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2.
Experimental Arthritis in the Rat Induced by the Superantigen Staphylococcal Enterotoxin A
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K. Gerlach C. Tomuschat R. Finke M. S. Staege C. Brütting J. Brandt B. Jordan R. Schwesig A. Rosemeier K.‐S. Delank M. E. Kornhuber A. Emmer 《Scandinavian journal of immunology》2017,85(3):191-196
The pathogenesis of rheumatoid arthritis (RA) is incompletely understood. Human endogenous retroviruses (HERVs) and their superantigenic envelope protein (env) have been implicated in the pathogenesis of RA. In the present investigation, the arthritogenic potential of the superantigen staphylococcal enterotoxin A (SEA) has been investigated. In the present investigation, the bacterial superantigen staphylococcal enterotoxin A (SEA) was injected into the right knee joint of 15 Lewis rats. Further nine animals received saline. Animals were sacrificed one, five and 10 days after the injection, respectively. The antigens CD3, CD4, CD8, MHC class I, MHC class II, Pax5 and CD138 were investigated by immunohistochemistry on cryo‐sections. After intra‐articular SEA injection, the inflammation was initially dominated by CD8+ T cells. In the course of the investigation, the numbers of CD4+, Pax5+, CD138+ and MHC class II+ cells increased. CD3 was expressed in low numbers as compared to CD8. After saline injection, no similar inflammatory response has been detected. The arthritis induced by the superantigen SEA may be a novel model for inflammatory joint diseases, that is rheumatoid arthritis or juvenile idiopathic arthritis. 相似文献
3.
A.?LauenrothEmail author K.?Laudner S.?Schulze K.-S.?Delank G.?Fieseler R.?Schwesig 《Manuelle Medizin》2018,56(2):182-187
Background
Clinical gait analysis is an established component in the evaluation of human physiological and pathological gait. Walking speed is one of the most important determinants of kinematic and kinetic parameters, and velocity-specific reference data are thus essential for interpretation of results. The aim of this study was to evaluate kinematic and kinetic gait treadmill data with respect to velocity, gender, height, and body mass.Subjects and methods
On a dynamometric treadmill, 141 healthy volunteers underwent three trials (30?s per trial) at walking speeds of 2, 4, and 6?km/h. Kinematic and kinetic parameters were obtained using the zebris FDM-TF1.8 Treadmill (zebris Medical GmbH, Isny, Germany).Results
In 80% (4/5) of the kinematic gait parameters, a significant influence (η2 > 0.2) of walking velocity was demonstrated. This ranged from 89% (stance: η2 = 0.243) to 98% (stride length: η2 = 0.982). Gender effects were observed in two (40%) kinematic gait parameters (stride length: η2 = 0.209; cadence: η2 = 0.202).Conclusion
Walking velocity has a large influence on the kinematics of gait on the treadmill. Therefore, clinical analysis of gait parameters should always be related to walking velocity. Use of a standardized velocity is highly recommended in a longitudinal investigation setting.4.
5.
Natalia Gutteck Susanne Lebek David Wohlrab Alexander Zeh Karl-Stefan Delank 《Archives of orthopaedic and trauma surgery》2013,133(1):11-14
Introduction
Due to the missing bony integration of the ceramic Moje prosthesis for replacing the first metatarsophalangeal joint (MTPI) in hallux rigidus, the mid-term results were bad so far. In case of revision, the distraction arthrodesis with autologous bone taken from the iliac crest as a salvage procedure is the method of choice.Method
In our prospective case series, the short-term results after revision of the Moje prosthesis with the ToeFit Plus? prosthesis were investigated. The clinical and radiological investigations were done in six MTPI over a 24-month period using AOFAS score and visual analogue scale.Results
There were no radiological signs of loosening or implant migration of the ToeFit Plus? 24 months, postoperatively. There was one fissure at the first proximal phalanx necessitating a wire stabilisation. No other complications could be observed. A significant improvement of the AOFAS score and the range of motion were observed 6 weeks postoperatively.Conclusion
We could show good and very good short-term results after the replacement of a loosened MTPI prosthesis with a ToeFit Plus?. Due to the conic screw anchorage, ToeFit Plus? is excellently suited for prosthesis replacement at the MTPI. With sufficient bony anchorage prerequisites, it is possible to preserve and improve the range of motion by changing the loosened MTPI prosthesis in the ToeFit Plus?, thereby avoiding the morbidity of gaining autologous bone from the iliac crest. 相似文献6.
Andrea Geiss Rolf Sobottke Karl Stefan Delank Peer Eysel 《European spine journal》2016,25(5):1417-1427
Purpose
Herniated nucleus pulposus has been considered to induce an adaptive immune response. Antigen recognition by antigen-presenting-cells (APCs) represents an important step within manifestation of an adaptive immune response. Macrophages have been assumed to function as APC, while importance of plasmacytoid dendritic cells for initiation of an immune response directed towards herniated nucleus pulposus has never been examined. The aim of the present study was to assess importance of plasmacytoid dendritic cells for initiation of immune response directed towards herniated discs.Methods
Fifteen patients with true sequestrations and three patients with subligamentous sequestrations underwent surgery after their neurological examinations. Disc material was harvested, weighted and digested for 90 min. Separated single cells were counted, stained for plasmacytoid dendritic cells (CD123+CD4+), macrophages (CD14+CD11c+) and memory T cells (CD4+CD45RO+) and analysed by flow cytometry. Both patient groups were compared in cell proportions. Furthermore, patients with true sequestrations (TRUE patients) were subdivided into subgroups based on severity of muscle weakness and results in straight leg raising (SLR) test. Subgroups were compared in cell proportions.Results
Plasmacytoid dendritic cells and memory T cells infiltrated true sequestrations stronger than the subligamentous sequestration and plasmacytoid dendritic cells predominated over macrophages in true sequestrations. Highest proportions of plasmacytoid dendritic cells were detected in infiltrates of patients having true sequestrations, severe muscle weakness and negative result in SLR test.Conclusions
The findings of the present study indicate that plasmacytoid dendritic cells are involved in initiation of an immune response directed towards herniated nucleus pulposus, while macrophages may reinforce the manifested immune response and mediate disc resorption.7.
Florian Radetzki D. Wohlrab F. Goehre H. Noser K. S. Delank T. Mendel 《Archives of orthopaedic and trauma surgery》2014,134(8):1115-1120
Introduction
Sacroiliac (SI) screws are used for osteosynthesis in unstable posterior pelvic ring injuries. In the cases of “sacral dysplasia”, in which the elevated upper sacrum does not allow a secure SI screw insertion into the S1 level, the S2 segment must be used to achieve stable fixation. The bone quality of the S2 segment is thinner compared to that of the S1 vertebra and may cause biomechanical weakness. An additional SI screw insertion into the S3 level may improve stability. With respect to the anatomical conditions of the posterior pelvic ring, there have been no anatomical investigations to date regarding SI screw placement into the third sacral segment.Materials and methods
CT raw datasets from 125 patients (ø59 years, ø172 cm, ø76 kg) were post-processed using Amira 5.2 software to generate 3D pelvic models. A program code implemented in C++ computed a transverse bone corridor for the first, second and third sacral segments for a typical SI screw diameter of 7.3 mm. Volume, sagittal cross-section, iliac entrance area and length of the determined screw corridors were measured. A confidence interval of 95 % was assumed (p < 0.05).Results
The fully automatic computation revealed a possible transverse insertion for one 7.3-mm screw in the third sacral segment in 30 cases (24 %). The rate (60 %) of feasible S3 screw placements in the cases of sacral dysplasia (n = 25) is significantly higher compared to that (15 %) of “normal” sacra (n = 100). With regard to the existence of transverse iliosacroiliac corridors as a function of sacral position in between the adjacent iliac bone bilaterally, a new classification of three different shape conditions can be made: caudad, intermediate minor, intermediate major, and cephalad sacrum. Gender, age, body height and body weight had no statistically significant influence on either possible screw insertion or on the calculated data of the corridors (p > 0.05).Conclusion
SI screw insertion into the third sacral level deserves discussion in the cases of sacral dysplasia. Biomechanical and practical utility must be verified. 相似文献8.
Anke Steinmetz Andreas Stang Malte Kornhuber Marc Röllinghoff Karl-Stefan Delank Eckart Altenmüller 《International archives of occupational and environmental health》2014,87(7):783-792
Objectives
Data concerning embouchure problems in professional brass players are scarce. Embouchure problems can potentially lead to focal dystonia. The aim of this study was to investigate the frequency of distinct embouchure problems in professional brass players. Furthermore, the frequency of “cramping”, a distinct symptom of embouchure dystonia, was evaluated in the context of established embouchure dystonia risk factors.Methods
Five hundred and eighty-five professional brass players participated in a cross-sectional study concerning embouchure problems. A self-administered questionnaire was developed to evaluate embouchure fatigue, embouchure disorders and their consequences. To study the association between risk factors and cramping (a symptom of embouchure dystonia), a log-binomial regression analysis was conducted, enabling estimation of prevalence ratios (PR) and 95 % confidence intervals (95 % CI).Results
Thirty percent (95 % CI 25.9–33.3) reported embouchure fatigue. The relative frequency of embouchure disorders was 59 % (95 % CI 54.6–63.6), with 26 % (95 % CI 22.4–29.5) reporting embouchure cramping. Embouchure disorders resulted in sick leave in 16 % (95 % CI 12.7–20.6). Female brass players (PR 2.0, 95 % CI 0.98–3.98) and musicians with a prior change in their embouchure (PR 2.4, 95 % CI 1.38–4.05) or breathing technique (PR 2.2, 95 % CI 1.25–3.72) and musicians with embouchure fatigue (PR 1.9, 95 % CI 1.18–2.93) presented more frequently with embouchure cramping than musicians with other or without risk factors.Conclusion
This study shows a high relative frequency of embouchure problems in professional brass players. Given that embouchure dystonia is often preceded by embouchure problems, these findings may assist in gaining further insight into the characteristics of embouchure dystonia and the development of preventive strategies. 相似文献9.
Otorrhea is the most common complication after tympanostomy tube insertions. In Germany there are currently two commonly used types of tympanostomy tubes: silicon tubes (ST) and gilded silver tubes (GT). Previously published in vitro studies by Tajima uncovered a positive correlation between the silicon concentration in culture fluid and the rate of growth of Staphylococcus aureus. Our study retrospectively evaluates the types of bacteria and rates of otorrhea after ST and GT insertions. The present study was undertaken to determine which of these tubes had a higher incidence of otorrhea and then whether silicon tubes stimulated the growth of certain types of bacteria, such as Staphylococcus aureus. In all, 186 ST and 59 GT were placed in 245 ears of 144 children. Both ST and GT were separated into three groups: first insertion of a tympanostomy tube, second implantation and insertion of a tympanostomy tube in an infected ear in the course of a mastoidectomy. No differences between ST and GT in causing otorrhea were found in the three groups. Nevertheless, ST in comparison to GT was associated with a higher incidence of infections with Pseudomonas aeruginosa. In contrast, a higher incidence of Staphylococcus aureus related to ST could not be proved. Twenty percent of the ears with mastoiditis were found to have Pseudomonas aeruginosa, but none of these ears implanted with a GT developed postoperative otorrhea. Our findings show that GT should be used when a ventilation tube is used during a mastoidectomy. Further, it is tenable to implant only GT because postoperative otorrhea in many cases is caused by insufficient water protection and water is frequently polluted with Pseudomonas aeruginosa. 相似文献
10.
Delank KS Fürderer S Popken F Eysel P 《Zeitschrift für Orthop?die und ihre Grenzgebiete》2004,142(4):410-414
AIM: The aim of the current investigation it was to evaluate the incidence, clinical symptoms and the results of surgical treatment of lumbar juxta-facet cysts. METHOD: Between January 2002 and July 2003 305 patients underwent decompression of the lumbar spinal canal. In 3.6 % of these (n = 11) juxta-facet cyst were found to be responsible for the complaints and resection of the cyst was performed. All patients underwent standardized clinical examination and pain evaluation by the means of a visual analogue scale in a follow-up of 6.8 month on average. RESULTS: The average history of lumbar pain was 26 months, that of leg pain 23 weeks, respectively. Radicular symptoms appeared in 7 patients, and 9 of 11 patients complained about spinal claudication. Clinical examination showed a typical pain provocation during reclination of the lumbar spine. However none showed a segmental instability. Preoperative MRI revealed facet cysts with an average diameter of 9 mm (4-18 mm). All of the patients showed signs of degenerative spondylarthritis. Postoperative examination revealed in 8 cases a very good and in 2 cases a good result. One patient complained about persisting sciatica in spite of MR-tomographic demonstration of complete resection of the cyst. The walking-distance improved by least 50 % in 10 cases. Although no spinal fusion was performed, no patient developed a postoperative segmental instability. CONCLUSION: Juxta-facet cysts represent a not uncommon differential diagnosis in patients with lumbar radiculopathy. In the case of missing signs of segmental instability, resection of the cyst without simultaneous spinal fusion seems to be an appropriate therapy. 相似文献