Role of podoplanin in the high interleukin-17A secretion resulting from interactions between activated lymphocytes and psoriatic skin-derived mesenchymal cells

In the context of psoriasis, T helper type 17 (Th17) cells infiltrate the inflammatory site and interact with local mesenchymal cells, including skin fibroblasts. The aim of this work was to study the interactions of skin-derived fibroblasts with peripheral blood mononuclear cells (PBMC) with a focus on the Th17 pathway and to identify a mechanism which leads to a high interleukin (IL)-17 secretion. A co-culture system between PBMC and skin fibroblasts was developed. Healthy and patient PBMC were added to non-lesional or lesional skin fibroblasts at a 5:1 ratio for 48 h in the presence or not of activation with phytohaemagglutinin (PHA). Monocytes were removed or not by adherence before the co-culture. An anti-podoplanin antibody was also used during the co-culture. Cytokine production (IL-8, IL-6, IL-1β and IL-17) was measured by enzyme-linked immunosorbent assay (ELISA) and cell staining (CD3, CD4, IL-17 and podoplanin) by flow cytometry. Without T cell receptor (TCR) activation, IL-8, IL-6 and IL-1β production increased in PBMC-fibroblast co-culture compared to PBMC alone. No additional effect was observed with TCR activation, with no difference in the Th17 cell percentage in activated-PBMC alone or co-cultured. Conversely, IL-17 production was increased highly only in co-cultures between control and patient activated-PBMC and skin fibroblasts. Removal of monocytes decreased cytokine production, notably that of IL-17. Addition of an anti-podoplanin antibody decreased IL-17 secretion by 60%. Interactions between resting PBMC and fibroblasts induce the IL-8, IL-6 and IL-1β production. PBMC activation and cell interactions are critical for a high IL-17 secretion. Podoplanin contributes largely to this massive IL-17 secretion.

Design and application of a fish-shaped lateral line probe for flow measurement

We introduce the lateral line probe (LLP) as a measurement device for natural flows. Hydraulic surveys in rivers and hydraulic structures are currently based on time-averaged velocity measurements using propellers or acoustic Doppler devices. The long-term goal is thus to develop a sensor system, which includes spatial gradients of the flow field along a fish-shaped sensor body. Interpreting the biological relevance of a collection of point velocity measurements is complicated by the fact that fish and other aquatic vertebrates experience the flow field through highly dynamic fluid-body interactions. To collect body-centric flow data, a bioinspired fish-shaped probe is equipped with a lateral line pressure sensing array, which can be applied both in the laboratory and in the field. Our objective is to introduce a new type of measurement device for body-centric data and compare its output to estimates of conventional point-based technologies. We first provide the calibration workflow for laboratory investigations. We then provide a review of two velocity estimation workflows, independent of calibration. Such workflows are required as existing field investigations consist of measurements in environments where calibration is not feasible. The mean difference for uncalibrated LLP velocity estimates from 0 to 50 cm/s under in a closed flow tunnel and open channel flume was within 4 cm/s when compared to conventional measurement techniques. Finally, spatial flow maps in a scale vertical slot fishway are compared for the LLP, direct measurements, and 3D numerical models where it was found that the LLP provided a slight overestimation of the current velocity in the jet and underestimated the velocity in the recirculation zone.

Prävalenz chronischer Trommelfellperforationen in der erwachsenen Bevölkerung

BACKGROUND

The goal of this study was to evaluate the prevalence of chronic tympanic membrane perforation in the adult population.

MATERIALS AND METHOD

The study population included 1,000 subjects (453 males, 547 females) aged 18-93 years. In addition to interview data, ear examinations were performed.

RESULTS

There were eight subjects with unilateral chronic tympanic membrane perforation and a single subject with a bilateral perforation. The age adjusted prevalence of chronic tympanic membrane perforation was 0.45% (95% confidence interval: 0.03-0.87). Eight out of nine subjects disliked tympanoplasty.

CONCLUSION

The high proportion of subjects with chronic tympanic membrane perforations who do not want to be operated suggests that there is a considerable need for novel therapeutic procedures.

Restoration of membrane TNF-like activity by cell surface targeting and matrix metalloproteinase-mediated processing of a TNF prodrug

Tumor necrosis factor (TNF) prodrugs are fusion proteins comprised of an N-terminal single-chain antibody variable fragment (scFv) targeting a TNF effector and a C-terminal TNF receptor (TNFR)1-derived inhibitor module. Introduction of matrix metalloproteinase (MMP)-2 recognition motifs between TNF and the TNFR1 fragment allowed activation by recombinant MMP-2 and MMP-expressing HT1080 cells. Processing by endogeneous MMPs required specific membrane binding of the TNF prodrug via the targeting scFv, ensuring strictly antigen-dependent activation. Interestingly, TNF bioactivity of the processed prodrug was approximately 1000-fold higher upon scFv-mediated targeting, and signaled juxtatropic cell death also to antigen-negative cells. Microscopical analyses of TNFR2 clustering and TNF receptor-associated factor 2 recruitment at contact sites to adjacent cells revealed the formation of stable TNFR complexes by target-bound, processed prodrug, resembling the increased signal capacity of natural, membrane-expressed TNF. MMP-2-sensitive TNF prodrugs represent novel cytokine-based reagents for targeted cancer therapy, which should be exploitable for MMP-overexpressing tumors.

Eva-Reha: Eine Software zur Unterstützung des ergebnisorientierten Qualitätsmanagements in der Rehabilitation

PURPOSE

Development of a computer software for supporting medical quallity management by documenting progression and results of medical rehabilitation in neurologic, orthopaedic, and geriatric patients.

METHODS

The software "Eva-Reha" (Evaluation of Medical Rehabilitation) was generated using C ++ in a client-server structure with Interbase being the underlying relational database management system. The software is network-compatible and runs under Windows NT and Windows 2000.

RESULTS

"Eva-Reha", developed by the "Medizinischer Dienst der Krankenversicherung Rheinland-Pfalz (MDK RLP)" supports quality management systems in medical rehabilitation. Since 2003 the MDK RLP provides neurologic and geriatric rehabilitation centres with the software free of charge. With the help of "Eva-Reha" progression and results of medical rehabilitation can be displayed metrically, thus facilitating individual rehabilitation planning and supporting motivation of the rehabilitation team. Therapeutic strategies can be evaluated for different ICD-10-diagnoses or impairment groups. Moreover, "Eva-Reha" provides valuable data for administration and controlling purposes, e. g. age structure, case mix, impairment on admission and medical as well as rehabilitative procedures. The system generates a request for extension in a set form which facilitates communication between rehabilitation centres and sponsors.

[Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies]

PURPOSE

Comparative evaluation of specimens obtained with different MR-compatible biopsy systems and a conventional ferromagnetic system.

METHODS

Biopsies of a pig liver were performed post-mortem with three different MR-compatible (Somatex; E-Z-EM; Daum) and one conventional biopsy system (Somatex), five with each device. The specimens were measured and the histopathological quality was graded on a scale from 0 (no tissue) to 9 (best). The tip of the needle was examined with an electron microscope before and after biopsy to demonstrate abrasion.

RESULTS

The histopathological score between the first and fifth specimen taken with one biopsy device showed no significant difference. The conventional system yielded significantly better results in nearly all categories (p < 0.05) than the MR-compatible biopsy systems. The areas of the specimens obtained with the MR-compatible biopsy systems (4.27-5.99 mm2) were significantly smaller than those from the conventional system (9.98 mm2). The needle tip abrasion of the different biopsy systems determined by electron microscopy showed no substantial difference.

CONCLUSION

Specimens obtained with MR-compatible biopsy systems compared to conventional biopsy systems are of lower histopathological quality. This might be caused by a smaller side notch of the MR-compatible biopsy devices. There was no difference in abrasion of the needle tip due to the softer, non-ferromagnetic alloys.

Optimized enhancement in helical CT: experiences with a real-time bolus tracking system in 628 patients

AIMS

Ultrafast detector technology enables bolus-triggered application of contrast media. In a prospective study we investigated the benefit of this new method with the intention of optimizing enhancement during examination of the chest and abdomen.

MATERIALS AND METHODS

In total, we examined 548 patients under standardized conditions. All examinations were performed on a Somatom Plus 4 Power CT system (Siemens Corp., Forchheim, Germany) using the CARE-Bolus software. This produces repetitive low-dose test images (e.g. for the lung: 140 kV, 43 mA, TI 0.5 s) and measures the Hounsfield attenuation in a pre-selected region of interest. After exceeding a defined threshold, a diagnostic spiral CT examination was begun automatically. The data obtained from 321 abdominal CT and 179 lung CT examinations were correlated with different parameters such as age, weight and height of the patients and parameters of vascular access. In a group of 80 patients, the injection of contrast medium was stopped after reaching a pre-defined threshold of an increase of 100 HU over the baseline. Then, we assessed the maximal enhancement of liver, pulmonal artery trunk and aortic arch.

RESULTS

There was no correlation between bolus geometry and age, body surface or weight. In helical CT of the abdomen the threshold was reached after a mean trigger time of 27 s (range 13-67 s) and only 65 ml (range 41-105 ml) of contrast medium were administered. In helical CT of the lung the threshold was reached after 21 s (range 12-48 s) and the mean amount of administered contrast medium was 48 ml (range 38-71 ml).

CONCLUSION

Bolus triggering allows optimized enhancement of the organs and reduces the dose of contrast material required compared with standard administration.

Effectiveness of cefetamet pivoxil in the treatment of pyelonephritis in children

Cefetamet pivoxil was investigated in an open, randomized comparative study involving a total of 37 children with acute pyelonephritis, whose ages ranged from 2 to 14 years. The patients received either 10 mg/kg (n = 18) or 20 mg/kg (n = 8) cefetamet pivoxil twice daily, or 30-50 mg/kg amoxycillin/clavulanic acid three times daily (n = 11) for a period of 7-10 days. Escherichia coli was the main causative agent isolated in 28 (75.7%) of the patients; other pathogens included Proteus mirabilis (three patients). Proteus species (one patient), Klebsiella pneumoniae (two patients), Pseudomonas diminuta (one patient) and mixed infections (three patients). No differences in the overall treatment outcome could be observed between the treatment regimens used and, at the end of treatment, all pathogens were eradicated with neither relapse, nor persistence of the isolated pathogen, nor reinfection occurring. The clinical signs and symptoms had subsided in all patients at treatment end and the tolerability of the trial drugs was found to be satisfactory with no premature treatment withdrawal required. It is concluded that cefetamet pivoxil in the standard twice-daily dose of 10 mg/kg was equally effective and as well tolerated as 20 mg/kg cefetamet pivoxil given twice daily or 30-50 mg/kg amoxycillin/clavulanic acid given three times daily.

An in vitro evaluation of the marginal integrity of a porcelain inlay system

There is currently no consensus of opinion regarding form of the finish line for porcelain inlays. This study compared beveled and nonbeveled finishing lines. Twenty-four Class II MOD cavities of a standardised design were prepared in extracted premolar teeth. Twelve were finished using a half enamel occlusal bevel and 12 were not beveled. Porcelain inlays were fabricated and luted with a dual-polymerizing resin material. The completed restorations were stored in water, thermocycled, and analysed using a scanning electron microscope. The quality of the enamel/composite resin interface was found to be considerably better than that of the inlay/composite resin interface. The adaptation of composite resin to enamel was of equal quality for both beveled and nonbeveled preparations.

Effect of granulocyte-macrophage colony-stimulating factor on neutropenia and related morbidity induced by myelotoxic chemotherapy

PURPOSE

A phase Ib/II clinical study was undertaken to assess the efficacy of recombinant human (rh) granulocyte-macrophage colony-stimulating (GM-CSF) factor in attenuating neutropenia and associated morbidity caused by high-dose anticancer chemotherapy administered in the presence or absence of autologous bone marrow support.

PATIENTS AND METHODS

Twenty-two patients with various solid tumors and lymphoid neoplasias were treated with a single daily subcutaneous dose of rh GM-CSF (250 micrograms/m2) 48 hours after receiving a second cycle of highly myelotoxic chemotherapy for a period of 10 days. Within-subject comparisons on neutropenia-related clinical and laboratory variables were made with data obtained from the same patients after they received the first neutropenia-inducing cycle of identical chemotherapy in the absence of GM-CSF.

RESULTS

GM-CSF was active in neutropenic patients because it significantly increased the neutrophilic nadir, reduced the time of relevant neutropenia, and reduced the duration of a patient's hospital stay and the necessity for parenteral antibiotics. No significant toxicity was encountered with subcutaneous GM-CSF treatment.

CONCLUSION

Although GM-CSF was shown to significantly reduce chemotherapy-associated morbidity in patients receiving myelotoxic cancer chemotherapy, additional studies are needed to assess whether the use of GM-CSF in anticancer chemotherapy will allow an increase in the dosage level, leading to improved response rates and survival among cancer patients.

Effect of granulocyte-macrophage colony-stimulating factor on neutropenia and related morbidity induced by myelotoxic chemotherapy

A phase Ib/II clinical study was undertaken to assess the efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) to attenuate neutropenia and associated morbidity caused by high-dose anticancer chemotherapy administered in the presence or absence of autologous bone marrow support. We treated 22 patients with various solid tumors and lymphoid neoplasias with a single daily subcutaneous dose of GM-CSF (250 micrograms/m2) 48 h after a second cycle of highly myelotoxic chemotherapy for a period of 10 days and compared intraindividually neutropenia-related clinical and laboratory variables with data obtained from the same patients having previously received a first neutropenia-inducing cycle of identical chemotherapy in the absence of GM-CSF. We show that GM-CSF is active in neutropenic patients by significantly increasing the neutrophil nadir, reducing the time of relevant neutropenia, and reducing the duration of the patient's hospital stay and necessity for parenteral antibiotics. No significant toxicity was encountered with subcutaneous GM-CSF treatment.

Quantitative margin analysis in the scanning electron microscope

Interface between restorative materials and tooth hard substances must be morphologically as perfect as possible to avoid plaque accumulation and subsequent secondary caries or pulpal diseases. Therefore the marginal behavior of restorations is an important parameter to predict their longevity. Morphologically, the quality of margins is characterized by different well defined criteria. Using a replica technique it is possible to assess the complete marginal circumference of restorations in the SEM. Margins of restorations show a large variety of their morphology. This publication describes a method to quantify the quality of dental restorations. The restoration margins are traced on the SEM screen with a digitizer and an interface to measure the margin's length. Simultaneously the margin quality is assessed and assigned to the corresponding lengths. The % distribution of the quality criteria for each restoration is then calculated. Using a comparative light microscope, the replicas are aligned and mounted identically in the SEM for longitudinal studies. The results presented are limited to tests for the accuracy of the method. Using 5 criteria to characterize the margin quality, it was found that the difference between two measurements by the same operator, 4 weeks apart was 3% +/- 2.6%. The largest difference for one group was 9%. In another accuracy test where 4 criteria for margin characterization were used, the difference between two measurements was 1.9% +/- 0.9%. The largest difference between two groups found was 3.4%. This method can be used for longitudinal studies in vivo, but also for in vitro screening tests with new materials.

[Psychological test procedures for the elderly]

This paper presents our standardized psychometric inventory for the psychological investigation in the elderly patients: exploration, standard intelligence test, standard concentration-test, investigations into questionnaires of neurosis, screening-investigations of organic brain damage. The incorporation of information about the environment and its various effects in the exploration indicates the necessity for paying attention to the individual person-environment-relationship in psycho-diagnostic considerations. The necessity of psychometric methods in the diagnostic and therapeutic intervention in the elderly patients were discussed.

A new immunoenzyme tracer for localization of antibodies in immunohistology: peroxidase-labeled protein A

Protein A from Staphylococcus aureus, characterized by high affinity binding properties for IgG-type antibodies, was labeled with peroxidase to form a stable immuno-histological tracer molecule of comparatively low molecular weight. It has been used for demonstration of antibodies against tissue antigens, in direct and indirect techniques, and the findings were consistent with those in routine immunofluorescence and in staining with peroxidase-coupled anti-IgG. In comparison, the lowest unspecific tissue adsorption and staining was obtained with Protein A-peroxidase in buffer containing glucose and mannose. The immunohistological preparations were mounted and stored for documentation without apparent loss of staining.

Lymphocyte response to mitogens in patients with malignant melanoma

Lymphocyte blast transformation of 23 melanoma patients was compared to that of 22 healthy persons after stimulation with the mitogens PHA, ConA, and PWM. Transformation rate of lymphocytes in microcultures was measured following 3H-Thymidin uptake in a Liquid-Scintillation-Counter. Calculations were based on analyses of variance. There was no significant difference in blastogenetic response between the 2 groups (patients and controls), but there were differences between the used mitogens.

[Morphea resembling pseudoxanthoma elasticum in progressive scleroderma]

Lesions of circumscribed scleroderma clinically appeared as pseudoxanthoma elasticum. The histological structure, however, revealed circumscribed scleroderma. The sclerodactyly, Raynaud's phenomenon, acrosclerosis and the laboratory results suggested systemic sclerosis.