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Kaufmann L, Pilic J, Auinger L, Mayer AL, Blatterer J, Semmler-Bruckner J, Abbas S, Rehman K, Ayaz M, Graier WF, Malli R, Petek E, Wagner K, Al Kaissi A, Khan MA, Windpassinger C. Analysis of a non-lethal biallelic frameshift mutation in ZMPSTE24 reveals utilization of alternative translation initiation codons. Clin Genet 2023; 104:491-496. [PMID: 37270786 DOI: 10.1111/cge.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/12/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
Restrictive dermopathy (RD) is a lethal condition caused by biallelic loss-of-function mutations in ZMPSTE24, whereas mutations preserving residual enzymatic activity of the ZMPSTE24 protein lead to the milder mandibuloacral dysplasia with type B lipodystrophy (MADB) phenotype. Remarkably, we identified a homozygous, presumably loss-of-function mutation in ZMPSTE24 [c.28_29insA, p.(Leu10Tyrfs*37)] in two consanguineous Pakistani families segregating MADB. To clarify how lethal consequences are prevented in affected individuals, functional analysis was performed. Expression experiments supported utilization of two alternative translation initiation sites, preventing complete loss of protein function consistent with the relatively mild phenotypic outcome in affected patients. One of these alternative start codons is newly formed at the insertion site. Our findings indicate that the creation of new potential start codons through N-terminal mutations in other disease-associated genes should generally be taken into consideration in the variant interpretation process.
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Affiliation(s)
- Lukas Kaufmann
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Johannes Pilic
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Lisa Auinger
- Division of Haematology, Medical University of Graz, Graz, Austria
| | - Anna-Lena Mayer
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Jasmin Blatterer
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Johann Semmler-Bruckner
- Neurogenetics Laboratory, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Safdar Abbas
- Gomal Centre of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Khurram Rehman
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Muhammad Ayaz
- Department of Biological Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - Wolfgang F Graier
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
- BioTechMed Graz, Graz, Austria
| | - Roland Malli
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
- BioTechMed Graz, Graz, Austria
| | - Erwin Petek
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Klaus Wagner
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Ali Al Kaissi
- Pediatric Orthopedic Department, Speising Hospital, Vienna, Austria
| | - Muzammil Ahmad Khan
- Gomal Centre of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Christian Windpassinger
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz, Austria
- Neurogenetics Laboratory, Department of Neurology, Medical University of Graz, Graz, Austria
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2
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Schaflinger E, Blatterer J, Khan AS, Kaufmann L, Auinger L, Tatrai B, Abbasi SW, Zeeshan Ali M, Abbasi AA, Al Kaissi A, Petek E, Wagner K, Ahmad Khan M, Windpassinger C. An exceptional biallelic N-terminal frame shift mutation in ZMPSTE24 leads to non-lethal progeria due to possible utilization of a downstream alternative start codon. Gene 2022; 833:146582. [PMID: 35597529 DOI: 10.1016/j.gene.2022.146582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/09/2021] [Revised: 03/29/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022]
Abstract
Biallelic mutations in ZMPSTE24 are known to be associated with autosomal recessive mandibuloacral dysplasia with type B lipodystrophy (MADB) and lethal restrictive dermopathy (RD), respectively. Disease manifestation is depending on the remaining enzyme activity of the mutated ZMPSTE24 protein. To date, complete loss of function has exclusively been reported in RD cases. In this study, we identified a novel N-terminal homozygous frameshift mutation (c.28_29insA) in a consanguineous family segregating with MADB. An in-depth analysis of the mutated sequence revealed, that the one base pair insertion creates a novel downstream in-frame start codon, which supposedly serves as an alternative translation initiation site (TIS). This possible rescue mechanism would explain the relatively mild clinical outcome in the studied individuals. Our findings demonstrate the necessity for careful interpretation of N-terminal variants potentially effecting translation initiation.
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Affiliation(s)
- Erich Schaflinger
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Jasmin Blatterer
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Aiman Saeed Khan
- Gomal Centre of Biochemistry and Biotechnology, Gomal University, D.I.Khan, Khyber Pakhtunkhwa, Pakistan
| | - Lukas Kaufmann
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Lisa Auinger
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Benjamin Tatrai
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Sumra Wajid Abbasi
- NUMS Department of Biological Sciences, National University of Medical Sciences, The Mall, Abid Majeed Road, Rawalpindi, Punjab, Pakistan
| | - Muhammad Zeeshan Ali
- Gomal Centre of Biochemistry and Biotechnology, Gomal University, D.I.Khan, Khyber Pakhtunkhwa, Pakistan
| | - Ansar Ahmad Abbasi
- Department of Zoology, Mirpur University of Science and Technology, Mirpur, AJK 10250, Pakistan
| | - Ali Al Kaissi
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Erwin Petek
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Klaus Wagner
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria
| | - Muzammil Ahmad Khan
- Gomal Centre of Biochemistry and Biotechnology, Gomal University, D.I.Khan, Khyber Pakhtunkhwa, Pakistan.
| | - Christian Windpassinger
- Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Graz 8010, Austria.
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Linnik J, Syedbasha M, Kaltenbach HM, Vogt D, Hollenstein Y, Kaufmann L, Cantoni N, Ruosch-Girsberger S, Müller AMS, Schanz U, Müller Pabst T, Stüssi G, Weisser M, Halter J, Stelling J, Egli A. Association of host factors with antibody response to seasonal influenza vaccination in allogeneic hematopoietic stem cell transplant (HSCT) patients. J Infect Dis 2021; 225:1482-1493. [PMID: 34415049 PMCID: PMC9016469 DOI: 10.1093/infdis/jiab391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/19/2021] [Accepted: 07/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Influenza vaccination efficacy is reduced after hematopoietic stem cell transplantation (HSCT) and patient factors determining vaccination outcomes are still poorly understood. METHODS We investigated the antibody response to seasonal influenza vaccination in 135 HSCT patients and 69 healthy volunteers (HVs) in a prospective observational multicenter cohort study. We identified patient factors associated with hemagglutination inhibition titers against A/California/2009/H1N1, A/Texas/2012/H3N2, and B/Massachusetts/2012 by multivariable regression on the observed titer levels and on seroconversion/seroprotection categories for comparison. RESULTS Both regression approaches yield consistent results but regression on titers estimated associations with higher precision. HSCT patients required two vaccine doses to achieve average responses comparable to a single dose in HVs. Pre-vaccination titers were positively associated with time after transplantation, confirming that HSCT patients can elicit potent antibody responses. However, an unrelated donor, absolute lymphocyte counts below the normal range and treatment with calcineurin inhibitors lower the odds of responding. CONCLUSIONS HSCT patients show a highly heterogeneous vaccine response, but overall, patients benefited from the booster shot and can acquire seroprotective antibodies over the years after transplantation. Several common patient factors lower the odds of responding, urging to identify additional preventive strategies in the poorly responding groups.
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Affiliation(s)
- Janina Linnik
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,Swiss Institute for Bioinformatics, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Hans-Michael Kaltenbach
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,Swiss Institute for Bioinformatics, Basel, Switzerland
| | - Dominik Vogt
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Lukas Kaufmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Nathan Cantoni
- Division of Oncology, Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Antonia M S Müller
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Urs Schanz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Müller Pabst
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Georg Stüssi
- Division of Hematology, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Maja Weisser
- Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland
| | - Jörg Halter
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Jörg Stelling
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,Swiss Institute for Bioinformatics, Basel, Switzerland
| | - Adrian Egli
- Department of Biomedicine, University of Basel, Basel, Switzerland.,Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel Switzerland
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Abstract
BACKGROUND In recent years, many medical specialties with a visual focus have been revolutionized by image analysis algorithms using artificial intelligence (AI). As dermatology belongs to this field, it has the potential to play a pioneering role in the use of AI. OBJECTIVE The current use of AI for the diagnosis and follow-up of dermatoses is reviewed and the future potential of these technologies is discussed. MATERIALS AND METHODS This article is based on a selective review of the literature using Embase and MEDLINE and the keywords "psoriasis", "eczema", "dermatoses" and "acne" combined with "artificial intelligence", "machine learning", "deep learning", "neural network", "computer-guided", "supervised machine learning" or "unsupervised machine learning" were searched. RESULTS In comparison to examiner-dependent intra- and interindividually fluctuating scores for the assessment of inflammatory dermatoses (e.g. the Psoriasis Areas Severity Index [PASI] and body surface area [BSA]), AI-based algorithms can potentially offer reproducible, standardized evaluations of these scores. Whereas promising algorithms have already been developed for the diagnosis of psoriasis, there is currently only scarce work on the use of AI in the context of eczema. CONCLUSIONS The latest developments in this field show the enormous potential of AI-based diagnostics and follow-up of dermatological clinical pictures by means of an autonomous computer-based image analysis. These noninvasive, optical examination methods provide valuable additional information, but dermatological interaction remains indispensable in daily clinical practice.
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Affiliation(s)
- L V Maul
- Klinik für Dermatologie, Universitätsspital Basel, Basel, Schweiz.
| | - N Meienberger
- Klinik für Dermatologie, Universitätsspital Zürich, Zürich, Schweiz
| | - L Kaufmann
- Medizinische Klinik 3, Kardiologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
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5
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Zimmermann M, Rose N, Lindner JM, Kim H, Gonçalves AR, Callegari I, Syedbasha M, Kaufmann L, Egli A, Lindberg RLP, Kappos L, Traggiai E, Sanderson NSR, Derfuss T. Antigen Extraction and B Cell Activation Enable Identification of Rare Membrane Antigen Specific Human B Cells. Front Immunol 2019; 10:829. [PMID: 31040853 PMCID: PMC6477023 DOI: 10.3389/fimmu.2019.00829] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 12/21/2018] [Accepted: 03/28/2019] [Indexed: 11/13/2022] Open
Abstract
Determining antigen specificity is vital for understanding B cell biology and for producing human monoclonal antibodies. We describe here a powerful method for identifying B cells that recognize membrane antigens expressed on cells. The technique depends on two characteristics of the interaction between a B cell and an antigen-expressing cell: antigen-receptor-mediated extraction of antigen from the membrane of the target cell, and B cell activation. We developed the method using influenza hemagglutinin as a model viral membrane antigen, and tested it using acetylcholine receptor (AChR) as a model membrane autoantigen. The technique involves co-culturing B cells with adherent, bioorthogonally labeled cells expressing GFP-tagged antigen, and sorting GFP-capturing, newly activated B cells. Hemagglutinin-specific B cells isolated this way from vaccinated human donors expressed elevated CD20, CD27, CD71, and CD11c, and reduced CD21, and their secreted antibodies blocked hemagglutination and neutralized viral infection. Antibodies cloned from AChR-capturing B cells derived from patients with myasthenia gravis bound specifically to the receptor on cell membrane. The approach is sensitive enough to detect antigen-specific B cells at steady state, and can be adapted for any membrane antigen.
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Affiliation(s)
- Maria Zimmermann
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Natalie Rose
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - John M Lindner
- Novartis Institute for BioMedical Research, Basel, Switzerland.,BioMed X Innovation Center, Heidelberg, Germany
| | - Hyein Kim
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ana Rita Gonçalves
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Ilaria Callegari
- Neuroscience Consortium, Monza Policlinico and Pavia Mondino, University of Pavia, Pavia, Italy
| | | | - Lukas Kaufmann
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Adrian Egli
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland.,Division of Clinical Microbiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Raija L P Lindberg
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ludwig Kappos
- Departments of Medicine, Neurologic Clinic and Policlinic, Clinical Research and Biomedical Engineering, University Hospital and University of Basel, Basel, Switzerland
| | | | - Nicholas S R Sanderson
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tobias Derfuss
- Department of Medicine, Neurologic Clinic and Policlinic, University Hospital and University of Basel, Basel, Switzerland
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6
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Läubli H, Balmelli C, Kaufmann L, Stanczak M, Syedbasha M, Vogt D, Hertig A, Müller B, Gautschi O, Stenner F, Zippelius A, Egli A, Rothschild SI. Influenza vaccination of cancer patients during PD-1 blockade induces serological protection but may raise the risk for immune-related adverse events. J Immunother Cancer 2018; 6:40. [PMID: 29789020 PMCID: PMC5964701 DOI: 10.1186/s40425-018-0353-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/09/2018] [Indexed: 12/12/2022] Open
Abstract
Background Immune checkpoint inhibiting antibodies were introduced into routine clinical practice for cancer patients. Checkpoint blockade has led to durable remissions in some patients, but may also induce immune-related adverse events (irAEs). Lung cancer patients show an increased risk for complications, when infected with influenza viruses. Therefore, vaccination is recommended. However, the efficacy and safety of influenza vaccination during checkpoint blockade and its influence on irAEs is unclear. Similarly, the influence of vaccinations on T cell-mediated immune reactions in patients during PD-1 blockade remains poorly defined. Methods We vaccinated 23 lung cancer patients and 11 age-matched healthy controls using a trivalent inactivated influenza vaccine to investigate vaccine-induced immunity and safety during checkpoint blockade. Results We did not observe significant differences between patients and healthy controls in vaccine-induced antibody titers against all three viral antigens. Influenza vaccination resulted in protective titers in more than 60% of patients/participants. In cancer patients, the post-vaccine frequency of irAEs was 52.2% with a median time to occurrence of 3.2 months after vaccination. Six of 23 patients (26.1%) showed severe grade 3/4 irAEs. This frequency of irAEs might be higher than the rate previously published in the literature and the rate observed in a non-study population at our institution (all grades 25.5%, grade 3/4 9.8%). Conclusions Although this is a non-randomized trial with a limited number of patients, the increased rate of immunological toxicity is concerning. This finding should be studied in a larger patient population.
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Affiliation(s)
- Heinz Läubli
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland.,Cancer Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Catharina Balmelli
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Lukas Kaufmann
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Michal Stanczak
- Cancer Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Mohammedyaseen Syedbasha
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Dominik Vogt
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Astrid Hertig
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Beat Müller
- Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | | | - Frank Stenner
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland.,Cancer Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Alfred Zippelius
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland.,Cancer Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - Sacha I Rothschild
- Department of Internal Medicine, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland. .,Cancer Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland.
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7
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Kaufmann L, Syedbasha M, Vogt D, Hollenstein Y, Hartmann J, Linnik JE, Egli A. An Optimized Hemagglutination Inhibition (HI) Assay to Quantify Influenza-specific Antibody Titers. J Vis Exp 2017. [PMID: 29286466 DOI: 10.3791/55833] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Antibody titers are commonly used as surrogate markers for serological protection against influenza and other pathogens. Detailed knowledge of antibody production pre- and post-vaccination is required to understand vaccine-induced immunity. This article describes a reliable point-by-point protocol to determine influenza-specific antibody titers. The first protocol describes a method to specify the antigen amounts required for hemagglutination, which standardizes the concentrations for subsequent usage in the second protocol (hemagglutination assay, HA assay). The second protocol describes the quantification of influenza-specific antibody titers against different viral strains by using a serial dilution of human serum or cell culture supernatants (hemagglutination inhibition assay, HI assay). As an applied example, we show the antibody response of a healthy cohort, which received a trivalent inactivated influenza vaccine. Additionally, the cross-reactivity between the different influenza viruses is shown and methods to minimize cross-reactivity by using different types of animal red blood cells (RBCs) are explained. The discussion highlights advantages and disadvantages of the presented assays and how the determination of influenza-specific antibody titers can improve the understanding of vaccine-related immunity.
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Affiliation(s)
- Lukas Kaufmann
- Applied Microbiology Research, Department of Biomedicine, University of Basel
| | | | - Dominik Vogt
- Applied Microbiology Research, Department of Biomedicine, University of Basel
| | - Yvonne Hollenstein
- Applied Microbiology Research, Department of Biomedicine, University of Basel
| | - Julia Hartmann
- Applied Microbiology Research, Department of Biomedicine, University of Basel
| | - Janina E Linnik
- Applied Microbiology Research, Department of Biomedicine, University of Basel; Department of Biosystems Science and Engineering, ETH Zurich; Swiss Institute of Bioinformatics
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel; Clinical Microbiology, University Hospital Basel;
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8
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Laubli HP, Balmelli C, Kaufmann L, Stanczak M, Syedbasha M, Vogt D, Mueller B, Gautschi O, Stenner F, Zippelius A, Egli A, Rothschild S. Immune response and adverse events to influenza vaccine in cancer patients undergoing PD-1 blockade. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14523] [Citation(s) in RCA: 5] [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] [Indexed: 11/20/2022] Open
Abstract
e14523 Background: Cancer patients (pts) are at risk to develop complications when infected with seasonal influenza viruses. Current guidelines propose that pts on PD-1 directed therapies may receive concurrent inactivated influenza immunization if not medically contraindicated. In this observational study, we aimed to assess the vaccine induced immune response and safety of immunotherapy and influenza vaccine. Methods: Metastatic cancer pts treated with at least one dose of either nivolumab or pembrolizumab were vaccinated with a trivalent inactive influenza vaccination between October and November 2015. Partners of the pts were vaccinated and included in our analysis as age-matched controls. Antibody titers against vaccine virus strains were measured by hemagglutination inhibition assay at days 7, 30, 60 and 180. Cytokine/chemokine profile and changes in peripheral immune cells were assessed in cancer pts at the same time points. Immune-related adverse events (irAE) were documented according to CTCAE v4.0. Results: We included 23 pts and 7 age-matched healthy controls. Median time between initiation of PD-1 inhibition and influenza vaccination was 74 days (range, 44-57). 22 pts were treated with nivolumab and 1 pt with pembrolizumab. 16 pts had a diagnosis of non-small cell lung cancer, 3 pts had renal cell carcinoma and 3 pts a malignant melanoma. In total, 12 pts (52.2%) experienced an irAE. 6 pts (26.1%) had grade 3 or 4 (G3/4) irAEs. This frequency seems to be higher than reported in the literature. G3/4 irAEs include colitis (n = 2), encephalitis (n = 1), vasculitis (n = 1), pneumonitis (n = 1), peripheral neuritis (n = 1). There was no major difference over time in the generation of antibody titers against strains in the vaccine. Peripheral leukocyte counts and cytokine/inflammatory chemokine levels were unchanged after vaccination. We did not observe unexpected local toxicities at the injection site. Conclusions: The seasonal influence vaccination reaches a protective range in these pts. Unexpectedly, however, an increased rate of clinically relevant irAEs was observed. Confirmation in a larger population and mechanistic understanding is required.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Adrian Egli
- University Hospital Basel, Basel, Switzerland
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9
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Rothschild S, Balmelli C, Kaufmann L, Stanczak M, Syedbasha M, Vogt D, Gautschi O, Egli A, Zippelius A, Laeubli H. Immune response and adverse events to influenza vaccine in cancer patients undergoing PD-1 blockade. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Klein E, Bahnmueller J, Mann A, Pixner S, Kaufmann L, Nuerk HC, Moeller K. Language influences on numerical development-Inversion effects on multi-digit number processing. Front Psychol 2013; 4:480. [PMID: 23935585 PMCID: PMC3733006 DOI: 10.3389/fpsyg.2013.00480] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [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: 05/06/2013] [Accepted: 07/09/2013] [Indexed: 11/27/2022] Open
Abstract
In early numerical development, children have to become familiar with the Arabic number system and its place-value structure. The present review summarizes and discusses evidence for language influences on the acquisition of the highly transparent structuring principles of digital-Arabic digits by means of its moderation through the transparency of the respective language's number word system. In particular, the so-called inversion property (i.e., 24 named as “four and twenty” instead of “twenty four”) was found to influence number processing in children not only in verbal but also in non-verbal numerical tasks. Additionally, there is first evidence suggesting that inversion-related difficulties may influence numerical processing longitudinally. Generally, language-specific influences in children's numerical development are most pronounced for multi-digit numbers. Yet, there is currently only one study on three-digit number processing for German-speaking children. A direct comparison of additional new data from Italian-speaking children further corroborates the assumption that language impacts on cognitive (number) processing as inversion-related interference was found most pronounced for German-speaking children. In sum, we conclude that numerical development may not be language-specific but seems to be moderated by language.
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Affiliation(s)
- E Klein
- Section Neuropsychology, Department of Neurology, University Hospital RWTH Aachen University Tuebingen, Germany ; IWM-KMRC Knowledge Media Research Center Tuebingen, Germany
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11
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Bentohami A, Bijlsma TS, Goslings JC, de Reuver P, Kaufmann L, Schep NWL. Radiological criteria for acceptable reduction of extra-articular distal radial fractures are not predictive for patient-reported functional outcome. J Hand Surg Eur Vol 2013. [PMID: 23186862 DOI: 10.1177/1753193412468266] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to assess the association between arm-specific disability measured with the QuickDASH questionaire and radiological criteria in patients with extra-articular distal radial fractures. A consecutive series of 385 patients were initially treated non-operatively for an extra-articular distal radial fracture and 257 (69 %) patients were included in the study. In 203 of these patients (78%) the quality of radiographic reduction was judged to be adequate by radiological parameters, which included dorsal tilt, radial inclination, and radial shortening. In 54 patients (22%) the quality of radiographic alignment was judged to be inadequate. We observed no effect of radiographic parameters on the functional outcome. Female sex and longer duration of follow-up (>35 months) were the only independent prognostic factors significantly associated with a worse QuickDASH score.
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Affiliation(s)
- A Bentohami
- Department of Surgery, Spaarne Hospital, Hoofddorp, The Netherlands.
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Pixner S, Zuber J, Heřmanová V, Kaufmann L, Nuerk HC, Moeller K. One language, two number-word systems and many problems: numerical cognition in the Czech language. Res Dev Disabil 2011; 32:2683-2689. [PMID: 21763104 DOI: 10.1016/j.ridd.2011.06.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 06/09/2011] [Indexed: 05/31/2023]
Abstract
Comparing numerical performance between different languages does not only mean comparing different number-word systems, but also implies a comparison of differences regarding culture or educational systems. The Czech language provides the remarkable opportunity to disentangle this confound as there exist two different number-word systems within the same language: for instance, "25" can be either coded in non-inverted order "dvadsetpät" [twenty-five] or in inverted order "pätadvadset" [five-and-twenty]. To investigate the influence of the number-word system on basic numerical processing within one culture, 7-year-old Czech-speaking children had to perform a transcoding task (i.e., writing Arabic numbers to dictation) in both number-word systems. The observed error pattern clearly indicated that the structure of the number-word system determined transcoding performance reliably: In the inverted number-word system about half of all errors were inversion-related. In contrast, hardly any inversion-related errors occurred in the non-inverted number-word system. We conclude that the development of numerical cognition does not only depend on cultural or educational differences, but is indeed related to the structure and transparency of a given number-word system.
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Affiliation(s)
- S Pixner
- Institute of Applied Psychology, UMIT The Health and Life Science University, Eduard Wallnöfer Zentrum 1, 6060 Hall in Tyrol, Austria.
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Moeller K, Pixner S, Zuber J, Kaufmann L, Nuerk HC. Early place-value understanding as a precursor for later arithmetic performance--a longitudinal study on numerical development. Res Dev Disabil 2011; 32:1837-1851. [PMID: 21498043 DOI: 10.1016/j.ridd.2011.03.012] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 03/16/2011] [Accepted: 03/16/2011] [Indexed: 05/30/2023]
Abstract
It is assumed that basic numerical competencies are important building blocks for more complex arithmetic skills. The current study aimed at evaluating this interrelation in a longitudinal approach. It was investigated whether first graders' performance in basic numerical tasks in general as well as specific processes involved (e.g., place-value understanding) reliably predicted performance in an addition task in third grade. The results indicated that early place-value understanding was a reliable predictor for specific aspects of arithmetic performance. Implications of the role of basic numerical competencies for the acquisition of complex arithmetic are discussed.
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Affiliation(s)
- K Moeller
- Knowledge Media Research Center, Konrad-Adenauer-Str. 40, 72072 Tuebingen, Germany.
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14
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Hofer SE, Pixner S, Starke M, Zotter S, Koehle J, Meraner D, Kremser C, Egger K, Schocke M, Kaufmann L. Neurokognitive Leistung und strukturelles zerebrales MRI bei Kindern und Jugendlichen mit Diabetes mellitus Typ 1. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277442] [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: 10/18/2022]
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Pixner S, Moeller K, Hermanova V, Nuerk HC, Kaufmann L. Whorf reloaded: Language effects on nonverbal number processing in first grade—A trilingual study. J Exp Child Psychol 2011; 108:371-82. [PMID: 21035126 DOI: 10.1016/j.jecp.2010.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 12/01/2022]
Affiliation(s)
- S Pixner
- Division of Psychology, Department for Human and Economic Sciences, UMIT-The Health and Life Sciences University, 6060 Hall in Tirol, Austria.
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Antonell A, Del Campo M, Magano LF, Kaufmann L, Martinez de la Iglesia J, Gallastegui F, Flores R, Schweigmann U, Fauth C, Kotzot D, Perez-Jurado LA. Partial 7q11.23 deletions further implicate GTF2I and GTF2IRD1 as the main genes responsible for the Williams-Beuren syndrome neurocognitive profile. J Med Genet 2009; 47:312-20. [DOI: 10.1136/jmg.2009.071712] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Rösen P, Schwippert B, Kaufmann L, Tschöpe D. Expression of Adhesion Molecules on the Surface of Activated Platelets is Diminished by PGI2-analogues and an NO (EDRF)-Donor: A Comparison Between Platelets of Healthy and Diabetic Subjects. Platelets 2009; 5:45-52. [DOI: 10.3109/09537109409006040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moeller K, Neuburger S, Kaufmann L, Landerl K, Nuerk HC. Basic number processing deficits in developmental dyscalculia: Evidence from eye tracking. Cognitive Development 2009. [DOI: 10.1016/j.cogdev.2009.09.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Delazer M, Ischebeck A, Domahs F, Zamarian L, Koppelstaetter F, Siedentopf CM, Kaufmann L, Benke T, Felber S. Learning by strategies and learning by drill—evidence from an fMRI study. Neuroimage 2005; 25:838-49. [PMID: 15808984 DOI: 10.1016/j.neuroimage.2004.12.009] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2004] [Revised: 09/06/2004] [Accepted: 12/07/2004] [Indexed: 11/26/2022] Open
Abstract
The present fMRI study investigates, first, whether learning new arithmetic operations is reflected by changing cerebral activation patterns, and second, whether different learning methods lead to differential modifications of brain activation. In a controlled design, subjects were trained over a week on two new complex arithmetic operations, one operation trained by the application of back-up strategies, i.e., a sequence of arithmetic operations, the other by drill, i.e., by learning the association between the operands and the result. In the following fMRI session, new untrained items, items trained by strategy and items trained by drill, were assessed using an event-related design. Untrained items as compared to trained showed large bilateral parietal activations, with the focus of activation along the right intraparietal sulcus. Further foci of activation were found in both inferior frontal gyri. The reverse contrast, trained vs. untrained, showed a more focused activation pattern with activation in both angular gyri. As suggested by the specific activation patterns, newly acquired expertise was implemented in previously existing networks of arithmetic processing and memory. Comparisons between drill and strategy conditions suggest that successful retrieval was associated with different brain activation patterns reflecting the underlying learning methods. While the drill condition more strongly activated medial parietal regions extending to the left angular gyrus, the strategy condition was associated to the activation of the precuneus which may be accounted for by visual imagery in memory retrieval.
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Affiliation(s)
- M Delazer
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020-Innsbruck, Austria.
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Biffiger K, Zwald D, Kaufmann L, Briner A, Nayki I, Pürro M, Bottcher S, Struckmeyer T, Schaller O, Meyer R, Fatzer R, Zurbriggen A, Stack M, Moser M, Oesch B, Kübler E. Validation of a luminescence immunoassay for the detection of PrP(Sc) in brain homogenate. J Virol Methods 2002; 101:79-84. [PMID: 11849686 DOI: 10.1016/s0166-0934(01)00421-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [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: 12/18/2022]
Abstract
A luminescence immunoassay (LIA) was developed for the diagnosis of bovine spongiform encephalopathy (BSE) in brain tissue using two different monoclonal antibodies for capture and detection of the protease-resistant fragment of the pathological prion protein (PrP27-30). PrP27-30 currently represents the most reliable marker for the infectious particle (denominated prion) causing transmissible spongiform encephalopathies (TSEs). Internal and official validation studies of this assay are described using brain homogenates from ascertained BSE positive and negative cows. Using more than 300 positive and 1400 negative bovine or ovine samples, an excellent sensitivity and specificity of 100% were demonstrated. More than 1000-fold dilutions of a BSE positive homogenate still resulted in a clear positive signal. In combination with a simple homogenisation procedure for the preparation of the samples, this assay lends itself for large scale screening of cattle and sheep for TSEs using complete automation of the process.
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Affiliation(s)
- Karin Biffiger
- Prionics AG, University of Zurich, Winterthurerstr. 190, CH-8057, Zurich, Switzerland
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Samra Z, Kaufmann L, Zeharia A, Ashkenazi S, Amir J, Bahar J, Reischl U, Naumann L. Optimal detection and identification of Mycobacterium haemophilum in specimens from pediatric patients with cervical lymphadenopathy. J Clin Microbiol 1999; 37:832-4. [PMID: 9986869 PMCID: PMC84575 DOI: 10.1128/jcm.37.3.832-834.1999] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [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: 11/20/2022] Open
Abstract
Acid-fast bacilli from pediatric patients with lymphadenopathy were detected in the BACTEC radiometric system and in MB Redox broth, but not on Löwenstein Jensen medium. PCR amplification identified the isolates as Mycobacterium haemophilum, which has special nutrition requirements (iron supplements) for growth. Suitable culture medium ensures optimal recovery of this microorganism, avoiding underdiagnosis.
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Affiliation(s)
- Z Samra
- Department of Microbiology, Rabin Medical Center, Petah Tiqva, Israel.
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24
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Giedion A, Boltshauser E, Briner J, Eich G, Exner G, Fendel H, Kaufmann L, Steinmann B, Spranger J, Superti-Furga A. Heterogeneity in Schwartz-Jampel chondrodystrophic myotonia. Eur J Pediatr 1997; 156:214-23. [PMID: 9083764 DOI: 10.1007/s004310050587] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [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: 02/04/2023]
Abstract
UNLABELLED The Schwartz-Jampel syndrome (SJS; chondrodystrophic myotonia; McK 255,800) is a recessively inherited condition defined by myotonia, short stature, and bone dysplasia. Genetic linkage between SJS and chromosomal region 1q36-34 has been observed in several families, but the gene has not yet been identified. We studied the clinical and radiological features in 81 patients from the literature and 5 own patients trying to identify distinct subgroups. In addition, we tested genetic linkage to the SJS locus on chromosome 1 in one family with two affected sibs. We found that a group of patients have mild skeletal changes which may be secondary consequences of myotonia, while another group of patients appear to have primary bone dysplasia with myotonia. Within this latter group, there are differences in age of manifestation, clinical course and pattern of bone changes. We tentatively isolate three different types of SJS: type 1A, usually recognized in childhood, with moderate bone dysplasia, corresponding to the original descriptions of Schwartz, Jampel and Aberfeld; type 1B, similar to type 1A but recognizable at birth, with more pronounced bone dysplasia resembling Kniest dysplasia; and type 2, manifest at birth, with increased mortality and bone dysplasia resembling Pyle disease. Genetic analysis of the family with two sibs affected by SJS type 2 showed evidence against linkage to chromosome 1p36-34. CONCLUSIONS SJS is clinically and radiologically heterogeneous. The causes of heterogeneity are not known yet but are likely to include both different mutations at the SJS locus on chromosome 1 and the presence of a second SJS locus. A tentative clinico-radiological classification can be useful for the characterization of patients and the development of genotype-phenotype correlations.
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Affiliation(s)
- A Giedion
- Institute of Clinical Pathology, University Hospital, Zurich, Switzerland
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25
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Hanes DS, Kaufmann L, Aisner S. Answer to Photo Quiz (See Page 865). Clin Infect Dis 1994. [DOI: 10.1093/clinids/19.5.937] [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: 11/13/2022] Open
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Benson J, Kaufmann L, Hue B, Pelhate M, Schürmann F, Gsell L, Piek T. The physiological action of analogues of philanthotoxin-4.3.3 at insect nicotinic acetylcholine receptors. ACTA ACUST UNITED AC 1993. [DOI: 10.1016/0742-8413(93)90212-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Benson JA, Schürmann F, Kaufmann L, Gsell L, Piek T. Inhibition of dipteran larval neuromuscular synaptic transmission by analogues of philanthotoxin-4.3.3: a structure-activity study. ACTA ACUST UNITED AC 1992; 102:267-72. [PMID: 1358540 DOI: 10.1016/0742-8413(92)90110-s] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
1. The blocking action of delta-philanthotoxin (PhTX-4.3.3), a wasp toxin composed of a polyamine chain, an aromatic amino acid (tyrosyl) nucleus and an aliphatic (butanoic) acid was studied, together with 33 structural analogues, at the glutamatergic neuromuscular synapse in larvae of the house fly, Musca domestica. 2. Shortening of the polyamine or the aliphatic acid chain, or removing the aromatic nucleus caused a decrease in potency. 3. An increase in potency was obtained by elongating the molecule in any of several directions: elongation of the polyamine chain with amine containing groups, by iodination of the aromatic moiety and by aliphatic or aromatic elongation of the butanoic acid.
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Affiliation(s)
- J A Benson
- Plant Protection Division, CIBA-GEIGY Ltd, Basel, Switzerland
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28
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McNeill MM, Gerber AR, McLaughlin DW, Vega RA, Winn K, Kaufmann L, Keyserling HL, Jarvis WR. Mannan antigenemia during invasive candidiasis caused by Candida tropicalis. Pediatr Infect Dis J 1992; 11:493-6. [PMID: 1608689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M M McNeill
- Mycotic Diseases Branch, Centers for Disease Control, Atlanta, GA
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Abstract
The hemodynamic effects of intravenously administered adenosine, a potent vasodilator, were examined in 15 patients with pulmonary hypertension. All patients were given adenosine, 50 micrograms/kg per min, increased by 50 micrograms/kg per min at 2 min intervals to a maximum of 500 micrograms/kg per min or until the development of untoward side effects. The patients were then given oral nifedipine, 20 mg every hour, until a greater than or equal to 20% decrease in pulmonary vascular resistance or systemic hypotension occurred. The administration of maximal doses of adenosine, 256 +/- 46 micrograms/kg per min, produced a 2.4% reduction in pulmonary artery pressure (p = NS), a 37% decrease in pulmonary vascular resistance (p less than 0.001) and a 57% increase in cardiac index (p less than 0.001). The administration of maximally effective doses of nifedipine (91 +/- 36 mg) produced a 15% reduction in the mean pulmonary artery pressure (p less than 0.05), a 24% decrease in pulmonary vascular resistance (p less than 0.01) and an 8% increase in cardiac index (p = NS). There was a significant correlation (r = 0.714, p = 0.01) between the reduction in pulmonary vascular resistance that resulted from adenosine administration and that achieved with the administration of nifedipine. Six patients had substantial reductions in pulmonary vascular resistance with adenosine but not with nifedipine. Thus, adenosine is an effective vasodilator in patients with pulmonary hypertension and can be used for safe and rapid assessment of vasodilator reserve in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- B J Schrader
- Department of Pharmacy Practice, University of Illinois, Chicago
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30
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Grob D, Sacher P, Scheier HJ, Kaufmann L, Dvorák J. [Orthopedic problems of the upper cervical spine in children and adolescents]. Orthopade 1991; 20:133-9. [PMID: 2067839] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Because of relatively low frequency of pathological changes of the upper cervical spine in childhood and adolescence, their management is not well known. Diagnostic problems occur due to the variety of malformations possible, persisting growth plates and ligamentous laxity. Because of this laxity, conservative treatment with immobilization is advocated even in severe dislocations as long as they are reducible. Persistent dislocations, chronic atlantoaxial instability (ADI greater than 5 mm), dens fractures type II and existing or progressing neurological deficits all indicate surgical intervention. Internal fixation allows easier postoperative care. Complications are rare. Patients with orthopedic problems of the upper cervical spine are presented, together with their management.
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Affiliation(s)
- D Grob
- Abteilungen für Orthopädie und Neurologie, Klinik Wilhelm Schulthess, Zürich
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31
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Abstract
In 41 diabetics (27 type I, 14 type II) and in 23 healthy controls the number of glycoprotein (GP) GPIB and GPIIB/IIIA molecules were determined on resting, peripheral platelets by means of flowcytometry after immunostaining with monoclonal antibodies which bind independently from the state of activation. The average number of both glycoproteins per platelet was significantly elevated (GPIB: 54,100 x 1.27 +/- 1 vs. 39,100 x 1.3 +/- 1 GPIIB/IIIA: 77,500 x 1.3 +/- 1 vs. 62,700 x 1.3 +/- 1, in diabetic patients. Platelet volume was significantly correlated with the number of GPIB molecules on normal and diabetic platelets (r (normal) = 0.52 +/- 0.07; r (diabetic) = 0.46 +/- 0.1). Additionally, von Willebrand factor-related antigen (vWF: AG) was increased to 129% x 1.3 +/- 1 in diabetics vs. 111% x 1.4 in controls. The increase of vWF: AG was significantly correlated with HbA1 (r = 0.38*) and seemed to depend on chronic hyperglycaemia. Since platelet glycoprotein receptor status is regulated by the bone-marrow megakaryocyto- thrombopoiesis, our observations support the hypothesis that platelet hyperactivity in the diabetic state may be due to primarily altered production of platelets with an increased number of functional glycoproteins. This may be paralleled by increased plasma levels of cytoadhesive proteins like vWF: AG, which interact with the studied glycoproteins and thereby potentiate the risk of disturbed microhaemorrheology.
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Affiliation(s)
- D Tschoepe
- Diabetes Research Institute, Heinrich Heine University, Duesseldorf, FRG
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32
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Tschöpe D, Langer E, Schauseil S, Rösen P, Kaufmann L, Gries FA. Increased platelet volume--sign of impaired thrombopoiesis in diabetes mellitus. Klin Wochenschr 1989; 67:253-9. [PMID: 2927060 DOI: 10.1007/bf01717328] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Increased functional properties of diabetic platelets might be already conditioned during thrombopoiesis in the stem cell system. This hypothesis was studied by recording the distribution characteristics of the peripheral platelet pool in 218 diabetic patients versus 51 controls. Furthermore, platelet membrane coating with the stem cell marker glycoprotein IB was analyzed in 41 diabetic subjects and compared to 23 healthy volunteers. A consistent, significant shift of the volume distribution to larger platelets was found in diabetics: Mean platelet volume (MPV) - 7.9 +/- 0.9 versus 7.2 +/- 0.8 [fl]; Megathrombocyte index (MTI) - 20.4 +/- 2.8 versus 18.1 +/- 2.5 [fl]. These deviations were present in all patient subsets, however did not correlate to parameters of glucose metabolism. Whole blood platelet count was increased in the patient group; 195.0 +/- 59.5 versus 184.0 +/- 37.5 x 10(3) plts/ul. Coating with glycoprotein IB receptors correlated significantly to platelet size in platelets of both controls and diabetics (r normal = 0.52 +/- 0.07; r diabetic = 0.46 +/- 0.1). The quantitative expression of glycoprotein IB was significantly enhanced in the diabetic group: 54,500 x 1.28 +/- 1 versus 39,100 x 1.3 +/- 1 molecules per platelet. In conclusion, these findings strongly support the assumption of diabetic stem cell dysfunction of the megakaryocytic series and progenitor cells resulting in platelets with primarily increased potency to adhere and aggregate in diabetes mellitus.
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Affiliation(s)
- D Tschöpe
- Diabetes Forschungsinstitut Universität Düsseldorf
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33
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Tschöpe D, Schauseil S, Roesen P, Kaufmann L, Gries FA. [Demonstration of thrombocyte membrane proteins with monoclonal antibodies by a flow cytometry bioassay]. Klin Wochenschr 1988; 66:117-22. [PMID: 3352192 DOI: 10.1007/bf01774225] [Citation(s) in RCA: 13] [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: 01/05/2023]
Abstract
Formation of a hemostatic plug is triggered by platelets. Platelet function (e.g. adhesion, aggregation) depends essentially on membrane bound receptor proteins. Conventional chromatographic analysis of these glycoprotein macromolecules is difficult and not appropriate for diagnostic routine. In combination of cytoflowmetric single cell analysis with monoclonal staining we developed a bio-assay for qualitative and semi-quantitative analysis of glycoprotein IB and IIB/IIIA on vital fixed platelets. The expression of these molecules was evaluated in 20 healthy volunteers. The assay offers for the first time the possibility of screening the expression of receptor proteins on platelet membranes, which are related to indicate either a functional lack in bleeding disorders or a prethrombotic state due to an enhanced functional potential in high risk patients.
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Affiliation(s)
- D Tschöpe
- Diabetes-Forschungsinstitut, Universität Düsseldorf
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34
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Abstract
The aim of this study was to examine whether therapeutical doses of nitrendipine influence platelet function. In eight healthy subjects, the platelet aggregation response to collagen in whole blood and platelet-rich plasma (PRP) was monitored over 12 h after single administration of 40 mg nitrendipine given orally and was strongly inhibited between 60-83% (0.3 microgram/ml collagen) versus baseline at the third and fourth hour. Stimulated thromboxane formation from exogeneous arachidonic acid decreased almost continuously, with lowest levels at the 12th hour. Basal thromboxane remained below 25 pg/ml, but platelet factor 4 increased to more than twice the baseline level in the fourth hour, presumably reflecting adrenergic counterregulation of hypotensive effects. These preliminary data show that therapeutic drug concentrations of nitrendipine inhibit platelet function. Therefore, calcium channel blockers may be of therapeutical value in the treatment of prethrombotic states with primary platelet hyperactivity as present, for example, in diabetes mellitus.
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Affiliation(s)
- D Tschöpe
- Diabetes Research Institute at the University of Düsseldorf, F.R.G
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35
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Illi OE, Kaufmann L, Eich G, Stauffer UG. [Knee injury in childhood: a retrospective analysis of patients of the Zurich Pediatric Surgery University Clinic]. Z Kinderchir 1987; 42:175-7. [PMID: 3617941 DOI: 10.1055/s-2008-1075578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
During the past 10 years (1976-1985) we treated more than 1000 knee injuries at our department. More than 90% were minor traumas and could be treated on an outpatient basis. In 78 children x-ray or clinical examination revealed a haemarthros which was confirmed by aspiration. This group represents 7.6% of patients. In 38 patients a major knee injury led to surgical treatment. Conservative treatment was successful in 40 children. In 26 cases we could not find the origin of haemarthrosis by clinical or radiological examination. 14 children showed major lesions, mostly undislocated fractures of the patella or avulsion of the cruciate ligaments. In all 78 patients haemarthrosis was evacuated by aspiration or during operation and the injured knee joint was immobilised for 4-6 weeks. 56 of the 78 patients (72%) were radiologically and clinically re-evaluated after 5 1/2 years (1-11 years). The aim of this presentation is to judge, based on our own patients, if arthroscopy in paediatric knee injuries is mandatory in every case as demanded by different authors. We were most interested to find out whether diagnostic errors lead to false, positive or negative indication for operation. In very few cases only our diagnosis was based on arthroscopic evaluation.
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36
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Mark AS, Winkler ML, Peltzer M, Kaufmann L, Higgins CB. Gated acquisition of MR images of the thorax: advantages for the study of the hila and mediastinum. Magn Reson Imaging 1987; 5:57-63. [PMID: 3586873 DOI: 10.1016/0730-725x(87)90484-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gated and nongated magnetic resonance (MR) scans of the chest were compared in five normal volunteers and 20 patients with chest disease to determine possible advantages of gated MR for delineation of noncardiac mediastinal anatomy. In order to compare gated and nongated images of the chest using similar imaging parameters, five spin-echo sequences were obtained in each of five normal volunteers: TR: 1000 msec, TE: 30 msec; gated to every heart beat (TR approximately 1000 msec, TE: 30 msec); TR: 2000 msec, TE: 30 msec; gated to every other heart beat (TR approximately 2000 msec), TE: 30 msec; TR: 500 msec, TE: 30 msec. In the 20 patients, the gated images were gated to every heart beat and the nongated images were obtained using a TR of 2000 msec, both with a TE of 30 msec. The noise in the periphery and in the center of the gated and nongated images at the level of the carina was compared in the five normal volunteers, using the signal intensity of the posterior chest wall as a control. There was 92% +/- 44% greater noise in the central region and 63% +/- 60% greater noise in the peripheral region on the nongated studies (TR: 1000 msec), than on the studies gated to every heart beat. In three of the five volunteers, the measured noise was greater on the nongated long TR (2000 msec) images than on the images gated to every other heart beat. However, the mediastinal structures below the level of the aortic arch were much better defined on the gated images in all five subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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Exner GU, Kaufmann L, Schreiber A. [Relations between development of the apophyses of the ilial crest (Risser's sign) and development of the hand skeleton in girls with scoliosis]. Z Orthop Ihre Grenzgeb 1985; 123:910-2. [PMID: 3832676 DOI: 10.1055/s-2008-1044778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The maturation of the iliac apophysis (Risser sign) and of the bones of the hand and wrist of 34 girls with scoliosis with 46 pairs of data were analyzed to get information upon their predictive value for further growth and development of the scoliotic curve. A strong correlation was found between the Risser sign and the maturation of the hand and wrist (r = 0.74, p less than 0.005). The prognostic value of the Risser sign (r = -0.57) for further height gain is superior to chronological age only (r = -0.52), the maturation of the hand and wrist (r = -0.62) however is superior to the Risser sign. It can be assumed that this also holds for their prognostic value for the progression of the scoliotic curve. We feel that in the clinician routine for girls with scoliosis the determination of the skeletal maturity from X-rays of the hand is sufficient and with its probably unavoidable irradiation risks to the gonads the determination of the Risser sign should be abandoned.
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Abstract
One hundred fourteen patients with Stage IA carcinoma of the cervix were retrospectively reviewed in regard to depth of invasion, capillary-like space involvement, stromal reaction, status of conization margins, and the incidence of lymph node metastasis. Type of treatment, recurrences, and deaths were also evaluated. Patients with less than 3 mm invasion can be treated conservatively, including conization, if fertility is desired. No lymph node metastasis or recurrence appeared in this group of patients irrespective of type of treatment. Patients with 3 to 5 mm invasion do appear to be at higher risk for recurrence, but conservative therapy may be used in individualized situations. Size of conization and status of surgical margins appear to be important determining factors in regard to conservative therapy. Data in the literature, as well as our experience, although limited, suggest that the status of capillary-like space involvement does not influence lymph node metastasis or recurrence. Invasion of 5 mm or more in depth should be treated as a Stage IB occult lesion.
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Abstract
36 cases of eosinophilic pleural effusion (EPE) are reviewed. The etiologies were: traumatic 25%, congestive heart failure (CHF) 14%, infectious 8.5%, idiopathic 8.5% and miscellaneous 11%. 33% (12 patients) had a tumoral etiology, yet in only 1 patient could all additional etiologies for EPE be ruled out. Hence, the conclusion is that EPE is rarely caused by a tumoral etiology, and that other etiologies should be considered. The comparison of pleural fluid and peripheral blood findings disclosed no significant difference among the various subgroups.
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Eisenberg JM, Schumacher HR, Davidson PK, Kaufmann L. Usefulness of synovial fluid analysis in the evaluation of joint effusions. Use of threshold analysis and likelihood ratios to assess a diagnostic test. Arch Intern Med 1984; 144:715-719. [PMID: 6712368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study applied threshold analysis and likelihood ratios to determine the usefulness of a diagnostic test. Eleven staff rheumatologists or rheumatology fellows provided probability estimates for the most likely diagnoses both before and after synovial fluid analyses were performed on 180 patients with joint effusions. They also indicated whether the planned therapy was altered by the test results. The therapeutic thresholds and log likelihood ratios were derived for the six most frequent diagnoses. Synovial fluid analysis was most useful for patients likely to have gout, pseudogout, or infectious arthritis. The derived therapeutic thresholds were consistent with recommended medical practice, for example, with a lower threshold for possible septic arthritis (20%) than for possible gout (65%). This study demonstrates that threshold analysis and likelihood ratios can be used to assess the clinical contribution of diagnostic tests.
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Doudin PA, Haas C, Navarro C, Pancheri E, Kaufmann L. [Communication in "functional" and "dysfunctional" families with adolescent children. I. Verbal communication]. Schweiz Arch Neurol Neurochir Psychiatr 1983; 133:223-237. [PMID: 6669966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This research studies family communications during the critical period of change provoked by the puberty of one of the children. Two groups of families are compared: one group of 15 "functional" families (no psychological consultation has been requested) and one group of 15 "dysfunctional" families (a psychological consultation has been requested for one of the adolescents). The micro-analysis of the verbal communications reveals a few significant differences between the two groups of families. The results point to structural differences between the family systems.
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Duruz N, Pancheri E, Kaufmann L. [Usefulness of an instrument of contextual analysis for the hospitalization of a psychiatric patient]. Soc Psychiatry 1983; 18:169-75. [PMID: 6635773 DOI: 10.1007/bf00583526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Engelhardt P, Kaufmann L. [Synopsis of diagnostic and prognostic signs in Perthes' disease (author's transl)]. Orthopade 1982; 11:3-10. [PMID: 7070823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kaufmann L, Loehr J, Razavi H. [Varisation osteotomy in Perthes' disease (author's transl)]. Orthopade 1982; 11:11-2. [PMID: 7070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Jani L, Suezawa Y, Kaufmann L. [Aseptic necroses of the spine: differential diagnosis and treatment of the vertebra plana (author's transl)]. Orthopade 1981; 10:40-4. [PMID: 7243269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Meili EO, Kaufmann L, Schneider W. [Substitution therapy in operations on hemophiliacs]. Ther Umsch 1979; 36:307-10. [PMID: 451949] [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: 12/15/2022]
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Meili EO, Blättler W, Jacky E, Schneider W, Kaufmann L, Sigg P, Frick PG. [Guidelines for the treatment of hemophilia]. Ther Umsch 1979; 36:345-58. [PMID: 313084] [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: 12/14/2022]
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Kaufmann L, Hakimzadeh A, Stuflesser H. [10-year results after epiphyseolysis. b) 10-year results after open reduction and subcapital osteotomy in epiphyseolysis capitis femoris]. Orthopade 1979; 8:65-7. [PMID: 15655962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- L Kaufmann
- Orthopädische Universitätsklinik Balgrist, CH-8008 Zürich, Schweiz
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Kaufmann L, Scherrer H. [Legg-Perthes disease. b) 10-year results of conservative management of Legg-Perthes disease]. Orthopade 1979; 8:56-9. [PMID: 15655960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- L Kaufmann
- Orthopädische Universitätsklinik Balgrist, CH-8008 Zürich, Schweiz
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Kaufmann L, Masson O, Masson D, Fivaz E. [Observations on the decoding of the therapeutic relationship in family therapy]. Psychother Psychosom 1978; 29:221-7. [PMID: 724931 DOI: 10.1159/000287131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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