509 research outputs found

    Low recurrence rate of a two-layered closure repair for primary and recurrent midline incisional hernia without mesh

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    Background: Incisional hernia is a serious complication after abdominal surgery and occurs in 11-23% of laparotomies. Repair can be done, for instance, with a direct suture technique, but recurrence rates are high. Recent literature advises the use of mesh repair. In contrast to this development, we studied the use of a direct suture repair in a separate layer technique. The objective of this retrospective observational study is to assess the outcomes (recurrences and complications) of a two-layered open closure repair for primary and recurrent midline incisional hernia without the use of mesh. Methods: In an observational retrospective cohort study, we analysed the hospital and outpatient records of 77 consecutive patients who underwent surgery for a primary or recurrent incisional hernia between 1st May 2002 and 8th November 2006. The repair consisted of separate continuous suturing of the anterior and posterior fascia, including the rectus muscle, after extensive intra-abdominal adhesiolysis. Results: Forty-one men (53.2%) and 36 women (46.8%) underwent surgery. Sixty-three operations (81.8%) were primary repairs and 14 (18.2%) were repairs for a recurrent incisional hernia. Of the 66 patients, on physical examination, three had a recurrence (4.5%) after an average follow-up of 2.6 years. The 30-day postoperative mortality was 1.1%. Wound infection was seen in five patients (6.5%). Conclusions: A two-layered suture repair for primary and recurrent incisional hernia repair without mesh with extensive adhesiolysis was associated with a recurrence rate comparable to mesh repair and had an acceptable complication rate

    Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model

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    Abstract Background Mesenchymal stromal cells (MSC) have shown promising results in the treatment of tendinopathy in equine medicine, making this therapeutic approach seem favorable for translation to human medicine. Having demonstrated that MSC engraft within the tendon lesions after local injection in an equine model, we hypothesized that they would improve tendon healing superior to serum injection alone. Methods Quadrilateral tendon lesions were induced in six horses by mechanical tissue disruption combined with collagenase application 3 weeks before treatment. Adipose-derived MSC suspended in serum or serum alone were then injected intralesionally. Clinical examinations, ultrasound and magnetic resonance imaging were performed over 24 weeks. Tendon biopsies for histological assessment were taken from the hindlimbs 3 weeks after treatment. Horses were sacrificed after 24 weeks and forelimb tendons were subjected to macroscopic and histological examination as well as analysis of musculoskeletal marker expression. Results Tendons injected with MSC showed a transient increase in inflammation and lesion size, as indicated by clinical and imaging parameters between week 3 and 6 (p < 0.05). Thereafter, symptoms decreased in both groups and, except that in MSC-treated tendons, mean lesion signal intensity as seen in T2w magnetic resonance imaging and cellularity as seen in the histology (p < 0.05) were lower, no major differences could be found at week 24. Conclusions These data suggest that MSC have influenced the inflammatory reaction in a way not described in tendinopathy studies before. However, at the endpoint of the current study, 24 weeks after treatment, no distinct improvement was observed in MSC-treated tendons compared to the serum-injected controls. Future studies are necessary to elucidate whether and under which conditions MSC are beneficial for tendon healing before translation into human medicine

    Tracking of autologous adipose tissue-derived mesenchymal stromal cells with in vivo magnetic resonance imaging and histology after intralesional treatment of artificial equine tendon lesions - a pilot study

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    Background: Adipose tissue-derived mesenchymal stromal cells (AT-MSCs) are frequently used to treat equine tendinopathies. Up to now, knowledge about the fate of autologous AT-MSCs after intralesional injection into equine superficial digital flexor tendons (SDFTs) is very limited. The purpose of this study was to monitor the presence of intralesionally injected autologous AT-MSCs labelled with superparamagnetic iron oxide (SPIO) nanoparticles and green fluorescent protein (GFP) over a staggered period of 3 to 9 weeks with standing magnetic resonance imaging (MRI) and histology. Methods: Four adult warmblood horses received a unilateral injection of 10 × 106 autologous AT-MSCs into surgically created front-limb SDFT lesions. Administered AT-MSCs expressed lentivirally transduced reporter genes for GFP and were co-labelled with SPIO particles in three horses. The presence of AT-MSCs in SDFTs was evaluated by repeated examinations with standing low-field MRI in two horses and post-mortem in all horses with Prussian blue staining, fluorescence microscopy and with immunofluorescence and immunohistochemistry using anti-GFP antibodies at 3, 5, 7 and 9 weeks after treatment. Results: AT-MSCs labelled with SPIO particles were detectable in treated SDFTs during each MRI in T2*- and T1-weighted sequences until the end of the observation period. Post-mortem examinations revealed that all treated tendons contained high numbers of SPIO- and GFP-labelled cells. Conclusions: Standing low-field MRI has the potential to track SPIO-labelled AT-MSCs successfully. Histology, fluorescence microscopy, immunofluorescence and immunohistochemistry are efficient tools to detect labelled AT-MSCs after intralesional injection into surgically created equine SDFT lesions. Intralesional injection of 10 × 106 AT-MSCs leads to the presence of high numbers of AT-MSCs in and around surgically created tendon lesions for up to 9 weeks. Integration of injected AT-MSCs into healing tendon tissue is an essential pathway after intralesional administration. Injection techniques have to be chosen deliberately to avoid reflux of the cell substrate injected. In vivo low-field MRI may be used as a non-invasive tool to monitor homing and engraftment of AT-MSCs in horses with tendinopathy of the SDFT

    Der diskrete Charme der Bourgeoisie - Ein Beitrag zur Soziologie des modernen Wirtschaftsbürgertums

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    Entgegen der These der Auflösungserscheinungen des Bürgertums stellt der Autor die Annahme auf den Prüfstand, dass wir es nach wie vor mit gesellschaftlichen Fraktionierungen bürgerlicher Lebensweisen zu tun haben. Am Beispiel autobiographischer Schriften von deutschen Topmanagern stellt der Text ein modernes Verständnis des Wirtschaftsbürgertums vor, das organisational (durch die Karrieremechanismen der Organisation) und institutionell (im Feld der Wirtschaft) verankert ist. Die moderne Sozialformation des Wirtschaftsbürgertums ist nur noch auf der Grundlage von Organisationen denkbar. Sie lässt sich, jenseits von Klasse und Stand, als Positionselite beschreiben. Anhand der Autobiographien lässt sich die Reproduktion dieser Elite auf Basis einer engen Verknüpfung zwischen familialer Herkunft, an organisationale Karrieren gebundene Leistungsbereitschaft und hoher formaler Bildung nachzeichnen. Die Abgrenzung in der Statusreproduktion zwischen Bildungs- und Wirtschaftsbürgertum weist der Autor am jeweiligen Verhältnis zur Bildung nach; zwar können beide einen hohen Bildungsgrad in Form von Bildungspatenten nachweisen, doch im Falle des Wirtschaftsbürgertums herrscht ein instrumentelles Verhältnis zur Bildung vor. Der hohe Bildungsgrad folgt hier dem Bedürfnis, den Status mittels formaler Bildung abzusichern und damit die Gefahr der eigenen Austauschbarkeit - als Personal der Organisation - zu kompensieren. Der Text macht außerdem generationale Effekte sichtbar; insbesondere indem er darlegt, inwieweit der "moderne Manager" einerseits in der Betonung seines Status seinen Vorgängern gleicht und sich doch gleichzeitig in der Art der Unternehmensführung abgrenzt - indem er bspw. die Managementkonzepte seiner Zeit aufgreift

    Ergodic infinite group extensions of geodesic flows on translation surfaces

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    We show that generic infinite group extensions of geodesic flows on square tiled translation surfaces are ergodic in almost every direction, subject to certain natural constraints. Recently K. Fr\c{a}czek and C. Ulcigrai have shown that certain concrete staircases, covers of square-tiled surfaces, are not ergodic in almost every direction. In contrast we show the almost sure ergodicity of other concrete staircases. An appendix provides a combinatorial approach for the study of square-tiled surfaces

    Quantitative live cell imaging of a tauopathy model enables the identification of a polypharmacological drug candidate that restores physiological microtubule interaction

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    Tauopathies such as Alzheimer’s disease are characterized by aggregation and increased phosphorylation of the microtubule-associated protein tau. Tau’s pathological changes are closely linked to neurodegeneration, making tau a prime candidate for intervention. We developed an approach to monitor pathological changes of aggregation-prone human tau in living neurons. We identified 2-phenyloxazole (PHOX) derivatives as putative polypharmacological small molecules that interact with tau and modulate tau kinases. We found that PHOX15 inhibits tau aggregation, restores tau’s physiological microtubule interaction, and reduces tau phosphorylation at disease-relevant sites. Molecular dynamics simulations highlight cryptic channel-like pockets crossing tau protofilaments and suggest that PHOX15 binding reduces the protofilament’s ability to adopt a PHF-like conformation by modifying a key glycine triad. Our data demonstrate that live-cell imaging of a tauopathy model enables screening of compounds that modulate tau-microtubule interaction and allows identification of a promising polypharmacological drug candidate that simultaneously inhibits tau aggregation and reduces tau phosphorylation
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