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Seefried L, Banholzer D, Fischer R, Grafe I, Hüning I, Morhart R, Oheim R, Semler O, Siggelkow H, Stockklausner C, Hoyer-Kuhn H. [Recommendations for the healthcare of patients with FOP]. Orthopadie (Heidelb) 2023; 52:924-930. [PMID: 37603129 PMCID: PMC10622346 DOI: 10.1007/s00132-023-04425-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Fibrodysplasia ossificans progressiva (FOP) is a very rare, severe genetic disorder triggered by a gain-of-function mutation in the ACVR1 gene that codes for the type I bone morphogenetic protein (BMP) receptor ACVR1 (activin A receptor-type 1), also known as ALK2 (activin receptor-like kinase-2). It leads to the onset and progression of heterotopic ossification (HO) in soft and connective tissue. HO is often preceded by episodes of soft tissue swelling or flare-ups. Flare-ups, characteristic of FOP, may be induced by trauma, infection, vaccination, or other medications, as well as surgical procedures or may occur spontaneously. As patients age, they develop severe mobility limitations due to progressive HO formation, including immobility, causing a shortened life expectancy. FOP's first characteristic clinical sign is the congenital malformation of one or both big toes with valgus axis deviation, which is present in almost all patients. To confirm the diagnosis, molecular genetic analysis of the ACVR1 gene is possible. AIM OF THE RECOMMENDATIONS This white paper aims to provide an overview of the necessary prerequisites and conditions for the care of patients with FOP and positively contribute to patients with FOP by improving the overall availability of knowledge. To achieve this, relevant aspects of the care of the very rare disease FOP are presented, from the initial diagnosis to the care in regular care based on the authors' knowledge (German FOP network) and the international FOP Treatment Guidelines. The recommendations presented here are addressed to all actors and decision-makers in the health care system and are also intended to inform patients and the public.
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Affiliation(s)
- L Seefried
- Osteologie/Klinische Studieneinheit, Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Deutschland.
| | - D Banholzer
- Sozialpädiatrisches Zentrum, Standort Mitte - Olgahospital, Haus M - Pädiatrie 1, Klinikum Stuttgart, Kriegsbergstr. 60, 70174, Stuttgart, Deutschland
| | - R Fischer
- FOP e. V., c/o Ralf Fischer, Frankfurter Landstr. 11a, 61440, Oberursel, Deutschland
| | - I Grafe
- Medizinische Klinik und Poliklinik III, Bereich Endokrinologie und Stoffwechsel, Diabetes, Knochenerkrankungen, UniversitätsCentrum für Gesundes Altern, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Zentrum für Metabolisch-Immunologische Erkrankungen und Therapietechnologien Sachsen (MITS), Technische Universität Dresden, Dresden, Deutschland
| | - I Hüning
- Institut für Humangenetik, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - R Morhart
- , Triftstr. 12, 82467, Garmisch-Partenkirchen, Deutschland
| | - R Oheim
- Institut für Osteologie und Biomechanik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - O Semler
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Köln, Deutschland
- Medizinische Fakultät und Uniklinik Köln, Zentrum für seltene Erkrankungen, Universität zu Köln, Köln, Deutschland
| | - H Siggelkow
- Zentrum für Endokrinologie, Osteologie, Rheumatologie, Nuklearmedizin und Humangenetik, MVZ ENDOKRINOLOGIKUM Göttingen, 37075, Göttingen, Deutschland
- Klinik für Gastroenterologie, gastrointestinale Onkologie und Endokrinologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Stockklausner
- Abteilung Kinder & Jugendmedizin, Klinikum Garmisch-Partenkirchen, Auenstr. 6, 82467, Garmisch-Partenkirchen, Deutschland
| | - H Hoyer-Kuhn
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Köln, Deutschland.
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Witzel JC, Giessel A, Heppner C, Lamersdorf A, Leha A, Glüer CC, Siggelkow H. Discrepancies Between Osteoporotic Fracture Evaluations in Men Based on German (DVO) Osteoporosis Guidelines or the FRAX Score. Exp Clin Endocrinol Diabetes 2023; 131:114-122. [PMID: 36368694 DOI: 10.1055/a-1977-4413] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Established scores estimate 10-year fracture risk in osteoporosis to assist with treatment recommendations. This study compared the risk probabilities of major osteoporotic and hip fractures calculated by the FRAX tool with those of the DVO score, established in German-speaking countries. MATERIAL AND METHODS This seven-year retrospective study analyzed data of 125 male patients (mean age: 59.2±10.7 years) evaluated for osteoporosis. For the DVO score, the therapy threshold of>30% for vertebral and hip fractures suggested by DVO guidelines was implemented. We calculated fracture risks based on FRAX scores with aBMD and applied a common therapy threshold of≥3% for hip fracture and subsequently determined the "DVO-equivalent risk level" for FRAX-based assessment that would identify as many male patients as identified by the DVO score. RESULTS Based on DVO score, 60.0% of patients had a 10-year risk of hip and vertebral fractures>30%. The recommendations for individuals based on FRAX scores for hip fracture with aBMD with risk≥3% overlapped with those based on DVO score in 36% of patients. Patients identified for treatment only by DVO score presented a higher percentage of spine fractures (65 vs. 41%). The thresholds for this "DVO-equivalent risk level" for 'FRAX with aBMD' was estimated to be≥6.7% for major osteoporotic fracture and≥2.1% for hip fracture.This study demonstrates that the DVO score was more sensitive than the FRAX score for patients with prevalent spinal fractures. We suggest considering the appropriate score and therapy threshold carefully in the daily care of male patients.
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Affiliation(s)
- J C Witzel
- Clinic of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Robert-Koch-Str. Göttingen, Germany.,MVZ Endokrinologikum Göttingen, Von-Siebold-Str. Göttingen, Germany
| | - A Giessel
- Clinic of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Robert-Koch-Str. Göttingen, Germany
| | - C Heppner
- MVZ Endokrinologikum Göttingen, Von-Siebold-Str. Göttingen, Germany
| | - A Lamersdorf
- MVZ Endokrinologikum Göttingen, Von-Siebold-Str. Göttingen, Germany
| | - A Leha
- Institute for Medical Statistics, University Medical Center Göttingen, Humboldtallee Göttingen, Germany
| | - C C Glüer
- Section Biomedical Imaging, Department of Radiology and Neuroradiology, MOINCC, Kiel, Germany
| | - H Siggelkow
- Clinic of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Robert-Koch-Str. Göttingen, Germany.,MVZ Endokrinologikum Göttingen, Von-Siebold-Str. Göttingen, Germany
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Thomasius F, Baum E, Bernecker P, Böcker W, Brabant T, Clarenz P, Demary W, Dimai HP, Engelbrecht M, Engelke K, Fratermann U, Grieser T, Gulich M, Hadji P, Henning J, Jehle PM, Kern PM, Ketteler M, Klatt G, Kraenzlin M, Maus U, Meier C, Moser U, Müller D, Peichl P, Pfeifer M, Rintelen B, Rueger JM, Schober HC, Schöffel D, Schwarz H, Siggelkow H, Suhm N, Wiese KG, Wörtler K, Kurth AA. DVO Leitlinie 2017 zur Prophylaxe, Diagnostik und Therapie der Osteoporose bei postmenopausalen Frauen und Männern. ACTA ACUST UNITED AC 2018. [DOI: 10.1055/s-0038-1673537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
ZusammenfassungDiese DVO Leitlinien, die in erster Linie für Allgemeinmediziner und Spezialisten für Knochenerkrankungen bestimmt sind, sollten von allen im klinischen und ambulanten Bereich tätigen medizinischen Fachkräften angewendet werden. Ziel der Leitlinie ist die Verbesserung der Diagnose, Prävention und Behandlung von Osteoporose und der Folgen der Erkrankung auf der Grundlage evidenzbasierter Medizin.Klare Empfehlungen, welche Patienten zu diagnostizieren und behandeln sind (basierend auf Risikofaktoren [einschließlich sekundärer Osteoporose]) sowie Primär-, Sekundär- oder Tertiärprävention werden dargestellt, mit dem Schwerpunkt auf der postmenopausalen Osteoporose und der Osteoporose bei Männern.Die Identifizierung von Patienten mit einem hohen Risiko für Frakturen wird hervorgehoben, und spezifische Schwellenwerte für die Intervention sind definiert (20 % Hüftfrakturrisiko innerhalb von 10 Jahren diagnostischer Schwellenwert, 30 % Hüftfrakturrisiko innerhalb von 10 Jahren therapeutische Schwelle). Die Diagnose von Osteoporose basiert auf der Anamnese des Patienten, der körperlichen Untersuchung, dem Funktionstest (z. B. Timed Up and Go Test), konventionellen Röntgenaufnahmen der Brust- und Lendenwirbelsäule und der Bestimmung der Knochenmineraldichte (BMD) durch das DXA Verfahren.Die Anamnese ist entscheidend für die Abschätzung des Frakturrisikos auf der Grundlage von 40 wissenschaftlich überprüften Risikofaktoren, die das Frakturrisiko mindestens verdoppeln (z. B. Begleiterkrankungen, Hüftfrakturen in der Familie, prävalente Frakturen an jedem Ort, Lebensstil, Anwendung von Medikamenten, körperliche Aktivität und Stürze). Röntgenaufnahmen der Brust- und Lendenwirbelsäule sind wichtig, um prävalente Wirbelkörperfrakturen zu erkennen. Beim Fehlen eines großen Traumas kann jede Fraktur bei Erwachsenen über dem Alter von 50 Jahren eine Diagnose von Osteoporose nahelegen, mit dem höchsten Risiko für eine nachfolgende Fraktur innerhalb einer kurzen Zeit nach der ersten Fraktur. BMD-Messungen mit DXA sind wichtig, um das individuelle Frakturrisiko besser abschätzen zu können. Eine grundlegende Laboruntersuchung ist obligatorisch, um verschiedene Formen der sekundären Osteoporose ausschließen zu können.Der DVO-Patientenfindungs-Algorithmus basiert auf dem Geschlecht, Alter, Knochenmineraldichte und vorbestehenden Frakturen als wichtigste Informationen. Die Indikation für eine aktive anti-osteoporotische Therapie kann durch multiple Risikofaktoren modifiziert und verfeinert werden. Dieser Algorithmus wurde seit dem Richtlinien-Update 2006 verwendet und wurde entsprechend der internationalen Literatur zu Risikofaktoren für Osteoporose und osteoporotische Frakturen aktualisiert und angepasst.Die Behandlung der Osteoporose enthält viele Therapiepfeiler. Zusammen mit Empfehlungen für Bewegung, Physiotherapie und Sturzprävention sowie Ernährung (z. B. Calcium, Vit. D), werden pharmakologische Behandlungen basierend auf evidenzbasierter Medizin empfohlen. Die aktiven Anti-Osteoporose-Medikamente müssen für die Indikation postmenopausale Osteoporose und männliche Osteoporose in Deutschland, Österreich und der Schweiz zugelassen sein. Das Management und die Vorbeugung von häufigen oder seltenen Nebenwirkungen aufgrund von Anti-Osteoporose-Behandlungen, die in der klinischen Praxis angewendet werden, werden ebenfalls detailliert behandelt.
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Haumann H, Weltermann B, Viehmann A, Grussendorf M, Jaursch-Hancke C, Karger S, Lederbogen S, Siggelkow H, Berndt P, Schelling J, Struewer E, Weckbecker K, Führer D. Endocrinologists' opinions on the quality of health care in patients with endocrine disorders: Objective, design and and first results of the german dialogue project “Selecting Wisely” involving general practicioners and endocrinologists. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547616] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sahlmann CO, Meller J, Siggelkow H, Homayounfar K, Ozerden M, Braune I, Kluge G, Meller B. Patients with autoimmune thyroiditis. Prevalence of benign lymphadenopathy. Nuklearmedizin 2012; 51:223-7. [PMID: 23042429 DOI: 10.3413/nukmed-0484-12-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/31/2012] [Indexed: 01/27/2023]
Abstract
UNLABELLED The prevalence of cervical lymphadenopathy in autoimmune thyroiditis (AIT) patients is actually unknown. The aim of the study was the detailed retrospective evaluation of 6 index-patients with lymphadenopathy in Robbins level VI and a prospective study with high resolution ultrasound of lymphadenopathy in AIT patients compared with controls in all compartments of the neck, accessible to sonographic evaluation. PATIENTS, METHODS The retrospective study comprises six patients with AIT, evaluated for enlarged Robbins level VI-LN. We report the findings of fine-needle aspiration Cytology, clonal analysis, histology, and serological testing. The prospective study evaluated the prevalence of lymphadenopathy in 49 consecutive patients with AIT (group 1) and 49 consecutive patients with normal thyroids or nontoxic goiter (group 2). RESULTS In the retrospective study, cytology of paratracheal LN revealed reactive lymphoid hyperplasia in 5/6 of the cases and a centroblastic lymphoma in one patient. The presence of monoclonal lymphatic cells was excluded in 5/6 patients and proven in 1/6 patients. Actual viral-infections were ruled out. In the prospective study AIT-patients showed significantly more enlarged LN in Robbins level II-IV and VI compared to controls. We found no correlation between lymphadenopathy, age, thyroid volume and nodularity, or autoantibody levels. During follow-up in 34 group 1-patients, lymphadenopathy remained stable in 28 patients, and decreased in 6 patients. CONCLUSION Lymphadenopathy in Robbins level II-IV and VI is common in AIT-patients and most probably related to the autoimmune process.
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Affiliation(s)
- C O Sahlmann
- Department of Nuclear Medicine, University Medical Centre (UMG), Göttingen, Germany
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Ponce ML, Koelling S, Kluever A, Heinemann DEH, Miosge N, Wulf G, Frosch KH, Schütze N, Hufner M, Siggelkow H. Coexpression of osteogenic and adipogenic differentiation markers in selected subpopulations of primary human mesenchymal progenitor cells. J Cell Biochem 2008; 104:1342-55. [PMID: 18286543 DOI: 10.1002/jcb.21711] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Knowledge of the basic mechanisms controlling osteogenesis and adipogenesis might provide new insights into the prevention of osteoporosis and age-related osteopenia. With the help of magnetic cell sorting and fluorescence activated cell sorting (FACS), osteoblastic subpopulations of mesenchymal progenitor cells were characterized. Alkaline phosphatase (AP) negative cells expressed low levels of osteoblastic and adipocytic markers. AP positive cells expressed adipocytic markers more strongly than the AP negative cell populations, thus suggesting that committed osteoblasts exhibit a greater adipogenic potential. AP negative cells differentiated to the mature osteoblastic phenotype, as demonstrated by increased AP-activity and osteocalcin secretion under standard osteogenic culture conditions. Surprisingly, this was accompanied by increased expression of adipocytic gene markers such as peroxisome proliferator-activated receptor-gamma2, lipoprotein lipase and fatty acid binding protein. The induction of adipogenic markers was suppressed by transforming growth factor-beta1 (TGF-beta1) and promoted by bone morphogenetic protein 2 (BMP-2). Osteogenic culture conditions including BMP-2 induced both the formation of mineralized nodules and cytoplasmic lipid vacuoles. Upon immunogold electron microscopic analysis, osteoblastic and adipogenic marker proteins were detectable in the same cell. Our results suggest that osteogenic and adipogenic differentiation in human mesenchymal progenitor cells might not be exclusively reciprocal, but rather, a parallel event until late during osteoblast development.
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Affiliation(s)
- M L Ponce
- Department of Gastroenterology and Endocrinology, Georg-August-University Goettingen, Goettingen, Germany
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Blaschke M, Giesen M, Baums M, Kopp R, Heikens J, Salinas-Riester G, Siggelkow H. Differential expression of ostoblast related genes in mesenchymal progenitor cells induced by serum of patients with active crohn's disease with and without osteoporosis. J Stem Cells Regen Med 2007; 2:47-48. [PMID: 24692898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- M Blaschke
- Department of Gastroenterology and Endocrinology, Georg-August-University , Goettingen, Germany
| | - M Giesen
- Department of Gastroenterology and Endocrinology, Georg-August-University , Goettingen, Germany
| | - M Baums
- Department of Orthopedic Surgery, Georg-August-University , Goettingen, Germany
| | - R Kopp
- Department of Gastroenterology and Endocrinology, Georg-August-University , Goettingen, Germany
| | - J Heikens
- Department of Molecular Cellbiology, Georg-August-University , Goettingen, Germany
| | - G Salinas-Riester
- Department of Molecular Cellbiology, Georg-August-University , Goettingen, Germany
| | - H Siggelkow
- Department of Gastroenterology and Endocrinology, Georg-August-University , Goettingen, Germany ; Endokrinologikum , Goettingen, Germany
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Braun PJ, Ritz V, Bähr V, Diederich S, Hüfner M, Siggelkow H. Transfection and overexpression of 11-ß-hydroxysteroid kinase type 1 in human osteosarcoma cells (HOS 58) and primary human osteoblasts. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932987] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Giesen M, Schäfer K, Hüfner M, Siggelkow H, Ritz V. Impact of RUNX2 knock down on human osteoblast differentiation. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rolf HJ, Wiese KG, Siggelkow H, Schliephake H, Bubernik GA. In vitro - studies with antler bone cells: Structure forming capacity, osteocalcin production and influence of sex steroids. ACTA ACUST UNITED AC 2006. [DOI: 10.1024/1019-1291.15.4.245] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Giesen M, Ponce ML, Viereck V, Hennies B, Hüfner M, Siggelkow H. Expression of transcription factors Osterix and Core binding factor alpha1 in two differentiating models of primary human osteoblasts in culture. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862987] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siggelkow H, Schmidt E, Hennies B, Hüfner M. Evidence of downregulation of matrix extracellular phosphoglycoprotein during terminal differentiation in human osteoblasts. Bone 2004; 35:570-6. [PMID: 15268910 DOI: 10.1016/j.bone.2004.03.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2003] [Revised: 03/10/2004] [Accepted: 03/30/2004] [Indexed: 10/26/2022]
Abstract
Matrix extracellular phosphoglycoprotein (MEPE) is an extracellular matrix protein that was first detected in tumor-induced osteomalacia (TIO). Investigations in mice revealed that MEPE is expressed in bone and teeth in a maturation-dependent manner, reaching its maximum during mineralization. However, from knockout experiments, although it has become clear that MEPE might function as a mineralization inhibitor, the exact mechanism of action is still unclear. Even less is known about the regulation of MEPE in men. Therefore, we have studied the time- and maturation-dependent expression of MEPE in two human osteoblast culture systems, the osteosarcoma cell line HOS 58 and primary trabecular osteoblasts. Cells were cultured for up to 29 days, and the influence of beta-glycerophosphate (bGP), ascorbate, transforming growth factor beta (TGF-beta), BMP-2, and dexamethasone was studied. HOS 58 cells showed no significant effect on MEPE gene expression up to 5.0 mM, but a significant inhibition was revealed at 10 and 20 mM, when osteocalcin (OC) expression was maximal. Under the same conditions, primary human osteoblasts showed no effect on MEPE gene expression. However, when cultured in the presence of 5 mM beta-glycerophosphate, ascorbate, and dexamethasone for 29 days, which are similar conditions to those described by Owen in his differentiation model in rat osteoblasts, a progressive inhibition of MEPE gene expression to 20% of the maximum was observed. Increasing osteocalcin expression indicated advancing differentiation. In conclusion, in contrast to the results in mice, when MEPE was maximally expressed during mineralization, in the human system, this factor seems to be maximally active in the proliferation and early matrix maturation phase. It was, however, strongly suppressed, associated with the mineralization phase.
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Affiliation(s)
- H Siggelkow
- Department of Gastroenterology and Endocrinology, Georg-August-University, Göttingen, Germany.
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Viereck V, Hofbauer LC, Gründker C, Blaschke S, Siggelkow H, Emons G. Raloxifen stimuliert Osteoprotegerin und hemmt Interleukin-6 in humanen Osteoblasten. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815214] [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] Open
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Hüfner M, Siggelkow H. [New data on the pathogenesis of steroid-induced osteoporosis: consequences for therapy and prevention]. Dtsch Med Wochenschr 2003; 128:1602-8. [PMID: 12884149 DOI: 10.1055/s-2003-40934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M Hüfner
- Schwerpunkt Endokrinologie, Abteilung Gastroenterologie und Endokrinologie, Medizinische Universitätsklinik, Zentrum Innere Medizin, Georg-August-Universität, Göttingen.
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Harms E, Siggelkow H, Buchfelder M, Saeger W, Hüfner M. [Macroadenoma of the pituitary gland with moderate hyperprolactinaemia]. Dtsch Med Wochenschr 2003; 128:667-70. [PMID: 12660899 DOI: 10.1055/s-2003-38281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
HISTORY AND CLINICAL FINDINGS A 46-year-old woman was referred to the neurosurgery department for treatment of a macroadenoma of the pituitary. She had complained of recurrent galactorrhoea for 7 years; a hysterectomy was performed 4 years ago. The clinical investigation was unremarkable, except for a slight galactorrheoa on both sides. INVESTIGATIONS The endocrinological work-up revealed a moderately elevated prolactin level of 3133 mU/l (147 ng/ml) with intact pituitary functions. She had no visual impairment and the MRI depicted a pituitary tumor with a maximal diameter of 1.9 cm and both intra- and suprasellar extension. DIAGNOSIS, TREATMENT AND CLINICAL COURSE The diagnosis of a nonfunctioning macrodenoma with functional hyperprolactinemia was made and a selective transsphenoidal adenomectomy was performed. The primary histology showed a chromophobe adenoma. However, additional immunohistological investigations revealed distinct staining for prolactin. In the meantime, because of persistent galactorrhea and elevated prolactin levels, treatment with cabergolin 0.5 mg/week was started. This stopped galactorrhea and normalized the prolactin levels. A follow-up MRI after 3 months of treatment showed a significant shrinkage of the residual tumor. CONCLUSION This case demonstrates that the differential diagnosis of macroprolactinoma with low secretory activity and functional hyperprolactinemia is very difficult preoperatively in individual cases. This is relevant because macroprolactinomas with low secretory activity can also be treated successfully with dopamine agonists. We therefore suggest a drug treatment trial with dopamine agonists in all macroadenoms with hyperprolactinemia, particularly in those with prolactin levels above 2000 mU/l (100 ng/ml).
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Affiliation(s)
- E Harms
- Schwerpunkt Endokrinologie, Abteilung Gastroenterologie u. Endokrinologie, Universität Göttingen
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Frosch KH, Barvencik F, Lohmann CH, Viereck V, Siggelkow H, Breme J, Dresing K, Stürmer KM. Migration, matrix production and lamellar bone formation of human osteoblast-like cells in porous titanium implants. Cells Tissues Organs 2002; 170:214-27. [PMID: 11919409 DOI: 10.1159/000047925] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [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: 11/19/2022] Open
Abstract
The goal of this study was to characterize growth, mineralization and bone formation of osteoblast-like cells in titanium pore channels of defined diameter. Titanium implants with continuous drill channels of diameters of 300, 400, 500, 600 and 1,000 microm were inserted into human osteoblast-like cell cultures. The ingrowth of the cells into the drill channels was investigated by transmitted-light microscopy and scanning electron microscopy. Immunofluorescence and histological analysis of 15-channel sections of each diameter were used to investigate the growth behavior and the matrix protein patterns. Mineralization was evidenced by Alizarin red staining and high-resolution microradiography. The ingrowth of human osteoblast-like cells in the drill channels occurred in a sequence of four characteristic stages. In stage 1, osteoblast precursor cells adhered to the wall of the channel and migrated three-dimensionally into the channel by forming foot-like protoplasmic processes. For all 15 sample drill channels that were investigated, the cell ingrowth over 20 days amounted on average to 793 microm (+/- 179) into 600-microm-diameter channels, where they migrated significantly faster than in all the other channels. In stage 2, approximately on day 5-7, the osteoblast-like cells began to anchor on the substrate wall by matrix proteins and to build up a dense network of matrix proteins in the drill channel. The mineralization of the extracellular matrix, while depending on cell stimulation, was initiated in stage 3, on average after 4 weeks. In drill channels of a diameter of 1,000 microm the cell growth was incomplete and no mineralization was found by radiological assessment. Starting in week 6, in the drill channels of diameters ranging from 300 to 600 microm, the network of extracellular matrix proteins and osteoblast-like cells began to form an osteon-like structure. Neither the highly developed migration behavior of osteoblastic cells nor the reorganization from a fiber-like matrix to a lamellar structure have so far been described for cell cultures.
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Affiliation(s)
- K-H Frosch
- Department of Traumatology, Plastic and Reconstructive Surgery, Georg August University, Göttingen, Germany.
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18
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Hüfner M, Siggelkow H. Therapie der Osteoporose mit Fluoriden. AKTUEL RHEUMATOL 2001. [DOI: 10.1055/s-2001-18141] [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: 10/17/2022]
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19
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Siggelkow H, Melzer A, Nolte W, Karsten K, Hoppner W, Hufner M. Presentation of a kindred with familial medullary thyroid carcinoma and Cys611Phe mutation of the RET proto-oncogene demonstrating low grade malignancy. Eur J Endocrinol 2001; 144:467-73. [PMID: 11331212 DOI: 10.1530/eje.0.1440467] [Citation(s) in RCA: 17] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Both multiple endocrine neoplasia type 2A (MEN 2A) and familial medullary thyroid carcinoma (FMTC) are caused by germline mutations of the RET proto-oncogene. A broad spectrum of malignancy within and between families has been described with no clear genotype-phenotype correlation due to a scarcity of available data of large kindreds. DESIGN Here we present the only known family with a germline mutation of codon 611 TGC to TTC (exon 10) in the RET proto-oncogene leading to a replacement of cysteine by phenylalanine (Cys611Phe or C611F). RESULTS Twenty family members of this large kindred are gene carriers (GCs) and seven (5-13 years old) are potential carriers but have yet to be analysed. The clinical course of medullary thyroid carcinoma (MTC) in this family is characterized by a very slow evolution and progression of the tumour with no MTC-related death to date. Of 11 patients (30-69 years old) having undergone thyroidectomy six were classified as pT1, four as pT2 and one as C-cell hyperplasia according to the TNM system of the International Union Against Cancer. Due to cervical and mediastinal lymph node metastasis one patient (44 years old) had to be operated on a second time. The seven non-operated GCs of the fourth and fifth generation (17-26 years old) are yearly monitored with pentagastrin stimulation tests; one non-operated GC (43 years old) has refused any further investigations. Screening for primary hyperparathyroidism and phaeochromocytoma was negative in all cases. CONCLUSION We suggest from these experiences that the general advice for thyroidectomy in early childhood should be modified in certain families, depending on genotype.
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Affiliation(s)
- H Siggelkow
- Department of Gastroenterology and Endocrinology, Georg-August-University, Gottingen, Germany.
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20
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Abstract
The human cysteine-rich protein 61 (hCYR61) belongs to the growing CCN (CYR61/CTGF/NOV) family of immediate early genes, which modulate cell growth and differentiation. hCYR61 is regulated by 1alpha, 25-dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) and growth factors in fetal human osteoblasts (hFOB cells). The murine homologue CYR61 was characterized as an extracellular matrix-associated protein that modulates basic fibroblast growth factor signaling, angiogenesis, and binds to integrin alpha(v)beta(3). Here we report the intracellular localization of the human CYR61 gene product by overexpressing fusion proteins with green fluorescent protein (GFP) in primary osteoblasts and the hFOB cell line. Full-length hCYR61-GFP localizes to the Golgi apparatus and cytoplasmatic granules, indicating targeting to the secretory pathway. Secretion of hCYR61 from osteoblasts is verified by Western blot detection from cellular supernatants. A truncated hCYR61-GFP fusion protein containing only the 34 N-terminal amino acids of hCYR61 also localizes to the Golgi apparatus mainly in the perinuclear region, which suggests that the N-terminus of hCYR61 is sufficient to target the protein to the secretory pathway. In summary, our results present the first evidence that human CYR61 localizes to the secretory pathway in primary osteoblasts and hFOB cells, and that it is secreted from these cells. The N-terminal 34 amino acids of hCYR61 provide a sufficient Golgi targeting sequence. Together with the immediate early regulation of hCYR61 mRNA by 1,25-(OH)(2)D(3), this suggests that hCYR61 might function as an extracellular signaling molecule in human bone.
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Affiliation(s)
- A Lechner
- Department of Metabolism, Endocrinology and Molecular Medicine, Medizinische Poliklinik, Universität Würzburg, Germany
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21
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Heinemann DE, Siggelkow H, Ponce LM, Viereck V, Wiese KG, Peters JH. Alkaline phosphatase expression during monocyte differentiation. Overlapping markers as a link between monocytic cells, dendritic cells, osteoclasts and osteoblasts. Immunobiology 2000; 202:68-81. [PMID: 10879691 DOI: 10.1016/s0171-2985(00)80054-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Human monocytes (Mo) in culture can be differentiated into macrophages (M phi), dendritic cells (DC) and osteoclasts. In addition, we have established a Mo-derived in vitro granuloma model which here was compared with ex-vivo isolated foreign body granuloma cells. In these models overlapping phenotypes developed between monocyte-derived dendritic cells (MoDC), osteoclasts, M phi, and osteoblasts. In Mo cultures granulomas were induced by immobilized particulate material. AP activity (osteoblast marker) was found to be co-expressed with cytoplasmic tartrate resistant acid phosphatase (TRAP) as a marker of osteoclasts. While proliferating, the number of AP+ cells decreased, being replaced by cells co-expressing the osteoclast markers vitronectin receptor (VNR) and TRAP. Coexpression of the Mo/M phi marker CD68 with AP or VNR confirmed the monocytic origin of the cells. When Mo were treated with interleukin-4 (IL-4), the number of AP+ cells markedly increased and remained stably expressed over 12 days. In explants from ex vivo granulomas obtained from endoprosthetic revisions the major cell type was the AP+ cell co-expressing CD68. The bone-specific alkaline phosphatase (BAP) as a marker of osteoblasts was detected by FACS analysis in the ex vivo granuloma cells. By RT-PCR the mRNA for osteocalcin, which is a highly specific marker for osteoblasts, was detected. From our results we conclude an ontogenetic relationship between macrophages, DC and osteoclasts. Furthermore, the data suggest a transdifferentiation between Mo and osteoblasts.
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Affiliation(s)
- D E Heinemann
- Department of Maxillofacial Surgery, Georg-August-University Goettingen, Germany
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22
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Heinemann DE, Lohmann C, Siggelkow H, Alves F, Engel I, Köster G. Human osteoblast-like cells phagocytose metal particles and express the macrophage marker CD68 in vitro. J Bone Joint Surg Br 2000; 82:283-9. [PMID: 10755442 DOI: 10.1302/0301-620x.82b2.9730] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Periprosthetic osteolysis is a major cause of aseptic loosening in artificial joint replacement. It is assumed to occur in conjunction with the activation of macrophages. We have shown in vitro that human osteoblast-like cells, isolated from bone specimens obtained from patients undergoing hip replacement, phagocytose fine particles of titanium alloy (TiAlV). The human osteoblast-like cells were identified immunocytochemically by the presence of bone-specific alkaline phosphatase (BAP). With increasing duration of culture, a variable number of the osteoblastic cells became positive for the macrophage marker CD68, independent of the phagocytosis of particles, with a fine granular cytoplasmic staining which was coexpressed with BAP as revealed by immunodoublestaining. The metal particles were not toxic to the osteoblastic cells since even in culture for up to four weeks massively laden cells were vital and had a characteristic morphology. Cells of the human osteosarcoma cell line (HOS 58) were also able to phagocytose metal particles but had only a low expression of the CD68 antigen. Fluorescence-activated cell scanning confirmed our immunocytochemical results. Additionally, the cells were found to be negative for the major histocompatibility complex-II (MHC-II) which is a marker for macrophages and other antigen-presenting cells. Negative results of histochemical tests for tartrate-resistant acid phosphatase excluded the contamination by osteoclasts or macrophages in culture. Our observations suggest that the osteoblast can either change to a phagocytosing cell or that the phagocytosis is an underestimated property of the osteoblast. The detection of the CD68 antigen is insufficient to prove the monocytic lineage. In order to discriminate between macrophages and osteoblasts additional markers should be used. To our knowledge, this is the first demonstration of cells of an osteoblastic origin which have acquired a mixed phenotype of both osteoblasts and macrophages.
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Affiliation(s)
- D E Heinemann
- Department of Orthopaedics, Georg-August-University, Goettingen, Germany
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23
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Siggelkow H, Rebenstorff K, Kurre W, Niedhart C, Engel I, Schulz H, Atkinson MJ, Hüfner M. Development of the osteoblast phenotype in primary human osteoblasts in culture: comparison with rat calvarial cells in osteoblast differentiation. J Cell Biochem 1999; 75:22-35. [PMID: 10462701] [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: 02/13/2023]
Abstract
In rat osteoblast-like cells, a time-dependent sequence of growth and differentiation-dependent genes has been identified and a model of osteoblast differentiation in culture suggested. We investigated the expression of the bone matrix-associated proteins osteonectin and procollagen I and of the bone cell phenotype-related proteins alkaline phosphatase and osteocalcin during cell culture in primary human osteoblast like cells. Primary human explant cultures from nine young healthy donors were established under highly standardized conditions. Cells in the second passage were analyzed on different days from day 1 to 32, comparing cells growing under the influence of ascorbate with controls. Gene expression was determined by Northern blot analysis or polymerase chain reaction. Osteocalcin expression was also investigated after 1,25-(OH)(2)D(3) stimulation. On the protein level, newly synthesized collagen I, alkaline phosphatase activity, and secretion of osteocalcin were analyzed at all time points. On comparing our findings to the pattern of gene expression suggested for the rat calvarial osteoblast system, we found a similar developmental sequence for the so-called "proliferation" as well as a similar, but lengthened, sequence for the "matrix maturation stage." During "matrix maturation," we found an ongoing proliferation despite increased alkaline phosphatase and decreased procollagen I gene expression. Our study, therefore, shows that in pHOB the gene expression profile proceeded to the "matrix maturation stage," as defined by Owen and colleagues, independent of ongoing proliferation. We were unable to observe the mineralization period as demonstrated by the missing increase of osteocalcin expression and lack of nodule formation in our human osteoblast model. In contrast to the rat system, we found a proliferation stimulating influence of ascorbate, suggesting species-specific differences in response to differentiation factors. From these data, we conclude that general considerations on physiology and pathophysiology of bone cell differentiation have to be confirmed in the human osteoblastic cell system.
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Affiliation(s)
- H Siggelkow
- Department for Gastroenterology and Endokrinology, Georg-August-University, D-37075 Göttingen, Germany
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24
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Zulewski H, Siggelkow H, Walden C, Becker W, Hüfner M. Evaluation of procollagen III peptide as a marker of tissue hyperthyroidism in long-term treated women with TSH suppressive doses of thyroxine. Exp Clin Endocrinol Diabetes 1999; 107:190-4. [PMID: 10376444 DOI: 10.1055/s-0029-1212096] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Increased serum concentrations of the aminoterminal propeptide of collagen III (PIIINP) are found in overt hyperthyroidism. Thus, measurement of serum PIIINP might be useful as an early marker of tissue hyperthyroidism in patients with TSH suppressive thyroxine treatment. In a prospective study we evaluated female patients followed in the thyroid outpatient clinic. Serum PIIINP concentrations were analysed in three groups: patients with TSH suppressive thyroxine treatment for more than 6 months (n = 33, TSH < 0.1 mU/l), patients with thyroxine substitution for hypothyroidism for more than 6 months (n = 20, TSH 0.2-4.0 mU/l) and spontaneous hyperthyroid patients (n = 8, TSH < 0.03 mU/l, increased freeT4 and/or T3). Beside TSH, thyroid hormones and serum PIIINP we measured serum SHBG and a clinical score. Hyperthyroid patients had clearly elevated serum PIIINP and SHBG values and a higher clinical score when compared with other study groups (p < 0.001). Patients with TSH suppressive thyroxine treatment had higher fT4 and T3 concentrations than the thyroxine substitution group (fT4 22 +/- 4.8 pmol/l vs. 17 +/- 2.6 pmol/l, T3 2.2 +/- 0.4 nmol/l vs. 1.8 +/- 0.3 nmol/l, p < 0.001) and also elevated serum SHBG values (77.6 +/- 27.5 nmol/l vs. 58.4 +/- 18 nmol/l, p < 0.01). However, serum PIIINP concentrations and the clinical score were very similar in both thyroxine treated groups (PIIINP in TSH suppression group 3.0 +/- 0.67 microg/l vs. 2.8 +/- 0.65 microg/l in the substitution group, clinical score 2 +/- 1.8 pts. vs. 1.7 +/- 1.5 pts. p = n.s.). In conclusion, serum PIIINP is not a reliable early marker for detection of tissue hyperthyroidism in long-term thyroxine treated women with suppressed TSH.
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Affiliation(s)
- H Zulewski
- Department of Internal Medicine, University Hospital of Göttingen, Germany.
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25
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Siggelkow H, Schulz H, Kaesler S, Benzler K, Atkinson MJ, Hüfner M. 1,25 dihydroxyvitamin-D3 attenuates the confluence-dependent differences in the osteoblast characteristic proteins alkaline phosphatase, procollagen I peptide, and osteocalcin. Calcif Tissue Int 1999; 64:414-21. [PMID: 10203418 DOI: 10.1007/pl00005823] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the present study a cell culture model of primary human osteoblasts based on degrees of confluence was investigated by measuring basal and 1,25(OH)2D3stimulated levels of the osteoblast characteristic proteins alkaline phosphatase (AP), procollagen I-peptide (PICP), and osteocalcin (OC), as well as the corresponding gene expression. Primary osteoblast-like cell cultures from seven donors were treated in the second passage with 1,25(OH)2D3 (5 x 10(-8) M for 48 hours) and investigated at four stages of confluence (stage I 50%, stage II 75%, stage III 100%, and stage IV 7 days postconfluence). In untreated cultures passing through the different stages of confluence, we saw a 1.8-fold increase of AP activity, a 2. 3-fold increase of OC secretion, but a decrease of PICP levels to 0. 36-fold. Gene expression showed only minor variation between the different confluence stages. 1,25(OH)2D3 did not significantly affect PICP production. Alkaline phosphatase protein was stimulated during proliferation until confluence, with no effect thereafter. Surprisingly, OC secretion and mRNA expression were stimulated in all four stages to the same absolute level independent of basal values. We conclude that our results correspond to other studies showing differentiation-stage dependent changes of basal levels of osteoblast-specific proteins. However, 1,25(OH)2D3 stimulation decreased the confluence-dependent difference for AP and abolished it for osteocalcin, thus leading to a more differentiated phenotype of the osteoblast. Therefore, 1,25(OH)2D3 stimulation might improve the reproducibility of results obtained at different confluence stages from cultures of clinical samples.
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Affiliation(s)
- H Siggelkow
- Department of Gastroenterology and Endocrinology, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
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26
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Siggelkow H, Benzler K, Atkinson MJ, Hüfner M. The use of confluence stages does not decrease the overall variability in primary human osteoblasts but can give additional information on differentiation in vitro. Exp Clin Endocrinol Diabetes 1998; 106:217-25. [PMID: 9710363 DOI: 10.1055/s-0029-1211979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Primary cultures of human osteoblast-like cells are frequently used to study osteoblast function. Due to inhomogeneous growth of primary osteoblasts in culture, it is of interest if the use of confluence stages for analysis would reduce the overall variability. Consequently, we have tested the influence of degree of confluence and passage number on the growth and differentiation of human primary osteoblast-like cells. Phenotypic features of primary human osteoblast-like cells were compared at four successive cell densities defined as stage of confluence I (50%), stage II (75%), stage III (100%) and stage IV (5 days post confluence). The stability of the system was also tested by comparing these observations obtained using cells from the 2nd and 4th passages. As a sign for further differentiation, the number of AP-positive cells increased with a decrease in proliferation. The secretion of procollagen-I decreased to 50% during culture while procollagen I mRNA doubled from proliferation to confluence. A constant activity of alkaline phosphatase, procollagen-I secretion and procollagen I gene expression over passages was seen together with a decrease in growth. The paper introduces a potential model of osteoblastic differentiation in vitro for human primary osteoblast-like cells. We were able to show an increasing differentiation with a decrease in proliferation and the stability of this differentiation behaviour over cell passages in this model, but we were not able to reduce the overall variability.
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Affiliation(s)
- H Siggelkow
- Department of Gastroenterology and Endocrinology, University of Göttingen, Germany.
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28
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Siggelkow H, Niedhart C, Kurre W, Ihbe A, Schulz A, Atkinson MJ, Hüfner M. In vitro differentiation potential of a new human osteosarcoma cell line (HOS 58). Differentiation 1998; 63:81-91. [PMID: 9674117 DOI: 10.1046/j.1432-0436.1998.6320081.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cultured rodent osteoblastic cells reiterate the phenotypic maturation of osteoblasts seen in vivo. Under appropriate culture conditions this maturation is a stepwise sequence of phenotypic changes culminating in the production of a mineralised matrix. Although individual components of the osteoblast phenotype are apparent in transformed osteosarcoma cell lines, the co-ordination of the maturation sequence appears to be compromised. Because to date no comparable human cell differentiation system has been developed we investigated the recently introduced HOS 58 osteosarcoma cell line up to 3 months in culture. Proliferation, the secretion of osteoblast specific proteins, gene expression and mineralisation were analysed at different time points. Low-density HOS 58 cultures exhibit rapid proliferation and high levels of c-myc, collagen type I and osteopontin mRNAs. This phenotypic stage was maximum between the 4th and 5th days of culture. As cell density increased expression of these genes declined and by day 14 the predominant mRNAs was alkaline phosphatase. Osteocalcin secretion was detected after confluence at an increasing level. In the presence of ascorbate and beta-glycerophosphate the production of alkaline phosphatase and collagen type I increased coincident with the elaboration of a Von Kossa staining matrix. Nevertheless no proper mineralisation of the collagenous matrix was detectable by electron microscopy. Hence, the human osteosarcoma cell line HOS 58 expressed a rather differentiated phenotype with further maturation during a culture period of 21 days. We conclude that the developmental sequence exhibited by the HOS 58 human osteosarcoma cell line is comparable to that described for primary rat osteoblasts. However, in detailed analysis considerable differences to other species are evident. Further evaluation of the HOS 58 system and comparison to other human osteoblast cell lines will be necessary to establish the most appropriate differentiation model for human bone cell cultures.
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Affiliation(s)
- H Siggelkow
- Abteilung für Gastroenterologie und Endokrinologie, Georg-August-Universität, Göttingen, Germany
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29
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Affiliation(s)
- M Hüfner
- Abteilung Gastroenterologie und Endokrinologie, Universität Göttingen
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30
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Siggelkow H, Hilmes D, Robenstorff K, Kurre W, Engel I, Hüfner M. Analysis of human primary bone cells by fluorescence activated cell scanning: methodological problems and preliminary results. Clin Chim Acta 1998; 272:111-25. [PMID: 9641353 DOI: 10.1016/s0009-8981(98)00007-2] [Citation(s) in RCA: 18] [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: 02/07/2023]
Abstract
We describe the development of flowcytometrical methods to analyse human primary osteoblast-like cultures obtained from trabecular bone explants in comparison to the human osteosarcoma cell line HOS 58. Two antigens typical of osteoblasts were studied: bone alkaline phosphatase and collagen/procollagen I; the non-specific attachment protein fibronectin served as control. The morphology of all different antigens is shown by immunocytochemistry before flowcytometrical analysis. The establishment of flowcytometry is described in detail. While all antigens tested were nearly 100% positive in the HOS 58 cells in immunocytochemistry and flowcytometry, in primary osteoblast-like cells results varied widely between both methods. Cell permeabilisation before flowcytometry improved the homogeneity of results, probably by increasing the accessibility of the specific antibody to intracellular compartments. Though up to 80% of cells were lost during preparation the ratio of positive versus negative cells in specific experiment was not dependent on the cell recovery. Therefore, the cells finally analysed seemed to be representative of the total population.
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Affiliation(s)
- H Siggelkow
- Department of Gastroenterology and Endocrinology, Georgia-Augusta University, Göttingen, Germany
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31
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Schütze N, Lechner A, Groll C, Siggelkow H, Hüfner M, Köhrle J, Jakob F. The human analog of murine cystein rich protein 61 [correction of 16] is a 1alpha,25-dihydroxyvitamin D3 responsive immediate early gene in human fetal osteoblasts: regulation by cytokines, growth factors, and serum. Endocrinology 1998; 139:1761-70. [PMID: 9528960 DOI: 10.1210/endo.139.4.5954] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
1Alpha,25-dihydroxyvitamin D3 (1,25-(OH)2D3) is a potent mediator of differentiation and maintenance of specific functions of osteoblasts. To detect novel targets for 1,25-(OH)2D3 action, we applied differential display PCR to human fetal osteoblast-like cells and identified the human analog of murine cystein rich protein 61 (hCYR61) as a 1,25-(OH)2D3-responsive immediate early gene in differentiated fetal osteoblast-like cells. The murine gene CYR61 is important for cell-cell and cell-matrix interactions, and it belongs to an emerging gene family of cysteine-rich proteins. hCYR61 messenger RNA (mRNA) steady-state levels were stimulated 11-fold by 10 nM 1,25-(OH)2D3 by 1 h and declined to control levels by 4 h. This transient stimulation of hCYR61 mRNA was not inhibited by cycloheximide but was prevented by actinomycin D, indicating that the 1,25-(OH)2D3 effect involves transcriptional events and does not require de novo protein synthesis. hCYR61 mRNA stability was not influenced by 1,25(OH)2D3, whereas cycloheximide treatment stabilized hCYR61 mRNA. FCS, as well as growth factors and cytokines such as basic fibroblast growth factor, epidermal growth factor, tumor necrosis factor alpha, and interleukin-1, strongly elevated hCYR61 mRNA steady-state levels within 1 h. hCYR61 mRNA was expressed also in primary human osteoblasts and osteosarcoma cell lines. Using a commercial tissue blot, hCYR61 mRNA was only observed in skeletal muscle. The fast and transient response of hCYR 61 to 1,25-(OH)2D3, serum, growth factors, and cytokines suggests an important role of hCYR61 for osteoblast function and differentiation.
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Affiliation(s)
- N Schütze
- Klinische Forschergruppe, Medizinische Poliklinik, Universität Würzburg, Germany
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32
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Roth C, Siggelkow H, Grüters A, Hüfner M, Lakomek M. [Neonatal Basedow's disease in twins from a mother with severe T3 hyperthyroidism]. Dtsch Med Wochenschr 1997; 122:572-7. [PMID: 9190309 DOI: 10.1055/s-2008-1047656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 02/04/2023]
Abstract
HISTORY AND CLINICAL FINDINGS Dizygotic twin sisters were born to a woman who, shortly before becoming pregnant, had developed Graves' disease with markedly elevated triiodothyronine (T3) levels and highly positive TSH receptor antibody titres (TRAb: 169 mU/ml). From the second week of life onwards they had a goitre and hyperexcitability, tachycardia and failure to thrive were noted. In addition, twin I had mild exophthalmos. As thyrostatic treatment of the mother was very difficult, intrauterine hypothyroidism or transitory hyperthyroidism had presumably occurred in the twins. INVESTIGATIONS Twin I had maximal thyroxine (T4) concentration of 26.2 micrograms/dl, while it was 24.7 micrograms/dl in twin II with suppressed TSH. Both twins had high concentrations of TRAb and antibodies against thyroid peroxidase. DIAGNOSIS, TREATMENT AND COURSE With the diagnosis of neonatal Graves' disease established, both twins were treated with propranolol (2 mg/kg.d) and phenobarbitone (2-4 mg/kg.d). Twin I, whose symptoms were more severe, also received propylthiouracil (5 mg/kg.d) until euthyroidism had been achieved. Although twin II became euthyroid spontaneously, she gained weight only slowly and microcephaly developed together with definite motor and mental retardation. It remains unclear whether these were consequences of intrauterine hypothyroidism or post-partum hyperthyroidism. CONCLUSION Graves' disease during pregnancy demands interdisciplinary collaboration between gynaecologist, physician and paediatrician to prevent severe sequelae in the children. Early risk assessment is possible by measuring the TSH receptor antibody titre in umbilical blood.
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Affiliation(s)
- C Roth
- Universitäts-Kinderklinik, Humboldt-Universität, Virchow-Klinikum, Berlin
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Jakob F, Siggelkow H, Homann D, Köhrle J, Adamski J, Schütze N. Local estradiol metabolism in osteoblast- and osteoclast-like cells. J Steroid Biochem Mol Biol 1997; 61:167-74. [PMID: 9365187] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bone is an estradiol-responsive tissue. Estrogen withdrawal during the menopause causes loss of bone mass and clinically relevant osteoporosis in a third of all women. Sufficient or impaired local production, as well as degradation of estradiol in cells present in the bone microenvironment might be an important mechanism of rescue or might contribute to the development of osteoporosis, respectively. We therefore investigated aromatase and 17beta-hydroxysteroid dehydrogenase type IV (17beta-HSD IV) expression in osteoblast- and osteoclast-like cells. Aromatase mRNA was increasingly expressed in myeloid THP 1 cells differentiated along the monocyte/phagocyte pathway exploiting vitamin D and either granulocyte-macrophage-stimulating factor (GMCSF) or macrophage-stimulating factor (MCSF). In long-term cultures, when sequentially exposed to vitamin D (days 0-21) and GMCSF (days 5-10) and plated on collagen, the amount of expression of aromatase mRNA steadily increased along with the increasing expression of osteopontin mRNA, alpha(v) integrin mRNA, c-fms (MCSF-receptor) mRNA and multinucleated cells developing. The conversion of estradiol from testosterone (10(-7) M/l) in the supernatants of dishes mirrored changes in aromatase mRNA expression and by day 21 rose to 30,000 ng/10(7) cells/24 h. 17Beta-HSD IV mRNA expression was abundant in undifferentiated THP 1 cells and was decreased to approximately 50% by day 21. Unstimulated SV-40 immortalized fetal osteoblasts did not express aromatase mRNA, but the expression was stimulated by the addition of the phorbol ester phorbol myristate acetate (PMA). Unstimulated osteoblasts from primary cultures did not express aromatase mRNA. Osteoblast-like osteosarcoma cells MG 63 expressed faint levels of aromatase mRNA in contrast to the osteosarcoma cell line HOS 58. 17Beta-HSD IV mRNA was expressed in fetal osteoblasts as well as in osteoblasts from primary culture, MG 63 and HOS 58 cells. In summary, we can show the expression of estradiol metabolizing enzymes in cells which are present in the bone microenvironment. Impaired aromatase expression and/or enhanced expression of 17beta-HSD IV may contribute to the pathogenesis of osteoporosis.
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Affiliation(s)
- F Jakob
- Clinical Research Unit Cell differentiation and local regulatory systems, Medizinische Poliklinik, University of Würzburg, Germany
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Muller R, Siggelkow H, Emrich D, Hufner M. Prophylactic application of thyrostatic drugs during excessive iodine exposure in euthyroid patients with thyroid autonomy: a randomized study. Eur J Endocrinol 1996; 134:337-41. [PMID: 8616532 DOI: 10.1530/eje.0.1340337] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In a prospective, randomized study we examined the influence of prophylactic short-term thyrostatic therapy on thyroid iodine metabolism in patients with euthyroid autonomy undergoing elective coronary angiography. From a total of 1177 patients, 51 fulfilled the criteria of euthyroid autonomy before coronary angiography (negative thyrotropin-releasing hormone test, 10-min uptake of at least 1.2%, 99mTc and no elevation of free thyroxine and free triiodothyronine indices) and were randomized into three groups: group 1 (N = 17) received 20mg/day of thiamazole and group 2 (N = 17) received 900 mg/day of sodium perchlorate; thyrostatic therapy was begun on the day before angiography and continued for 14 days; group 3 (N = 17) served as controls without treatment. Parameters of thyroid function-free thyroxine (FT4) index and free triiodothyronine (FT3) index, thyrotropin (TSH) and delta-TSH urine iodine excretion and 99mTc uptake were determined before and 30 days after coronary angiography. At the end of the study the mean FT4 index and FT3 index were elevated significantly in the control group compared with baseline values, but were still within the normal range. In contrast, the mean FT4 index and FT3 index remained unchanged in the treated groups. Four mild cases of hyperthyroidism were observed at the end of the study: two cases in the control group and one case in each of the treated groups. Thyrotropin suppression, urine iodine excretion and 99mTc uptake differed significantly between the treated groups and the control group. In the treated groups TSH suppression, urine iodine excretion and 99mTC uptake remained unchanged 30 days after coronary angiography compared with baseline values. In the control group the degree of TSH suppression and the level of urine iodine excretion increased (about twofold) significantly after coronary angiography, whereas 99mTc uptake decreased significantly (ca. 50%). In conclusion, short-term prophylactic thyrostatic therapy seems to have a protective effect against iodine excess in patients with euthyroid autonomy. However, mild hyperthyroidism could not be prevented in some cases. Probably a combination therapy of thiamazole and perchlorate would be more effective.
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Siggelkow H, Hüfner M. [Prevention of osteoporosis--why? Who? How?]. Med Klin (Munich) 1995; 90:639-44. [PMID: 8569632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- H Siggelkow
- Schwerpunkt Endokrinologie, Abteilung Gastroenterologie und Endokrinologie, Universitätsklinik Göttingen
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Spanner M, Weber K, Lanske B, Ihbe A, Siggelkow H, Schütze H, Atkinson MJ. The iron-binding protein ferritin is expressed in cells of the osteoblastic lineage in vitro and in vivo. Bone 1995; 17:161-5. [PMID: 8554925 DOI: 10.1016/s8756-3282(95)00176-x] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Ferritin, a metal-binding protein responsible for maintaining the bioavailability of iron, has been demonstrated in cells of the osteoblastic lineage. Messenger RNAs encoding the light and heavy chain subunits of ferritin were detected in ROS 17/2.8, ROS 25/1, and UMR106 rat osteosarcoma cell lines, in fetal rat calvaria, and in primary cultures of rat calvarial osteoblast-like cells. In vivo, the expression of ferritin light-chain mRNA was observed in both active osteoblasts and in osteocytes. A 450-kD iron-binding protein was immunoprecipitated from ROS 17/2.8 cells by an antiferritin antiserum. This protein comigrated with native ferritin, and could be dissociated into subunits comigrating with ferritin light and heavy chains. Addition of extracellular Fe59-transferrin to cultures of ROS 17/2.8 cells resulted in the sequestration of the iron in intracellular ferritin. These observations demonstrate that cells of the osteoblastic lineage possess a functional ferritin-based iron uptake and storage system capable of regulating metal homeostasis in bone.
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Affiliation(s)
- M Spanner
- Institut für Pathologie, GSF-Forschungszentrum für Umwelt und Gesundheit, München, Germany
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Siggelkow H. [Geriatric problems in rehabilitation]. Z Gesamte Hyg 1981; 27:878-80. [PMID: 7344347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Siggelkow H. [Rehabilitation at an advanced age]. Z Gesamte Hyg 1980; 26:214-8. [PMID: 7456538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Schulz J, Gutschker A, Geissler W, Siggelkow H. [Aspects of myocardial infarction treatment in patients of higher age (author's transl)]. Aktuelle Gerontol 1980; 10:17-20. [PMID: 6106401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The influence of a 6 weekly physical training of the performance in patients of the age between 60 and 70 years who have had a definitive myocardial infarction has been tested in phase II or rehability. Dayly in patient and under physicinal control the conditioning were executed in the time of 30 minutes on a bicycle--hometrainer. The personal intensity of training was choosed so that anwunted to 60--70% of heart-frequency obtained by the maximal exercise. Additional a terrain-training was taken part. Under conditioning a different relation of performance was recognized by patients (12 patients--performance decreased, 15 patients--constant performance, 33 patients--performance increased). To prevent a negative development of physical performance the result of performance--pulse (N/Hf) should be observe especially.
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Siggelkow H. [Geriatrics and rehabilitation]. Z Gesamte Hyg 1977; 23:586-8. [PMID: 910514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Siggelkow H. [Rehabilitation of aged people with special reference to the locomotor system]. Z Gesamte Hyg 1975; 21:714-6. [PMID: 1226926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Körner I, Siggelkow H. [Use of "care index for old age pensioners". 2]. Dtsch Gesundheitsw 1969; 24:1407-9. [PMID: 5376079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Körner I, Siggelkow H. [Use of "care index for old age pensioners". 1]. Dtsch Gesundheitsw 1969; 24:1327-8. [PMID: 5376193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Brüschke G, Haase J, Mehls E, Rühland W, Schulz FH, Siggelkow H. [Special aspects, indications and risks in the clinical treatment of elderly persons]. Dtsch Gesundheitsw 1969; 24:1323-6. [PMID: 5376192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Siggelkow H. [Emergency treatment of apoplexy]. Dtsch Gesundheitsw 1968; 23:1840-1843. [PMID: 5712676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Siggelkow H, Körner I. [On a health care index for old-age and disability insurance users]. Dtsch Gesundheitsw 1968; 23:998-1001. [PMID: 4234834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Siggelkow H. [On the management of the apoplectic syndrome]. Z Alternsforsch 1967; 20:239-245. [PMID: 5594105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Siggelkow H. [Behavior of the blood-and cerebrospinal fluid pressure during application of procaine. 3. Correlation between blood-and cerebrospinal fluid pressure]. Dtsch Gesundheitsw 1967; 22:1985-7. [PMID: 5600929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Siggelkow H. [Behavior of the blood-and cerebrospinal fluid pressure under procaine]. Dtsch Gesundheitsw 1967; 22:1956-7. [PMID: 5601593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Siggelkow H. [Behavior of blood-and cerebrospinal fluid pressure under procaine. 1. Arterial blood pressure]. Dtsch Gesundheitsw 1967; 22:1850-1853. [PMID: 5600038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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