Stummer W.,Universitatsklinikum Munster |
Tonn J.-C.,Ludwig Maximilians University of Munich |
Mehdorn H.M.,Universitatsklinikum Schleswig Holstein Campus Kiel |
Nestler U.,Universitatsklinikum Giessen |
And 4 more authors.
Journal of Neurosurgery | Year: 2011
Object. Accumulating data suggest more aggressive surgery in patients with malignant glioma to improve outcome. However, extended surgery may increase morbidity. The randomized Phase III 5-aminolevulinic acid (ALA) study investigated 5-ALA-induced fluorescence as a tool for improving resections. An interim analysis demonstrated more frequent complete resections with longer progression-free survival (PFS). However, marginal differences were found regarding neurological deterioration and the frequency of additional therapies. Presently, the authors focus on the latter aspects in the final study population, and attempt to determine how safety might be affected by cytoreductive surgery. Methods. Patients with malignant gliomas were randomized for fluorescence-guided (ALA group) or conventional white light (WL) (WL group) microsurgery. The final intent-to-treat population consisted of 176 patients in the ALA and 173 in the WL group. Primary efficacy variables were contrast-enhancing tumor on early MR imaging and 6-month PFS. Among secondary outcome measures, the National Institutes of Health Stroke Scale (NIH-SS) score and the Karnofsky Performance Scale (KPS) score were used for assessing neurological function. Results. More frequent complete resections and improved PFS were confirmed, with higher median residual tumor volumes in the WL group (0.5 vs 0 cm3, p = 0.001). Patients in the ALA group had more frequent deterioration on the NIH-SS at 48 hours. Patients at risk were those with deficits unresponsive to steroids. No differences were found in the KPS score. Regarding outcome, a combined end point of risks and neurological deficits was attempted, which demonstrated results in patients in the ALA group to be superior to those in participants in the WL group. Interestingly, the cumulative incidence of repeat surgery was significantly reduced in ALA patients. When stratified by completeness of resection, patients with incomplete resections were quicker to deteriorate neurologically (p = 0.0036). Conclusions. Extended resections performed using a tool such as 5-ALA-derived tumor fluorescence, carries the risk of temporary impairment of neurological function. However, risks are higher in patients with deficits unresponsive to steroids.
Koroschetz J.,Universitatsklinikum Schleswig Holstein Campus Kiel |
Rehm S.E.,Universitatsklinikum Schleswig Holstein Campus Kiel |
Gockel U.,CASQUAR GmbH Computerassoziierte Qualitatssicherung u. Rehabilitations forderung |
Brosz M.,StatConsult GmbH |
And 3 more authors.
BMC Neurology | Year: 2011
Background: Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities.Methods: The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, PainDETECT). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts.Results: Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%).Conclusions: DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be found in 20-35% of patients of both aetiologies. © 2011 Koroschetz et al; licensee BioMed Central Ltd.
Rufer F.,Universitatsklinikum Schleswig Holstein Campus Kiel
Ophthalmologe | Year: 2011
Reliable measurements of the intraocular pressure (IOP) are necessary for glaucoma patients. The measuring procedure, anatomical changes of the eye or extraocular influences can lead to errors during applanation tonometry. The IOP is overestimated if measured through the wrong eyepiece of the slit lamp, if a force is interfering with the tonometer arm during the measurement, if the lid comes into contact with the tonometer tip, if blepharospasm occurs, if there is lid retraction or if a Valsalva maneuver is present. An underestimation of the IOP occurs if staining with fluorescein is absent or insufficient, if the illumination is not bright enough, if a corneal stromal edema is present, after LASIK, during accommodation, during repeated measures within a few minutes or during systemic blood pressure drop. Discrepancies of the IOP in both directions can appear if the calibration of the tonometer is irregular, if abnormal central corneal thickness or astigmatism is present. For correct measurements calibrations are advised once or twice a year. © 2011 Springer-Verlag.
Raum K.,JuliusWolff Institute |
Grimal Q.,Paris-Sorbonne University |
Grimal Q.,French National Center for Scientific Research |
Grimal Q.,French Institute of Health and Medical Research |
And 6 more authors.
Current Osteoporosis Reports | Year: 2014
Bone quality is determined by a variety of compositional, micro- and ultrastructural properties of the mineralized tissue matrix. In contrast to X-ray-based methods, the interaction of acoustic waves with bone tissue carries information about elastic and structural properties of the tissue. Quantitative ultrasound (QUS) methods represent powerful alternatives to ionizing x-ray based assessment of fracture risk. New in vivo applicable methods permit measurements of fracture-relevant properties, [eg, cortical thickness and stiffness at fragile anatomic regions (eg, the distal radius and the proximal femur)]. Experimentally, resonance ultrasound spectroscopy and acoustic microscopy can be used to assess the mesoscale stiffness tensor and elastic maps of the tissuematrix at microscale resolution, respectively. QUS methods, thus, currently represent the most promising approach for noninvasive assessment of components of fragility beyond bone mass and bone microstructure providing prospects for improved assessment of fracture risk. © Springer Science+Business Media 2014.
Jin X.,University of Kiel |
Gotz M.,Friedrich - Alexander - University, Erlangen - Nuremberg |
Wille S.,University of Kiel |
Wille S.,Universitatsklinikum Schleswig Holstein Campus Kiel |
And 3 more authors.
Advanced Materials | Year: 2013
The stress-induced photo-luminescence response of tetrapodal shaped ZnO filler embedded in a silicone elastomer is used to demonstrate a novel concept for self-reporting materials. Applied tensile stress can be followed in composites with low and high filler fractions by measuring the photoluminescence response of the T-ZnO. The deformation of the interlocked ZnO network appears to be essential for the self-reporting mechanism. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Straschewski S.,University of Ulm |
Warmer M.,University of Hamburg |
Frascaroli G.,University of Ulm |
Hohenberg H.,University of Hamburg |
And 3 more authors.
PLoS ONE | Year: 2010
Recombinant viruses labelled with fluorescent proteins are useful tools in molecular virology with multiple applications (e.g., studies on intracellular trafficking, protein localization, or gene activity). We generated by homologous recombination three recombinant cytomegaloviruses carrying the enhanced yellow fluorescent protein (EYFP) fused with the viral proteins IE-2, ppUL32 (pp150), and ppUL83 (pp65). In growth kinetics, the three viruses behaved all like wild type, even at low multiplicity of infection (MOI). The expression of all three fusion proteins was detected, and their respective localizations were the same as for the unmodified proteins in wild-type virus-infected cells. We established the in vivo measurement of fluorescence intensity and used the recombinant viruses to measure inhibition of viral replication by neutralizing antibodies or antiviral substances. The use of these viruses in a pilot screen based on fluorescence intensity and high-content analysis identified cellular kinase inhibitors that block viral replication. In summary, these viruses with individually EYFP-tagged proteins will be useful to study antiviral substances and the dynamics of viral infection in cell culture. © 2010 Straschewski et al.
Gedamu D.,University of Kiel |
Paulowicz I.,University of Kiel |
Kaps S.,University of Kiel |
Lupan O.,University of Kiel |
And 6 more authors.
Advanced Materials | Year: 2014
Two flame-based synthesis methods are presented for fabricating ZnO-nanostructure-based UV photodetectors: burner flame transport synthesis (B-FTS)and crucible flame transport synthesis (C-FTS). B-FTS allows rapid growth of ZnO nanotetrapods and in situ bridging of them into electrical contacts. The photo detector made from interconnected ZnO nanotetrapod networks exhibits fast response/recovery times and a high current ratio under UV illumination. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Mahn F.,Universitatsklinikum Schleswig Holstein Campus Kiel |
Baron R.,Universitatsklinikum Schleswig Holstein Campus Kiel
Schmerz | Year: 2010
The term "peripheral neuropathic pain syndromes" summarizes several chronic pain syndromes, which can occur focal ly or generalized in the peripheral nervous system in the course of an impairment of afferent neurons. Controlled clinical trials gave distinct indications for systemic treatments with antidepressants, anticonvulsants and opioid analgesics in several neuropathic pain syndromes. In addition to these systemic therapies, there are also two topical treatment options: topical application of lidocaine and capsaicin. An important cause of sensitization phenomena of afferent nociceptors is the upregulation of sodium channels and thermosensor channels. I n the context of a partial nerve lesion that leaves behind partially preserved or regenerated afferent nerve fibres, just these channels could be used as target structures for topical medications. Topically applied drugs are absorbed systemically only in minute quantities, so systemic side effects are negligible. Pharmacological interactions with systematically acting substances are also virtually absent; thus, topically applied substances are especially appropriate for add-on therapy in addition to systemic pain medication. © Deutsche Gesellschaft zum Studium des Schmerzes.
Ullrich G.,Freiberuflicher Wissenschaftler |
Bobis I.,Universitatsklinikum Schleswig Holstein Campus Kiel |
Bewig B.,Universitatsklinikum Schleswig Holstein Campus Kiel
Pneumologie | Year: 2015
Aims: To explore pregnancy and motherhood in cystic fibrosis patients from the women's perspective. Methods: Data were assessed with a purpose designed questionnaire and the paper focuses on the following sections: pregnancy and birth (feedback of significant others, women's knowledge, concerns, and overall judgement), and the first year as a mother (overall judgement). Sample: 38/73 mothers filled in the questionnaire; mean age was 33.8y±7.1y and mean age of firstborn child was 6.9y±5.7 years. Nine women had more than one biological child. 18 mothers (47%) were currently employed, 12 of whom with 19 to 30 hours per week and none full-time. Mean FEV1 in perc. Pred. was 66±19%. Results: Pregnancy in CF should be planned and prepared, and this was achieved in 28 women, while 10 pregnancies were unplanned. The feedback of significant others towards wish for child/pregnancy was more positive in those who planned. Mothers' own parents reacted least enthusiastic, irrespective of whether or not pregnancy had been planned. The feedback of CF-teams differed according to women's lung function. The women's knowledge about pregnancy and CF was rather poor. Their concerns predominantly referred to detrimental effects of CF medication to the unborn child. Conclusions: Motherhood is increasingly becoming an option for young women with CF. Therefore, CF-teams are well-advised to proactively engage them in a dialogue about wish for child and impact of CF on motherhood. Knowledge about pregnancy/motherhood and CF should be increased. © Georg Thieme Verlag KG Stuttgart, New York.
Berneburg M.,University of Tübingen |
Schwarz T.,Universitatsklinikum Schleswig Holstein Campus Kiel
Hautarzt | Year: 2013
Phototherapy represents one of the essential options in the treatment of skin diseases by dermatologists. The beginnings of phototherapy were based on empirical observations and only later the underlying molecular and cellular mechanisms of the different modalities of phototherapy were unravelled by scientific research. Due to these findings, some phototherapeutic indications were subsequently altered. In this article, the known photobiological effects of ultraviolet radiation will be discussed and put in relation to the different forms of phototherapy as they are applied in the daily practice by dermatologists. © 2013 Springer-Verlag Berlin Heidelberg.