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Banisch T, Heide S, Kaden I, Herzog M, Weigert N, Plontke SK. [Gunshot wound of the paranasal sinuses with an unusual route of the bullet]. HNO 2021; 69:146-149. [PMID: 32394148 DOI: 10.1007/s00106-020-00859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Banisch
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland.
| | - S Heide
- Institut für Rechtsmedizin, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - I Kaden
- Klinik für bildgebende Diagnostik und Interventionsradiologie, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Deutschland
| | - M Herzog
- Klinik für HNO-Krankheiten, Kopf- und Halschirurgie, Carl-Thiem-Krankenhaus, Cottbus, Deutschland
| | - N Weigert
- Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Deutschland
| | - S K Plontke
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Deutschland
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Abstract
Background The lost guidewire in central venous catheterization is a commonly described complication. The percutaneous endovascular retrieval method is safe and has a very low complication rate. Objectives Guidewires extending to the inferior cava vein are usually retrieved via the femoral vein. Under special circumstances, femoral venous access may be impossible and alternative vascular approaches are required. Case report We report a case in which we used an alternative vascular approach, from the subclavian site contralateral to the insertion, in a patient with extensive inguinal burn injuries. Conclusions Cross-over subclavian retrieval can be an alternative approach for retrieval of a lost guidewire, but it involves an increased risk of puncture-related complications such as pneumothorax.
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Affiliation(s)
- M.F. Struck
- Department of Plastic and Hand Surgery, Burn Trauma Center, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale - Germany
| | - I. Kaden
- Department of Diagnostic Imaging and Interventional Radiology, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale - Germany
| | - A. Heiser
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale - Germany
| | - M. Steen
- Department of Plastic and Hand Surgery, Burn Trauma Center, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale - Germany
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Schwan S, Ludtka C, Friedmann A, Mendel T, Meisel HJ, Heilmann A, Kaden I, Goehre F. Calcium Microcrystal Formation in Recurrent Herniation Patients After Autologous Disc Cell Transplantation. Tissue Eng Regen Med 2017; 14:803-814. [PMID: 30603529 DOI: 10.1007/s13770-017-0076-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/04/2017] [Accepted: 07/12/2017] [Indexed: 12/25/2022] Open
Abstract
Autologous disc cell transplantation (ADCT) is a cell-based therapy aiming to initiate regeneration of intervertebral disc (IVD) tissue, but little is known about potential risks. This study aims to investigate the presence of structural phenomena accompanying the transformation process after ADCT treatment in IVD disease. Structural phenomena of ADCT-treated patients (Group 1, n = 10) with recurrent disc herniation were compared to conventionally-treated patients with recurrent herniation (Group 2, n = 10) and patients with a first-time herniation (Group 3, n = 10). For ethical reasons, a control group of ADCT patients who did not have a recurrent disc herniation was not possible. Tissue samples were obtained via micro-sequestrectomy after disc herniation and analyzed by micro-computed tomography, scanning electron microscopy, energy dispersive spectroscopy, and histology in terms of calcification zones, tissue structure, cell density, cell morphology, and elemental composition. The major differentiator between sample groups was calcium microcrystal formation in all ADCT samples, not found in any of the control group samples, which may indicate disc degradation. The incorporation of mineral particles provided clear contrast between the different materials and chemical analysis of a single particle indicated the presence of magnesium-containing calcium phosphate. As IVD calcification is a primary indicator of disc degeneration, further investigation of ADCT and detailed investigations assessing each patient's Pfirrmann degeneration grade following herniation is warranted. Structural phenomena unique to ADCT herniation prompt further investigation of the therapy's mechanisms and its effect on IVD tissue. However, the impossibility of a perfect control group limits the generalizable interpretation of the results.
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Affiliation(s)
- S Schwan
- 1Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.,2Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Huelse-Str. 1, 06120 Halle (Saale), Germany
| | - C Ludtka
- 1Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.,2Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Huelse-Str. 1, 06120 Halle (Saale), Germany.,3Department of Chemical and Biomolecular Engineering, University of Tennessee, 1512 Middle Drive, Knoxville, TN 37996 USA
| | - A Friedmann
- 1Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.,2Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Huelse-Str. 1, 06120 Halle (Saale), Germany
| | - T Mendel
- 4Department of Trauma Surgery, Friedrich-Schiller-University, Am Klinikum 1, 07747 Jena, Germany.,Department of Trauma Surgery, BG-Klinikum Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - H J Meisel
- Department of Neurosurgery, BG-Klinikum Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - A Heilmann
- 2Department of Biological and Macromolecular Materials, Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Walter-Huelse-Str. 1, 06120 Halle (Saale), Germany
| | - I Kaden
- Department of Diagnostic Imaging and Interventional Radiology, BG-Klinikum Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - F Goehre
- 1Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.,Department of Neurosurgery, BG-Klinikum Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany.,Department of Neurosurgery, Helsinki University Central Hospital, University of Helsinki, Topeliuksenkatu 5, 00029 Helsinki, Finland
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Kaden I, Braunschweig R, Kaden D. Einführung: Aktueller Stand der Bildgebung – Was tun wir? ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581688] [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: 10/22/2022]
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Kaden I. Die postoperative Wirbelsäule - Systematik und Implantate. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kaden I. Die postoperative Wirbelsäule - Komplikationen und Pitfalls. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Holzinger D, Flechtenmacher C, Henfling N, Kaden I, Grabe N, Lahrmann B, Schmitt M, Hess J, Pawlita M, Bosch FX. Identification of oropharyngeal squamous cell carcinomas with active HPV16 involvement by immunohistochemical analysis of the retinoblastoma protein pathway. Int J Cancer 2013; 133:1389-99. [PMID: 23457055 DOI: 10.1002/ijc.28142] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [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: 10/04/2012] [Accepted: 02/22/2013] [Indexed: 11/11/2022]
Abstract
Viral oncogene RNA expression is regarded as reliable biomarker to identify oropharyngeal squamous cell carcinomas (OPSCC) with active HPV16 involvement. This study addressed whether the expression profile of the cellular proteins p16(INK4a), pRb, Cyclin D1 and p53 provide surrogate marker combinations that identify OPSCC with active HPV16 in situations where only formalin-fixed biopsies are available. Protein expression was analyzed by immunohistochemistry on tissue microarrays created from 188 OPSCC of which the HPV16 DNA and RNA status had been established previously from snap-frozen biopsies. Associations of single markers and of marker combinations with HPV16 DNA, viral RNA expression patterns and overall survival as primary end point were evaluated by statistical analysis. Most tumors with active HPV16 involvement (RNA(+) group; n = 40) showed a specific protein pattern, that is, high p16(INK4a) (80%), low pRb (85%), low Cyclin D1 (95%) and normal p53 (73%). This pattern was significantly different from the pattern observed in HPV DNA-negative tumors (HPV(-) group) and in HPV16 DNA-positive tumors lacking viral RNA expression patterns (RNA(-) group). The combination of high p16(INK4a) and low pRb levels was distinctly superior to p16(INK4a) alone; it was strongly associated with RNA(+) tumors (OR 41.4, 95%CI 10.7-162.5), with improved survival (HR 0.37, 95%CI 0.2-0.8) and had best predictive values (78% sensitivity, 93% specificity, 78% PPV, 93% NPV). In conclusion, if only formalin-fixed biopsy material is available, the marker combination high p16(INK4a) /low pRb is well suited to identify OPSCC with biologically active HPV16 which represent a distinct OPSCC entity with improved prognosis.
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Affiliation(s)
- Dana Holzinger
- Department of Otolaryngology, Experimental Head and Neck Oncology, Head and Neck Surgery, Heidelberg University, Germany.
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Braunschweig R, Kaden I, Schwarzer J, Sprengel C, Klose K. Image data compression in diagnostic imaging: international literature review and workflow recommendation. ROFO-FORTSCHR RONTG 2009; 181:629-36. [PMID: 19513963 DOI: 10.1055/s-0028-1109341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Today healthcare policy is based on effectiveness. Diagnostic imaging became a "pacesetter" due to amazing technical developments (e. g. multislice CT), extensive data volumes, and especially the well defined workflow-orientated scenarios on a local and (inter)national level. To make centralized networks sufficient, image data compression has been regarded as the key to a simple and secure solution. In February 2008 specialized working groups of the DRG held a consensus conference. They designed recommended data compression techniques and ratios. MATERIAL AND METHOD The purpose of our paper is an international review of the literature of compression technologies, different imaging procedures (e. g. DR, CT etc.), and targets (abdomen, etc.) and to combine recommendations for compression ratios and techniques with different workflows. The studies were assigned to 4 different levels (0 - 3) according to the evidence. 51 studies were assigned to the highest level 3. RESULTS We recommend a compression factor of 1 : 8 (excluding cranial scans 1:5). For workflow reasons data compression should be based on the modalities (CT, etc.). PACS-based compression is currently possible but fails to maximize workflow benefits. Only the modality-based scenarios achieve all benefits. CONCLUSION Imaging equipment manufacturers are encouraged to improve the compression technology of their imaging devices (e. g. freely selectable compression ratios in the output filter). Double compression should be strictly avoided. Lossless compression formats should be switched off.
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Affiliation(s)
- R Braunschweig
- Klinik für Bildgebende Diagnostik und Interventionsradiologie, BG-Kliniken Bergmannstrost Halle
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Struck MF, Kaden I, Heiser A, Steen M. Cross-over endovascular retrieval of a lost guide wire from the subclavian vein. J Vasc Access 2008; 9:304-306. [PMID: 19085905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The lost guidewire in central venous catheterization is a commonly described complication. The percutaneous endovascular retrieval method is safe and has a very low complication rate. OBJECTIVES Guidewires extending to the inferior cava vein are usually retrieved via the femoral vein. Under special circumstances, femoral venous access may be impossible and alternative vascular approaches are required. CASE REPORT We report a case in which we used an alternative vascular approach, from the subclavian site contralateral to the insertion, in a patient with extensive inguinal burn injuries. CONCLUSIONS Cross-over subclavian retrieval can be an alternative approach for retrieval of a lost guidewire, but it involves an increased risk of puncture-related complications such as pneumothorax.
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Affiliation(s)
- M F Struck
- Department of Plastic and Hand Surgery, Burn Trauma Center, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale, Germany.
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Abstract
Anisocoria after blunt head trauma, associated with altered vigilance, is not unusually assumed to expanding intracranial mass lesion. Obvious signs of head-trauma and vomiting might strengthen this diagnosis. We report from an unconscious 15-year-old girl (Glasgow-Coma-Scale score 3) that showed these symptoms secondary after head-trauma due to alcohol intoxication but turned out to be misleading after cranial computed tomography (CT). Surprisingly, an artificial eye was found that previously remained undetected in clinical examination. Artificial eyes implemented after enucleation therapy in retinoblastoma or eye-trauma are nowadays perfectly fitting. Prehospital discrimination of artificial eyes and natural eyes might be difficult in comatose emergency patients. Neurological examination should check corneal reflex and manual palpation of the bulbus. Independent from anisocoria, patients presenting GCS 3 and head injury need rapid admission to CT-diagnostic, neurosurgical treatment respectively.
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Affiliation(s)
- M F Struck
- Operative Intensivstation, Klinik für Anaesthesiologie, Intensiv- und Notfallmedizin, BG-Kliniken Bergmannstrost, Merseburger Strasse 165, 06112 Halle, Deutschland.
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Braunschweig R, Kaden I. Datenkompression und Archivierungsstrategien. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Veltkamp C, Ruhwald R, Giesem T, Autschbach F, Kaden I, Veltkamp R, Sartor RB, Stremmel W. CD4+CD25+ cell depletion from the normal CD4+ T cell pool prevents tolerance toward the intestinal flora and leads to chronic colitis in immunodeficient mice. Inflamm Bowel Dis 2006; 12:437-46. [PMID: 16775487 DOI: 10.1097/00054725-200606000-00002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
CD4+CD25+ regulatory T cells have been shown to prevent immune-mediated colitis in mice; however, it is unclear whether the absence of CD4+CD25+ in the normal CD4+ T cell pool is responsible for the development of chronic colitis. Using the T cell-deficient Tgepsilon26 mouse model, we show that CD4+CD25- cells but not CD4+CD25+ cells induce a severe intestinal inflammation. Transfer of CD4+CD25+ cells, together with CD4+CD25- cells, ameliorated intestinal inflammation, and reconstitution with the whole mesenteric lymph node cell pool did not induce colitis in recipients. Transferred CD4+CD25- cells were found mainly in the mesenteric lymph nodes, where they showed an activated TH1-like phenotype. In the absence of regulatory CD4+CD25+ T cells, recipient CD4 cells secreted IFN-gamma in response to stimulation with intestinal bacterial antigen that was prevented in vivo and in vitro by regulatory CD4+CD25+ cells. These studies suggest that CD4+CD25- cells have a strong colitogenic effect in the Tgepsilon26 colitis model and that CD4+CD25+ cells may be the main regulators that prevent or downregulate the proinflammatory effect of colitogenic T cells in the Tgepsilon26 mouse model.
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Affiliation(s)
- Claudia Veltkamp
- Department of Gastroenterology, Ruprecht-Karls-University, Heidelberg, Germany.
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Braunschweig R, Kaden I. RIS/KIS – PACS/DACS. Was ist das? Eine klinische Strategiediskussion. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940318] [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: 10/20/2022]
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Braunschweig R, Höller I, Kaden I, Stuttmann R, Wawro W. Zeitmanagement bei der Erstversorgung polytraumatisierter Patienten. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940745] [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: 10/20/2022]
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Braunschweig R, Wawro W, Röhl K, Schilling O, Kaden I. Wirbelsäulenfrakturen und ihre Folgen. Begutachtung aus der Sicht des Radiologen. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940364] [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: 10/20/2022]
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Kaden IK, Kaden I, Braunschweig R, Geis I, Tolksdorf D. Zentrale Archivierung von Krankenhausdaten - „DACS - ein ASP-Konzept“. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867717] [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: 10/19/2022]
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Veltkamp C, Sartor RB, Giese T, Autschbach F, Kaden I, Veltkamp R, Rost D, Kallinowski B, Stremmel W. Regulatory CD4+CD25+ cells reverse imbalances in the T cell pool of bone marrow transplanted TGepsilon26 mice leading to the prevention of colitis. Gut 2005; 54:207-14. [PMID: 15647183 PMCID: PMC1774840 DOI: 10.1136/gut.2004.046953] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Erroneous thymic selection of developing T lymphocytes may be responsible for the expansion of self reactive T cells or may contribute to the absence of regulatory T cells important in controlling peripheral inflammatory processes. Colitis in bone marrow (BM) transplanted Tgepsilon26 mice is induced by abnormally activated T cells developing in an aberrant thymic microenvironment. We investigated the protective role of regulatory CD4+CD25+ T cells in this model. METHODS BM from (C57BL/6 x CBA/J) F1 mice was transplanted into specific pathogen free Tgepsilon26 mice (BM-->Tgepsilon26). Transplanted mice received no cells (control), sorted CD4+CD25+, or CD4+CD25- cells from mesenteric lymph nodes (MLN) of normal mice. MLN cell subsets were analysed using membrane markers. Cytokine secretion of MLN cells was measured using intracellular cytokine staining and cytokine secretion in anti-CD3 stimulated cell cultures. Colitis was measured by histological scores. RESULTS CD4+CD25+ cells were reduced in the MLNs of BM-->Tgepsilon26 mice. Transfer of regulatory CD4CD4+CD25+ but not of CD4+CD25- cells reduced the number of MLN CD4+ T cells in BM-->Tgepsilon26 recipients and increased the number of MLN CD8+ cells, thereby normalising the CD4+/CD8+ ratio. CD4+CD25+ but not CD4+CD25- cell transfer into BM-->Tgepsilon26 mice reduced the number of tumour necrosis factor alpha+ CD4+ cells and increased the secretion of transforming growth factor beta by MLN cells. Transfer of 3 x 10(5) CD4+CD25+ cells after BM transplantation into Tgepsilon26 mice prevented colitis whereas CD4+CD25- cells had no protective effect. CONCLUSIONS These results suggest that defective selection or induction of regulatory T cells in the abnormal thymus is responsible for the development of colitis in BM-->Tgepsilon26 mice. Transfer of CD4+CD25+ cells can control intestinal inflammation in BM-->Tgepsilon26 mice by normalising the number and function of the MLN T cell pool.
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Affiliation(s)
- C Veltkamp
- Department of Gastroenterology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
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Kaden I, Kaden I, Braunschweig R, Sprengel C, Schwarzer J, Brill M. DSA versus MRA. Eine ökonomische und diagnostische Effizienzanalyse. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827839] [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: 10/19/2022]
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Abstract
In a prospective study of 1,500 neurologic consultations during 1978 and 1984 within the Johns Hopkins Hospital, iatrogenic neurologic conditions were found in 14 percent of patients. The most common antecedents were angiography, cardiac surgery, and immunosuppression. Neurologists found previously unsuspected significant neurologic conditions in 27 percent of patients. Determining the underlying causes of delirium posed a special diagnostic problem. The accuracy of general physicians and surgeons in the application of criteria for brain death was low. Consultations for solely medical-legal reasons are increasing. These findings indicate the need for improved surveillance of neurological injury in hospitals, earlier recognition of delirium and research into its mechanisms, and additional education about criteria for brain death.
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