51
|
Schneider AM, Weghuber D, Hetzer B, Entenmann A, Müller T, Zimmermann G, Schütz S, Huber WD, Pichler J. Vedolizumab use after failure of TNF-α antagonists in children and adolescents with inflammatory bowel disease. BMC Gastroenterol 2018; 18:140. [PMID: 30219028 PMCID: PMC6139155 DOI: 10.1186/s12876-018-0868-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 09/03/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vedolizumab is safe and effective in adult patients with Crohn's disease (CD) and ulcerative colitis (UC); however, data in children with inflammatory bowel disease (IBD) are scarce. Therefore, we evaluated vedolizumab use in a cohort of Austrian paediatric patients with IBD. METHODS Twelve patients (7 female; 7 CD; 5 UC), aged 8-17 years (median, 15 years), with severe IBD who received vedolizumab after tumour necrosis factor α antagonist treatment were retrospectively analysed. Clinical activity scores, relevant laboratory parameters, and auxological measures were obtained at infusion visits. RESULTS In the CD group, 1/7 patient discontinued therapy due to a severe systemic allergic reaction; 1/7 and 2/7 patients achieved complete and partial response, respectively, at week 14; and 3/7 patients discontinued therapy due to a primary non-response or loss of response. In the UC group, complete clinical remission was achieved at weeks 2, 6, and 14 in 2/5, 1/5 and 1/5 patients respectively; partial response was observed in one patient at week 2. CD activity scores did not significantly change from baseline to week 38 (median 47.5 vs. 40 points, p = 1,0), while median UC activity scores changed from 70 to 5 points (p < 0,001). Substantial weight gain and increased albumin and haemoglobin levels were observed in both groups. CONCLUSION These results demonstrate that vedolizumab can be an effective treatment for individual paediatric patients with IBD who are unresponsive, intolerant, or experience a loss of efficacy in other therapies. However, vedolizumab appears to be more effective in paediatric UC than in paediatric CD.
Collapse
|
52
|
Rohracher A, Zimmermann G, Villanueva V, Garamendi I, Sander JW, Wehner T, Shankar R, Ben-Menachem E, Brodie MJ, Pensel MC, Di Gennaro G, Maurousset A, Strzelczyk A, Rheims S, Rácz A, Menzler K, Bertol-Alegre V, García-Morales I, López-González FJ, Toledo M, Carpenter KJ, Trinka E. Perampanel in routine clinical use across Europe: Pooled, multicenter, observational data. Epilepsia 2018; 59:1727-1739. [DOI: 10.1111/epi.14520] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/02/2018] [Indexed: 12/28/2022]
|
53
|
Dobesberger J, Höfler J, Leitinger M, Kuchukhidze G, Zimmermann G, Thomschewski A, Unterberger I, Walser G, Kalss G, Rohracher A, Neuray C, Kobulashvili T, Höller Y, Trinka E. Personalized safety measures reduce the adverse event rate of long-term video EEG. Epilepsia Open 2018; 2:400-414. [PMID: 29588971 PMCID: PMC5862109 DOI: 10.1002/epi4.12078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 11/07/2022] Open
Abstract
Objective Safety in epilepsy monitoring units (EMUs) has become an increasing concern because adverse events occur in up to 10% of patients undergoing long‐term video EEG in EMUs. The aim of this study was to assess the effectiveness of a specific safety protocol in an EMU. Methods We retrospectively assessed the adverse event rates in a group without (group 1, 84‐month period, Innsbruck, Austria) and a group with (group 2, 33‐month period, Salzburg, Austria) personalized safety measures utilizing a standardized protocol for long‐term epilepsy monitoring in high‐risk patients. Differences in adverse event rates during and after long‐term video EEG between the two groups were calculated and compared. Results In group 1, 44/507 (9%, 95% confidence interval [CI] 6.5–11.5%) patients experienced 53 adverse events: 20/507 (4%, 95% CI 2.6–6.0%) patients had psychiatric events, 15/507 (3%, 95% CI 1.8–4.8%) patients sustained a total of 19 injuries during seizures, and 10/507 (2%, 95% CI 1.1–3.6%) patients had 13 episodes of status epilepticus; one adverse event was treatment‐related (valproic acid–induced encephalopathy; 1/507, 0.2%, 95% CI 0.0–1.1%). By using the new safety protocol in group 2, the adverse event rate was only 5% (95% CI 3.4–7.6%; 30 adverse events in 26/491; 45% reduction; p = 0.036), in contrast. These events included 13 psychiatric complications in 13/491 (2%, 95% CI 1.6–4.5%, p = 0.252) patients, 12 seizure‐related injuries in 9/491 (2%, 95% CI 1.0–3.4%, p = 0.250) patients, and 5 episodes of status epilepticus in 4/491 (1%, 95% CI 0.3–2.1%, p = 0.120) patients. Significance Implementation of personalized safety measures in high‐risk patients resulted in a clinically relevant reduction of adverse events in the EMU. Safety protocols are a valid tool to reduce the occurrence of adverse events in EMUs.
Collapse
|
54
|
Leuschner G, Reiter F, Stocker F, Crispin A, Kneidinger N, Veit T, Klenner F, Ceelen F, Zimmermann G, Leuchte H, Reu S, Dinkel J, Behr J, Neurohr C. Idiopathische Lungenfibrose bei jungen Patienten – ernstzunehmend und nicht so selten. Pneumologie 2018. [DOI: 10.1055/s-0037-1619240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
55
|
Stelzer D, Weber A, Ihle F, Matthes S, Ceelen F, Zimmermann G, Kneidinger N, Schramm R, Winter H, Zoller M, Vogeser M, Behr J, Neurohr C. Posaconazole liquid vs tablet formulation in lung transplant recipients. Mycoses 2017; 61:186-194. [DOI: 10.1111/myc.12724] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 08/13/2017] [Accepted: 10/29/2017] [Indexed: 12/12/2022]
|
56
|
Granbichler CA, Zimmermann G, Oberaigner W, Kuchukhidze G, Ndayisaba JP, Taylor A, Luef G, Bathke AC, Trinka E. Potential years lost and life expectancy in adults with newly diagnosed epilepsy. Epilepsia 2017; 58:1939-1945. [DOI: 10.1111/epi.13902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 11/28/2022]
|
57
|
Höller Y, Butz K, Thomschewski A, Schmid E, Uhl A, Bathke AC, Zimmermann G, Tomasi SO, Nardone R, Staffen W, Höller P, Leitinger M, Höfler J, Kalss G, Taylor AC, Kuchukhidze G, Trinka E. Reliability of EEG Interactions Differs between Measures and Is Specific for Neurological Diseases. Front Hum Neurosci 2017; 11:350. [PMID: 28725190 PMCID: PMC5496950 DOI: 10.3389/fnhum.2017.00350] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/20/2017] [Indexed: 11/21/2022] Open
Abstract
Alterations of interaction (connectivity) of the EEG reflect pathological processes in patients with neurologic disorders. Nevertheless, it is questionable whether these patterns are reliable over time in different measures of interaction and whether this reliability of the measures is the same across different patient populations. In order to address this topic we examined 22 patients with mild cognitive impairment, five patients with subjective cognitive complaints, six patients with right-lateralized temporal lobe epilepsy, seven patients with left lateralized temporal lobe epilepsy, and 20 healthy controls. We calculated 14 measures of interaction from two EEG-recordings separated by 2 weeks. In order to characterize test-retest reliability, we correlated these measures for each group and compared the correlations between measures and between groups. We found that both measures of interaction as well as groups differed from each other in terms of reliability. The strongest correlation coefficients were found for spectrum, coherence, and full frequency directed transfer function (average rho > 0.9). In the delta (2–4 Hz) range, reliability was lower for mild cognitive impairment compared to healthy controls and left lateralized temporal lobe epilepsy. In the beta (13–30 Hz), gamma (31–80 Hz), and high gamma (81–125 Hz) frequency ranges we found decreased reliability in subjective cognitive complaints compared to mild cognitive impairment. In the gamma and high gamma range we found increased reliability in left lateralized temporal lobe epilepsy patients compared to healthy controls. Our results emphasize the importance of documenting reliability of measures of interaction, which may vary considerably between measures, but also between patient populations. We suggest that studies claiming clinical usefulness of measures of interaction should provide information on the reliability of the results. In addition, differences between patient groups in reliability of interactions in the EEG indicate the potential of reliability to serve as a new biomarker for pathological memory decline as well as for epilepsy. While the brain concert of information flow is generally variable, high reliability, and thus, low variability may reflect abnormal firing patterns.
Collapse
|
58
|
Faßler D, Zimmermann G. Erweiterung des Anwendungsbereiches der Diffusreflexionsspektroskopie auf das kurzwellige UV. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1971-24619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
59
|
Ondruschka B, Ziegler U, Zimmermann G. Zu möglichen Umlagerangen zwischen isomeren C3H5-Radikalen. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1986-267144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
60
|
|
61
|
Baukloh W, Zimmermann G. Wasserstoffdurchlässigkeit von Stahl beim elektrolytischen Beizen. ACTA ACUST UNITED AC 2016. [DOI: 10.1002/srin.193600770] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
62
|
Leitinger M, Trinka E, Gardella E, Rohracher A, Kalss G, Qerama E, Höfler J, Hess A, Zimmermann G, Kuchukhidze G, Dobesberger J, Langthaler PB, Beniczky S. Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study. Lancet Neurol 2016; 15:1054-62. [DOI: 10.1016/s1474-4422(16)30137-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/17/2016] [Accepted: 06/14/2016] [Indexed: 01/15/2023]
|
63
|
Zimmermann G. Life Expectancy Comparison between a Study Cohort and a Reference Population. AUSTRIAN JOURNAL OF STATISTICS 2016. [DOI: 10.17713/ajs.v45i2.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Questions of life expectancy are highly relevant in clinical practice, in particular if one isinterested in the life expectancy loss due to a certain disease in comparison with the generalpopulation. Therefore,we propose a methodology which enables the researcher to compare more easily life expectancies between a study cohort and a reference population. Firstly, we take the formula commonly used in official statistics and adapt it to a survival analytic setting, thus establishing a link between official statistics and survival analysis. Further, we discuss two commonly encountered sources of potentially severe bias, and how to remedy them. We hope that the proposed approach facilitates the use of life tables, particularly in clinical studies with mortalityas primary endpoint.
Collapse
|
64
|
Höfler J, Rohracher A, Kalss G, Zimmermann G, Dobesberger J, Pilz G, Leitinger M, Kuchukhidze G, Butz K, Taylor A, Novak H, Trinka E. (S)-Ketamine in Refractory and Super-Refractory Status Epilepticus: A Retrospective Study. CNS Drugs 2016; 30:869-76. [PMID: 27465262 PMCID: PMC4996879 DOI: 10.1007/s40263-016-0371-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim was to describe the safety and efficacy of (S)-ketamine [(S)-KET] in a series of patients with refractory and super-refractory status epilepticus (RSE and SRSE) in a specialized neurological intensive care unit (NICU). METHODS We retrospectively analyzed the data of patients with RSE and SRSE treated with (S)-KET in the NICU, Salzburg, Austria, from 2011 to 2015. Data collection included demographic features, clinical presentation, diagnosis, electroencephalogram (EEG) data, anticonvulsant treatment, timing, and duration of treatment with (S)-KET. Outcomes were seizure control and death. RESULTS A total of 42 patients (14 women) with RSE and SRSE were treated with (S)-KET. The median duration of status epilepticus (SE) was 10 days [first quartile (Q1) 5.0, Q3 21.0]; the median latency from SE onset to the first administration of (S)-KET was 3 days (Q1 2.0, Q3 6.8). Prior to (S)-KET administration, patients had received a median of two (Q1 2.0, Q3 3.0) anesthetics and three (Q1 2.0, Q3 4.0) antiepileptic drugs. Forty percent of patients (17/42) received propofol: 65 % prior to (S)-KET; 35 % at the same time with (S)-KET. Seven patients received a median bolus of (S)-KET of 200 mg (Q1 200, Q3 250) followed by a continuous infusion, while 35 started with a continuous infusion (maximum rate median 2.55 mg/kg/h; Q1 2.09, Q3 3.22). In 64 % of patients (27/42), (S)-KET was the last drug before SE cessation; in five patients, it was given with propofol at the same time. Median duration of administration was 4 days (Q1 2.0, Q3 6.8). Overall (S)-KET treatment was well tolerated, adverse effects were not observed, and overall mortality was 45.2 %. CONCLUSIONS Treatment of SRSE in adult patients with (S)-KET led to resolution of status in 64 %. No adverse events were found, indicating a favorable safety profile.
Collapse
|
65
|
Stelzer D, Ihle F, Weber A, Kneidinger N, Meis T, Zimmermann G, Schramm R, Winter H, Frey L, Vogeser M, Andraschko M, Behr J, Neurohr C. Influence of Pantoprazole Dosages on Azole Plasma Concentrations in Lung Transplant Recipients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
66
|
Taguchi CMC, Bernardon JK, Zimmermann G, Baratieri LN. Tooth fragment reattachment: a case report. Oper Dent 2014; 40:227-34. [PMID: 25535781 DOI: 10.2341/14-034-t] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this article is to present a case report for the multidisciplinary treatment of anterior tooth fractures with invasion of the biologic width and pulpectomy. Successful esthetic and functional results were achieved by bonding the crown fragment, without any form of preparation or the utilization of intracanal posts.
Collapse
|
67
|
Bauer HJ, Berninger G, Zimmermann G. Nachweis interstitieller Wasserstoffeinlagerung in NiCu-Legierungen auf magnetischem und röntgenographischem Wege. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/zna-1968-1220] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ferromagnetic nickel-copper alloys can be charged with cathodic hydrogen in high concentrations whereby they loose their ferromagnetic behavior. Measurements of magnetization of these alloys show a quicker absorption of hydrogen compared to nickel. The interstitial occlusion of hydrogen gives rise to a reversible lattice expansion of some percent (without change of structure). During the desorption there appear on the studied alloys (10 to 35%) simultaneously two different values of lattice parameters. This is due to the transition between two NiCu-H phases of different H-con-centrations (β- and α-phase). With increasing Cu-content a decreasing lattice expansion of the hydrogen-rich non-ferromagnetic phase is found. This expansion up to a Cu-content of 35% is proportional to the mean magnetic moment per atom of the corresponding hydrogen-free alloy. The comparison with the quantity of absorbed hydrogen suggests further - in analogy to Vegards law for mixed crystals - proportionality between lattice expansion of the β-phase (as function of the Cu-content) and the corresponding atomic ratio hydrogen/metal. The results can be understood as a decrease of the solubility of hydrogen caused by the increased filling of the d-holes by s-electrons of Cu. - Further X-ray studies showed an overcharging effect by an additive continuous increase of the lattice parameters of the β-phase.
Collapse
|
68
|
Zimmermann U, Zhu JJ, Meinzer FC, Goldstein G, Schneider H, Zimmermann G, Benkert R, Thürmer F, Melcher P, Webb D, Haase A. High Molecular Weight Organic Compounds in the Xylem Sap of Mangroves: Implications for Long-Distance Water Transport. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/j.1438-8677.1994.tb00789.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
69
|
Böttcher D, Gräfe H, Zimmermann G, Alexander H, Ellenberger C, Schoon HA. Transcription of equine chorionic gonadotropin/luteinizing hormone b subunit gene in the endometrium of non-pregnant mares. PFERDEHEILKUNDE 2014. [DOI: 10.21836/pem20140103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
70
|
Böttcher D, Gräfe H, Zimmermann G, Alexander H, Ellenberger C, Schoon HA. Equine chorionic gonadotropin in the uterus of non-pregnant mares? Reprod Biol 2013. [DOI: 10.1016/j.repbio.2013.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
71
|
Abstract
Non-union fracture is a pathological condition having some impairment of the cellular part of the repair: a reduction of MSC and of the osteoblastic activation. Non union is therefore a good indication for cell-based therapies using stem cells. We described the rational of this treatment and described the technique of autologous bone marrow concentrate implantation that was until now used. With the development of stem cell research and regenerative medicine, we believed that therapy based on cytotherapy has great potential. In this review, clinical applications of cytotherapy are summarized and analyzed. Current problems and future challenges are discussed.
Collapse
|
72
|
Wulffen WV, Ihle F, Waelde A, Arias Herrera V, Bäzner C, Huppmann P, Kneidinger N, Meis T, Schild C, Zimmermann G, Neurohr C. Flugreisen bei pulmonaler Hypertonie: Ergebnisse einer Patientenbefragung an einem PH-Schwerpunktzentrum. Pneumologie 2012. [DOI: 10.1055/s-0032-1302868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
73
|
Ihle F, Baezner C, Meis T, Wulffen WV, Huppmann P, Zimmermann G, Arias Herrera V, Schild C, Kneidinger N, Leuchte N, Behr J, Neurohr C. Lebensqualität von Patienten mit pulmonaler Hypertonie – Ein Vergleich mit der deutschen Normbevölkerung. Pneumologie 2012. [DOI: 10.1055/s-0032-1302579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
74
|
Jakob K, Zimmermann G, Ihle F, Meis T, Wulffen WV, Huppmann P, Arias Herrera V, Schild C, Kneidinger N, Neurohr C. Erstanwendung Pirfenidon – Beschreibung des Münchner Patientenkollektivs. Pneumologie 2012. [DOI: 10.1055/s-0032-1302822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
75
|
Zimmermann G, Schmeckenbecher KHK, Boeuf S, Weiss S, Bock R, Moghaddam A, Richter W. Differential gene expression analysis in fracture callus of patients with regular and failed bone healing. Injury 2012; 43:347-56. [PMID: 22138123 DOI: 10.1016/j.injury.2011.10.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 10/05/2011] [Accepted: 10/23/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although several systemic and local factors are known to impair fracture healing, there is still no explanation, why some patients with sufficient fracture stability, showing none of the existing risk factors, still fail to heal normally. An investigation of local gene expression patterns in the fracture gap of patients with non-unions could decisively contribute to a better understanding of the pathophysiology of impaired fracture healing. For the first time, this study compares the expression of a large variety of osteogenic and chondrogenic genes in patients with regular and failed fracture healing. METHODS Between March 2006 and May 2007, a total of 130 patients who were surgically treated at the Berufsgenossenschaftliche Unfallklink Ludwigshafen were screened for the study. Tissue samples of patients with normal and failed fracture healing were collected intraoperatively. Patients were divided into groups depending on the fracture date, and only patients with fractures two to four weeks old and patients with non-unions more than 9 months old were included in the final analysis. For the gene expression analysis, a customised cDNA array - containing 226 genes involved in osteo- and chondrogenesis - was used. RESULTS In the cDNA array analysis, the expression of eight genes was significantly elevated two-fold or more in the group with failed fracture healing relative to the normal controls. Conversely, no genes were found to be expressed at a higher level in the control group. The identified genes are supposed to be involved in extracellular matrix assembly, cytoskeletal structure, and differentiative and proliferative processes. CONCLUSIONS The differences in gene expression pattern indicate a change in the composition and structure of the extracellular matrix, and a possible turn in the healing programme towards fibrous scar tissue formation, leading to non-union.
Collapse
|