The Passage of S100B from Brain to Blood Is Not Specifically Related to the Blood-Brain Barrier Integrity

Following brain injury, S100B is released from damaged astrocytes but also yields repair mechanisms. We measured S100B in the cerebrospinal fluid (CSF) and serum (Cobas e411 electrochemiluminescence assay, Roche) longitudinally in a large cohort of patients treated with a ventricular drainage following traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Statistical analysis was performed with SPSS software applying the Mann-Whitney rank sum test or chi-test where appropriate. S100B in CSF and serum was significantly increased following TBI (n = 71) and SAH (n = 185) for at least one week following injury. High S100B levels in CSF and serum were inconsistent associated with outcome. The passage of S100B from CSF to blood (100∗serumS100B/CSFS100B) was significantly decreased although the albumin quotient suggested an “open” blood-CSF barrier. Events possibly interfering with the BBB did not affect the S100B passage (P = .591). In conclusion, we could not confirm S100B measurements to reliably predict outcome, and a compromised blood-CSF barrier did not affect the passage of S100B from CSF to serum

Die "Bewegte Schule" auf dem Prüfstand: Qualitätsmerkmale einer grundschulpädagogischen Innovation

Teubert H, Thiel A, Kleindienst-Cachay C. Die "Bewegte Schule" auf dem Prüfstand: Qualitätsmerkmale einer grundschulpädagogischen Innovation. In: Gogoll A, Menze-Sonneck A, eds. Qualität im Schulsport. Schriften der Deutschen Vereinigung für Sportwissenschaft. Vol 148. Hamburg: Czwalina; 2005: 148-153

Treatment of posttraumatic syringomyelia: evidence from a systematic review.

Following spinal cord injury (SCI), the routine use of magnetic resonance imaging (MRI) resulted in an incremental diagnosis of posttraumatic syringomyelia (PTS). However, facing four decades of preferred surgical treatment of PTS, no clear consensus on the recommended treatment exists. We review the literature on PTS regarding therapeutic strategies, outcomes, and complications. We performed a systematic bibliographic search on ("spinal cord injuries" [Mesh] AND "syringomyelia" [Mesh]). English language literature published between 1980 and 2020 was gathered, and case reports and articles examining syrinx due to other causes were excluded. The type of study, interval injury to symptoms, severity and level of injury, therapeutic procedure, duration of follow-up, complications, and outcome were recorded. Forty-three observational studies including 1803 individuals met the eligibility criteria. The time interval from SCI to the diagnosis of PTS varied between 42 and 264 months. Eighty-nine percent of patients were treated surgically (n = 1605) with a complication rate of 26%. Symptoms improved in 43% of patients postoperatively and in 2% treated conservatively. Stable disease was documented in 50% of patients postoperatively and in 88% treated conservatively. The percentage of deterioration was similar (surgery 16%, 0.8% dead; conservative 10%). Detailed analysis of surgical outcome with regard to symptoms revealed that pain, motor, and sensory function could be improved in 43 to 55% of patients while motor function deteriorated in around 25%. The preferred methods of surgery were arachnoid lysis (48%) and syrinx drainage (31%). Even diagnosing PTS early in its evolution with MRI, to date, no satisfactory standard treatment exists, and the present literature review shows similar outcomes, regardless of the treatment modality. Therefore, PTS remains a neurosurgical challenge. Additional research is required using appropriate study designs for improving treatment options

Constitutive ablation of dendritic cells breaks self-tolerance of CD4 T cells and results in spontaneous fatal autoimmunity

Lack of immunological tolerance against self-antigens results in autoimmune disorders. During onset of autoimmunity, dendritic cells (DCs) are thought to be critical for priming of self-reactive T cells that have escaped tolerance induction. However, because DCs can also induce T cell tolerance, it remains unclear whether DCs are required under steady-state conditions to prevent autoimmunity. To address this question, we crossed CD11c-Cre mice with mice that express diphtheria toxin A (DTA) under the control of a loxP-flanked neomycin resistance (neoR) cassette from the ROSA26 locus. Cre-mediated removal of the neoR cassette leads to DTA expression and constitutive loss of conventional DCs, plasmacytoid DCs, and Langerhans cells. These DC-depleted (ΔDC) mice showed increased frequencies of CD4 single-positive thymocytes and infiltration of CD4 T cells into peripheral tissues. They developed spontaneous autoimmunity characterized by reduced body weight, splenomegaly, autoantibody formation, neutrophilia, high numbers of Th1 and Th17 cells, and inflammatory bowel disease. Pathology could be induced by reconstitution of wild-type (WT) mice with bone marrow (BM) from ΔDC mice, whereas mixed BM chimeras that received BM from ΔDC and WT mice remained healthy. This demonstrates that DCs play an essential role to protect against fatal autoimmunity under steady-state conditions

Development of pre-syrinx state and syringomyelia following a minor injury: a case report

Background!#!A generally accepted rule is that posttraumatic syringomyelia (PTS) results from spinal cord injury (SCI).!##!Case presentation!#!Here, we report the development of syringomyelia without SCI in a 54-year-old Caucasian man following a mild motor vehicle accident. The computed tomography on admission excluded an injury of the spine. Because of neck and back pain, magnetic resonance imaging was performed on day 3 post-injury and demonstrated minimal changes from a ligamentous strain at the cervicothoracic transition. Any traumatic affection of the bone, vertebral discs, intraspinal compartment, or spinal cord were excluded. Some limb weakness and neurogenic bladder dysfunction started manifesting within the following weeks. Repeated MRIs following the accident demonstrated arachnoid adhesions at the C1-2 level and spinal cord edema equivalent to a pre-syrinx state at 12 months and syrinx formation at 24 months. Because of further deterioration, decompression was performed at 36 months.!##!Conclusions!#!We conclude that even after a minor trauma PTS can occur and that medullary edema (pre-syrinx state) may precede syrinx formation

The neurotrophic protein S100B: value as a marker of brain damage and possible therapeutic implications

We provide a critical analysis of the value of S100B as a marker of brain damage and possible therapeutic implications. The early assessment of the injury severity and the consequent prognosis are of major concern for physicians treating patients suffering from traumatic brain injury (TBI). A reliable indicator to accurately determine the extent of the brain damage has to meet certain requirements: (i) to originate in the central nervous system (CNS) with no contribution from extracerebral sources; (ii) a passive release from damaged neurons and/or glial cells without any stimulated active release; (iii) a lack of specific effects on neurons and/or glial cells interfering with the initial injury; (iv) an unlimited passage through the blood-brain barrier (BBB). The measurement of putative biochemical markers, such as the S100B protein, has been proposed in this role. Over the past decade, numerous studies have reported a positive correlation of S100B serum levels with a poor outcome following TBI. However, some studies raise doubt whether the serum measurement of S100B is a valid biochemical marker of brain damage. We summarize the specific properties of S100B and analyze whether they support or counteract the necessary requirements to designate this protein as an indicator of brain damage. Finally, we report recent experimental findings suggesting a possible therapeutic potential of S100B

Inhaltsbereich 5: Bewegen an und mit Geräten - Turnen und Akrobatik

Menze-Sonneck A. Inhaltsbereich 5: Bewegen an und mit Geräten - Turnen und Akrobatik . In: Kleindienst-Cachay C, Frohn J, Kastrup V, eds. Sportunterricht . Kompetent im Unterricht der Grundschule. Vol 7. Hohengehren: Schneider; 2016: 105-121

Intra‑tumoral treatment with oxygen‑ozone in glioblastoma: A systematic literature search and results of a case series

Despite progress in surgery and radiochemotherapy, the prognosis of glioblastoma (GB) remains poor. GB cells exhibit a preference for hypoxia to maintain their tumor-forming capacity. Treatment strategies utilizing oxygen (O-2) or ozone (O-3) and generating reactive oxygen species induce cell growth inhibition and apoptosis. The anti-tumorigenic properties of O-2-O-3 are accompanied by a key role in regulating immunogenicity. The present study reported a case series of an intra-tumoral O-2-O-3 application in recurrent GB. Following surgery in combination with standard radiochemotherapy, O-2-O-3 (5 ml at 40 mu g/ml) was applied every four weeks into the tumor vicinity. The patients received a median of 27 (range, 3-44) O-2-O-3 applications. In addition, a systematic literature search was performed in order to evaluate the role of O-3 in the treatment of malignancies. The median overall survival rate was 40 (range, 16-53) months. The median survival rate following the first recurrence or the initiation of the O-2-O-3 treatment, respectively, was 34 (range, 12-53) months. In one patient, a local infection and in another, hemorrhage occurred, necessitating in both the temporary removal of the reservoir. The data from the present study support the potential benefit of an intra-tumoral O-2-O-3 application in recurrent GB. The scientific literature revealed by the bibliographic search suggests that O-3 may be considered a viable adjuvant therapy in oncological patients. The present study may serve as a starting point for further observational and clinical studies elucidating the cellular and systemic effects of O-2 and/or O-3 and demonstrating their efficacy and safety in larger patient samples