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1.
The vagal nerve as a link between the nervous and immune system in the instance of polymicrobial sepsis 总被引:5,自引:0,他引:5
Wolfram Kessler Tobias Traeger Alexandra Westerholt Friederike Neher Marlene Mikulcak Antje Müller Stefan Maier Claus-Dieter Heidecke 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2006,391(2):83-87
Background The role of the vagal nerve in the autonomic nervous system is widely well known. Recently, an additional function was revealed
serving as a connector between the nervous and immune system. This connection is called the “cholinergic inflammatory pathway.”
Through stimulation of the acetylcholine receptors located upon the macrophages, the “unspecific” immune system can be directly
influenced.
Methods The vagal nerve was completely transected directly posterior to its passage through the diaphragm. The effect of complete
vagotomy was analyzed using a murine model of polymicrobial peritonitis (colon ascendens stent peritonitis, CASP). Survival
and clinical course of vagotomized or sham-operated mice were analyzed in the CASP model.
Results After CASP surgery, vagotomy led to a significantly increased mortality (64.7%) in comparison to sham-vagotomized animals
(34%). No difference in the bacterial load of various tissues (lung, liver, spleen, blood, lavage fluid, and kidney) from
septic animals with or without vagotomy was observed. Vagotomized animals reveal elevated serum cytokine levels (TNF, IL-6,
IL-10, and MCP-1) 20 h after the induction of polymicrobial peritonitis.
Conclusion The vagal nerve is therefore an important modulator of the immune system.
W. Kessler and T. Traeger contributed equally to this work
Best of Forum Papers presented at the Annual Meeting of the German Society of Surgery, 2–5 May 2006, Berlin, Germany 相似文献
2.
Differential Stripping: Determination of the Amount of Topically Applied Substances Penetrated into the Hair Follicles
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Alexa Teichmann Ute Jacobi Michael Ossadnik† Heike Richter Stefan Koch† Wolfram Sterry Jürgen Lademann 《Journal of general internal medicine》2005,20(5):264-269
The determination of penetration pathways of topically applied substances into the skin is the subject of several investigations. Recently, follicular penetration has become a major focus of interest. To date, a direct, non-invasive quantification of the amount of topically applied substance penetrated into the follicles had not been possible. The development of such a method was the aim of this study. Therefore, the advantages of both stripping techniques, tape stripping and cyanoacrylate skin surface biopsy, were combined and evaluated. Tape stripping was used to remove the part of the stratum corneum that contained the topically applied dye. Subsequently, the follicular contents were ripped off by cyanoacrylate skin surface biopsy. The combined method termed "differential stripping" was evaluated in vitro and in vivo , and the amount of topically applied fluorescent dye penetrated into the hair follicles was quantified after different penetration times. After 30 min, 5% of the recovered concentration of sodium fluorescein was found in the follicular infundibula, where it was still detectable after 48 h. Altogether, the results of this investigation revealed that differential stripping is a new method that can be used to study the penetration of topically applied substances into the follicular infundibula non-invasively and selectively. 相似文献
3.
Prof. Dr. E. Minar B. Pokrajac R. Wolfram A. Budinsky C. Kirisits R. Pötter 《Gef?sschirurgie》2003,8(2):75-84
The therapeutic concept of irradiation of the vessel wall for prevention of restenosis after endovascular procedures is based on increasing knowledge about the pathophysiology of the process leading to restenosis. There is until now only a limited number of studies concerning the use of brachytherapy (BT) in the peripheral circulation, which is in contrast to the already large experience in the coronary circulation. In the peripheral trials the radiation dose was administered by a remote afterloader using a gamma source. According to the available data, vascular BT is a promising technology with the potential to reduce the restenosis rate. The Vienna-2-Trial was the first randomised study to demonstrate the efficacy of endovascular BT for prophylaxis of restenosis after femoropopliteal percutaneous transluminal angioplasty. However, we have to await further supportive data from ongoing clinical trials before definitive recommendations can be given. Currently, endovascular BT seems already justified in patients with recurrent interventions or after long-segment femoropopliteal angioplasty because of the high risk of restenosis in these patients. The next years will demonstrate the ultimate role of endovascular BT in comparison to the rapidly evolving field of drug-eluting stents. 相似文献
4.
Markus Friedrich Wolfram Sterry Khusru Asadullah 《Journal der Deutschen Dermatologischen Gesellschaft》2003,1(1):12-21
The current standard systemic therapeutic modalities for psoriasis have many potential side effects. Progress made in the understanding of the pathophysiology of psoriasis as a T‐cell‐mediated dermatosis provide options for new more precise therapeutic approaches. These immunological therapeutic strategies involve the inhibition/depletion of activated T‐lymphocytes, the inhibition of antigen presentation and thus the regulation of T‐cell activation, the inhibition of adhesion of inflammatory cells, the inhibition of effects of proinflammatory mediators and the administration of antiinflammatory cytokines. This article summarizes these new systemic therapeutic approaches. Clinical results in the early studies have been mixed. In the next years further results of phase II‐ and phase III‐studies may be expected, which should allow better assessment of the potential of those particular approaches. Some of these approaches could lead to the approval of new drugs to treat psoriasis and to enhance or replace already existing therapeutic options. Furthermore results of therapeutic experiments should contribute to a better understanding of the disease. As we learn which mechanisms are more or less important for the disease, we will be better able to plan intervention strategies. 相似文献
5.
Henryk Barthel Michael Wiener Claudia Dannenberg Simone Bettin Bernhard Sattler Wolfram H. Knapp 《European journal of nuclear medicine and molecular imaging》1997,24(10):1245-1252
This study addresses the question of whether the normal range for distribution of local cerebral blood flow (lCBF) in adults
can be transferred to the 4- to 15-year-old age group. Twenty-three children (age: 4–15 years; mean 11±3 years, group I) and
10 adults (age: 27–56 years; mean 45±10 years, group II) without evidence of cerebrovascular disease or other brain diseases
underwent technetium-99m ethyl cysteinate dimer single-photon emission tomography. Counts in cortical and subcortical regions
of interest (ROIs) were related to those in cerebellar ROIs (= 100%). Relative cortical activity in group I exceeded that
in group II, particularly in left parietal (107.6%±9.8% vs 84.1%±12.4%), left frontal (97.7%±6.7% vs 79.4%±8.9%) and left
temporal areas (99.7%±7.4% vs 84.9%±10.1%) and in the cingulate cortex (112.1%±9.1% vs 95.9%±10.1%, P<0.05). Cerebral activity uptake per injected dose was inversely correlated with age in 19 children of group I (r = –0.77, P<0.001). In group I, there was also an inverse correlation between age and the relative local count density in the parietal
(r = –0.42 to –0.57), frontal (r = –0.48), temporal (r = –0.42 to –0.58) and occipital cortex (r = –0.44). In these cortical regions relative counts differed when subgroups of children aged 4–10 and 11–15 years were analysed.
It is concluded that there are systematic differences between 4- to 15-year-old children and adults with regard to normal
lCBF. Diagnostic use of perfusion agents has to consider age-adjusted normal flow maps; normal ranges should be determined
separately for the age groups 4–10 and 11–15 years.
Received 23 March and in revised form 11 July 1997 相似文献
6.
Tim Strate Claus Schneider Emre Yekebas Wolfram T Knoefel Christian Bloechle Jakob R Izbicki 《Journal of investigative surgery》2003,16(1):13-21
This study was devised to identify sepsis-relevant parameters that early and reliably predict a lethal outcome in intra-abdominal sepsis. In 18 Duroc pigs, peritonitis was induced through standardized gastrotomy. Twelve hours later the defect was oversewn and the abdominal cavity lavaged thoroughly. Sepsis relevant parameters were measured before initiating therapy, and 30 min later animals were extubated and observed for a period of 6 days under adequate analgesia with free access to water and food. All parameters were correlated with survival postoperatively. In the treatment group, 7 out of 18 pigs (39%) died within the observation period. Endotoxin level at 30 min after initiation of therapy [17.9 EU/mL (+/- 12.1) vs. 110.9 EU/mL (+/- 21); p <.001] and Delta pHi [0.015 (+/- 0.011) vs. -0.039 (+/- 0.013); p =.016] were identified as the two parameters with highest predictive power regarding mortality in a multivariate analysis. In conclusion measurement of endotoxin and gastric tonometry should gain wider clinical application in septic patients. 相似文献
7.
8.
9.
Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI) 总被引:1,自引:0,他引:1
Oliver Gimm Evelyn König Phuong Nguyen Thanh Michael Brauckhoff Wolfram Karges Henning Dralle 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):679-684
Background and aims Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor.
In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until
recently.
Materials and methods Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial
calcium injection (SACI). In addition, insulin was measured before surgery and every 10–15 min after resection of the tumor
using a quick insulin assay.
Results Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance
imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected
(n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively,
underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped
to normal levels within 20 min in all cases. After a follow-up of 0.8–3 years, all patients remained biochemically cured.
Conclusions Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon
if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted
using a quick insulin assay.
This paper was presented at the 2nd Biennial Meeting of the European Society of Endocrine Surgeons (ESES), May 18–20, 2006,
Krakow, Poland. 相似文献
10.
John R. Graybill Laura K. Najvar Annette Fothergill Thomas Hardin Michael Rinaldi Chris Lambros Steven L. Regen 《Antimicrobial agents and chemotherapy》1998,42(1):147-150
KY-62 is a water-soluble analog of amphotericin B. In vitro testing of five clinical isolates of Candida albicans showed KY-62 to have potency similar to that of amphotericin B. KY-62 was administered to mice infected intravenously with C. albicans. In vivo, KY-62 was effective in immunocompetent mice, with potency similar to that of amphotericin B. KY-62 was well tolerated up to 30 mg/kg of body weight per dose, an amount that would be lethal with amphotericin B. KY-62 was less effective in mice rendered neutropenic with 5-fluorouracil. The addition of flucytosine had little effect. KY-62 may have potential for clinical development. 相似文献