Die intraartikuläre Therapie der Arthrose mit Hyaluronsäure – Stellenwert 2007

Ingo Arnold

doi:10.1055/s-0037-1619712

Die intraartikuläre Therapie der Arthrose mit Hyaluronsäure – Stellenwert 2007

Arthritis und Rheuma ◽

10.1055/s-0037-1619712 ◽

2007 ◽

Vol 27 (04) ◽

pp. 225-231

Author(s):

Ingo Arnold

Keyword(s):

Ex Vivo ◽

Level 1

ZusammenfassungDie epidemiologischen Daten unterstreichen die Bedeutung derArthrosekrankheit. Obwohl in den letztenJahren erheb- licheAnstrengungenin immunologischerund pathophysio- logischer Hinsicht unternommen wurden, steht eine zufriedenstellende konservative Behandlungsoption weiterhin aus. Anders als in der internistischen Rheumatologie, wie am Beispiel der Biologicals ersichtlich, fehlt dem Orthopäden im Fall der Arthrose eine zuverlässige Möglichkeit, den Krankheitsverlauf nachhaltig zu beeinflussen. Arthrotische Gelenke zeigen u. a. eine deutlich erniedrigte Hyaluronan- Konzentration. Neben der Möglichkeit derVerbesserung der viskoelastischen Eigenschaften sind inzwischen auch zahlreiche immunmodulatorische Mechanismen im Zusammenhang mit der Gelenkhomöostase unter dem Einfluss von Hyaluronan (überwiegend ex vivo) nachgewiesen. Trotzdem ist unter Berücksichtigung einer umfassenden Übersicht über die zahlreichen Publikationen zu diesem Thema im Sinne eines Evidenzgrades Level 1 eher nur ein moderater Effektfür die allerdings risikoarme intra-artiku- läre Hyaluronan-Therapie abzuleiten. Für eine valide Aussage im direkten Vergleich mit i.a.-Kortikosteroid reicht dagegen die aktuelle Datenlage nicht aus.

Download Full-text

Comparison of heat induced damage at the saphenofemoral junction after ablation with 1,470 nm laser or radiofrequency

VASA ◽

10.1024/0301-1526/a000598 ◽

2017 ◽

Vol 46 (2) ◽

pp. 101-107 ◽

Cited By ~ 1

Author(s):

Evren Ozcinar ◽

Mehmet Cakici ◽

Oktay Korun ◽

Unsal Han ◽

Ugursay Kiziltepe

Keyword(s):

Laser Ablation ◽

Continuous Wave ◽

Ex Vivo ◽

In Vivo Studies ◽

Control Group ◽

Damage Score ◽

Significant Difference ◽

Level 1 ◽

Total Damage ◽

Saphenofemoral Junction

Abstract. Background: The aim of this study was to evaluate the heat induced damage at the saphenofemoral junction level according to histopathological changes after radiofrequency or 1,470 nm radial tip laser ablation. Patients and methods: Varicose vein segments of 6–10 mm in diameter were exposed to radiofrequency (Closure Fast catheter, 7 cm heat segment, one cycle, 15 seconds, 10 Watt, 120 °C) or laser ablation (1,470 nm radial tip, continuous wave, vein diameter: 6 cm/8 cm/10 cm-power: 10 Watt-pullback speed: 2.2 mm/s, 1.7 mm/s, 1.3 mm/s-LEED: 45J/cm, 60J/cm, 75J/cm-EFE 25J/cm2, respectively). Approximate 2 cm segments of the vein were left untreated, then histopathological examinations of the untouched segments (5 slices: level 1 – furthest segment, level 2 – nearest segment) for heat induced damage were performed. A total damage scoring system was established, including the presence of endothelial swelling, intimal thickening, cellular vacuolisation in the muscle layer, oedema in the tunica media, and extent of necrosis. Results: At level 1, the furthest segment of the specimen, there was no significant difference between the laser and control group, while the total damage score of the radiofrequency group was significantly higher than the control group (p < 0.01). Radiofrequency group had higher total damage score compared to the laser group at level 1 (p < 0.01), 2 (p < 0.01), and 5 (p < 0.01); while no significant difference was observed at level 3 (p = 0.46) and 4 (p = 0.13). Conclusions: Significant heat induced damage may be seen even if the 2 cm segment of the vessel is left unablated. Radiofrequency ablation seems to cause more histological damage than laser ablation in this ex vivo study. Further in vivo studies are necessary, in order to validate these findings.

Download Full-text

Ultrastructural study on the development of rat amygdaloid body

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100159709 ◽

1990 ◽

Vol 48 (3) ◽

pp. 432-433

Author(s):

A. Manolova ◽

S. Manolov

Keyword(s):

Nerve Cells ◽

Amygdaloid Complex ◽

Amygdaloid Body ◽

Thin Ring ◽

Morphological Criteria ◽

Neural Processes ◽

Abundant Cytoplasm ◽

Level 1 ◽

Few Data ◽

Oval Shape

Relatively few data on the development of the amygdaloid complex are available only at the light microscopic level (1-3). The existence of just general morphological criteria requires the performance of other investigations in particular ultrastructural in order to obtain new and more detailed information about the changes in the amygdaloid complex during development.The prenatal and postnatal development of rat amygdaloid complex beginning from the 12th embrionic day (ED) till the 33rd postnatal day (PD) has been studied. During the early stages of neurogenesis (12ED), the nerve cells were observed to be closely packed, small-sized, with oval shape. A thin ring of cytoplasm surrounded their large nuclei, their nucleoli being very active with various size and form (Fig.1). Some cells possessed more abundant cytoplasm. The perikarya were extremely rich in free ribosomes. Single sacs of the rough endoplasmic reticulum and mitochondria were observed among them. The mitochondria were with light matrix and possessed few cristae. Neural processes were viewed to sprout from some nerve cells (Fig.2). Later the nuclei were still comparatively large and with various shape.

Download Full-text

Correlation of γ-radioactivity and Scanning Electron Microscopy in measurement of retention of 111Indium-labeled canine endothelial cells on synthetic vascular grafts

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100156419 ◽

1989 ◽

Vol 47 ◽

pp. 886-887

Author(s):

E.J. Prendiville ◽

S. Laliberté Verdon ◽

K. E. Gould ◽

K. Ramberg ◽

R. J. Connolly ◽

...

Keyword(s):

Blood Flow ◽

Ex Vivo ◽

Vascular Grafts ◽

Retention Data ◽

Vascular Prostheses ◽

Group 4 ◽

Human Fibronectin ◽

Insufficient Time ◽

Group 3 ◽

Group 2

Endothelial cell (EC) seeding is postulated as a mechanism of improving patency in small caliber vascular grafts. However the majority of seeded EC are lost within 24 hours of restoration of blood flow in previous canine studies . We postulate that the cells have insufficient time to fully develop their attachment to the graft surface prior to exposure to hemodynamic stress. We allowed EC to incubate on fibronectin-coated ePTFE grafts for four different time periods after seeding and measured EC retention after perfusion in a canine ex vivo shunt circuit.Autologous canine EC, were enzymatically harvested, grown to confluence, and labeled with 30 μCi 111 Indium-oxine/80 cm 2 flask. Four groups of 5 cm x 4 mm ID ePTFE vascular prostheses were coated with 1.5 μg/cm.2 human fibronectin, and seeded with 1.5 x 105 EC/ cm.2. After seeding grafts in Group 1 were incubated in complete growth medium for 90 minutes, Group 2 were incubated for 24 hours, Group 3 for 72 hours and Group 4 for 6 days. Grafts were then placed in the canine ex vivo circuit, constructed between femoral artery and vein, and subjected to blood flow of 75 ml per minute for 6 hours. Continuous counting of γ-activity was made possible by placing the seeded graft inside the γ-counter detection crystal for the duration of perfusion. EC retention data after 30 minutes, 2 hours and 6 hours of flow are shown in the table.

Download Full-text

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

Clinical Science ◽

10.1042/cs20190999 ◽

2019 ◽

Vol 133 (22) ◽

pp. 2283-2299

Author(s):

Apabrita Ayan Das ◽

Devasmita Chakravarty ◽

Debmalya Bhunia ◽

Surajit Ghosh ◽

Prakash C. Mandal ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Chronic Inflammation ◽

Ex Vivo ◽

Human Subjects ◽

Critical Role ◽

Atherosclerotic Cardiovascular Disease ◽

Tnf Α ◽

Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

Download Full-text

The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00107 ◽

2020 ◽

Vol 63 (9) ◽

pp. 2921-2929

Author(s):

Alan H. Shikani ◽

Elamin M. Elamin ◽

Andrew C. Miller

Keyword(s):

Ex Vivo ◽

Moisture Loss ◽

Speaking Valve ◽

Time Zero ◽

In Series ◽

Turbulent Airflow ◽

The Difference ◽

Loss Efficiency ◽

Heat And Moisture ◽

Lung Simulation

Purpose Tracheostomy patients face many adversities including loss of phonation and essential airway functions including air filtering, warming, and humidification. Heat and moisture exchangers (HMEs) facilitate humidification and filtering of inspired air. The Shikani HME (S-HME) is a novel turbulent airflow HME that may be used in-line with the Shikani Speaking Valve (SSV), allowing for uniquely preserved phonation during humidification. The aims of this study were to (a) compare the airflow resistance ( R airflow ) and humidification efficiency of the S-HME and the Mallinckrodt Tracheolife II tracheostomy HME (M-HME) when dry (time zero) and wet (after 24 hr) and (b) determine if in-line application of the S-HME with a tracheostomy speaking valve significantly increases R airflow over a tracheostomy speaking valve alone (whether SSV or Passy Muir Valve [PMV]). Method A prospective observational ex vivo study was conducted using a pneumotachometer lung simulation unit to measure airflow ( Q ) amplitude and R airflow , as indicated by a pressure drop ( P Drop ) across the device (S-HME, M-HME, SSV + S-HME, and PMV). Additionally, P Drop was studied for the S-HME and M-HME when dry at time zero (T 0 ) and after 24 hr of moisture testing (T 24 ) at Q of 0.5, 1, and 1.5 L/s. Results R airflow was significantly less for the S-HME than M-HME (T 0 and T 24 ). R airflow of the SSV + S-HME in series did not significant increase R airflow over the SSV or PMV alone. Moisture loss efficiency trended toward greater efficiency for the S-HME; however, the difference was not statistically significant. Conclusions The turbulent flow S-HME provides heat and moisture exchange with similar or greater efficacy than the widely used laminar airflow M-HME, but with significantly lower resistance. The S-HME also allows the innovative advantage of in-line use with the SSV, hence allowing concurrent humidification and phonation during application, without having to manipulate either device.

Download Full-text