- Institut für Diabetes Technologie an der Universität Ulm, Ulm - Germany
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Rotter N, Schmitz B, Sommer F, Röhrer S, Schuler PJ, Bischof F, Scheithauer MO, Hoffmann TK. First use of flat-panel computed tomography during cochlear implant surgery : Perspectives for the use of advanced therapies in cochlear implantation. HNO 2017; 65:61-65. [PMID: 27534759 DOI: 10.1007/s00106-016-0213-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cochlear implantation in routine cases with normal anatomy is commonly performed without intraoperative image guidance. Revision cochlear implantation as well as surgery in malformations require not only a precise understanding of the underlying complex anatomy, but surgeons need to transform two-dimensional computed tomography (2D CT) scans into the surgical field and use this information for intraoperative surgical navigation. So far, information about the exact position of the electrode during insertion cannot be provided to the surgeon. Here, we present our first operative experience with cochlear implant surgery supported by intraoperative Dyna-CT technology, providing the surgeon with detailed views of the electrode location. METHODS To prove the feasibility of the procedure, two cases of cochlear implantation were performed with intraoperative application of cone-beam CT acquired by a C-arm Dyna-CT system (Artis Zeego, Siemens Healthcare, Erlangen, Germany). Image reconstruction was performed intraoperatively in order to assess the correct positioning of the electrodes. RESULTS Intraoperative Dyna-CT enabled clear visualization of the surgical anatomy and intracochlear electrode position. Dyna-CT technology can be applied with acceptable additional time requirements without adding too much complexity to the surgical procedure. CONCLUSION Intraoperative data acquisition by Dyna-CT represents a suitable option for online surgical navigation during cochlear implant surgery. This imaging technology will push further advances in cochlear implant surgery and lateral skull base surgery, particularly if linked to intraoperative navigation.
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Affiliation(s)
- N Rotter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany.
| | - B Schmitz
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany
| | - F Sommer
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - S Röhrer
- Department of Neurosurgery, Ulm University Medical Center, Ulm, Germany
| | - P J Schuler
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - F Bischof
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - M O Scheithauer
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - T K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
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Grünert SC, Schlatter SM, Schmitt RN, Gemperle-Britschgi C, Mrázová L, Balcı MC, Bischof F, Çoker M, Das AM, Demirkol M, de Vries M, Gökçay G, Häberle J, Uçar SK, Lotz-Havla AS, Lücke T, Roland D, Rutsch F, Santer R, Schlune A, Staufner C, Schwab KO, Mitchell GA, Sass JO. 3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: Clinical presentation and outcome in a series of 37 patients. Mol Genet Metab 2017; 121:206-215. [PMID: 28583327 DOI: 10.1016/j.ymgme.2017.05.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/20/2017] [Indexed: 11/28/2022]
Abstract
3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency (HMGCLD) is a rare inborn error of ketone body synthesis and leucine degradation, caused by mutations in the HMGCL gene. In order to obtain a comprehensive view on this disease, we have collected clinical and biochemical data as well as information on HMGCL mutations of 37 patients (35 families) from metabolic centers in Belgium, Germany, The Netherlands, Switzerland, and Turkey. All patients were symptomatic at some stage with 94% presenting with an acute metabolic decompensation. In 50% of the patients, the disorder manifested neonatally, mostly within the first days of life. Only 8% of patients presented after one year of age. Six patients died prior to data collection. Long-term neurological complications were common. Half of the patients had a normal cognitive development while the remainder showed psychomotor deficits. We identified seven novel HMGCL mutations. In agreement with previous reports, no clear genotype-phenotype correlation could be found. This is the largest cohort of HMGCLD patients reported so far, demonstrating that HMGCLD is a potentially life-threatening disease with variable clinical outcome. Our findings suggest that the clinical course of HMGCLD cannot be predicted accurately from HMGCL genotype. The overall outcome in HMGCLD appears limited, thus rendering early diagnosis and strict avoidance of metabolic crises important.
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Affiliation(s)
- Sarah Catharina Grünert
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Sonja Marina Schlatter
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Robert Niklas Schmitt
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Corinne Gemperle-Britschgi
- Division of Clinical Chemistry & Biochemistry and Children's Research Center, University Children's Hospital, Zürich, Switzerland
| | - Lenka Mrázová
- Institute of Inherited Metabolic Disorders, Charles University in Prague - 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic
| | - Mehmet Cihan Balcı
- Division of Pediatric Nutrition and Metabolism, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Felix Bischof
- Department of Neurology, University of Tübingen, Germany
| | - Mahmut Çoker
- Division of Metabolism and Nutrition, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Anibh M Das
- Department of Pediatrics, Hannover Medical School, Hannover, Germany
| | - Mübeccel Demirkol
- Division of Pediatric Nutrition and Metabolism, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Maaike de Vries
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gülden Gökçay
- Division of Pediatric Nutrition and Metabolism, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Johannes Häberle
- Division of Metabolism and Children's Research Center, University Children's Hospital, Zürich, Switzerland
| | - Sema Kalkan Uçar
- Division of Metabolism and Nutrition, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Amelie Sophia Lotz-Havla
- Department of Inborn Errors of Metabolism, Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Thomas Lücke
- Department of Neuropediatrics, University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Dominique Roland
- Inborn Errors of Metabolism Unit, Institute of Pathology and Genetics, Charleroi, Gosselies, Belgium
| | - Frank Rutsch
- Department of General Pediatrics, Münster University Children's Hospital, Münster, Germany
| | - René Santer
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Schlune
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Christian Staufner
- Department of General Pediatrics, Division of Neuropediatrics and Pediatric Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Karl Otfried Schwab
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Grant A Mitchell
- Centre de Recherche and Département de Pédiatrie, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada; Département de Biochimie, Université de Montréal, Montréal, Québec, Canada
| | - Jörn Oliver Sass
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany; Division of Clinical Chemistry & Biochemistry and Children's Research Center, University Children's Hospital, Zürich, Switzerland; Bioanalytics & Biochemistry, Department of Natural Sciences, University of Applied Sciences, Rheinbach, Germany.
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Bischof F, Flüchter P, Pajonk FB. Multimediale Schulung von Rettungsfachpersonal. Notf Rett Med 2017. [DOI: 10.1007/s10049-016-0201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Abbasi A, de Paula Vieira R, Bischof F, Walter M, Movassaghi M, Berchtold NC, Niess AM, Cotman CW, Northoff H. Sex-specific variation in signaling pathways and gene expression patterns in human leukocytes in response to endotoxin and exercise. J Neuroinflammation 2016; 13:289. [PMID: 27832807 PMCID: PMC5105243 DOI: 10.1186/s12974-016-0758-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/02/2016] [Indexed: 12/26/2022] Open
Abstract
Background While exercise effects on the immune system have received increasing attention in recent years, it remains unclear to what extent gender and fluctuations in sex hormones during menstrual cycle influence immunological responses to exercise. Methods We investigated mRNA changes induced through exhaustive exercise (half-marathon; pre-exercise and post-exercise [30 min, 3 h, 24 h] on whole blood cultures ± lipopolysaccharide [LPS] [1 h]) with a specific focus on sex differences (men vs women in luteal phase) as an extension of our previous study. Results Inflammation related signaling pathways, TLRs, cytosolic DNA sensing and RIG-I like receptors were differentially activated between sexes in LPS-stimulated cultures. Genes differentially regulated between sexes included TNIP-1, TNIP-3, IL-6, HIVEP1, CXCL3, CCR3, IL-8, and CD69, revealing a bias towards less anti-inflammatory gene regulation in women compared to men. In addition, several genes relevant to brain function (KMO, DDIT4, VEGFA, IGF1R, IGF2R, and FGD4) showed differential activation between sexes. Some of these genes (e.g., KMO in women, DDIT4 in both sexes) potentially constitute neuroprotective mechanisms. Conclusions These data reveal that the exercise-induced change in gene expression might be gender and menstrual cycle phase dependent. Electronic supplementary material The online version of this article (doi:10.1186/s12974-016-0758-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Asghar Abbasi
- Institute for Memory Impairments and Neurological Disorders (MIND Institute), University of California-Irvine (UCI), Irvine, CA, USA. .,Institute for Memory Impairments and Neurological Disorders (MIND Institute), Gillespie Neuroscience Research Facility, 1113, University of California, Irvine, 92697.4540, USA.
| | - Rodolfo de Paula Vieira
- Laboratory of Pulmonary and Exercise Immunology (LABPEI), Nove de Julho University (UNINOVE), Sao Paulo, Brazil
| | - Felix Bischof
- Hertie Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
| | - Michael Walter
- Agilent Technologies Sales and Services, GmbH & Co. KG, Hewlett-Packard-Strasse 8, 76337, Waldbronn, Germany
| | - Masoud Movassaghi
- Department of Pathology and Laboratory Medicine, University of California-Los Angeles (UCLA), Los Angeles, CA, USA
| | - Nicole C Berchtold
- Institute for Memory Impairments and Neurological Disorders (MIND Institute), University of California-Irvine (UCI), Irvine, CA, USA
| | - Andreas M Niess
- Department of Sports Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Carl W Cotman
- Institute for Memory Impairments and Neurological Disorders (MIND Institute), University of California-Irvine (UCI), Irvine, CA, USA
| | - Hinnak Northoff
- Zentrum für Klinische Transfusionsmedizin (ZKT) and Institute of Clinical and Experimental Transfusion Medicine (IKET), University Hospital Tuebingen, Tuebingen, Germany
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Flüchter P, Müller V, Bischof F, Pajonk FGB. [Emergency Doctor Training for Psychiatric Emergencies: Evaluation of an Interactive Training Program]. Psychiatr Prax 2016; 44:105-107. [PMID: 27618172 DOI: 10.1055/s-0042-112256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim Emergency physicians are often confronted with psychiatric emergencies, but are not well trained for it and often feel unable to cope sufficiently with them. The aim of this investigation was to examine whether multisensoric training may improve learning effects in the training of emergency physicians with regard to psychiatric emergencies. Method Participation in a multi-modal, multi-media training program with video case histories and subsequent evaluation by questionnaire. Results 66 emergency physicians assessed their learning effects. 75 % or 73 % rated it as "rather high" or "very high". In particular, in comparison with classical training/self-study 89 % assessed the effects in learning as "rather high" or "very high" . Conclusion This training receives a high level of acceptance. Using videos, learning content may be provided more practice-related. Thus, emergency physicians are able to develop a greater understanding of psychiatric emergencies.
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Affiliation(s)
| | | | - Felix Bischof
- Institut für Anästhesiologie, Deutsches Herzzentrum Berlin
| | - Frank-Gerald Bernhard Pajonk
- Klinik und Poliklinik für Psychiatrie und Psychotherapie am Klinikum rechts der Isar, Technische Universität München
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Wiggenhauser P, Bischof F, Lindemann J. Symptom Schwindel bei einem bislang gesunden Jugendlichen. Laryngorhinootologie 2016; 95:783-786. [DOI: 10.1055/s-0042-109612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- P. Wiggenhauser
- Universitätsklinik für Hals-, Nasen- Ohren-heilkunde, Universitätsklinikum Ulm, Ulm
| | - F. Bischof
- Universitätsklinik für Hals-, Nasen- Ohren-heilkunde, Universitätsklinikum Ulm, Ulm
| | - J. Lindemann
- Universitätsklinik für Hals-, Nasen- Ohren-heilkunde, Universitätsklinikum Ulm, Ulm
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Bischof F, Weber Y. Fampridin: Gute Krankengymnastik reicht aus – Kontra. Akt Neurol 2015. [DOI: 10.1055/s-0035-1552711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- F. Bischof
- Abteilung Neurologie mit Schwerpunkt Vaskuläre Neurologie, Universität Tübingen
| | - Y. Weber
- Abteilung Neurologie mit Schwerpunkt Epileptologie, Hertie Institut für Klinische Hirnforschung, Universität Tübingen
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Dubois E, Ruschil C, Bischof F. Low frequencies of central memory CD4 T cells in progressive multifocal leukoencephalopathy. Neurol Neuroimmunol Neuroinflamm 2015; 2:e177. [PMID: 26568972 PMCID: PMC4630684 DOI: 10.1212/nxi.0000000000000177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 09/23/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess alterations in the composition of peripheral immune cells in acute progressive multifocal leukoencephalopathy (PML). METHODS Fresh blood samples from 5 patients with acute PML and 10 healthy controls were analyzed by flow cytometry for naive, central memory and effector memory CD4 and CD8 T cells, B lymphocytes, plasma cells, memory B cells, plasma blasts, and natural killer (NK) cells. The frequency of central memory CD4 T cells was determined longitudinally during the course of PML in 2 patients. RESULTS The frequencies of naive, central memory and effector memory CD8 T cells, B cells, plasma cells, and NK cells were not altered in patients with PML. In contrast, the frequencies of naive CD4 T cells (p = 0.04) and central memory CD4 T cells (p < 0.00001) were reduced and the frequencies of effector memory CD4 T cells were increased (p = 0.01). Longitudinal analysis showed that this pattern was preserved in a patient with fatal PML outcome and restored in one patient who recovered from PML. CONCLUSIONS These data indicate that PML is associated with reduced frequencies of peripheral central memory helper T cells but not with alterations in the frequencies of cytotoxic T cell populations, B lymphocytes, plasma cells, or NK cells.
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Affiliation(s)
- Evelyn Dubois
- Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Christoph Ruschil
- Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Felix Bischof
- Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
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Marquetand J, Bischof F, Nägele T. P4. Contrast-enhancing lesions within the spinal chord help to identify IRIS in patients with natalizumab-PML. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Dammeier N, Schubert V, Hauser TK, Bornemann A, Bischof F. Case report of a patient with progressive multifocal leukoencephalopathy under treatment with dimethyl fumarate. BMC Neurol 2015; 15:108. [PMID: 26152311 PMCID: PMC4495627 DOI: 10.1186/s12883-015-0363-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/24/2015] [Indexed: 01/17/2023] Open
Abstract
Background Progressive multifocal leukoencephalopathy is a severe demyelinating disease caused by the polyoma JC virus in patients with reduced immunocompetence. A few cases of progressive multifocal leukoencephalopathy have been reported in patients treated with fumaric acid esters. Case presentation A 53-year-old Caucasian woman reported to our clinic with a first focal epileptic seizure and mild cognitive impairment. Since 1.5 years, she was treated with fumaderm for her psoriasis. During that time, her lymphocyte counts ranged between 450 and 700/μl. Cerebral magnet resonance imaging showed multifocal subcortical T2 hyperintense lesions with partial gadolinium enhancement. She did not have antibodies against human immunodeficiency virus 1 and 2 and cerebrospinal fluid-polymerase chain reaction for viral infections including a sensitive JC-virus polymerase chain reaction were negative. The diagnosis of progressive multifocal leukoencephalopathy was established by histological analysis and detection of JC-virus desoxyribonucleic acid in brain biopsy specimens. Dimethyl fumarate was stopped and Mirtazapin and Mefloquin were initiated. Neurological examination and imaging remained stable. Conclusions Progressive multifocal leukoencephalopathy can occur in patients with lymphocyte counts between 450 and 700/μl, produce only faint symptoms and is not excluded by negative JC-virus-polymerase chain reaction in cerebrospinal fluid. The incidence of progressive multifocal leukoencephalopathy may thus be underestimated and a more careful surveillance of patients would be necessary.
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Affiliation(s)
- Nele Dammeier
- University Tübingen, Center of Neurology and Hertie Institute for Clinical Brain Research, Hoppe-Seyler Strasse 3, 72076, Tübingen, Germany.
| | - Victoria Schubert
- University Tübingen, Center of Neurology and Hertie Institute for Clinical Brain Research, Hoppe-Seyler Strasse 3, 72076, Tübingen, Germany.
| | - Till-Karsten Hauser
- University Tübingen, Diagnostic and interventional Neuroradiology, Hoppe-Seyler Strasse 3, 72076, Tübingen, Germany.
| | - Antje Bornemann
- Institute for pathology und neuropathology, section neuropathology, Hoppe-Seyler Strasse 3, 72076, Tübingen, Germany.
| | - Felix Bischof
- University Tübingen, Center of Neurology and Hertie Institute for Clinical Brain Research, Hoppe-Seyler Strasse 3, 72076, Tübingen, Germany.
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Abbasi A, Forsberg K, Bischof F. The role of the ubiquitin-editing enzyme A20 in diseases of the central nervous system and other pathological processes. Front Mol Neurosci 2015; 8:21. [PMID: 26124703 PMCID: PMC4466442 DOI: 10.3389/fnmol.2015.00021] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/24/2015] [Indexed: 11/28/2022] Open
Abstract
In recent years, the ubiquitin-editing enzyme A20 has been shown to control a large set of molecular pathways involved in the regulation of protective as well as self-directed immune responses. Here, we assess the current and putative roles of A20 in inflammatory, vascular and degenerative diseases of the central nervous system and explore future directions of research.
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Affiliation(s)
- Asghar Abbasi
- Department of Neuroimmunology, Hertie Institute for Clinical Brain Research and Center of Neurology, University Hospital Tübingen Tübingen, Germany
| | - Kirsi Forsberg
- Department of Neuroimmunology, Hertie Institute for Clinical Brain Research and Center of Neurology, University Hospital Tübingen Tübingen, Germany
| | - Felix Bischof
- Department of Neuroimmunology, Hertie Institute for Clinical Brain Research and Center of Neurology, University Hospital Tübingen Tübingen, Germany
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15
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Sommer F, Hoffmann TK, Tewes S, Kastl K, Rettinger G, Nordmann M, Rotter N, Bischof F, Saul B, Schuler PJ. [The Electronic Patient Record of the University Hospital Ulm in the Clinical Routine]. Laryngorhinootologie 2015; 94:661-9. [PMID: 25739073 DOI: 10.1055/s-0034-1396867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F Sommer
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - T K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - S Tewes
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - K Kastl
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - G Rettinger
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - M Nordmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - N Rotter
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - F Bischof
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - B Saul
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - P J Schuler
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
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Silber T, Ziemann U, Ernemann U, Bischof F. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience. Eur J Radiol 2014; 83:2190-2195. [DOI: 10.1016/j.ejrad.2014.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Toni Silber
- Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Ulf Ziemann
- Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Germany
| | - Felix Bischof
- Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany.
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17
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Seeger A, Klose U, Bischof F, Strobel J, Ernemann U, Hauser TK. Zoomed EPI DWI of Acute Spinal Ischemia Using a Parallel Transmission System. Clin Neuroradiol 2014; 26:177-82. [PMID: 25168248 DOI: 10.1007/s00062-014-0342-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE A new method for diffusion-weighted imaging (DWI) using independent parallel transmission technique resulting in zoomed DWI was applied in four patients suffering from acute spinal cord ischemia. METHODS Four patients with clinical symptoms of acute spinal cord ischemia were examined on a 3 T MR-system equipped with a two-channel transmit array. Scans included T2-weighted turbo spin echo, conventional DWI, and zoomed DWI. Image evaluation was performed with regard to overall image quality, anatomic delineation of the spinal cord, and the level of confidence to establish the diagnosis of spinal cord ischemia. RESULTS Through spatially selective excitation, zoomed DWI allows for acquisition of high-resolution images with reduced scan time due to a reduced field of view in phase-encoding direction, resulting in zoomed images. In all cases the ischemia was demonstrated in conventional DWI as well as zoomed DWI. CONCLUSIONS Compared to conventional DWI, zoomed DWI enables a faster image acquisition and allowed a more detailed analysis of the spinal lesion which may be critical to attribute the lesion to a particular vessel territory.
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Affiliation(s)
- A Seeger
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - U Klose
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - F Bischof
- Department of Neurology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - J Strobel
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - U Ernemann
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - T-K Hauser
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
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18
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Maricic I, Halder R, Bischof F, Kumar V. Dendritic cells and anergic type I NKT cells play a crucial role in sulfatide-mediated immune regulation in experimental autoimmune encephalomyelitis. J Immunol 2014; 193:1035-46. [PMID: 24973441 DOI: 10.4049/jimmunol.1302898] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CD1d-restricted NKT cells can be divided into two groups: type I NKT cells use a semi-invariant TCR, whereas type II express a relatively diverse set of TCRs. A major subset of type II NKT cells recognizes myelin-derived sulfatides and is selectively enriched in the CNS tissue during experimental autoimmune encephalomyelitis (EAE). We have shown that activation of sulfatide-reactive type II NKT cells by sulfatide prevents induction of EAE. In this article, we have addressed the mechanism of regulation, as well as whether a single immunodominant form of synthetic sulfatide can treat ongoing chronic and relapsing EAE in SJL/J mice. We have shown that the activation of sulfatide-reactive type II NKT cells leads to a significant reduction in the frequency and effector function of myelin proteolipid proteins 139-151/I-A(s)-tetramer(+) cells in lymphoid and CNS tissues. In addition, type I NKT cells and dendritic cells (DCs) in the periphery, as well as CNS-resident microglia, are inactivated after sulfatide administration, and mice deficient in type I NKT cells are not protected from disease. Moreover, tolerized DCs from sulfatide-treated animals can adoptively transfer protection into naive mice. Treatment of SJL/J mice with a synthetic cis-tetracosenoyl sulfatide, but not α-galactosylceramide, reverses ongoing chronic and relapsing EAE. Our data highlight a novel immune-regulatory pathway involving NKT subset interactions leading to inactivation of type I NKT cells, DCs, and microglial cells in suppression of autoimmunity. Because CD1 molecules are nonpolymorphic, the sulfatide-mediated immune-regulatory pathway can be targeted for development of non-HLA-dependent therapeutic approaches to T cell-mediated autoimmune diseases.
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Affiliation(s)
- Igor Maricic
- Laboratory of Autoimmunity, Torrey Pines Institute for Molecular Studies, San Diego, CA 92121; and
| | - Ramesh Halder
- Laboratory of Autoimmunity, Torrey Pines Institute for Molecular Studies, San Diego, CA 92121; and
| | - Felix Bischof
- Department of Neurology, University of Tubingen, Tubingen D-72076, Germany
| | - Vipin Kumar
- Laboratory of Autoimmunity, Torrey Pines Institute for Molecular Studies, San Diego, CA 92121; and
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Seeger A, Kramer U, Bischof F, Schuettauf F, Ebner F, Danz S, Ernemann U, Hauser TK. Feasibility of Noninvasive Diagnosis and Treatment Planning in a Case Series with Carotid-Cavernous Fistula using High-Resolution Time-Resolved MR-Angiography with Stochastic Trajectories (TWIST) and Extended Parallel Acquisition Technique (ePAT 6) at 3 T. Clin Neuroradiol 2014; 25:241-7. [PMID: 24599323 DOI: 10.1007/s00062-014-0298-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 02/10/2014] [Indexed: 01/29/2023]
Abstract
PURPOSE The evaluation of carotid-cavernous fistulas (CCFs) and the intracranial vasculature has been predominantly carried out using conventional digital subtraction angiography (DSA). Recent developments in time-resolved magnetic resonance angiography (MRA) provide the opportunity to assess both multiple arterial and venous phases with high temporal and spatial resolution. Here, we investigated the feasibility of this technique to functionally assess CCF prior to intervention. METHODS Six consecutive patients with clinical symptoms of a CCF were scheduled for clinically indicated MRA and underwent a protocol that comprised conventional imaging sequences and high resolution time-resolved MRA with interleaved stochastic trajectories (TWIST). The location of the fistulous communication, the flow pattern, and venous drainage were determined by time-resolved MRA and compared with DSA which was available in five out of six patients. RESULTS Typical morphological findings (including enlargement of the superior ophthalmic vein, exophthalmos) were found in all cases in both conventional MRI and time-resolved MRA source data. The temporal resolution of time-resolved MRA enabled a good separation of the early filling of the cavernous sinus during the arterial phase. Direct fistulous communication was assessed in three patients with good correlation to DSA, whereas indirect CCF could not definitely be visualized. The time-resolved MRA provided information about the flow pattern and the venous drainage of the fistula in all patients, which is essential for therapy planning. CONCLUSION Time-resolved MRA provides important morphological and functional information in patients with CCF. Although DSA remains the gold standard for diagnosis and exact classification of fistulas, time-resolved MRA can provide the relevant hemodynamic information to plan interventional treatment as a one-step procedure with a focused diagnostic workup.
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Affiliation(s)
- A Seeger
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany,
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20
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Bender B, Heine C, Danz S, Bischof F, Reimann K, Bender M, Nägele T, Ernemann U, Korn A. Diffusion restriction of the optic nerve in patients with acute visual deficit. J Magn Reson Imaging 2013; 40:334-40. [DOI: 10.1002/jmri.24367] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/26/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology; University Hospital; Tübingen Germany
| | - Christian Heine
- Department of Ophthalmology; Universiy Hospital; Tübingen Germany
| | - Sören Danz
- Department of Diagnostic and Interventional Neuroradiology; University Hospital; Tübingen Germany
| | - Felix Bischof
- Department of Neurology; University Hospital; Tübingen Germany
| | - Katrin Reimann
- Department of Otorhinolaryngology; University Hospital; Tübingen Germany
| | - Miriam Bender
- Department of Otorhinolaryngology; University Hospital; Ulm Germany
| | - Thomas Nägele
- Department of Diagnostic and Interventional Neuroradiology; University Hospital; Tübingen Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology; University Hospital; Tübingen Germany
| | - Andreas Korn
- Department of Diagnostic and Interventional Neuroradiology; University Hospital; Tübingen Germany
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21
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Klose J, Schmidt NO, Melms A, Dohi M, Miyazaki JI, Bischof F, Greve B. Suppression of experimental autoimmune encephalomyelitis by interleukin-10 transduced neural stem/progenitor cells. J Neuroinflammation 2013; 10:117. [PMID: 24053338 PMCID: PMC3852052 DOI: 10.1186/1742-2094-10-117] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 09/08/2013] [Indexed: 02/07/2023] Open
Abstract
Neural stem/progenitor cells (NSPCs) have the ability to migrate into the central nervous system (CNS) to replace damaged cells. In inflammatory CNS disease, cytokine transduced neural stem cells may be used as vehicles to specifically reduce inflammation and promote cell replacement. In this study, we used NSPCs overexpressing IL-10, an immunomodulatory cytokine, in an animal model for CNS inflammation and multiple sclerosis (MS). Intravenous injection of IL-10 transduced neural stem/progenitor cells (NSPCIL-10) suppressed myelin oligodendrocyte glycoprotein aa 35–55 (MOG35-55)- induced experimental autoimmune encephalomyelitis (EAE) and, following intravenous injection, NSPCIL-10 migrated to peripheral lymphoid organs and into the CNS. NSPCIL-10 suppressed antigen-specific proliferation and proinflammatory cytokine production of lymph node cells obtained from MOG35-55 peptide immunized mice. In this model, IL-10 producing NSPCs act via a peripheral immunosuppressive effect to attenuate EAE.
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Affiliation(s)
- Juliane Klose
- Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Strasse 27, 72076 Tübingen, Germany.
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22
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Hansel B, Bischof F. „Würfelzucker - das Diabetes-Lernspiel“ - ein neues Tool für die Schulung von für Typ 2 Diabetikern. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Starker M, Bischof F, Lindenfeld T. [Total hip arthroplasty with shortening subtrochanteric osteotomy and custom-made prosthesis in Crowe type IV developmental dysplasia]. Z Orthop Unfall 2011; 149:518-25. [PMID: 21984422 DOI: 10.1055/s-0031-1280029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM Total hip arthroplasty in patients with a Crowe type IV developmental dysplasia is a technically demanding procedure with a higher complication rate compared to a standard total hip replacement. Specific anatomic features and the necessity of a femoral shortening osteotomy are the reasons for more complications. In this retrospective study we intended to find out whether the use of a custom-made stem based on a CT scan will lead to a better outcome including a lower complication rate. MATERIAL UND METHOD: From 2003 to 2010 we implanted a cementless CTX® individual stem in combination with a subtrochanteric Z-shaped shortening osteotomy in 25 patients with a high hip dislocation, four of them were men (one bilateral) and 16 women (four bilateral). Mean age of the patients was 44.6 years. In all cases the cup was implanted at the level of the anatomic hip centre. Patients were followed with a clinical and radiographic assessment. The morphology of the femur was analysed by CT scans. RESULTS The average amount of femoral shortening was 3.4 cm (max. 4.2/min. 2.6 cm). Lengthening of the leg was achieved with an average of 3.8 cm (max. 4.4/min. 3.2 cm). The remaining leg length discrepancy was 0.8 cm (max. 1.2/min. 0.4 cm). In none of the cases did an intraoperative fracture of the femur occur, either in the proximal or in the distal part of the femur. Enlargement of the intramedullary canal was not necessary in any case. The planned depth of the prosthesis could be achieved in all patients. We did not observe any problems with wound healing in our patients. The average Harris hip score was 90 (83 up to 100). Additional cerclage wires are not necessary with this technique when the osteotomy is well adapted. After complete healing the osteotomy can just be noticed by a certain hypertrophy of the cortical bone. In our cases we had a complication rate of 16 %, significantly lower in comparison to literature values. CONCLUSIONS Total hip arthroplasty in type IV developmental dysplasia with a custom-made stem based on a CT scan is a procedure that respects the special anatomic features preoperatively und is able to correct the deformity with the individually manufactured prosthesis. High femoral anteversion is corrected at the level of the neck of the stem. There is no necessity for a derotation at the level of the osteotomy. The osteotomy is stabilised by the Z-shape and through a perfect intramedullary fit of the stem. The anatomic shape of the subtrochanteric region is perfectly suitable to perform a femoral shortening.
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Affiliation(s)
- M Starker
- Klinik für Orthopädie und Unfallchirurgie, Katholisches Klinikum Duisburg.
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24
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Bischof F. Acute inflammatory neuropathies: new evidence for disease classification from Japan. J Neurol Neurosurg Psychiatry 2011; 82:239. [PMID: 21325024 DOI: 10.1136/jnnp.2010.235440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Martinez-Sosa D, Helmreich B, Netter T, Paris S, Bischof F, Horn H. Pilot-scale anaerobic submerged membrane bioreactor (AnSMBR) treating municipal wastewater: the fouling phenomenon and long-term operation. Water Sci Technol 2011; 64:1804-1811. [PMID: 22020472 DOI: 10.2166/wst.2011.745] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An anaerobic submerged membrane bioreactor (AnSMBR) on pilot-scale treating a mixture composed of municipal wastewater and glucose under mesophilic temperature conditions was operated for 206 days. The performance of the AnSMBR was evaluated at different fluxes, biomass concentrations and gas sparging velocities (GSV). GSV was used to control fouling. In addition, the AnSMBR was operated in cycles that included relaxation and backwashing phases. The increase in the transmembrane pressure (fouling rate) was measured under different operational conditions and was used to evaluate the stability of the process. The fouling rate could be controlled for a long period of time at a flux of 7 l m(-2) h(-1) with a GSV of 62 m/h and an average biomass concentration of 14.8 g TSS/L. The membrane was physically cleaned after 156 days of operation. The cleaning efficiency was almost 100% indicating that no irreversible fouling was developed inside the pores of the membrane. The COD removal efficiency was close to 90%. As in anaerobic processes, nutrients were not exposed to degradation and almost no pathogens were found in the effluent, hence the effluent could be used for irrigation in agriculture.
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Affiliation(s)
- D Martinez-Sosa
- Institute of Water Quality Control, Technische Universität München, Am Coulombwall, D-85748 Garching, Germany.
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26
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Lange C, Scholl M, Melms A, Bischof F. CD62L(high) Treg cells with superior immunosuppressive properties accumulate within the CNS during remissions of EAE. Brain Behav Immun 2011; 25:120-6. [PMID: 20837133 DOI: 10.1016/j.bbi.2010.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 09/05/2010] [Accepted: 09/07/2010] [Indexed: 11/16/2022] Open
Abstract
The role of regulatory T cell populations within the CNS in the regulation of CNS-autoimmunity is controversial. We show that during recovery from relapsing remitting experimental autoimmune encephalomyelitis, regulatory T cells accumulate within the CNS that express high levels of CD62L. These CD62L(high) Treg cells express increased amounts of CTLA-4, ICOS and TGF-β and are more potent than CD62L(low) Treg cells in suppressing proliferation and inducing apoptosis in effector T cells. CD62L(high) Treg cells thus represent a population of Treg cells that display superior immunosuppressive properties and accumulate in the CNS during recovery from CNS-autoimmunity.
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Affiliation(s)
- Christian Lange
- Hertie Institute for Clinical Brain Research, Department of General Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
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27
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Voss M, Bischof F. Recurrent myelitis after allogeneic stem cell transplantation. Report of two cases. BMC Neurol 2010; 10:76. [PMID: 20809972 PMCID: PMC2936883 DOI: 10.1186/1471-2377-10-76] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 09/01/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Allogeneic and autologous haematopoietic stem cell transplantation are established treatment options for haematological malignancies and may possibly be employed to treat a range of genetic and autoimmune diseases. CASE PRESENTATION We report two patients who developed an acute myelitis within their thoracic spinal cord after allogeneic stem cell transplantation. Myelitis in these patients was not related to graft versus host disease or immune reconstitution and was responsive to intravenous methylprednisolone and cyclophosphamide. CONCLUSIONS Myelitis is a possibly disabling consequence of haematopoietic stem cell transplantation.
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Affiliation(s)
- Martin Voss
- Hertie Institute for Clinical Brain Research, Department of General Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
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28
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Bischof F, Langer J, Begall K. [Electromagnetic fields of mobile telephone systems--thresholds, effects and risks for cochlear implant patients and healthy people]. Laryngorhinootologie 2008; 87:768-74. [PMID: 18975245 DOI: 10.1055/s-2008-1077620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Every day life is detectably affected by manifold natural sources of electromagnetic fields (EMF), e. g. infrared radiation, light and the terrestrial magnetic field. However, there is still uncertainty about the consequences or hazards of artificial EMF, which emerge from mobile phone or wireless network (wireless local area network [WLAN]) services, for instance. Following recommendations of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) the German Commission on Radiation Protection (SSK) defined corresponding thresholds for high frequency electromagnetic fields (HF-EMF) in 2003. By observing those thresholds HF-EMF is thought to be innocent so far. However, there is still controversial discussion about induction of cancer or neurovegetative symptoms due to inconsistent study results. Patients with cochlea implants are of particular interest within the speciality of otorhinolaryngology due to specific hazards, which arise during mobile telephone use from the distance between brain and inductive metal implants (electrode) on the one hand and the electronic system of the cochlear implant and the source of HF-EMF on the other hand. Besides many studies about the impact of HF-EMF on common welfare, there are only very few surveys (n = 6) covering the effects on patients with cochlear implants. The purpose of this paper is to overview sources, thresholds and subsequently harmful or harmless effects of HFEMF. Due to the current state of knowledge about the impact of mobile phone use on health, we assume, that HF-EMF are harmless both for healthy people and patients with cochlea implants, provided that legal thresholds are observed.
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Affiliation(s)
- F Bischof
- Klinik für Hals-Nasen-Ohrenheilkunde, AMEOS Klinikum St. Salvator Halberstadt GmbH.
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29
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Abstract
In addition to their immunostimulatory capacity, dendritic cells (DCs) play a crucial role in central and peripheral tolerance mechanisms. In the absence of an infection, immature DCs constantly take up, process and present self-antigens to specific T cells, which leads to the induction of T-cell anergy or deletion. In recent years, several additional mechanisms have been identified by which DCs constantly downregulate immune responses to maintain immunological tolerance. Among these are the complex interactions between several DC subtypes and different types of regulatory T cells. In this review, we summarize recent key findings and concepts in this field.
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Affiliation(s)
- Christian Lange
- Department of General Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen, Germany.
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30
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Plewnia C, Bischof F, Reimold M. Suppression of verbal hallucinations and changes in regional cerebral blood flow after intravenous lidocaine: a case report. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:301-3. [PMID: 17011097 DOI: 10.1016/j.pnpbp.2006.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 07/30/2006] [Accepted: 08/21/2006] [Indexed: 11/24/2022]
Abstract
Simple and complex auditory phantom-perceptions such as tinnitus and musical hallucinations occur predominantly in elderly subjects and are often associated with hearing impairment. Isolated verbal hallucinations without other psychotic features are rare. It has been shown that an intravenous (i.v.) injection of lidocaine can transiently suppress tinnitus. Here we present the case of a 74 year old left-handed women with severely distressing, continuous verbal auditory hallucinations without other psychotic features. I.v. injections of 100 mg lidocaine but not saline resulted in substantial transient suppressions of the hallucinations for several hours. Using [(15)O]H(2)O positron-emission tomography (PET) decreased regional cerebral blood flow associated with reduced perception of voices was found in the right angular and supramarginal gyrus, right inferior frontal gyrus, orbitofronal cortex and in major parts of the cingulate cortex. These data suggest to further investigate the clinical relevance of i.v. lidocaine in patients with therapy-resistant verbal hallucinations, support the notion of common pathophysiological mechanisms in different forms of auditory phantom-perception and demonstrate the feasibility of a new strategy for imaging studies on auditory hallucinations.
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Affiliation(s)
- Christian Plewnia
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Osianderstrasse 24, D-72076 Tuebingen, Germany.
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Melms A, Kötter I, Mitsdoerffer M, Kümmerle-Deschner J, Bischof F, Weller M. Rituximab bei Therapie-refraktären neuroimmunologischen Erkrankungen. Akt Neurol 2007. [DOI: 10.1055/s-2007-987478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lübken M, Wichern M, Letsiou I, Kehl O, Bischof F, Horn H. Thermophilic anaerobic digestion in compact systems: investigations by modern microbiological techniques and mathematical simulation. Water Sci Technol 2007; 56:19-28. [PMID: 18048973 DOI: 10.2166/wst.2007.729] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Thermophilic anaerobic digestion in compact systems can be an economical and ecological reasonable decentralised process technique, especially for rural areas. Thermophilic process conditions are important for a sufficient removal of pathogens. The high energy demand, however, can make such systems unfavourable in terms of energy costs. This is the case when low concentrated wastewater is treated or the system is operated at low ambient temperatures. In this paper we present experimental results of a compact thermophilic anaerobic system obtained with fluorescent in situ hybridisation (FISH) analysis and mathematical simulation. The system was operated with faecal sludge for a period of 135 days and with a model substrate consisting of forage and cellulose for a period of 60 days. The change in the microbial community due to the two different substrates treated could be well observed by the FISH analysis. The Anaerobic Digestion Model no. 1 (ADM1) was used to evaluate system performance at different temperature conditions. The model was extended to contribute to decreased methanogenic activity at lower temperatures and was used to calculate energy production. A model was developed to calculate the major parts of energy consumed by the digester itself at different temperature conditions. It was demonstrated by the simulation study that a reduction of the process temperature can lead to higher net energy yield. The simulation study additionally showed that the effect of temperature on the energy yield is higher when a substrate is treated with high protein content.
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Affiliation(s)
- M Lübken
- Institute of Water Quality Control, Technical University of Munich, Am Coulombwall, Garching, Germany.
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Lübken M, Wichern M, Bischof F, Prechtl S, Horn H. Development of an empirical mathematical model for describing and optimizing the hygiene potential of a thermophilic anaerobic bioreactor treating faeces. Water Sci Technol 2007; 55:95-102. [PMID: 17506425 DOI: 10.2166/wst.2007.132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Poor sanitation and insufficient disposal of sewage and faeces are primarily responsible for water associated health problems in developing countries. Domestic sewage and faeces are prevalently discharged into surface waters which are used by the inhabitants as a source for drinking water. This paper presents a decentralized anaerobic process technique for handling of such domestic organic waste. Such an efficient and compact system for treating faeces and food waste may be of great benefit for developing countries. Besides a stable biogas production for energy generation, the reduction of bacterial pathogens is of particular importance. In our research we investigated the removal capacity of the reactor concerning pathogens, which has been operated under thermophilic conditions. Faecal coliforms and intestinal enterococci have been detected as indicator organisms for bacterial pathogens. By the multiple regression analysis technique an empirical mathematical model has been developed. The model shows a high correlation between removal efficiency and both, hydraulic retention time (HRT) and temperature. By this model an optimized HRT for defined bacterial pathogens effluent standards can be easily calculated. Thus, hygiene potential can be evaluated along with economic aspects. In this paper not only results for describing the hygiene potential of a thermophilic anaerobic bioreactor are presented, but also an exemplary method to draw the right conclusions out of biological tests with the aid of mathematical tools.
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Affiliation(s)
- M Lübken
- Institute of Water Quality Control, Technical University of Munich, Am Coulombwall, 85748 Garching, Germany.
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34
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Amend B, Doster H, Lange C, Dubois E, Kalbacher H, Melms A, Bischof F. Induction of autoimmunity by expansion of autoreactive CD4+CD62Llow cells in vivo. J Immunol 2006; 177:4384-90. [PMID: 16982873 DOI: 10.4049/jimmunol.177.7.4384] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The prerequisites of peripheral activation of self-specific CD4(+) T cells that determine the development of autoimmunity are incompletely understood. SJL mice immunized with myelin proteolipid protein (PLP) 139-151 developed experimental autoimmune encephalomyelitis (EAE) when pertussis toxin (PT) was injected at the time of immunization but not when injected 6 days later, indicating that PT-induced alterations of the peripheral immune response lead to the development of autoimmunity. Further analysis using IA(s)/PLP(139-151) tetramers revealed that PT did not change effector T cell activation or regulatory T cell numbers but enhanced IFN-gamma production by self-specific CD4(+) T cells. In addition, PT promoted the generation of CD4(+)CD62L(low) effector T cells in vivo. Upon adoptive transfer, these cells were more potent than CD4(+)CD62L(high) cells in inducing autoimmunity in recipient mice. The generation of this population was paralleled by higher expression of the costimulatory molecules CD80, CD86, and B7-DC, but not B7-RP, PD-1, and B7-H1 on CD11c(+)CD4(+) dendritic cells whereas CD11c(+)CD8alpha(+) dendritic cells were not altered. Collectively, these data demonstrate the induction of autoimmunity by specific in vivo expansion of CD4(+)CD62L(low) cells and indicate that CD4(+)CD62L(low) effector T cells and CD11c(+)CD4(+) dendritic cells may be attractive targets for immune interventions to treat autoimmune diseases.
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Affiliation(s)
- Bastian Amend
- Hertie Institute for Clinical Brain Research, Department of General Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
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35
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Magnus T, Schreiner B, Korn T, Jack C, Guo H, Antel J, Ifergan I, Chen L, Bischof F, Bar-Or A, Wiendl H. Microglial expression of the B7 family member B7 homolog 1 confers strong immune inhibition: implications for immune responses and autoimmunity in the CNS. J Neurosci 2006; 25:2537-46. [PMID: 15758163 PMCID: PMC6725171 DOI: 10.1523/jneurosci.4794-04.2005] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Inflammation of the CNS is usually locally limited to avoid devastating consequences. Critical players involved in this immune regulatory process are the resident immune cells of the brain, the microglia. Interactions between the growing family of B7 costimulatory ligands and their receptors are increasingly recognized as important pathways for costimulation and/or inhibition of immune responses. Human and mouse microglial cells constitutively express B7 homolog 1 (B7-H1) in vitro. However, under inflammatory conditions [presence of interferon-gamma (IFN-gamma) or T-helper 1 supernatants], a significant upregulation of B7-H1 was detectable. Expression levels of B7-H1 protein on microglial cells were substantially higher compared with astrocytes or splenocytes. Coculture experiments of major histocompatibility complex class II-positive antigen-presenting cells (APC) with syngeneic T cells in the presence of antigen demonstrated the functional consequences of B7-H1 expression on T-cell activation. In the presence of a neutralizing anti-B7-H1 antibody, both the production of inflammatory cytokines (IFN-gamma and interleukin-2) and the upregulation of activation markers (inducible costimulatory signal) by T cells were markedly enhanced. Interestingly, this effect was clearly more pronounced when microglial cells were used as APC, compared with astrocytes or splenocytes. Furthermore, B7-H1 was highly upregulated during the course of myelin oligodendrocyte glycoprotein-induced and proteolipid protein-induced experimental allergic encephalomyelitis in vivo. Expression was predominantly localized to areas of strongest inflammation and could be colocalized with microglial cells/macrophages as well as T cells. Together, our data propose microglial B7-H1 as an important immune inhibitory molecule capable of downregulating T-cell activation in the CNS and thus confining immunopathological damage.
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MESH Headings
- Animals
- Autoimmunity/physiology
- B7-1 Antigen/biosynthesis
- B7-1 Antigen/physiology
- Cells, Cultured
- Central Nervous System/immunology
- Central Nervous System/metabolism
- Coculture Techniques
- Down-Regulation/immunology
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Encephalomyelitis, Autoimmune, Experimental/prevention & control
- Humans
- Lymphocyte Activation/immunology
- Mice
- Mice, Inbred C57BL
- Microglia/immunology
- Microglia/metabolism
- RNA, Messenger/biosynthesis
- RNA, Messenger/immunology
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
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Affiliation(s)
- Tim Magnus
- Department of Neurology, University of Homburg, D-66424 Homburg, Germany
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Lange C, Guo H, Melms A, Bischof F. Mechanismen spezifischer Toleranzinduktion in autoreaktiven T Helfer Zellen in vivo. Akt Neurol 2005. [DOI: 10.1055/s-2005-919406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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37
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Guo H, Röcken M, Melms A, Weissert R, Bischof F. IL4 mediated suppression of autoimmunity in the central nervous system. Akt Neurol 2005. [DOI: 10.1055/s-2005-919402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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38
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Dürr M, Melms A, Bischof F. Mechanismen endogener Reaktivierung autoreaktiver T Helfer Zellen, die Schüben von Autoimmunität im ZNS vorausgehen. Akt Neurol 2005. [DOI: 10.1055/s-2005-919405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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39
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Abstract
3-Hydroxy-3-methylglutaryl-CoA lyase deficiency is a disorder of leucine metabolism that usually presents with recurrent episodes of life-threatening hypoglycemia during early childhood. We report on a 36-year-old woman with seizures, recurrent metabolic disturbances, and severe leukoencephalopathy. The diagnosis was made by analysis of amino acids in urine and serum and was confirmed by demonstration of the deficient enzyme in cultured skin fibroblasts. The patient improved clinically on oral L-carnitine substitution. This treatable condition can remain unrecognized in adults and should be considered a potential cause of leukoencephalopathy.
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Affiliation(s)
- Felix Bischof
- Department of General Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany.
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Bischof F, Bins A, Dürr M, Zevering Y, Melms A, Kruisbeek AM. A Structurally Available Encephalitogenic Epitope of Myelin Oligodendrocyte Glycoprotein Specifically Induces a Diversified Pathogenic Autoimmune Response. J Immunol 2004; 173:600-6. [PMID: 15210822 DOI: 10.4049/jimmunol.173.1.600] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis is an inflammatory disease of the CNS that involves immune reactivity against myelin oligodendrocyte glycoprotein (MOG), a type I transmembrane protein located at the outer surface of CNS myelin. The epitope MOG92-106 is a DR4-restricted Th cell epitope and a target for demyelinating autoantibodies. In this study, we show that the immune response elicited by immunization with this epitope is qualitatively different from immune responses induced by the well-defined epitopes myelin basic protein (MBP) 84-96 and proteolipid protein (PLP) 139-151. Mice with MOG92-106-, but not with MBP84-96- or PLP139-151-induced experimental autoimmune encephalomyelitis developed extensive B cell reactivity against secondary myelin Ags. These secondary Abs were directed against a set of encephalitogenic peptide Ags derived from MBP and PLP as well as a broad range of epitopes spanning the complete MBP sequence. The observed diversification of the B cell reactivity represents a simultaneous spread toward a broad range of antigenic epitopes and differs markedly from T cell epitope spreading that follows a sequential cascade. The Abs were of the isotypes IgG1 and IgG2b, indicating that endogenously recruited B cells receive help from activated T cells. In sharp contrast, B cell reactivity in MBP84-96- and PLP139-151-induced experimental autoimmune encephalomyelitis was directed against the disease-inducing Ag only. These data provide direct evidence that the nature of the endogenously acquired immune reactivity during organ-specific autoimmunity critically depends on the disease-inducing Ag. They further demonstrate that the epitope MOG92-106 has the specific capacity to induce a widespread autoimmune response.
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Affiliation(s)
- Felix Bischof
- Department of Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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41
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Bischof F, Hofmann M, Schumacher TNM, Vyth-Dreese FA, Weissert R, Schild H, Kruisbeek AM, Melms A. Analysis of autoreactive CD4 T cells in experimental autoimmune encephalomyelitis after primary and secondary challenge using MHC class II tetramers. J Immunol 2004; 172:2878-84. [PMID: 14978089 DOI: 10.4049/jimmunol.172.5.2878] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, is primarily mediated by CD4 T cells specific for Ags in the CNS. Using MHC class II tetramers, we assessed expansion and phenotypic differentiation of polyclonal self-reactive CD4 T cells during EAE after primary and secondary challenge with the specific Ag. After EAE induction in SJL mice with proteolipid protein 139-151, CNS-specific T cells up-regulated activation markers and expanded in the draining lymph nodes and in the spleen. Less than 20% of total autoreactive T cells entered the CNS simultaneously with Th cells of other specificities. Almost all tetramer-positive cells in the CNS were activated and phenotypically distinct from the large peripheral pool. When EAE was induced in Ag-experienced mice, disease symptoms developed earlier and persisted longer; autoreactive T cells were more rapidly activated and invaded the CNS earlier. In striking contrast to specific CTLs that respond after secondary viral challenge, the absolute numbers of autoreactive CD4 T cells were not increased, indicating that the accelerated autoreactivity in Ag-experienced mice is not related to higher frequencies of autoreactive CD4 T cells.
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Affiliation(s)
- Felix Bischof
- Department of Neurology and Institute for Cell Biology, University of Tübingen, Tübingen, Germany.
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42
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Bischof F, Hofmann M, Weissert R, Schild H, Kruisbeek A, Melms A. Qualitative und nicht quantitative Eigenschaften autoreaktiver T-Helfer-Lymphozyten bestimmen die Ausprägung einer ZNS-gerichteten Autoimmunerkrankung. Akt Neurol 2004. [DOI: 10.1055/s-2004-833376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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43
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Friese MA, Platten M, Lutz SZ, Naumann U, Aulwurm S, Bischof F, Bühring HJ, Dichgans J, Rammensee HG, Steinle A, Weller M. MICA/NKG2D-mediated immunogene therapy of experimental gliomas. Cancer Res 2003; 63:8996-9006. [PMID: 14695218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The failure of conventional cancer therapy renders glioblastoma an attractive target for immunotherapy. Tumor cells expressing ligands of the activating immunoreceptor NKG2D stimulate tumor immunity mediated by natural killer (NK), gammadelta T, and CD8(+) T cells. We report that human glioma cells express the NKG2D ligands MICA, MICB, and members of the UL16-binding protein family constitutively. However, glioma cells resist NK cell cytolysis because of high MHC class I antigen expression. Plasmid-mediated or adenovirus-mediated overexpression of MICA in glioma cells enhances their sensitivity to NK and T-cell responses in vitro and markedly delays the growth of s.c. and intracerebral LN-229 human glioma cell xenografts in nude mice and of SMA-560 gliomas in syngeneic VMDk mice. Glioma cells forming progressive tumors after implantation of stably MICA-transfected human LN-229 cells lost MICA expression, indicating a strong selection against MICA expression in vivo. Rejection of MICA-expressing SMA-560 cells in VMDk mice resulted in protective immunity to a subsequent challenge with wild-type tumor cells. Finally, the growth of syngeneic intracerebral SMA-560 tumors is inhibited by peripheral vaccination with adenovirus-mediated, MICA-infected irradiated tumor cells, and vaccination results in immune cell activation in the NK and T-cell compartments in vivo. These data commend MICA immunogene therapy as a novel experimental treatment for human malignant gliomas.
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Affiliation(s)
- Manuel A Friese
- Department of Neurology, University of Tübingen, Tübingen, Germany
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44
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Halsch E, Bischof F, Hofferbert M. Optimierte Bioabfallvergärung durch Thermodruckhydrolyse. CHEM-ING-TECH 2002. [DOI: 10.1002/1522-2640(200205)74:5<635::aid-cite635>3.0.co;2-#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - F. Bischof
- FH Amberg‐Weiden, Kaiser‐Wilhelm‐Ring 23, D‐92224 Amberg
| | - M. Hofferbert
- ATZ‐EVUS, Kropfersrichterstraße 6 – 8, D‐92237 Sulzbach‐Rosenberg
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45
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Abstract
A high incidence of long-bone fractures has been observed in children and young adults with quadriplegic cerebral palsy in residential care. This study aimed to determine factors that contribute to these fractures and to institute preventive treatment. Twenty individuals (12 males, eight females) of a cohort of 88 residents with spastic quadriplegia in residential care in Gauteng, South Africa who had sustained fractures were compared with a random sample of age-matched control participants (10 males, 10 females) from the same facility. Participants ranged in age from 6 to 29 years (median 17.5 years). The majority of fractures were in the upper extremities. There was radiological and biochemical evidence of rickets and osteomalacia in both groups. However, the severity of the disease was more pronounced in the group with fractures. There was a significant relation (p=0.002) between the number of fractures and the use of anticonvulsant therapy (ACT). Three months of vitamin D administration (calciferol 5000 iu/day) resulted in a marked clinical improvement. There were no fractures during this period in either group. In addition, the mean serum calcium (Ca) and phosphate (Pi) levels increased (Ca from 2.17 to 2.35 mmol/L and Pi from 1.13 to 1.66 mmol/L) and mean total alkaline phosphatase level decreased (from 1123 to 423 U/L). We concluded that vitamin D deficiency was the major factor contributing to the occurrence of fractures in this population. Unless sunlight exposure can be guaranteed, vitamin D supplementation should be considered for children and adults in residential care, especially if they are on ACT, even in areas with year-round sunshine.
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Affiliation(s)
- F Bischof
- Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa.
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46
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Bischof F, Wienhold W, Wirblich C, Malcherek G, Zevering O, Kruisbeek AM, Melms A. Specific treatment of autoimmunity with recombinant invariant chains in which CLIP is replaced by self-epitopes. Proc Natl Acad Sci U S A 2001; 98:12168-73. [PMID: 11593032 PMCID: PMC59786 DOI: 10.1073/pnas.221220998] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The invariant chain (Ii) binds to newly synthesized MHC class II molecules with the CLIP region of Ii occupying the peptide-binding groove. Here we demonstrate that recombinant Ii proteins with the CLIP region replaced by antigenic self-epitopes are highly efficient in activating and silencing specific T cells in vitro and in vivo. The Ii proteins require endogenous processing by antigen-presenting cells for efficient T cell activation. An Ii protein encompassing the epitope myelin basic protein amino acids 84-96 (Ii-MBP84-96) induced the model autoimmune disease experimental allergic encephalomyelitis (EAE) with a higher severity and earlier onset than the peptide. When applied in a tolerogenic manner, Ii-MBP84-96 abolished antigen-specific T cell proliferation and suppressed peptide-induced EAE more effectively than peptide alone. Importantly, i.v. administration of Ii proteins after EAE induction completely abrogated the disease, whereas peptides only marginally suppressed disease symptoms. Ii fusion proteins are thus more efficient than peptide in modulating CD4(+) T cell-mediated autoimmunity, documenting their superior qualities for therapeutic antigen delivery in vivo.
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Affiliation(s)
- F Bischof
- Division of Immunology, The Netherlands Cancer Institute, 1066CX Amsterdam, The Netherlands.
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47
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Bischof F. Hyperbaric oxygen therapy in cerebral palsy. S Afr Med J 2001; 91:182. [PMID: 11291406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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48
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Abstract
4-Nonylphenol (4-NP) occurs in sewage sludge as a result of the breakdown of detergents which contains nonylphenol ethoxylates (NPEs). 4-NP is of environmental concern because of its toxicity to biological systems. The present paper reports results of aerobic treatment under thermophilic conditions of sewage sludge artificially contaminated with 4-NP. Experiments were carried out using three parallel laboratory-scale batch reactors operating with blank, 50 and 100 mg/l of 4-NP concentration. For the two studied concentrations up to 66% 4-NP reduction was achieved at a specific air flow rate of 16 l/(l.h) and a thermophilic temperature of 60 degrees C, within 10 days of operation. The presence of 4-NP has minor effect on the rate of sludge oxidation and the nitrogen and phosphorous content in the sludge.
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Affiliation(s)
- F A Banat
- Department of Chemical Engineering, Jordan University of Science and Technology, Irbid.
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49
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Rittmeister M, Bischof F, Starker M. [Individual cement-free total hip endoprosthesis in a patient with a rare form of dwarfism (Fuhrmann syndrome)]. Z Orthop Ihre Grenzgeb 2000; 138:235-9. [PMID: 10929615 DOI: 10.1055/s-2000-10142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We present a single case study of a 47-year-old female patient with a rare form of primary dysostotic dwarfism. This syndrome was first described by Fuhrmann in 1972. Seven years ago, this patient underwent bilateral cementless total hip arthroplasties for severe osteoarthritis about her hips. Custom-made components were used. While achondroplastic patients present with wide femoral medullary canals, it is clinically relevant that Fuhrmann Syndrome features narrow femoral medullary canals. This complicating anatomical factor in Fuhrmann syndrome as well as the increased anteversion angles were overcome by the use of CAD stems. We conclude that the custom-made stems, although in our case measuring half the size of the smallest commercially available design, have proved to be durable and able to withstand physiological loads at follow-up period of 72 months.
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Affiliation(s)
- M Rittmeister
- Rheumaorthopädische Abteilung der Orthopädischen Universitätsklinik, Frankfurt/M
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50
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Kandziora F, Jäger A, Bischof F, Herresthal J, Starker M, Mittlmeier T. Arthroscopic labrum refixation for post-traumatic anterior shoulder instability: suture anchor versus transglenoid fixation technique. Arthroscopy 2000; 16:359-66. [PMID: 10802472 DOI: 10.1016/s0749-8063(00)90079-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
SUMMARY The aim of this retrospective study was to compare recurrence rates following transglenoid labrum refixation or fixation using the suture anchor (FASTak, Arthrex, Naples, FL) technique. Additionally, parameters that apparently influence the rate of redislocation were investigated. There were 163 patients with post-traumatic anterior shoulder instability treated with an arthroscopic labrum refixation; 108 patients (66.3%) were stabilized with the transglenoid suture technique (group I) and 55 patients (33. 7%) with the suture anchor (FASTak) technique (group II). The average follow-up was 4.5 years (range, 2.0 to 7.9 years) in group I and 3.2 years (range, 2.0 to 5.0 years) in group II. The Rowe score increased from a preoperative average of 35.0 points in group I and 35.4 points in group II to a postoperative average of 68.3 points in group I and 84.6 points in group II (P <.01). There was recurrence in 35 patients (32.4%) in group I and 9 patients (16.4%) in group II (P <.05). All incidents of redislocation occurred during the first 21 postoperative months; 58.4% of the patients (n = 63) in group I and 16.4% of the patients in group II (n = 9) had to reduce their sporting activity (P <.001). Independent of the type of surgery, there was a significant correlation of the postoperative rate of redislocation and age (P <.001), number of preoperative dislocations (P <.01), and degree of labrum lesion (P <.001). No correlation with the rate of redislocation was shown for gender, handedness, dislocation-operation interval, degree of Hill-Sachs lesion, or number of transglenoid sutures or anchors. Concerning post-traumatic anterior shoulder instability, the arthroscopic labrum reconstruction with the suture anchor (FASTak) technique was superior to the transglenoid technique but has not yet achieved the level of success obtained by open surgery. With fewer than 5 preoperative redislocations after a first traumatic shoulder dislocation, the arthroscopic treatment is recommended. In cases of more frequent preoperative dislocations, open surgery in combination with a capsular shift should be performed.
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Affiliation(s)
- F Kandziora
- Orthopädische Universitätsklinik der J. W. Goethe Universität, Frankfurt am Main, Berlin, Germany.
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