Pavlidis P.,Katholisches Klinikum Koblenz |
Gouveris H.,University Clinic |
Anogeianaki A.,Aristotle University of Thessaloniki |
Koutsonikolas D.,Aristotle University of Thessaloniki |
And 2 more authors.
Chemical Senses | Year: 2013
The aim of the study was to investigate age-related changes in electrogustometry (EGM) thresholds, in morphology and density of the fungiform papillae (fPap) and in vessels' shape and density at the tip of the human tongue.In 156 nonsmokers (74 males, 82 females; age range: 10-80 years), divided in age groups, EGM thresholds at the chorda tympani area, at the soft palate area, and at the area of the vallate papillae were recorded bilaterally. Morphology and density of the fPap and blood vessels' density and morphology at the tip of the tongue were examined using contact endoscopy (CE). EGM thresholds at the chorda tympani area were significantly higher in both men and women ←60 years of age than in younger individuals. At the soft-palatine area, EGM thresholds were significantly higher in men aged 20-29 years and ←60 years compared with men of other age groups. In women older than 50 years, thresholds at all 3 areas were significantly higher than in the younger age groups. No significant differences in EGM thresholds between the two sexes at all locations tested were detected. The density of fPap decreased significantly in men aged >50 years and in women aged >60 years compared with younger individuals. Vascular density decreased significantly and vascular morphology worsened at the tip of the tongue in subjects older than 60 years of age compared with younger subjects. The study showed statistically significant differences in EGM thresholds between the right and the left side of the tongue and between the two sexes. Aging is associated with a progressive increase in EGM thresholds. Density of fPap plays an important role for taste acuity in females aged >60 years and males aged ←50 years. Morphology of fPap and vessels' density and morphology at the tip of the tongue, as tested by CE, emerge as factors influencing taste function in subjects of both sexes aged >60 years. © The Author 2012. Published by Oxford University Press. All rights reserved.
News Article | November 4, 2015
Surgery is unavoidable for treating inner ear tumors, but the inner ear is difficult to access. This is because it is covered by a cranial bone known as the mastoid, or petrosal bone. What's more, the surrounding tissue contains lots of nerves and blood vessels. For this reason the surgeons will cut out as much of the mastoid bone as needed until they have located each one of these sensitive structures. Only then can they be sure not to damage them. What this entails most of the time is the removal of the entire bone. The hole thus created is filled in with fatty tissue taken from the abdomen after the completion of the procedure. In the future this operation will be performed in a less invasive fashion, requiring just a small hole measuring 5 mm in diameter through which the tumor can be resected from the inner ear. The technology that makes this possible goes by the name of NiLiBoRo, a German acronym which stands for "Non-linear Drilling Robot". The system is being developed by researchers in the Mannheim Project Group for Automation in Medicine and Biotechnology, part of the Fraunhofer Institute for Production Technology and Automation IPA, in cooperation with the Technical University of Darmstadt, the University of Aachen, and the Düsseldorf University Clinic. Drilling machines capable of boring a tunnel through bone already exist, but they can do so only in a straight line. "NiLiBoRo is the first one that can drill around corners as well," says project group scientist Lennart Karstensen. It is this particular characteristic that makes it possible to perform minimally invasive surgery on inner ear tumors. If the tunnel were to run in a straight line, it would at times come troublingly close to hitting nerves. To avoid injuring nerve tissue, the tunnel would have to be no more than 1 to 2 mm in diameter. However, it is impossible to perform surgery through such a small opening. The NiLiBoRo on the other hand is capable of steering around sensitive areas. This makes it possible to achieve a tunnel diameter of 5 m, which is wide enough to perform the operation. Hydraulic lines allow the robot worm to crawl forward So how does this "worm" manage to drill around curves and corners through the mastoid bone? "The worm consists of a 'head' and a 'tail' section," explains Karstensen. "Both of these parts are connected with one another by means of a flexible bellows mechanism." The design is reminiscent of an articulated public transit bus in which the front and rear sections are coupled by means of a hose-like center section that looks like an accordion. As it travels through the bone, the robot is connected to the "outside world" – in other words the control units and pumps in the operation room – by means of 8 to 12 hydraulic lines. It is these lines that allow the robot to crawl forward in the right direction. This is done by first pumping hydraulic fluid into three bladders found in the rear section of the robot. The bladders fill in the empty space between the worm and the bone and thereby fix the rear section of the robot in place. The hydraulic fluid then travels into the bellows. This causes the "accordion" to expand, which pushes the head forward. The worm stretches, so to speak, and presses its front section further into the bone. The drill attached to the head bores deeper inward. Now the rear section retracts towards the head in a motion similar to that of a real worm. To do so, the bladders in the front section are pumped full of fluid to hold the front in place while the fluid in the rear bladders is evacuated. At this point the fluid is also being sucked out of the bellows through the hydraulic lines. The robot contracts, which pulls the rear section up behind the front. In this way the NiLiBoRo makes its way forward bit by bit. "We can alter the robot's direction of travel by adjusting the bladders in the front section. For instance, if we wanted to move left then we fill the left bladder with less fluid than the right, which will cause the robot to veer to the left," says Karstensen. In the laboratory, and later in the operation room, the path the NiLiBoRo takes as it drills its way forward is precisely monitored by an electromagnetic tracking system, or EMT for short. Designed by partners at the Technical University of Darmstadt, this system works by sporadically capturing images of the robot using computer tomography in order to monitor its position. Researchers have already constructed an initial prototype of the NiLiBoRo, which is currently five times larger than the planned final version. Right now it is composed of only the forward section together with the heart of the machine, the bellows. The developers plan to continue optimizing and expanding the prototype piece by piece. Once all the technology has been developed, the NiLiBoRo will be shrunk down to its final size. Researchers hope to have the miniature robot ready for testing by physicians in two years.
News Article | December 14, 2016
New York City is known for its strange sights. But on 12 July, even locals were shocked by what they saw: more than 30 people staggering around a Brooklyn block with empty stares, shuffling their arms and feet and occasionally groaning. What sounds like the opening of a horror movie was suspected from the start to be the work of a synthetic cannabinoid. Now, a new analysis, out today in The New England Journal of Medicine , confirms those suspicions. But it has also raised scientific ire over its prolific use of the word “zombie.” Developed by academics and pharma companies to study cannabinoid receptors in the human body, synthetic cannabinoids act on the same receptor on brain cells as cannabis. The compounds, which can be up to 100 times more potent than cannabis, are a rapidly growing class of drugs, usually dissolved in liquid and sprayed on leaves to be smoked. There are hundreds of different compounds, and though they are quickly made illegal in many places, new ones appear every year. To find out what was responsible for the Brooklyn episode, researchers from the University of California, San Francisco (UCSF), started with a foil-wrapped pouch of herbs found on one of the patients, labeled “AK-47 24 Karat Gold.” When they analyzed a sample, they found it contained the substance AMB-FUBINACA, a powerful synthetic cannabinoid similar to a compound first patented by Pfizer in 2009. The researchers also found breakdown products of AMB-FUBINACA in the blood of eight patients. But the most interesting thing, says Rainer Spanagel, a pharmacologist at the Central Institute of Mental Health in Mannheim, Germany, is that AMB-FUBINACA seems to have resulted in fewer serious side effects compared with similar compounds. “These highly potent cannabinoids usually have a strong toxic effect on the heart, but that does not seem to be the case here,” he says. The authors also note that its effects on the brain were not accompanied by hyperthermia or acute kidney injury, as is often the case. But the Brooklyn episode is “nothing special,” says Volker Auwärter, a forensic toxicologist at University Clinic Freiburg in Germany. “We have people coming to the hospital all the time,” similarly affected by synthetic cannabinoids. One of those is MDMB-CHMICA, which has been associated with at least 71 serious adverse events including 29 deaths in eight EU states, according to a 2016 report by the European Monitoring Centre for Drugs and Drug Addiction and the Europol law enforcement agency. Many prisons in the United Kingdom are awash in similar substances, says David Nutt, a pharmacologist at Imperial College London. “We have people go to hospitals with adverse events every day,” he says. Auwärter and Spanagel also criticized the use of the word “zombie” in the article, which appears once in the title and six times in the text. “It’s frankly surprising that an old, prestigious journal like The New England Journal of Medicine would sensationalize it this way,” Spanagel says. And Auwärter calls it “a bit of a trick to make the story sexier.” Roy Gerona, a clinical chemist at UCSF and the last author on the paper, says the word’s use started as a whim. “We were joking around: What if we just put in ‘zombie outbreak’ and see what happens?” he says. A controversial title, Gerona adds, could also help get the attention not just of scientists, but regulators and policymakers for the problem of synthetic cannabinoids. “I feel bad that we are stooping to this level, but unfortunately the more sensational a title, the more attention it gets,” he notes. Indeed, medical journals apparently have a fondness for the undead. Exactly a year ago, on 14 December 2015 published a paper called “Zombie infections: epidemiology, treatment, and prevention.” That, however, was a tongue-in-cheek paper title for the journal’s traditionally goofy Christmas edition.
Trimborn A.,Senckenberg Institute |
Senf B.,Goethe University Frankfurt |
Muenstedt K.,Justus Liebig University |
Buentzel J.,Municipal Hospital |
And 5 more authors.
Annals of Oncology | Year: 2013
Background: Cancer patients often use complementary and alternative medicine (CAM), yet discussion with the oncologist is often missing and oncologists lack knowledge in CAM. Patients and methods: In order to learn more about the attitude of professionals in oncology toward CAM, a survey was conducted on employees of a German university clinic using a structured questionnaire. Results: In total, 547 employees took part in the survey. One-third would definitely use CAM on cancer patients. Female employees are more interested in CAM than males (80%versus 20%; P = 0.001); physicians are less interested than nurses (57% versus 72%; P = 0.008). 2.5% of physicians and 9% of nurses are convinced that CAM is as effective as conventional therapy in cancer. Fifty-two percent of physicians and 12% of nurses agree that adverse effects due to CAM may be possible. Seventy-three percent did not consider themselves adequately informed on CAM for their professional work. Conclusions: As a substantial part of participants would use CAM on cancer patients and most are interested in but not trained on this topic, there is a need for training of professionals from different professions working in oncology. © The Author 2013.
News Article | November 30, 2016
Could a psychedelic drug help people who are dying of cancer face their fears? Two long-awaited studies suggest that the hallucinogenic compound in magic mushrooms, psilocybin, could do just that. “They are the most rigorous double-blind placebo-controlled trials of a psychedelic drug in the past 50 years,” writes David Nutt, a pharmacologist at Imperial College London who was not involved in the work, in an editorial accompanying the papers. Both studies, published today in the , combined a psychedelic trip with several sessions of psychotherapy. In one, at Johns Hopkins University in Baltimore, Maryland, 51 cancer patients received two doses of the drug 5 weeks apart, one relatively high and one so low that it was unlikely to have any effect. In the second study, at New York University (NYU) in New York City, 29 cancer patients randomly received either psilocybin or niacin, a compound that mimics some side effects of psilocybin—including a flushed, hot feeling—but without the hallucinogenic properties. Seven weeks later, the patients received the other compound. Of the participants who received the high dose in the second study, 83% reported feeling significantly less depression and 58% reported less anxiety after 7 weeks. Only 14% of those who received niacin reported less anxiety and less depression. And the effect in both studies was still apparent months later. For instance, in the Johns Hopkins study, about 60% of all participants still showed normal levels of depression and anxiety after 6 months. “The findings are impressive, with good safety data and large effect sizes," says Robin Carhart-Harris, who studies psychedelic drugs at Imperial College London. "My feeling is that these studies will play a significant role in waking up the scientific and medical mainstream to the therapeutic potential of psychedelics." Two things in particular are striking about the results, says Isabella Heuser, a psychiatrist at Charité, the University Clinic in Berlin: There seemed to be a rapid onset of the effect, and it was still measurable months later. “These are still small trials,” Heuser cautions. “But the fact that they both show very similar results is very encouraging.” Guy Goodwin, a psychiatrist at the University of Oxford in the United Kingdom, says the trials have moved the field forward. “I think they represent a kind of landmark," he says. “But they are the beginning of something, not the end or the proof of something.” Many cancer patients develop severe depression and anxiety after their diagnosis, says Roland Griffiths, who led the John Hopkins study. These feelings can persist even when the cancer is gone. Dinah Bazer, a 69-year old woman from Brooklyn, New York, who participated in the NYU study, was diagnosed with ovarian cancer in 2010. Surgery and chemotherapy were successful but she was consumed with anxiety and fear of the cancer coming back. “It was running my life and ruining my life,” she says. “This drug saved my life.” But patients like Bazer don’t typically have the option for such treatment today. In the 1960s, psilocybin and LSD were used to treat depression or alcoholism in numerous trials. But widespread misuse—and their association with the counter-culture—led to a political backlash. In 1970, U.S. President Richard Nixon banned the drugs and virtually all research ceased. Research started up again in the 1990s, but it has been hampered by strict regulations and methodological issues. One of the problems facing researchers is how to ensure that participants and investigators don’t know whether they are dealing with the drug or a placebo. In the Johns Hopkins study, participants and therapists were told that patients would receive psilocybin on both occasions and that the dose could vary. But fooling participants who might be feeling the effects of a powerful mind-altering drug isn’t easy. This is particularly worrisome, because the measures of effect on depression or anxiety tend to be subjective, Goodwin says. “If they could show for instance that people go back to work or that they move around more, that would be objective evidence.” How exactly psilocybin could lead to a decrease in anxiety and depression is unclear. Both studies found that patients who have a stronger mystical experience also showed a better outcome, whether or not they reported being religious, says Stephen Ross, who led the NYU study. Bazer, for instance, says she experienced “being bathed in God’s love” for hours after taking psilocybin. “I really had no other way to describe this incredibly powerful experience," says Bazer, who says she was and still is an atheist. “I believe this was something that happened in my brain." But whether that experience somehow catalyzes changes itself, or is just a side effect of other changes, is hard to pinpoint. Either way, the treatment could help many patients, Ross says. The Food and Drug Administration is currently reviewing an application for a phase III trial of psilocybin, the last step before the therapy could be approved. There is good reason to be hopeful, Ross says. On Tuesday, the regulatory body gave the green light for a phase III trial of another contentious drug: using ecstasy to treat posttraumatic stress disorder.
News Article | September 16, 2016
Researchers are collaborating to expand the potential of their robot assistant for the treatment of children diagnosed with autism spectrum disorder (ASD). Specifically, the goal is to explore the ways in which the AISOY robot can enhance therapy sessions at the UMH University Clinic.
News Article | September 16, 2016
Researchers at the Universidad Miguel Hernández (UMH) and AISOY Robotics are collaborating to expand the potential of their robot assistant for the treatment of children diagnosed with autism spectrum disorder (ASD). Specifically, the goal is to explore the ways in which the AISOY robot can enhance therapy sessions at the UMH University Clinic.
Yeung C.-H.,University Clinic
Asian Journal of Andrology | Year: 2010
Mammalian spermatozoa have relatively high water permeability and swell readily, as in the hypo-osmotic swelling test used in the andrology clinic. Physiologically, spermatozoa experience changes in the osmolality of the surrounding fluids in both the male and the female tracts on their journey from the testis to the ovum. Sperm volume regulation in response to such osmotic challenges is important to maintain a stable cell size for the normal shape and function of the sperm tail. Alongside ion channels for the fluxes of osmolytes, water channels would be crucial for sperm volume regulation. In contrast to the deep knowledge and numerous studies on somatic cell aquaporins (AQPs), the understanding of sperm AQPs is limited. Among the 13 AQPs, convincing evidence for their presence in spermatozoa has been confined to AQP7, AQP8 and AQP11. Overall, current findings indicate a major role of AQP8 in water influx and efflux for sperm volume regulation, which is required for natural fertilization. The preliminary data suggestive of a role for AQP7 in sperm glycerol metabolism needs further substantiation. The association of AQP11 with the residual cytoplasm of elongated spermatids and the distal tail of spermatozoa supports the hypothesis of more than just a role in conferring water permeability and also in the turnover and recycling of surplus cellular components made redundant during spermiogenesis and spermiation. This would be crucial for the maintenance of a germinal epithelium functioning efficiently in the production of spermatozoa. © 2010 AJA, SIMM & SJTU All rights reserved.
Lange J.,Friedrich - Alexander - University, Erlangen - Nuremberg |
Auernheimer V.,Friedrich - Alexander - University, Erlangen - Nuremberg |
Strissel P.L.,University Clinic |
Goldmann W.H.,Friedrich - Alexander - University, Erlangen - Nuremberg
Biochemical and Biophysical Research Communications | Year: 2013
Mechanical forces play an important role in the organization, growth, maturation, and function of living tissues. At the cellular level, the transmission of forces from outside the cell through cell-matrix and cell-cell contacts are believed to control spreading, motility, maturation as well as intracellular signaling cascades that may change many characteristics in cells. We looked at cell populations of mouse embryonic fibroblasts that are deficient of focal adhesion kinase (FAK) and examined their mechanical profile. We observed that the lack of FAK induces a mesenchymal-epithelial switch including the regulation of adherens junctions via E-cadherin, leading to increased cell-cell-cohesion. Our results show that the absence of FAK influences the macroscopic cell colony spreading in two (2D) and three (3D) dimensions as well as the velocity fields of the tissue, the single cell persistence and correlation length, changing from an independent to a collective mode of migration. Additionally, the single cell size in the sheet decreases significantly. © 2013 Elsevier Inc.
News Article | February 3, 2016
He created stunningly lifelike moulages: wax models of the human body in states of disease, once used for training doctors. Later, he turned to art, rising in the 1950s to become a star of the US abstract scene with paintings featuring vibrantly hued geometric shapes. Adolf Fleischmann (1892–1968) had impacts on medicine and art that were equally powerful and strangely divided. This year, two Berlin exhibitions (for which I have contributed to the catalogues) will explore Fleischmann's oeuvre: Surfaces at the Berlin Museum of Medical History at the Charité (which adapts a joint presentation of the Museum of Concrete Art and the German Museum of Medical History, both in Ingolstadt) and the Adolf Fleischmann Retrospective at Daimler Contemporary Berlin. Whereas Surfaces is a survey of Fleischmann's varied life, focusing on medical works made between 1917 and 1927, the Daimler Contemporary retrospective concentrates on Fleischmann's artistic career in the United States, between 1952 and 1965. The German-born Fleischmann trained as a graphic illustrator, then studied fine art in Stuttgart from 1911 to 1913. Heavily wounded in the First World War, he moved to neutral Switzerland in 1917 to work as a medical sculptor at Zurich's Surgical University Clinic. With the encouragement of the eminent moulage-maker Luise (Lotte) Volger and under clinic head and eminent surgeon Paul Clairmont, Fleischmann built up a unique collection of 400 surgical moulages over 10 years. These documented, in graphic 3D, trauma, pathological changes in the body, and therapeutic interventions visible on the patient's skin — such as wounds caused by strong electrical currents, swellings of the thyroid gland and side-effects of X-rays, such as skin atrophy. Impressive moulages of this kind will be on display at the Museum of Medical History. Medical moulage-making, which had begun in cities including Jena, Germany, in the early nineteenth century, blossomed from the 1850s in the European medical centres of London, Paris, Vienna and Berlin. Around 1900, it spread around the world, coexisting with photography and other forms of graphic medical illustration until the 1950s, when the colour slide finally reached a satisfactory technical standard. Creating a moulage involved taking a plaster cast of an area of the patient's skin and filling it with coloured liquid wax. Once detached, the wax shell was painted and finished from life to capture every nuance of form and colour, creating a perfect illusion for teaching. Although the process was clearly mimetic, the observational skill demanded was superb training for the artist's eye: in the topography of diseased and traumatized skin, Fleischmann could study organic form and detect graphic patterns and gradations of colour. Although Fleischmann's moulages are unsigned, he did sign other works in his medical oeuvre, indicating that he felt they stood out visually and even artistically. These are 30 histopathological drawings of skin tissue, held at the Zurich Moulage Museum and largely overlooked. In Zurich between 1918 and 1927, Fleischmann used a microscope to make unprecedentedly subtle and accurate ink drawings of the dermatological evidence of diseases, such as the scaly skin disorder ichthyosis vulgaris, Hodgkin's lymphoma or the systemic autoimmune condition lupus erythematosus. He documented the intricate details of complex structures and interactions of cells, nerves and veins, building his scientific understanding of visible organization and structure. As with the moulages, he reproduced form and colour; but with the drawings he also did more. There is a dynamical element in his mastery of line: the illustrations reveal a subtle movement, sublime gestures, the hidden contours under the skin. In these images, Fleischmann liberates himself as an artist. He had been striving to become a fine artist, and to be seen as one, since the 1920s in Zurich. Here, he was able to absorb expressionist and cubist artworks, in particular those of Munich's Blue Rider group, which included Wassily Kandinsky and Franz Marc. But his path to acceptance was long and strewn with obstacles. The rise of Nazism and the Second World War forced moves to France, Spain, Italy and, post-war, back to Paris. Studying the work of artistic luminaries Robert Delaunay and Piet Mondrian, he finally arrived at his own distinct style in 1950. Settling in New York City two years later, he produced a stream of outstanding abstract paintings and prints that drew heavily on the urban elements of his new home. Fleischmann only occasionally returned to medical imaging. However, there are hints of his microscopic drawings in several of his late works of art, such as the oil painting Composition 71 N.Y. (1956), highlighted in the Daimler Contemporary show. Rounded motifs call to mind a microscope lens, for instance, and intricate grids of horizontal and vertical lines — combined with the 'flickering' appearance of the colours — give the pieces a visual dynamic. Perhaps this is why Fleischmann's artworks, although radically abstract in composition, appear so breathtakingly lively.