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Frosch M, Demerath T, Fung C, Prinz M, Urbach H, Erny D, Taschner CA. Freiburg Neuropathology Case Conference : Headache, Mental Confusion and Mild Hemiparesis in a 68-year-old Patient. Clin Neuroradiol 2023; 33:1159-1164. [PMID: 37872367 PMCID: PMC10654210 DOI: 10.1007/s00062-023-01359-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Affiliation(s)
- M Frosch
- Department of Neuropathology, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - T Demerath
- Department of Neuroradiology, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - C Fung
- Department of Neurosurgery, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - D Erny
- Department of Neuropathology, University of Freiburg, Freiburg, Germany
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - C A Taschner
- Department of Neuroradiology, University of Freiburg, Freiburg, Germany.
- Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany.
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Thomann P, Häni L, Vulcu S, Schütz A, Frosch M, Jesse CM, El-Koussy M, Söll N, Hakim A, Raabe A, Schucht P. P18.10.B Natural history of meningiomas - a serial volumetric analysis of 240 tumors. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The management of asymptomatic intracranial meningiomas is controversial. Through the assessment of growth predictors, we aimed to create the basis for practicable clinical pathways for the management of these tumors.
Material and Methods
We volumetrically analyzed meningiomas radiologically diagnosed at our institution between 2003 and 2015. For this purpose, we used exclusively thin-layered MR images (i.e. ≤ 2mm slice thickness). The primary endpoint was tumor growth defined as a 14.35% increase in tumor volume. We identified predictive clinical and radiological characteristics and used the significant variables from a multivariable regression model to construct a decision tree based on the exhaustive Chi-squared Automatic Interaction Detection (exhaustive CHAID) algorithm.
Results
Of 240 meningiomas, 159 (66.3%) demonstrated growth during a mean observation period of 46.9 months. On multivariable logistic regression analysis, older age (OR=0.979 (0.958-1.000), p=0.048) and presence of calcification (OR=0.442 (0.224-0.872), p=0.019) had a negative predictive value for tumor growth, while T2-signal iso-/hyperintensity (OR=4.415 (2.056-9.479), p<0.001) had a positive predictive value. A decision tree model yielded three growth risk groups based on T2-signal intensity and presence of calcifications with a proportion of growing tumors of 34.1% in the low risk group, 60.0% in the intermediate risk group and 80.2% in the high risk group. Median tumor volume doubling time (Td) was 185.7 months in the low risk, 100.1 months in the intermediate risk and 51.7 months in the high risk group (p<0.001). While 0% of meningiomas in the low and intermediate risk group had a Td of ≤12 months, 8.9% in the high risk group did so (p=0.021).
Conclusion
Most meningiomas demonstrated growth during follow-up. The presence or absence of calcifications and the signal intensity on T2-weighted imaging allow a practical and simple stratification of meningiomas into low, intermediate and high risk tumors. Small tumors in the low or intermediate risk categories can be monitored with longer follow-up intervals, whereas in the high risk category proactive management decisions can be justified.
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Affiliation(s)
- P Thomann
- University Hospital Bern , Bern , Switzerland
| | - L Häni
- University Hospital Bern , Bern , Switzerland
| | - S Vulcu
- University Hospital Bern , Bern , Switzerland
| | - A Schütz
- University Hospital Bern , Bern , Switzerland
| | - M Frosch
- Medical Center - University of Freiburg , Freiburg , Germany
| | - C M Jesse
- University Hospital Bern , Bern , Switzerland
| | - M El-Koussy
- Hospital of Emmental , Burgdorf , Switzerland
| | - N Söll
- University Hospital Bern , Bern , Switzerland
| | - A Hakim
- University Hospital Bern , Bern , Switzerland
| | - A Raabe
- University Hospital Bern , Bern , Switzerland
| | - P Schucht
- University Hospital Bern , Bern , Switzerland
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Frosch M, Kremers N, Lisko K, Urbach H, Prinz M, Taschner CA. Freiburg Neuropathology Case Conference : A 42-year-old Patient with Progressive Neurological Deficits, Multiple Brain Lesions and Accompanying Affection of Peripheral Nerves. Clin Neuroradiol 2021; 31:529-535. [PMID: 34115143 PMCID: PMC8211581 DOI: 10.1007/s00062-021-01021-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 12/02/2022]
Affiliation(s)
- M Frosch
- Departments of Neuropathology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - N Kremers
- Departments of Neuroradiology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - K Lisko
- Departments of Neurology and Neurophysiology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Urbach
- Departments of Neuroradiology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany
| | - M Prinz
- Departments of Neuropathology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C A Taschner
- Departments of Neuroradiology, Medical Centre, University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacherstr. 64, 79106, Freiburg, Germany.
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Heiligenhaus A, Minden K, Tappeiner C, Baus H, Bertram B, Deuter C, Foeldvari I, Föll D, Frosch M, Ganser G, Gaubitz M, Günther A, Heinz C, Horneff G, Huemer C, Kopp I, Lommatzsch C, Lutz T, Michels H, Neß T, Neudorf U, Pleyer U, Schneider M, Schulze-Koops H, Thurau S, Zierhut M, Lehmann HW. Update of the evidence based, interdisciplinary guideline for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Semin Arthritis Rheum 2018; 49:43-55. [PMID: 30595409 DOI: 10.1016/j.semarthrit.2018.11.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 08/20/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Uveitis in juvenile idiopathic arthritis (JIAU) is frequently associated with the development of complications and visual loss. Topical corticosteroids are the first line therapy, and disease modifying anti-rheumatic drugs (DMARDs) are commonly used. However, treatment has not been standardized. METHODS Interdisciplinary guideline were developed with representatives from the German Ophthalmological Society, Society for Paediatric Rheumatology, Professional Association of Ophthalmologists, German Society for Rheumatology, parents' group, moderated by the Association of the Scientific Medical Societies in Germany. A systematic literature analysis in MEDLINE was performed, evidence and recommendations were graded, an algorithm for anti-inflammatory treatment and final statements were discussed in a consensus meeting (Nominal Group Technique), a preliminary draft was fine-tuned and discussed thereafter by all participants (Delphi procedure). RESULTS Consensus was reached on recommendations, including a standardized treatment strategy according to uveitis severity in the individual patient. Thus, methotrexate shall be introduced for uveitis not responding to low-dose (≤ 2 applications/day) topical corticosteroids, and a TNFalpha antibody (preferably adalimumab) used, if uveitis inactivity is not achieved. In very severe active uveitis with uveitis-related deterioration of vision, systemic corticosteroids should be considered for bridging until DMARDs take effect. If TNFalpha antibodies fail to take effect or lose effect, another biological should be selected (tocilizumab, abatacept or rituximab). De-escalation of DMARDs should be preceded by a period of ≥ 2 years of uveitis inactivity. CONCLUSIONS An interdisciplinary, evidence-based treatment guideline for JIAU is presented.
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Affiliation(s)
- A Heiligenhaus
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany.
| | - K Minden
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Tappeiner
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - H Baus
- The Participation of the Following Bodies: Parents' Group for Children with Uveitis and their Families, Germany
| | - B Bertram
- Professional Association of Ophthalmologists (BVA), Germany
| | - C Deuter
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - I Foeldvari
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - D Föll
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - M Frosch
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - G Ganser
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - M Gaubitz
- German Society of Rheumatology (DGRh), Germany
| | - A Günther
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Heinz
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - G Horneff
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - C Huemer
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - I Kopp
- Association of the Scientific Medical Societies in Germany (AWMF), Germany
| | - C Lommatzsch
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - T Lutz
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - H Michels
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - T Neß
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - U Neudorf
- The Society for Paediatric Rheumatology (GKJR), Germany
| | - U Pleyer
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - M Schneider
- German Society of Rheumatology (DGRh), Germany
| | | | - S Thurau
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - M Zierhut
- Department of Ophthalmology, Guideline of the German Ophthalmological Society (DOG), St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany
| | - H W Lehmann
- The Society for Paediatric Rheumatology (GKJR), Germany
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Schmidt P, Wager J, Frosch M, Zernikow B. [Pediatric general practitioners and tertiary care structures for pain therapy. A qualitative study on the need for networking]. Schmerz 2016; 28:398-404. [PMID: 25034651 DOI: 10.1007/s00482-014-1457-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite the urgency of the problem of chronic pediatric pain and the importance of early interventions, many children experience intermittent episodes of pain over a long period of time. One aim of this study was to investigate the need of structured diagnostic tools and therapies of chronic pediatric pain in pediatric general practices. Another aim was to describe the aims, services and challenges of a network between pediatric practices and a tertiary pediatric pain centre, from the perspective of general pediatric practitioners. MATERIAL AND METHODS A qualitative research design was selected and 20 general pediatric practitioners were interviewed using a semistructured interview guide. Interviews were analyzed by use of qualitative content analysis according to Mayring. RESULTS Generally, the idea of a network between pediatric practices and the German Pediatric Pain Centre was rated positively by pediatric general practitioners. From the results of the analysis three categories were identified: (i) expectations from the network (ii) desire for cooperation in the network and (iii) recommendations for improved patient care. CONCLUSION A network with a centre for tertiary care was preferred by the general pediatric practitioners. To optimize the care of children with chronic pain further education for general pediatric practitioners as well as structured diagnostic tools and therapies of frequent pediatric chronic pain diseases are warranted.
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Affiliation(s)
- P Schmidt
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
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Affiliation(s)
- M Bulla
- University Department of Pediatrics and Nephrology, Münster, FRG
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7
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Minoia F, Davì S, Horne A, Consolaro A, Rosina S, Davidsone Z, De Cunto C, De Inocencio J, Eisenstein E, Espada G, Fishbach M, Frosch M, Gallizzi R, Gamir ML, Griffin T, Grom A, Hennon T, Horneff G, Huasong Z, Ruperto N, Martini A, Cron RQ, Ravelli A. PReS-FINAL-2141: Clinical features, therapeutic interventions and outcome of 362 patients with macrophage activation syndrome enrolled in a multinational survey. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044446 DOI: 10.1186/1546-0096-11-s2-p153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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8
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Quartier P, Ruperto N, Wulffraat N, Brunner H, Brik R, Mccann L, Foster H, Frosch M, Gerloni V, Harel L, Len C, Houghton K, Joos R, Abrams K, Lheritier K, Kessabi S, Martini A, Lovell D. PReS-FINAL-2158: Effect of canakinumab on functional ability and health-related quality of life in systemic juvenile idiopathic arthritis (SJIA) patients. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044557 DOI: 10.1186/1546-0096-11-s2-p170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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9
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Dueckers G, Frosch M, Assaf C, Wiggermann H, Schneider D, Niehues T. P03-015 - Dapson treats chronic Pupura Schoenlein (PSH). Pediatr Rheumatol Online J 2013. [PMCID: PMC3952112 DOI: 10.1186/1546-0096-11-s1-a213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Tappe D, Müller A, Frosch M, Stich A. Limitations of amphotericin B and nitazoxanide in the treatment of alveolar echinococcosis. Annals of Tropical Medicine & Parasitology 2013; 103:177-81. [DOI: 10.1179/136485909x385036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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11
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Van Den Heuvel I, Boschin M, Langer M, Frosch M, Gottschalk A, Ellger B, Hahnenkamp K. Anesthetic management in pediatric patients with epidermolysis bullosa: a single center experience. Minerva Anestesiol 2013; 79:727-732. [PMID: 23419339] [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: 06/01/2023]
Abstract
BACKGROUND Anesthesia in children with dystrophic epidermolysis bullosa (EB) presents a significant challenge as many children have a difficult airway and are at risk for additional blistering. In this retrospective study we compared deep sedation/ analgesia and general anesthesia for safety and efficiency. Procedure, type of anesthesia, airway management, complications, time for induction and awakening, length of stay in recovery room, length of procedure were noted and compared, qualitatively and with statistic tests as appropriate. METHODS Fourteen children underwent 148 procedures: 79 under general anesthesia, 67 under sedation. RESULTS Several complications - including intubation difficulties and the need for change of airway management - were observed in the general anesthesia group, none in the sedated group. Induction time was 36 min vs. 17 min (P<0.001), mean time to recovery 23 min vs. 6 min (P<0.001). Surgical duration did not differ between groups. CONCLUSIONS In children with dystrophic EB deep sedation/ analgesia can be safely performed and is less time consuming than traditional management.
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Affiliation(s)
- I Van Den Heuvel
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University hospital Muenster, Germany.
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12
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Quartier P, Ruperto N, Wulffrat N, Brunner H, Brik R, McCann L, Foster H, Frosch M, Gerloni V, Harel L, Len C, Houghton K, Joos R, Kim D, Abrams K, Lheritier K, Ricci J, Martini A, Lovell D. THU0477 Canakinumab Improves Health-Related Quality of Life (HRQOL) and Daily Functioning in Systemic Juvenile Idiopathic Arthritis (SJIA) Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1005] [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: 11/03/2022]
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Feldmann R, Weglage J, Frosch M. Cognitive function in patients with epidermolysis bullosa: social adjustment and emotional problems. Klin Padiatr 2011; 224:22-5. [PMID: 22187330 DOI: 10.1055/s-0031-1295437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Children with Epidermolysis bullosa (EB) suffer from an intractable, burdensome skin disease that may result in cognitive as well as social and emotional problems. PATIENTS To assess cognitive problems in patients with EB, we investigated 20 affected children and adolescents, 6-17 years of age (mean: 10.8 years; SD: 3.4 years), and 24 healthy controls (6-15 years, mean: 10.9 years; SD: 3.0 years) for cognitive abilities. Additionally, parents were asked to assess social and emotional problems of their children. METHODS Patients and controls were assessed using the Wechsler Intelligence Scales. Parents completed Achenbach's Child Behaviour Checklist (CBCL), a parent-report measure on emotional and behavioural symptoms in children. RESULTS The mean scores of the young patients tested with WISC-R and WAIS-R showed no significant left shift if compared to healthy controls. Analyzing the subtypes of EB, however, considerable cognitive deficits were associated with recessive dystrophic EB (RDEB), severe generalized. Less social competence and more social and emotional problems were reported for the entire patient group. CONCLUSIONS Functional rehabilitation is required to increase not only the physical but the cognitive development of the severely affected children with RDEB. Children and adolescents with all subtypes of EB require therapeutic support regarding their social and emotional life.
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Affiliation(s)
- R Feldmann
- University Hospital, Pediatrics, Münster, Germany.
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15
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Dueckers G, Guellac N, Arbogast M, Dannecker G, Foeldvari I, Frosch M, Ganser G, Heiligenhaus A, Horneff G, Illhardt A, Kopp I, Krauspe R, Markus B, Michels H, Schneider M, Singendonk W, Sitter H, Spamer M, Wagner N, Niehues T. German evidence and consensus based guidelines 2010 for the treatment of juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2011. [PMCID: PMC3194537 DOI: 10.1186/1546-0096-9-s1-p181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Frosch M, Bilde M, DeCarlo PF, Jurányi Z, Tritscher T, Dommen J, Donahue NM, Gysel M, Weingartner E, Baltensperger U. Relating cloud condensation nuclei activity and oxidation level ofα-pinene secondary organic aerosols. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2011jd016401] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Frosch
- Department of Chemistry; University of Copenhagen; Copenhagen Denmark
| | - M. Bilde
- Department of Chemistry; University of Copenhagen; Copenhagen Denmark
| | - P. F. DeCarlo
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
- Center for Atmospheric Particle Studies; Carnegie Mellon University; Pittsburgh Pennsylvania USA
| | - Z. Jurányi
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
| | - T. Tritscher
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
| | - J. Dommen
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
| | | | - M. Gysel
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
| | - E. Weingartner
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
| | - U. Baltensperger
- Laboratory of Atmospheric Chemistry; Paul Scherrer Institut; Villigen Switzerland
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Heiligenhaus A, Michels H, Schumacher C, Kopp I, Neudorf U, Niehues T, Baus H, Becker M, Bertram B, Dannecker G, Deuter C, Foeldvari I, Frosch M, Ganser G, Gaubitz M, Gerdes G, Horneff G, Illhardt A, Mackensen F, Minden K, Pleyer U, Schneider M, Wagner N, Zierhut M. Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Rheumatol Int 2011; 32:1121-33. [DOI: 10.1007/s00296-011-2126-1] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 08/22/2011] [Indexed: 12/14/2022]
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18
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Dueckers G, Guellac N, Arbogast M, Dannecker G, Foeldvari I, Frosch M, Ganser G, Heiligenhaus A, Horneff G, Illhardt A, Krauspe R, Markus B, Michels H, Schneider M, Singendonk W, Sitter H, Spamer M, Wagner N, Niehues T. Interdisziplinäre S2-Therapieleitlinie der Juvenilen Idiopathischen Arthritis (2. Auflage). Klin Padiatr 2011; 223:386-94. [DOI: 10.1055/s-0031-1287837] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Dressler F, Frosch M, Mönkemöller K, Thon A, Weißbarth-Riedel E, Horneff G. Results of the German ESPED-Recording of New Patients with Juvenile Dermatomyositis (JDM). Klin Padiatr 2011; 223:280-2. [DOI: 10.1055/s-0031-1273723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Valenza G, Müller S, Schmitt C, Turnwald D, Lam TT, Frosch M, Abele-Horn M, Pfeifer Y. Evaluation of the VITEK 2 AST-N111 card for detection of extended-spectrum beta-lactamases (ESBLs) in Escherichia coli, Klebsiella pneumoniae, and Klebsiella oxytoca compared to ESBL Etests and combination disk methods. Eur J Clin Microbiol Infect Dis 2011; 30:869-72. [PMID: 21271268 DOI: 10.1007/s10096-011-1169-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 01/08/2011] [Indexed: 11/26/2022]
Abstract
The VITEK 2 AST-N111 card was evaluated for detection of extended-spectrum beta-lactamases (ESBLs) by testing 51 ESBL positive and 50 ESBL negative isolates of E. coli, K. pneumoniae, and K. oxytoca. The occurrence of beta-lactamase genes was confirmed by PCR and sequencing. The advanced expert system (AES) of the VITEK 2 system achieved sensitivity and specificity values of 100% and 96.0%, respectively. The ESBL test of the VITEK 2 AST-N111 card showed a sensitivity of 92.1% and a specificity of 90.0%. Contradictory results obtained with the two VITEK 2 tools could be clarified by combination disk tests in nine of 11 isolates. The combined use of AES and ESBL tests of the AST-N111 card in association with combination disk tests in case of contradictory results seems to be a reliable method for ESBL detection.
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Affiliation(s)
- G Valenza
- Institute of Hygiene and Microbiology, University of Wuerzburg, Josef-Schneider-Str. 2 / E1, 97080, Wuerzburg, Germany.
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Kleinert S, Kurzai O, Elias J, Marten K, Engelke C, Feuchtenberger M, Sandstede J, Frosch M, Tony HP, Kneitz C. Comparison of two interferon-gamma release assays and tuberculin skin test for detecting latent tuberculosis in patients with immune-mediated inflammatory diseases. Ann Rheum Dis 2010; 69:782-4. [PMID: 20185504 DOI: 10.1136/ard.2009.113829] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Objective A commercial cysticercosis Western blot was evaluated for serological cross-reactivity of sera from patients with alveolar (AE) and cystic echinococcosis (CE). Methods A total of 161 sera were examined, including 31 sera from AE-patients, 11 sera from CE-patients, 9 sera from patients with other parasitic diseases and 109 sera from patients with unrelated medical conditions. All AE-and CE-sera were also examined by the echinococcosis Western blot. Results More sera from patients with AE than with CE showed cross-reactivity in the form of ladder-like patterns ("Mikado aspect") and untypical bands at 6-8 kDa (71% and 77.4% versus 27.3% and 45.5%, respectively). In contrast, triplets of bands in the area above 50 kDa and between 24 and 39-42 kDa were more frequent in CE than in AE sera. The fuzzy band at 50-55 kDa typical for cysticercosis was absent in all AE and CE sera. Conclusions Atypical banding patterns in the cysticercosis Western blot should raise the suspicion of a metacestode infection different from Taenia solium, i.e. Echinococcus multilocularis or E. granulosus, especially when the Mikado aspect and an altered 6-8 kDa band is visible in the absence of a fuzzy 50-55 kDa band.
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Affiliation(s)
- Dennis Tappe
- Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
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Affiliation(s)
- D Tappe
- Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
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Frosch M, Viemann D, Wittkowski H, Foell D, Vogl T, Barczyk K, Wulffraat N, Roth J. The TLR4 ligands MRP8 and MRP14 in the diagnosis and pathogenesis of systemic onset juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334093 DOI: 10.1186/1546-0096-6-s1-p34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Schnarr S, Hammer M, Frosch M. Fortschritte im pathogenetischen Verständnis und in der diagnostischen Erregeridentifikation. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043650] [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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Ehlert K, Frosch M, Roth J, Juergens H, Vormoor J. 235: Long Term Follow-Up in Three Pediatric Patients with Farber Disease, Type 2/3, following Allogeneic Hematopoietic Stem Cell Transplantation from Related and Unrelated Donors. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.244] [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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Abstract
Systemic juvenile idiopathic arthritis (SJIA) is characterized by the clinical features of remitting fever, a typical skin rash and arthritis. Many patients show frequent flares or persistent disease activity with significant morbidity and serious complications. Recent investigations in the pathophysiology of SJIA have focused on mediators of the innate immune system. Especially IL-1beta, IL-6 and IL-18 as well as phagocyte-specific S100-proteins (S100A8, S100A9 and S100A12) are correlated with disease activity and secondary complications. Beside IL-6 all these molecules are secreted by a so-called alternative pathway. A loss of control of the alternative secretory pathway seems to be involved in release of pro-inflammatory proteins leading to the inflammatory process of SJIA. These insights lead to new promising treatment approaches, like application of recombinant anti-IL-1 receptor antagonist or anti-IL-6 receptor antibodies in patients resistant to conventional anti-inflammatory treatment. First case studies show improvement and remission on therapy in a substantial portion of these patients. In this review, we summarize the current knowledge of pathophysiology and experiences in the treatment of SJIA.
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Affiliation(s)
- M Frosch
- University of Muenster, Department of Paediatrics, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany.
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Abstract
Infectious uveitis caused by Borrelia, tuberculosis or syphilis is a rare condition, even in childhood. Because these diseases can be treated successfully, knowledge of their diagnosis and therapy is highly important. The clinical aspects vary from simple conjunctivitis to endophthalmitis or neuro-ophthalmological diseases. The diagnosis of and therapy for borreliosis depend on the stage of the disease. The involvement of different organ systems or positive indirect tests (tuberculin skin test, interferon gamma assays) are important factors in the diagnosis of tuberculosis as the cause of a uveitis. Serology is essential for the diagnosis and monitoring of syphilis.
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Affiliation(s)
- T Ness
- Universitäts-Augenklinik Freiburg.
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Abstract
Systemic and topical corticosteroids constitute an important part in the treatment of children with uveitis, because of their rapid therapeutic onset. Patients with anterior uveitis receive eye drops initially every 30 minutes or every hour. Children will experience the same side effects as adults but, in addition, there will be a growth retardation. Therefore, if treatment is required for extended periods of time it is important to avoid steroid quantities above the Cushing level and to initiate an additional systemic immunosuppressive treatment regimen early.
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Affiliation(s)
- S R Thurau
- Augenklinik der Ludwig-Maximilians-Universität, München.
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Abele-Horn M, Stoy K, Frosch M, Reinert RR. Comparative evaluation of a new Vitek 2 system for identification and antimicrobial susceptibility testing of Streptococcus pneumoniae. Eur J Clin Microbiol Infect Dis 2007; 25:55-7. [PMID: 16424974 DOI: 10.1007/s10096-005-0071-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M Abele-Horn
- Institute for Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Strabe 2, 97080 Würzburg, Germany.
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Tappe D, Claus H, Kern J, Marzinzig A, Frosch M, Abele-Horn M. First case of febrile bacteremia due to a wild type and small-colony variant of Escherichia coli. Eur J Clin Microbiol Infect Dis 2007; 25:31-4. [PMID: 16418831 DOI: 10.1007/s10096-005-0072-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reported here is a case of a febrile illness caused by a wild type and small-colony variant of Escherichia coli in an anorectic patient. A review of the literature revealed that the formation of small-colony variants in E. coli has been recognized since 1931. In recent years, an association has been established between those variants and chronic recurrent infections. This report describes for the first time the isolation of an E. coli small-colony variant from a blood culture of a patient who had suffered from chronic urinary tract infections in the past.
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Affiliation(s)
- D Tappe
- Institute of Hygiene and Microbiology, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany.
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Elias J, Reinhardt M, Hautmann W, Harms I, Oppermann H, Schröter M, Hellenbrand W, Oster P, Kurzai O, Taha MK, Nossal R, Frosch M, Vogel M. 3. Würzburger Workshop zur Epidemiologie, Prävention und Therapie der invasiven Meningokokkenerkrankung 2006. Gesundheitswesen 2007; 69:256-62. [PMID: 17533569 DOI: 10.1055/s-2007-973087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
On October 5th, 2006, the German Reference Centre for Meningococci (NRZM) held the 3rd Workshop on Epidemiology, Prevention and Treatment of Invasive Meningococcal Disease, in collaboration with the German Society for Hygiene and Microbiology (DGHM). Given the recent recommendation of the German Standing Committee on Vaccination (STIKO) for conjugate meningococcal C vaccination of all children in the second year of life, observations from meningococcal C conjugate vaccination campaigns in other European countries were presented and compared to the German situation. Moreover, the newly implemented cluster detection routines employed at the NRZM and their integration into the interactive geographical information system EpiScanGIS were shown. Based on recent experiences from regional outbreaks in Oberallgäu, Sangerhausen, and Greater Aachen, examples for public health intervention were given at the conference. In addition, current developments in the area of meningococcal research, as well as trends in antimicrobial susceptibility were covered. Finally, the latest evidence concerning the clinical management and chemoprophylaxis of this invasive bacterial disease was discussed.
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Affiliation(s)
- J Elias
- Nationales Referenzzentrum für Meningokokken, Institut für Hygiene und Mikrobiologie, Universität Würzburg, Germany.
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Reinhardt M, Elias J, Albert J, Frosch M, Vogel U, Harmsen D. P1246 EpiScanGIS: a geographical information system for laboratory surveillance of meningococcal disease in Germany. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71086-5] [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: 11/15/2022]
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Valenza G, Ruoff C, Vogel U, Frosch M, Abele-Horn M. P1720 Evaluation of the new VITEK 2 NH identification card. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Otto-Karg I, Jandl S, Müller T, Stirzel B, Vogel U, Frosch M, Hebestreit H, Abele-Horn M. P1719 Validation of VITEK 2 GN Cards and VITEK 2 Version 4.02 Software for identification and antimicrobial susceptibility testing of nonfermenting Gram-negative bacilli from cystic fibrosis patients. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71558-3] [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: 12/01/2022]
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Ehlert K, Roth J, Frosch M, Fehse N, Zander N, Vormoor J. Farber's disease without central nervous system involvement: bone-marrow transplantation provides a promising new approach. Ann Rheum Dis 2006; 65:1665-6. [PMID: 17105855 PMCID: PMC1798467 DOI: 10.1136/ard.2005.048322] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Müller C, Vogel U, Frosch M, Berner R. Vergleichende Genomanalyse von Meningokokken zur Identifizierung von Virulenzfaktoren – Ergebnisse erfordern prospektive Untersuchung. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946046] [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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Müller C, Vogel U, Frosch M, Berner R. Vergleichende Genomanalyse von Meningokokken zur Identifizierung von Virulenzfaktoren – Ergebnisse erfordern prospektive Untersuchung. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943131] [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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Klucken J, Ingelsson M, Shin Y, Irizarry MC, Hedley-Whyte ET, Frosch M, Growdon J, McLean P, Hyman BT. Clinical and biochemical correlates of insoluble alpha-synuclein in dementia with Lewy bodies. Acta Neuropathol 2006; 111:101-8. [PMID: 16482476 DOI: 10.1007/s00401-005-0027-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Revised: 11/28/2005] [Accepted: 11/28/2005] [Indexed: 11/25/2022]
Abstract
Alpha-synuclein is a major constituent of Lewy bodies, the fibrillar aggregates that form within neurons in Parkinson's disease and dementia with Lewy bodies (DLB). Recent biochemical data show that alpha-synuclein accumulates in Parkinson's disease in a detergent insoluble form. We now examine the relationship between detergent insoluble alpha-synuclein and the presence of Lewy bodies, clinical measures of dementia and biochemical parameters in a series of individuals with DLB. We found that Triton X-100 insoluble alpha-synuclein enriched nearly twofold in the temporal cortex of patients with DLB compared to age-matched controls. By contrast the total amount of alpha-synuclein protein was unchanged. Surprisingly, the degree of Triton X-100 insoluble alpha-synuclein did not correlate with either the duration of illness or the number of Lewy bodies counted using stereological methods from an adjacent block of tissue. However, the Triton X-100 soluble fraction of alpha-synuclein did correlate strongly with the expression of several heat shock proteins (HSPs) in DLB but not control cases, suggesting a coordinated HSP response in DLB neocortex.
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Affiliation(s)
- J Klucken
- Department of Neurology, MassGeneral Institute for Neurodegenerative disease, Massachusetts General Hospital, 114 16th Street, Charlestown, MA 02129, USA
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Valenza G, Kallmann B, Berend A, Mlynski R, Nöckler K, Kurzai O, Frosch M, Abele-Horn M. Isolation of Brucella melitensis from a patient with hearing loss. Eur J Clin Microbiol Infect Dis 2006; 25:67-8. [PMID: 16418830 DOI: 10.1007/s10096-006-0084-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Valenza
- Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany.
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Schulze zur Wiesch A, Foell D, Frosch M, Vogl T, Sorg C, Roth J. Myeloid related proteins MRP8/MRP14 may predict disease flares in juvenile idiopathic arthritis. Clin Exp Rheumatol 2004; 22:368-73. [PMID: 15144135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE An unsolved problem in juvenile idiopathic arthritis (JIA) is to identify patients at special risk for relapse. It is important to adjust anti-inflammatory and immunosuppressive therapy to the children's actual disease activity especially in times of remission. Our aim was to analyze if the serum levels of MRP8/MRP14 are reliable predictive markers for the risk of relapse in clinically inactive juvenile idiopathic arthritis. METHODS Serum concentrations of MRP8/MRP14 were determined by ELISA and correlated with laboratory and clinical parameters for disease activity in patients with JIA. 29 patients with changing disease activity were followed up for a mean time of 2.9 years. Two groups of patients--one before relapse (mean 3.7 months) but without clinical signs of disease reactivation, and one in remission for 12 further months--were compared. RESULTS MRP8/MRP14 serum levels in patients before relapses were significantly higher than the levels in patients in stable remission for one year (662 ng/ml versus 395 ng/ml; p < 0.05). Using a cut-off for MRP8/MRP14 of 450 ng/ml the likelihood ratio for relapse was 3.7 (positive predictive value 80%), while no differences were found for C-reactive protein and erythrocyte sedimentation rate between the two groups. CONCLUSION MRP8/MRP14 correlate with individual disease activity in patients with JIA. Our data suggest that local disease activity may be present even months before flares become clinically apparent. Serum levels of MRP8/MRP14 can give a hint as to clinically occult disease activity, in this way helping to adjust therapy in times of low disease activity.
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Vogel U, Elias J, Frosch M. Meningokokken-Erkrankungen in Deutschland: Bericht über die aktuelle epidemiologische Situation. Gesundheitswesen 2004. [DOI: 10.1055/s-2004-825163] [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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Foell D, Frosch M, Schulze zur Wiesch A, Vogl T, Sorg C, Roth J. Methotrexate treatment in juvenile idiopathic arthritis: when is the right time to stop? Ann Rheum Dis 2004; 63:206-8. [PMID: 14722212 PMCID: PMC1754897 DOI: 10.1136/ard.2003.005686] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate whether prolonged methotrexate (MTX) treatment after induction of remission influences the subsequent duration of remission in patients with juvenile idiopathic arthritis (JIA), and to analyse the usefulness of myeloid related proteins 8 and 14 (MRP8/MRP14) as predictive markers for the stability of remission at the time when MTX is withdrawn. METHODS Twenty five patients with oligoarticular and polyarticular JIA who received MTX to induce remission were followed up. MTX treatment was stopped after a mean of 3.8 months (group 1) or 12.6 months (group 2) after remission was documented. Differences in the number of relapses between these groups were looked for. Additionally, MRP8/MRP14 were analysed by ELISA in 22 patients. RESULTS No difference was found in the number of relapses between patients with prolonged or early discontinued MTX treatment. Patients who were in stable remission had significantly lower MRP levels when MTX was discontinued than patients with relapses. With a cut off point for MRP8/MRP14 at 250 ng/ml, sensitivity and specificity were 100% and 70%, respectively. CONCLUSION Longer duration of MTX treatment after induction of remission does not generally improve the status of remission in patients with JIA. Residual synovial inflammation seems to influence the rate of relapses after discontinuation of MTX treatment. MRP8/MRP14 indicate residual activity even in the absence of other laboratory or clinical signs of continuing inflammation. Normal serum concentrations of MRP8/MRP14 in clinical inactive arthritis may help to identify patients in whom MTX can be safely withdrawn after remission is achieved.
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Affiliation(s)
- D Foell
- Department of Paediatrics, University of Muenster, Albert-Schweitzer-Str 33, D-48149 Muenster, Germany.
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Kurzai O, Vaeth T, Hamelmann W, Müller FMC, Klinker H, Langmann P, Frosch M, Mühlschlegel F. Combined surgical and antifungal treatment of a subcutaneous infection due to Paecilomyces lilacinus. Med Mycol 2003; 41:253-8. [PMID: 12964718 DOI: 10.1080/1369378031000147467] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 10/26/2022] Open
Abstract
Paecilomyces lilacinus was the causal agent of a case of subcutaneous infection in a patient with liver cirrhosis. Surgical treatment in combination with systemic amphotericin B therapy led to complete recovery. Retrospectively performed microdilution testing revealed dose dependent in vitro susceptibility of the isolate to voriconazole (MIC = 2 g/ml) and terbinafine (MIC = 1 microg/ml).
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Affiliation(s)
- O Kurzai
- Institute of Hygiene and Microbiology, Department of Internal Medicine, University of Würzburg, Germany.
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Abstract
We describe the isolation of the melanized meristematic fungus Pseudotaeniolina globosa from the aortic wall of a patient who died while undergoing surgery for aortic aneurysm and aortic valve regurgitation as a result of dilated cardiomyopathy. Meristematic fungi related to P. globosa have until now been considered as environmental saprobes found predominantly in ecological niches with low water activity. The isolate was identified by phenotypic analyses and by sequencing of the rDNA internal-transcribed spacer domain. The clinical significance of this isolation remains unclear but isolation of meristematic fungi from clinical specimen should be thoroughly evaluated in terms of their significance in future.
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Affiliation(s)
- O Kurzai
- Departments of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
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Wulffraat NM, Haas PJ, Frosch M, De Kleer IM, Vogl T, Brinkman DMC, Quartier P, Roth J, Kuis W. Myeloid related protein 8 and 14 secretion reflects phagocyte activation and correlates with disease activity in juvenile idiopathic arthritis treated with autologous stem cell transplantation. Ann Rheum Dis 2003; 62:236-41. [PMID: 12594109 PMCID: PMC1754451 DOI: 10.1136/ard.62.3.236] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To determine whether myeloid related proteins (MRP8/MRP14), a complex of two S100 proteins related to neutrophil and monocyte activation, might be used as a marker for disease activity, and as an early indicator of relapse in juvenile idiopathic arthritis. PATIENTS AND METHODS A group of 12 patients who underwent an autologous haematopoietic stem cell transplantation (ASCT) for refractory juvenile idiopathic arthritis (JIA) were studied. MRP8/MRP14 serum concentrations were determined by a sandwich enzyme linked immunosorbent assay (ELISA) as described. Improvement from baseline was described by a definition of improvement employing a core set of criteria as detailed previously by Giannini. RESULTS After ASCT, MRP8/MRP14 serum concentrations in JIA showed a positive correlation with the Child Health Assessment Questionnaire (CHAQ; r=0.80) and erythrocyte sedimentation rate (r=0.45), but not with the total leucocyte count (r=0.26). Mean MRP8/MRP14 serum concentrations dropped markedly in the first three months after ASCT (p=0.0039) and clinical parameters of disease activity such as CHAQ markedly improved (p=0.0039). During a transient relapse there was an increase in MRP8/MRP14. CONCLUSIONS MRP8/MRP14 serum concentration can be used as a marker for disease activity in patients who receive an ASCT for refractory JIA. This indicates a role of macrophage activation in the pathogenesis of JIA. The occurrence of MAS in three patients in this study was not preceded by significant changes in MRP8/MRP14 concentration.
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Affiliation(s)
- N M Wulffraat
- Department of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands.
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Abstract
OBJECTIVE To evaluate sensitivity of arthrosonography of hip and knee joints for monitoring disease activity in juvenile rheumatoid arthritis (JRA). METHODS Twenty eight patients with JRA with active disease at entry in 15 hips and 38 knee joints were followed up three times in intervals of 4-6 weeks. Sonographic, clinical, and laboratory findings were documented at the same time in clinically active and inactive disease. As controls of the sonographic variables 10 children without a history of arthritis were examined by ultrasound. RESULTS In active arthritis of the hip joint 19/31 (61%) examinations showed a pathological widening of the synovial joint space. There was no significant correlation between sonographic and clinical measures of disease activity in coxitis. Marked effusion within the suprapatellar pouch was seen in 87% and thickening of the synovial membrane in 92% of cases of active gonarthritis in patients with JRA. There was a significant difference in the number of patients with joint effusion and in the mean joint effusion between patients with clinically active gonarthritis at entry and inactive arthritis at follow up (p<0.001). In contrast, synovial thickening persisted in about 80% after induction of clinical remission. CONCLUSION The data confirm the high sensitivity of arthrosonography in imaging changes in hip and knee joints of patients with JRA. Sonographic effusion of the knee provided the highest correlation with measures of clinical disease activity. Further prospective studies should evaluate whether persistent thickening of the synovial membrane detected by ultrasound in clinically inactive arthritis indicates residual inflammatory activity and an increased risk of relapse.
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Affiliation(s)
- M Frosch
- Department of Paediatrics, University of Muenster, Albert-Schweitzer-Str 33, D-48149 Muenster, Germany.
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