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Biomedical subjects

W Lungershausen

Publications and source records attributed to W Lungershausen.

17 recordsLinked to original sources

Macrophage specificity of three anti-CD68 monoclonal antibodies (KP1, EBM11, and PGM1) widely used for immunohistochemistry and flow cytometry.

OBJECTIVES: To investigate the specificity of three anti-CD68 monoclonal antibodies (mAbs) for macrophages (Mphi) in immunohistochemistry (IHC) and flow cytometry (FACS). METHODS: IHC was performed on cryostat sections of rheumatoid arthritis (RA) and osteoarthritis (OA) synovial membranes using the anti-CD68 mAbs KP1, EBM11, and PGM1, and the fibroblast (FB) markers CD90 and prolyl 4-hydroxylase. Expression of CD68 was also analysed by FACS on the monocytic cell lines THP-1 and U937, as well as on synovial fibroblasts (SFB), skin FB, and gingival FB (both surface and intracellular staining). RESULTS: In IHC, there was an overlap between CD68 (mAbs KP1 and EBM11) and the FB markers CD90/prolyl 4-hydroxylase in the lining layer, diffuse infiltrates, and stroma of RA and OA synovial membranes. In FACS analysis of THP-1 and U937 cells, the percentage of cells positive for the anti-CD68 mAbs KP1 and EBM11 progressively increased from surface staining of unfixed cells, to surface staining of pre-fixed cells, to intracellular staining of the cells. Upon intracellular FACS of different FB, nearly all cells were positive for KP1 and EBM11, but only a small percentage for PGM1. In surface staining FACS, a small percentage of FB were positive for all three anti-CD68 mAbs. CONCLUSION: An overlap between CD68 (mAbs KP1 or EBM11) and the FB markers CD90 or prolyl 4-hydroxylase may prevent unequivocal identification of Mphi in synovial tissue by IHC or in monocytic cells and FB upon intracellular FACS. This may be due to sharing of common markers by completely different cell lineages.

Aged↗

[Locking plate osteosynthesis for fractures of the proximal humerus].

BACKGROUND: Beside non-operative treatment the therapeutic options for proximal fractures of the humerus range from closed reduction and transcutaneous K-wiring to total joint replacement. While the first is regarded as minimally invasive the latter is a rather complex intervention. Plating has been disregarded as combining the disadvantages of an extended approach with too often insufficient primary postoperative stability. The new concept of completely angle stabile plate fixation aims on improving this balance by achieving greater stability even in osteoporotic fractures. STUDY DESIGN: This retrospective analysis compares 51 patients treated with a partially (39) or complete (12) angle stabile humeral plate (Königseeplatte in two modifications) with 32 patients treated according to surgeons preference with conventional plates or K-wires. Both groups were treated at the same department during the same period and did not differ in their age nor sex distribution. RESULTS: Until discharge there were 2 secondary dislocations discovered in group 1 and 7 in group 2. The follow-up rate was 47.1 % (24/51) in group 1 and 46.8 % (15/32) in group 2. The time interval from surgery amounted to 1.2 (0.66-1.75) and 1.0 (0.72-1.32) years respectively. Among the patients available for follow-up in group 1 8 had sustained a two-, 8 a three- and 3 a four-part fracture according to Neer's classification. In group two there were accordingly 2 two-, 8 three- and 1 four part fractures. Clinical assessment using Neer's score revealed an average of 71,8 (63.9-79.8) points in group 1 and 67.6 (47.3-78.7) in group 2. When the results of Neer's scores were expressed in percentage of the unaffected arm a mean of 73.6 (65.6-81.8) in group 1 and 69.3 (51.8-86.9) was obtained. The only statistically significant difference was observed within the sub-group of three-part fractures: treated by angle stabile plates (group 1) these patients (n = 8) achieved a mean Neer-Score of 81 (77-86) compared to 68 (52-84) (n = 8). In group 1 70.8 % of patients followed-up presented an "excellent" or "good" result according to Neer's criteria, in group 2 60 % did so. CONCLUSION: We conclude from our first experience with angle stabile plates for fractures of the proximal humerus that particularly in three part fractures this method might improve functional outcome and is worth further consideration and testing.

Aged↗

Mosaic chromosomal aberrations in synovial fibroblasts of patients with rheumatoid arthritis, osteoarthritis, and other inflammatory joint diseases.

Chromosomal aberrations were comparatively assessed in nuclei extracted from synovial tissue, primary-culture (P-0) synovial cells, and early-passage synovial fibroblasts (SFB; 98% enrichment; P-1, P-4 [passage 1, passage 4]) from patients with rheumatoid arthritis (RA; n = 21), osteoarthritis (OA; n = 24), and other rheumatic diseases. Peripheral blood lymphocytes (PBL) and skin fibroblasts (FB) (P-1, P-4) from the same patients, as well as SFB from normal joints and patients with joint trauma (JT) (n = 4), were used as controls. Analyses proceeded by standard GTG-banding and interphase centromere fluorescence in situ hybridization. Structural chromosomal aberrations were observed in SFB (P-1 or P-4) from 4 of 21 RA patients (19%), with involvement of chromosome 1 [e.g. del(1)(q12)] in 3 of 4 cases. In 10 of the 21 RA cases (48%), polysomy 7 was observed in P-1 SFB. In addition, aneusomies of chromosomes 4, 6, 8, 9, 12, 18, and Y were present. The percentage of polysomies was increased in P-4. Similar chromosomal aberrations were detected in SFB of OA and spondylarthropathy patients. No aberrations were detected in i) PBL or skin FB from the same patients (except for one OA patient with a karyotype 45,X[10]/46,XX[17] in PBL and variable polysomies in long-term culture skin FB); or ii) synovial tissue and/or P-1 SFB of normal joints or of patients with joint trauma. In conclusion, qualitatively comparable chromosomal aberrations were observed in synovial tissue and early-passage SFB of patients with RA, OA, and other inflammatory joint diseases. Thus, although of possible functional relevance for the pathologic role of SFB in RA, these alterations probably reflect a common response to chronic inflammatory stress in rheumatic diseases.

Arthritis, Psoriatic↗

Expression of interferon regulatory factors and indoleamine 2,3-dioxygenase in Chlamydia trachomatis-infected synovial fibroblasts.

Synovial fibroblasts probably represent host cells for Chlamydia trachomatis during initial intra-articular infection in reactive arthritis. In vitro synovial cells produce interferon-beta (IFN-beta) in response to chlamydial infection. IFN-beta expression can be activated by interferon regulatory factor-1 (IRF-1) and interferon-stimulated gene factor 3gamma (ISGF3gamma). In this study, we demonstrate that infection of synovial fibroblasts with C. trachomatis serotype D induced the expression of IRF-1 mRNA as shown by reverse transcription-PCR. Tumor necrosis factor-alpha (TNF-alpha) stimulation enhanced IRF-1 mRNA levels in infected cells and was required to detect IRF-1 protein by immunoblotting. The level of constitutively expressed IRF-2 was not significantly affected after infection. C. trachomatis was found to cause an up-regulation of ISGF3gamma protein in synovial cells. Induction of the tryptophan-catabolizing enzyme indoleamine 2,3-dioxygenase (IDO) is an important mechanism of the host cell response to control intracellular infection by chlamydiae. It has been described that IRF-1 can induce IDO gene expression. Infection of synovial fibroblasts alone in the absence of exogenous cytokine induced the expression of IDO mRNA which was enhanced by TNF-alpha treatment. The stimulation of IRF-1, ISGF3gamma, and IDO expression was most effective when viable chlamydiae were used as inoculum. Neutralization of IFN-beta in the culture medium of infected cells diminished but did not abrogate expression of IRF-1, ISGF3gamma, and IDO. The increased production of IRF-1 and ISGF3gamma in C. trachomatis-infected synovial fibroblasts may contribute to induction of IFN-beta and IDO.

Antibodies↗

[Joint empyema].

Bacterial joint infection is rare but may have an unfavourable functional aotcome. The different stages of purulent arthritis, depending on the pathophysiological developments, require different treatment measures. Clinical examination, analysis of joint tap and arthroscopy are crucial for diagnosis. Surgical management comprises: (1) open or arthroscopic débridement with intensive flush lavage; (2) postoperative drainage and flush lavage; (3) early and continuous active and passive motion. Recovery will be complete only if therapy is instituted as early as possible (within 3 days). Joint empyema must therefore be treated as a surgical emergency.

Adult↗

Secretion of cytokines by human synoviocytes during in vitro infection with Chlamydia trachomatis.

OBJECTIVE: Since Chlamydia-induced reactive arthritis is associated with the presence of viable chlamydiae in the synovial membrane, we studied the ability of Chlamydia trachomatis to stimulate a cytokine response by fibroblast-like synoviocytes in culture. METHODS: Fibroblast-like cells derived from biopsies of the synovial membrane were infected with Chlamydia trachomatis serotype E. Interleukin-6 (IL-6), transforming growth factor-beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha) were determined using bio-assays. Granulocyte macrophage colony stimulating factor (GMCSF) was quantified by ELISA. RESULTS: Fibroblast-like synovial cells were capable of supporting chlamydial growth in vitro. Chlamydia trachomatis stimulated synoviocytes to produce IL-6, TGF-beta, and GMCSF. IL-1beta increased the production of IL-6 and GMCSF by mock-infected and infected cells. Treatment of synoviocytes with interferon-gamma resulted in the release of TNF-alpha in response to chlamydial infection. CONCLUSION: Chlamydia-induced cytokine release from synovial fibroblasts may contribute to alterations in the synovial membrane promoting the development of joint inflammation.

Bacteria↗

[Biological osteosyntheses].

Soft tissue condition and local blood circulation are most important concerning bone reconstruction and healing of fractures. Therefore additional damage of soft tissue caused by operations must be avoided. Using biological osteosynthesis as much stability as necessary and highest possible saving of vascularity should be achieved. Most important and actual techniques will be discussed in this paper. Today's method of choice in long bone shaft fractures is the unreamed interlokked nail. On the contrary exact reposition and minimal fixation with screws and plates is the standard in fractures near the joint to gain exercise stability.

Bone Plates↗

Primary cultivation of human synovial cells from nonrheumatic synovial tissue and fluid.

Cultures were established from adherent cells of synovial fluid and from collagenase-dispersed specimens of synovial tissue. In cultures derived from synovial tissue, prolyl hydroxylase-positive cells of fibroblast-like morphology were identified as the predominant cell type. In cultures from synovial fluid the majority of adherent cells was macrophage-like in appearance and strongly positive for CD 68. Cells with a stellate morphology could rarely be observed in cultures from synovial tissue. Their relations to other forms will be discussed. Several simple methods for cultivating adherent synovial cells are presented.

Cell Culture Techniques↗

[Traumatic vascular lesions of the knee joint].

The popliteal artery is a "critical" or key-artery, whose sudden occlusion leads to the ischemia-syndrome. The rate of amputation after missing or too late recovery is very high. The real time for the recovery runs to 3-6 hours. The reason for the injury of the vessel is the dorsal luxation of the knee-joint, the fracture of the lower thigh or the fracture of the tibial head with extreme dislocation of the fragments. The management of the diagnosis, the contents and the order of the surgical treatment are reported.

Amputation, Surgical↗

[Therapeutic electrical procedures in recurring, drug refractory tachycardias. I. Antitachycardiac implantable pacemaker systems].

In 9 Patients with medicamentously therapy-refractory tachycardias (twice paroxysmal AV-node-reentry tachycardia, four times paroxysmal orthrodromic reentry tachycardia in the WPW-syndrome, once paroxysmal atrial reentry tachycardia, twice recurrent ventricular tachycardia) after adequate electrophysiological testings antitachycardiac pacemakers able to activate the patients were implanted. In these cases the implantable tachyblocker TUR-RFP-01 was used in 4 cases for the highly frequent volley atrial stimulation, in 2 cases for the more highly frequent volley ventricular stimulation. In 3 patients the interruption of the tachycardia was performed by ventricular underdrive stimulation by means of putting the magnet on a conventional R-wave-inhibited ventricular pacemaker. In all cases the recurrent tachycardias could reliably be terminated by the patients themselves by activation of the antitachycardiac systems (duration of the follow-up period 3-14 months, on an average 10.7 +/- 3.4 months); only in one case in the further course a change of the stimulation parameters was necessary which were carefully tested at the beginning. On account of the danger of the acceleration of the tachycardia and of the evocation of ventricular fibrillation, respectively, should, however, be performed highly frequent ventricular stimulations for the termination of ventricular tachycardias only in readiness for defibrillation.

Aged↗

[Early and late results of internal small intestine splinting for ileus].

The continuous inside splinting of the small intestine was carried out in 82 children and adults, because of postoperative ileus, chronic recurrent ileus and diffuse peritonitis. Possibly the splinting had contributed in one case to the perforation of the paralytic small intestine with a fatal outcome. In another case there occurred a relapse of an ileus. All other patients have no complaints in connexion with the splinting operation. Control examinations take place. A "total folding" of the small intestine was not observed by the radioscopy.

Adult↗