The intestinal micro-environment imprints stromal cells to promote efficient Treg induction in gut-draining lymph nodes.

De novo induction of Foxp3⁺ regulatory T cells (Tregs) is particularly efficient in gut-draining mesenteric and celiac lymph nodes (mLN and celLN). Here we used LN transplantations to dissect the contribution of stromal cells and environmental factors to the high Treg-inducing capacity of these LN. After transplantation into the popliteal fossa, mLN and celLN retained their high Treg-inducing capacity, whereas transplantation of skin-draining LN into the gut mesenteries did not enable efficient Treg induction. However, de novo Treg induction was abolished in the absence of dendritic cells (DC), indicating that this process depends on synergistic contributions of stromal and DC. Stromal cells themselves were influenced by environmental signals as mLN grafts taken from germ-free donors and celLN grafts taken from vitamin A-deficient donors did not show any superior Treg-inducing capacity. Collectively, our observations reveal a hitherto unrecognized role of LN stromal cells for the de novo induction of Foxp3⁺ Tregs.

[Paediatric pseudophakia - refractive changes after primary and secondary intraocular lens implantation]. / Pseudophakie bei Kindern - Refraktionsentwicklung nach primärer und sekundärer Intraokularlinsen-Implantation.

BACKGROUND: A so-called myopic shift after cataract extraction and IOL implantation is known to occur in children. How much is difficult to predict. In this study we report the refractive development in pseudophakic children after primary and secondary IOL implantation. METHODS: The refractive change in all patients receiving an IOL-implantation between 2000 and 2008 with a follow-up of a minimum of 6 months was reviewed (6 - 107 months). Rigid or foldable lenses were implanted by the same technique. Refraction postoperatively and at last follow-up was measured. 62 eyes of 41 patients were reviewed. Patients were divided into three groups based on age at time of surgery: 3 - 4 years, 5 - 6 years and 7 - 12 years. RESULTS: The mean myopic shift was 2.5 D in both study groups, patients with primary and secondary IOL implantation. In the group with 3 - 4-year-old children mean myopic shift was 1.5 D in primary and 1.0 D in secondary implantations, in the group with 5 - 6-year-old children 2.75 D in primary and 3.25 D in secondary implantations and in the group with 7 - 12-year-old children 2.0 D in both primary and secondary implanted IOLs. CONCLUSIONS: We have shown that there are no differences in refractive changes between primary and secondary IOL implantations in our study group. In contrast to other findings we found the lowest myopic shift in the group of 3 - 4-year-old patients. Our results show that a prediction of expected myopic shift in children after IOL implantations remains difficult.

Superspace description of the modulated structure of the metal-salt-hybrid Bi(7-delta)Ni2Br(5-2delta) (delta = 1/9).

The compound Bi(7-delta)Ni2Br(5-2delta) = (Bi3Ni)2[Bi(1-delta)Br4]Br(1-2delta) (delta = 1/9) is a sub-bromide of the intermetallic phase Bi3Ni. Its crystal structure contains metallic rods, 1infinity[Bi3Ni], which are embedded in a salt-like matrix of bromido-bismuthate(III) and bromide anions. The non-stoichiometry originates from the variation of the number n of trans edge-sharing octahedra in the [Bi(n)Br(4n + 2)]((n + 2)-) oligomers (3 < or = n < or = 5), as well as from vacancies on the sites of the isolated Br atoms. The simplified structure is described in the orthorhombic space group Cmcm with a = 4.0660 (4), b = 23.305 (3), c = 17.130 (2) A. It shows a statistical distribution of vacancies and orientational disorder of the concatenated octahedra. By choosing the modulation vector q = a*/9 + b*/2, the additional weak reflections of the diffraction pattern can be indexed. In the [3 + 1]-dimensional superspace group Pmnm(alpha(1/2)0)000, an ordered structure model is achieved. The modulated crystal structure bears a strong resemblance to the somewhat higher oxidized sub-bromide Bi(7-delta)Ni2Br5 (delta = 1/9).

[Clinical and radiological results of surgical removal of periarticular ossifications after hip prosthesis implantation]. / Klinische und radiologische Ergebnisse der operativen Entfernung von periartikulären Ossifikationen nach Hüftendoprothese.

The occurrence of heterotopic ossification (HO) is a well-recognized problem after total hip replacement. In a retrospective study, we investigated 32 patients who had undergone surgical excision of symptomatic HO followed by radiation with 7 Gy and nonsteroidal anti-inflammatory drug therapy between 1994 and 1999. The mean follow-up was 20 months (range: 12-60). Clinical and radiographic follow-up examinations included Harris hip score and classification according to Brooker. The preoperative Brooker class was III in 16 cases and IV in 16 patients. Comparison of the Brooker classification at follow-up revealed a statistically significant improvement (p < 0.0001; class 0:3, class I: 14, class II: 8, class III: 7 patients). In one case with symptomatic Brooker class III ossification, surgical reexcision of HO was necessary. A statistically significant increase (p < 0.05) in mean range of motion (ROM) was observed in flexion [preoperative: 57 degrees (+/- 26), follow-up: 83 degrees (+/- 21)], in abduction [preoperative: 17 degrees (+/- 12), follow-up: 24 degrees (+/- 9)], and in rotation (preoperative: 16 degrees (+/- 17), follow-up: 31 degrees (+/- 18)]. Comparison of preoperative Harris hip score (60 +/- 11) and Harris hip score at the time of follow-up examination (73 +/- 17) revealed a statistically significant increase (p < 0.0001) after treatment. At the time of follow-up examination, 18 patients (56%) assessed their pain symptoms as low but 6 patients (19%) reported strong pain symptoms. Nevertheless, the score at the time of examination (35 +/- 10) was statistically improved (p < 0.02) when compared to the preoperative score (30 +/- 8). Surgical excision of Brooker class III or IV heterotopic ossification with limited ROM followed by irradiation and anti-inflammatory prophylaxis results in significant improvement in flexion, abduction, and rotation arc and significant reduction of HO in radiographic examination at follow-up, but pain relief was only satisfactory.

[Results of operative therapy of periprosthetic femur shaft fractures in total hip endoprostheses]. / Ergebnisse der operativen Therapie periprothetischer Femurschaftfrakturen bei Hüfttotalendoprothesen.

Periprosthetic femoral shaft fracture represents an uncommon but potentially devastating complication associated with total hip arthroplasty. The treatment should result in complete union of the fracture and at the same time guarantee stability of the implant. 15 patients treated between 1992 to 1998 were analysed. Clinical and radiographic follow-up averaged 30 months (6-79 months) in 13 cases. Two patients died regardless of the fracture. The method of treatment depended on the intraoperative stability of the prosthesis and in addition on the fracture type (Bethea). In 5 cases of intraoperative stability of the prosthesis plate fixation was performed. Plate fixation was complicated by fixation failure combined with a recurrent fracture in two cases leading to shift to a long stem prosthesis. Ten cases of fractures associated with loose stems were treated with a new prosthesis using a long stem system. In these cases an uncomplicated healing of the fracture was achieved with adequate stability in radiographic examinations. The average Harris score was 70 (26-93). For fractures near the femoral stem or in case of implant loosening we recommend the shift to a long stem prosthesis. Also in fractures distally from the femoral stem tip we prefer now long stem implants rather than plate fixation to avoid large exposure of the femoral shaft and resultant complications.

[The aging of mentally handicapped within the family and society]. / La personne handicapée mentale vieillissante au sein de sa famille et dans la société.

The increase of the hope of life of the population poses specific problems, and often harrowing for the families with a mentally handicapped relative. Will be able the society to take up the challenge issued by the medicine and a better standard of living, in accompanying all its members with dignity.

Apoptosis inhibiting factor Bcl-xL might be the crucial member of the Bcl-2 gene family in colorectal cancer.

Since the role of the Bcl-2 gene family has been only poorly investigated in colorectal cancer, we have examined the expression of the apoptosis blockers Bcl-xL and Bcl-2, as well as the proapoptotic factors Bax and Bak. Northern blot analysis and immunohistochemistry were performed on normal and cancerous colonic tissue from 12 patients. In colorectal cancer, Bcl-xL immunoreaction was stronger than in normal controls, and 83% of the cancers had increased Bcl-xL mRNA expression. The median densitometric Bcl-xL values were 3.4-fold higher in carcinomas (P<0.005). In contrast to the normal colon, colorectal carcinomas often lack any Bcl-2 immunostaining, and Bcl-2 mRNA was not detectable by Northern blots either. Bax was not obviously altered in colorectal cancer, either at the protein level or at the mRNA level compared to the normal control colon. Bak mRNA expression exhibited a wide variation in carcinomas, but was somewhat decreased in comparison to the controls. Of these members of the Bcl-2 gene family, Bcl-xL seems to play a major role in colorectal tumorigenesis and disease progression. An agonistic effect might have caused the tendency for reduced Bak expression. The Bcl-2/Bax regulation system of cell homeostasis seems to be of lesser importance.

Influence of stimulus cross talk on results of the twitch-interpolation technique at the biceps brachii muscle.

Biceps brachii muscles of five healthy volunteers were tested with a high-resolution twitch-interpolation technique. Parameters of the electrical surface stimulation were varied. It was found that a supramaximal stimulus strength activates both biceps and triceps brachii motor units simultaneously severely affecting twitch-interpolation results. Crosstalk contamination of twitches, however, can be avoided, if submaximal stimuli are used yielding twitch-interpolation results for the biceps-brachii that are similar to those of the quadriceps muscle.

Metabolites of microorganisms. 242 pyridindolol glucosides from Streptomyces parvulus.

From a new strain of Streptomyces, Streptomyces parvulus, strain Tü 2480 three glucosides of the alkaloid pyridindolol were isolated. The structure elucidation is based on spectroscopic investigations and degradation to pyridindolol and alpha,D-methyl glucoside.