18 results on '"C. Depner"'
Search Results
2. EphrinB2 repression through ZEB2 mediates tumour invasion and anti-angiogenic resistance
- Author
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Franziska Foss, Sascha Seidel, Ángel M. Cuesta, María Rodríguez Aburto, Jan Hofmann, C. Depner, Boyan K. Garvalov, Till Acker, F. Finkelmeier, H. Zum Buttel, Guido Reifenberger, K. Kaulich, Marta Segarra, S. Barbus, Nuray Böğürcü, and Amparo Acker-Palmer
- Subjects
0301 basic medicine ,Cell signaling ,Science ,General Physics and Astronomy ,Repressor ,Down-Regulation ,Angiogenesis Inhibitors ,Ephrin-B2 ,Biology ,General Biochemistry, Genetics and Molecular Biology ,Article ,Neovascularization ,03 medical and health sciences ,Downregulation and upregulation ,ddc:570 ,Glioma ,medicine ,Gene silencing ,Animals ,Humans ,Neoplasm Invasiveness ,Psychological repression ,Zinc Finger E-box Binding Homeobox 2 ,Regulation of gene expression ,Mice, Knockout ,Multidisciplinary ,Neovascularization, Pathologic ,General Chemistry ,medicine.disease ,Hypoxia-Inducible Factor 1, alpha Subunit ,Xenograft Model Antitumor Assays ,Cell Hypoxia ,Cell biology ,Up-Regulation ,Bevacizumab ,Gene Expression Regulation, Neoplastic ,Mice, Inbred C57BL ,030104 developmental biology ,Drug Resistance, Neoplasm ,medicine.symptom - Abstract
Diffuse invasion of the surrounding brain parenchyma is a major obstacle in the treatment of gliomas with various therapeutics, including anti-angiogenic agents. Here we identify the epi-/genetic and microenvironmental downregulation of ephrinB2 as a crucial step that promotes tumour invasion by abrogation of repulsive signals. We demonstrate that ephrinB2 is downregulated in human gliomas as a consequence of promoter hypermethylation and gene deletion. Consistently, genetic deletion of ephrinB2 in a murine high-grade glioma model increases invasion. Importantly, ephrinB2 gene silencing is complemented by a hypoxia-induced transcriptional repression. Mechanistically, hypoxia-inducible factor (HIF)-1α induces the EMT repressor ZEB2, which directly downregulates ephrinB2 through promoter binding to enhance tumour invasiveness. This mechanism is activated following anti-angiogenic treatment of gliomas and is efficiently blocked by disrupting ZEB2 activity. Taken together, our results identify ZEB2 as an attractive therapeutic target to inhibit tumour invasion and counteract tumour resistance mechanisms induced by anti-angiogenic treatment strategies., Ephrins are transmembrane proteins involved in cell-cell communication, and implicated in cancer cell growth and progression. Here, the authors show that EphrinB2 expression is reduced in glioma cells both by genetic and epigenetic alterations and under hypoxia, through a HIF1α-mediated direct regulation of ZEB2, which enhances invasion and anti-angiogenic resistance.
- Published
- 2015
3. Patientenzufriedenheit im QMR-Kontext: Modell, Methode und Ergebnisse
- Author
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M Heberer, M Bergman, A Prengel, C Abshagen, and C Depner
- Subjects
business.industry ,medicine ,Hospital quality ,General Medicine ,Medical emergency ,Patient assessment ,Hospital performance ,medicine.disease ,business - Published
- 2009
4. Sleep and circadian rhythms: pillars of health-a Keystone Symposia report.
- Author
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Cable J, Schernhammer E, Hanlon EC, Vetter C, Cedernaes J, Makarem N, Dashti HS, Shechter A, Depner C, Ingiosi A, Blume C, Tan X, Gottlieb E, Benedict C, Van Cauter E, and St-Onge MP
- Subjects
- Animals, Blood Pressure physiology, Cardiovascular Diseases genetics, Cardiovascular Diseases physiopathology, Cardiovascular Diseases psychology, Circadian Clocks physiology, Humans, Meals psychology, Neoplasms genetics, Neoplasms physiopathology, Neoplasms psychology, Risk Factors, Circadian Rhythm physiology, Congresses as Topic trends, Meals physiology, Research Report, Sleep physiology
- Abstract
The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease., (© 2021 New York Academy of Sciences.)
- Published
- 2021
- Full Text
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5. Correction: Serine-dependent redox homeostasis regulates glioblastoma cell survival.
- Author
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Engel AL, Lorenz NI, Klann K, Münch C, Depner C, Steinbach JP, Ronellenfitsch MW, and Luger AL
- Published
- 2021
- Full Text
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6. Miles to go before we sleep…a step toward transparent evaluation of consumer sleep tracking devices.
- Author
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Goldstein CA and Depner C
- Subjects
- Software, Actigraphy, Sleep
- Published
- 2021
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7. Serine-dependent redox homeostasis regulates glioblastoma cell survival.
- Author
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Engel AL, Lorenz NI, Klann K, Münch C, Depner C, Steinbach JP, Ronellenfitsch MW, and Luger AL
- Subjects
- Antineoplastic Agents pharmacology, Cell Line, Tumor, Cell Proliferation drug effects, Cell Survival drug effects, Gene Expression Regulation, Neoplastic drug effects, Glioblastoma genetics, Glioblastoma pathology, Homeostasis drug effects, Humans, Oxidation-Reduction drug effects, Phosphoglycerate Dehydrogenase antagonists & inhibitors, Reactive Oxygen Species metabolism, Serine metabolism, Tumor Microenvironment drug effects, Glioblastoma metabolism, Glycine Hydroxymethyltransferase genetics, NF-E2-Related Factor 2 genetics, Phosphoglycerate Dehydrogenase genetics
- Abstract
Background: The amino acid serine is an important substrate for biosynthesis and redox homeostasis. We investigated whether glioblastoma (GBM) cells are dependent on serine for survival under conditions of the tumour microenvironment., Methods: Serine availability in GBM cells was modulated pharmacologically, genetically and by adjusting serine and glycine concentrations in the culture medium. Cells were investigated for regulation of serine metabolism, proliferation, sensitivity to hypoxia-induced cell death and redox homeostasis., Results: Hypoxia-induced expression of phosphoglycerate dehydrogenase (PHGDH) and the mitochondrial serine hydroxymethyltransferase (SHMT2) was observed in three of five tested glioma cell lines. Nuclear factor erythroid 2-related factor (Nrf) 2 activation also induced PHGDH and SHMT2 expression in GBM cells. Low levels of endogenous PHGDH as well as PHGDH gene suppression resulted in serine dependency for cell growth. Pharmacological inhibition of PHGDH with CBR-5884 reduced proliferation and sensitised cells profoundly to hypoxia-induced cell death. This effect was accompanied by an increase in reactive oxygen species and a decrease in the NADPH/NADP
+ ratio. Similarly, hypoxia-induced cell death was enhanced by PHGDH gene suppression and reduced by PHGDH overexpression., Conclusions: Serine facilitates adaptation of GBM cells to conditions of the tumour microenvironment and its metabolism could be a plausible therapeutic target.- Published
- 2020
- Full Text
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8. Perfect timing: circadian rhythms, sleep, and immunity - an NIH workshop summary.
- Author
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Haspel JA, Anafi R, Brown MK, Cermakian N, Depner C, Desplats P, Gelman AE, Haack M, Jelic S, Kim BS, Laposky AD, Lee YC, Mongodin E, Prather AA, Prendergast BJ, Reardon C, Shaw AC, Sengupta S, Szentirmai É, Thakkar M, Walker WE, and Solt LA
- Subjects
- Animals, Cell Differentiation, Circadian Rhythm immunology, Education, Humans, Immune System, Microbiota immunology, National Institutes of Health (U.S.), Sleep immunology, T-Lymphocytes, United States, Circadian Rhythm physiology, Immunity, Sleep physiology
- Abstract
Recent discoveries demonstrate a critical role for circadian rhythms and sleep in immune system homeostasis. Both innate and adaptive immune responses - ranging from leukocyte mobilization, trafficking, and chemotaxis to cytokine release and T cell differentiation -are mediated in a time of day-dependent manner. The National Institutes of Health (NIH) recently sponsored an interdisciplinary workshop, "Sleep Insufficiency, Circadian Misalignment, and the Immune Response," to highlight new research linking sleep and circadian biology to immune function and to identify areas of high translational potential. This Review summarizes topics discussed and highlights immediate opportunities for delineating clinically relevant connections among biological rhythms, sleep, and immune regulation.
- Published
- 2020
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9. EphrinB2 repression through ZEB2 mediates tumour invasion and anti-angiogenic resistance.
- Author
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Depner C, Zum Buttel H, Böğürcü N, Cuesta AM, Aburto MR, Seidel S, Finkelmeier F, Foss F, Hofmann J, Kaulich K, Barbus S, Segarra M, Reifenberger G, Garvalov BK, Acker T, and Acker-Palmer A
- Subjects
- Angiogenesis Inhibitors pharmacology, Angiogenesis Inhibitors therapeutic use, Animals, Bevacizumab pharmacology, Bevacizumab therapeutic use, Cell Hypoxia genetics, Down-Regulation genetics, Ephrin-B2 metabolism, Gene Expression Regulation, Neoplastic, Glioma blood supply, Humans, Hypoxia-Inducible Factor 1, alpha Subunit metabolism, Mice, Inbred C57BL, Mice, Knockout, Neoplasm Invasiveness, Neovascularization, Pathologic drug therapy, Neovascularization, Pathologic metabolism, Up-Regulation genetics, Xenograft Model Antitumor Assays, Zinc Finger E-box Binding Homeobox 2 genetics, Drug Resistance, Neoplasm genetics, Ephrin-B2 genetics, Glioma genetics, Glioma pathology, Neovascularization, Pathologic genetics, Neovascularization, Pathologic pathology, Zinc Finger E-box Binding Homeobox 2 metabolism
- Abstract
Diffuse invasion of the surrounding brain parenchyma is a major obstacle in the treatment of gliomas with various therapeutics, including anti-angiogenic agents. Here we identify the epi-/genetic and microenvironmental downregulation of ephrinB2 as a crucial step that promotes tumour invasion by abrogation of repulsive signals. We demonstrate that ephrinB2 is downregulated in human gliomas as a consequence of promoter hypermethylation and gene deletion. Consistently, genetic deletion of ephrinB2 in a murine high-grade glioma model increases invasion. Importantly, ephrinB2 gene silencing is complemented by a hypoxia-induced transcriptional repression. Mechanistically, hypoxia-inducible factor (HIF)-1α induces the EMT repressor ZEB2, which directly downregulates ephrinB2 through promoter binding to enhance tumour invasiveness. This mechanism is activated following anti-angiogenic treatment of gliomas and is efficiently blocked by disrupting ZEB2 activity. Taken together, our results identify ZEB2 as an attractive therapeutic target to inhibit tumour invasion and counteract tumour resistance mechanisms induced by anti-angiogenic treatment strategies.
- Published
- 2016
- Full Text
- View/download PDF
10. Strategies for structuring interdisciplinary education in Systems Biology: an European perspective.
- Author
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Cvijovic M, Höfer T, Aćimović J, Alberghina L, Almaas E, Besozzi D, Blomberg A, Bretschneider T, Cascante M, Collin O, de Atauri P, Depner C, Dickinson R, Dobrzynski M, Fleck C, Garcia-Ojalvo J, Gonze D, Hahn J, Hess HM, Hollmann S, Krantz M, Kummer U, Lundh T, Martial G, Dos Santos VM, Mauer-Oberthür A, Regierer B, Skene B, Stalidzans E, Stelling J, Teusink B, Workman CT, and Hohmann S
- Abstract
Systems Biology is an approach to biology and medicine that has the potential to lead to a better understanding of how biological properties emerge from the interaction of genes, proteins, molecules, cells and organisms. The approach aims at elucidating how these interactions govern biological function by employing experimental data, mathematical models and computational simulations. As Systems Biology is inherently multidisciplinary, education within this field meets numerous hurdles including departmental barriers, availability of all required expertise locally, appropriate teaching material and example curricula. As university education at the Bachelor's level is traditionally built upon disciplinary degrees, we believe that the most effective way to implement education in Systems Biology would be at the Master's level, as it offers a more flexible framework. Our team of experts and active performers of Systems Biology education suggest here (i) a definition of the skills that students should acquire within a Master's programme in Systems Biology, (ii) a possible basic educational curriculum with flexibility to adjust to different application areas and local research strengths, (iii) a description of possible career paths for students who undergo such an education, (iv) conditions that should improve the recruitment of students to such programmes and (v) mechanisms for collaboration and excellence spreading among education professionals. With the growing interest of industry in applying Systems Biology approaches in their fields, a concerted action between academia and industry is needed to build this expertise. Here we present a reflection of the European situation and expertise, where most of the challenges we discuss are universal, anticipating that our suggestions will be useful internationally. We believe that one of the overriding goals of any Systems Biology education should be a student's ability to phrase and communicate research questions in such a manner that they can be solved by the integration of experiments and modelling, as well as to communicate and collaborate productively across different experimental and theoretical disciplines in research and development., Competing Interests: The authors declare no conflict of interest.
- Published
- 2016
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11. A prospective clinical trial comparing Biobrane(®) Dressilk(®) and PolyMem(®) dressings on partial-thickness skin graft donor sites.
- Author
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Schulz A, Depner C, Lefering R, Kricheldorff J, Kästner S, Fuchs PC, and Demir E
- Subjects
- Adult, Aged, Aged, 80 and over, Bandages, Female, Humans, Male, Middle Aged, Occlusive Dressings, Pain, Patient Satisfaction, Wound Healing, Young Adult, Burns surgery, Coated Materials, Biocompatible therapeutic use, Glycerol therapeutic use, Polyurethanes therapeutic use, Re-Epithelialization, Skin Transplantation methods, Surgical Wound therapy, Transplant Donor Site
- Abstract
Introduction: In a single-center, prospective, randomized clinical trial three different configured wound dressings Biobrane(®), Dressilk(®) and PolyMem(®) were compared with each other regarding objective and subjective healing parameters and cost efficiency., Methods: 28 burn patients received surgical treatment with split-thickness skin grafting, while utilizing Biobrane(®), Dressilk(®) and PolyMem(®) as a single bound donor site wound dressing in all patients. Following a standardized case report form, we monitored several parameters such as pain, transparency of the dressing, active bleeding, exudation and inflammation by using the Verbal Rating Scale 1-10 through out., Results: With regard to re-epithelialization, pain and acute bleeding all three dressings were equivalent. Dressilk(®) and Biobrane(®) presented clearly superior to PolyMem(®) in both wound assessment and in the reduction of mild inflammation and exudation. High subjective satisfaction rates were reported with Dressilk(®) and Biobrane(®) dressings in regard to comfort and mobility. During the continuous monitoring period Biobrane(®) outperformed Dressilk(®) by providing higher wound transparency rates and offering a better level of wound control during the entire study period. Regarding their cost efficiency, PolyMem(®) and Dressilk(®) are clearly superior to Biobrane(®)., Conclusion: The "ideal" wound dressing maximizes patients' comfort while reducing pain and the risk of pulling off migrating epidermal cells from the wound surface. In addition reliable wound status evaluation (minimizing complications), an increase of treatment cost value efficacy, and reduced hospitalization rates should be provided. Dressilk(®) and Biobrane(®) were favored by patients and surgeons for providing an effective and safe healing environment, with overall low complication rates with respect to infection and exudation. Regarding cost-effectiveness PolyMem(®) and Dressilk(®) presented superior to Biobrane(®)., (Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.)
- Published
- 2016
- Full Text
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12. Auditory mismatch impairments are characterized by core neural dysfunctions in schizophrenia.
- Author
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Gaebler AJ, Mathiak K, Koten JW Jr, König AA, Koush Y, Weyer D, Depner C, Matentzoglu S, Edgar JC, Willmes K, and Zvyagintsev M
- Subjects
- Adult, Attention physiology, Brain Mapping, Cerebral Cortex pathology, Female, Humans, Image Processing, Computer-Assisted methods, Magnetic Resonance Imaging methods, Male, Middle Aged, Neural Pathways physiopathology, Neuropsychological Tests, Schizophrenia pathology, Schizophrenic Psychology, Young Adult, Cerebral Cortex physiopathology, Nerve Net physiopathology, Schizophrenia physiopathology
- Abstract
Major theories on the neural basis of schizophrenic core symptoms highlight aberrant salience network activity (insula and anterior cingulate cortex), prefrontal hypoactivation, sensory processing deficits as well as an impaired connectivity between temporal and prefrontal cortices. The mismatch negativity is a potential biomarker of schizophrenia and its reduction might be a consequence of each of these mechanisms. In contrast to the previous electroencephalographic studies, functional magnetic resonance imaging may disentangle the involved brain networks at high spatial resolution and determine contributions from localized brain responses and functional connectivity to the schizophrenic impairments. Twenty-four patients and 24 matched control subjects underwent functional magnetic resonance imaging during an optimized auditory mismatch task. Haemodynamic responses and functional connectivity were compared between groups. These data sets further entered a diagnostic classification analysis to assess impairments on the individual patient level. In the control group, mismatch responses were detected in the auditory cortex, prefrontal cortex and the salience network (insula and anterior cingulate cortex). Furthermore, mismatch processing was associated with a deactivation of the visual system and the dorsal attention network indicating a shift of resources from the visual to the auditory domain. The patients exhibited reduced activation in all of the respective systems (right auditory cortex, prefrontal cortex, and the salience network) as well as reduced deactivation of the visual system and the dorsal attention network. Group differences were most prominent in the anterior cingulate cortex and adjacent prefrontal areas. The latter regions also exhibited a reduced functional connectivity with the auditory cortex in the patients. In the classification analysis, haemodynamic responses yielded a maximal accuracy of 83% based on four features; functional connectivity data performed similarly or worse for up to about 10 features. However, connectivity data yielded a better performance when including more than 10 features yielding up to 90% accuracy. Among others, the most discriminating features represented functional connections between the auditory cortex and the anterior cingulate cortex as well as adjacent prefrontal areas. Auditory mismatch impairments incorporate major neural dysfunctions in schizophrenia. Our data suggest synergistic effects of sensory processing deficits, aberrant salience attribution, prefrontal hypoactivation as well as a disrupted connectivity between temporal and prefrontal cortices. These deficits are associated with subsequent disturbances in modality-specific resource allocation. Capturing different schizophrenic core dysfunctions, functional magnetic resonance imaging during this optimized mismatch paradigm reveals processing impairments on the individual patient level, rendering it a potential biomarker of schizophrenia., (© The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2015
- Full Text
- View/download PDF
13. Failure of secondary wound closure after sternal wound infection following failed initial operative treatment: causes and treatment.
- Author
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Phan TQ, Depner C, Theodorou P, Lefering R, Perbix W, Spilker G, and Weinand C
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- Aged, Aged, 80 and over, Female, Humans, Middle Aged, Reoperation, Retrospective Studies, Surgical Wound Dehiscence etiology, Wound Infection etiology, Wounds and Injuries etiology, Coronary Artery Bypass adverse effects, Osteomyelitis surgery, Sternum, Surgical Flaps, Wounds and Injuries surgery
- Abstract
Background: Patients transferred to Plastic Surgery Departments for sternum osteomyelitis have a high morbidity of about 3%. Despite several known options for sternal wound coverage and salvage operations, wound dehiscence or wound necrosis can occur, increasing patient morbidity., Patients and Methods: One hundred thirty-five patients admitted between January 2007 and December 2010 were evaluated in a retrospective study for wound dehiscence after salvage wound coverage at our institution. Various flaps were applied, such as pectoralis major myocutaneous pedicled flaps, pectoralis major muscle pedicled flaps, latissimus dorsi pedicled flaps, greater omental flaps, and vertical rectus abdominis muscle and transverse rectus abdominis muscle flaps. Inclusion criteria were sternal wound infection, bacterial wound infection, previous wound debridement outside our institution, vacuum-assisted closure device wound treatment at our institution, and secondary flap closure of the sternal defect at our institution. A multivariate regression analysis was performed., Results: One hundred thirty patients met the inclusion criteria. In all patients, bacterial wound colonization was shown. Forty patients showed wound dehiscence after closure at our institution. Reasons for wound dehiscence were attributed to wound size, >4 different species of bacteria colonizing the wound, gram-negative bacteria, Candida albicans, intensive care unit stay, and female gender. Interestingly, wound dehiscence was not significant correlated to obesity, smoking, atherosclerosis, renal insufficiency or type of closure influenced significantly, or necrosis., Conclusions: Female patients after CABG, with large sternal wounds infected with gram-negative bacteria and candida, have an 85% risk of wound dehiscence after flap coverage for sternal wound infection.
- Published
- 2013
- Full Text
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14. Donor-site morbidity of the sensate extended lateral arm flap.
- Author
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Depner C, Erba P, Rieger UM, Iten F, Schaefer DJ, and Haug M
- Subjects
- Female, Graft Survival, Humans, Male, Middle Aged, Pain Measurement, Patient Satisfaction, Postoperative Complications, Range of Motion, Articular, Retrospective Studies, Surveys and Questionnaires, Treatment Outcome, Arm, Surgical Flaps blood supply
- Abstract
The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retrospective study of 25 consecutive patients analyzing postoperative complications using a visual analogue scale questionnaire revealed high patients satisfaction and negligible donor-site morbidity of the ELAF. Scar visibility was the commonest negative outcome. Impaired mobility of the elbow had the highest correlation with patient dissatisfaction. Sensory deficits or paresthetic disorders did not affect patient satisfaction. The extension of the lateral arm flap and positioning over the lateral humeral epicondyle is a safe and well-accepted procedure with minimal donor-site morbidity. To optimize outcomes, a maximal flap width of 6 or 7 cm and intensive postoperative mobilization therapy is advisable., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2012
- Full Text
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15. Neural correlates of the attention network test in schizophrenia.
- Author
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Backes V, Kellermann T, Voss B, Krämer J, Depner C, Schneider F, and Habel U
- Subjects
- Adult, Case-Control Studies, Female, Humans, Male, Neuropsychological Tests, Orientation, Psychiatric Status Rating Scales, Attention, Brain physiopathology, Magnetic Resonance Imaging, Neural Pathways physiopathology, Schizophrenia physiopathology, Schizophrenic Psychology
- Abstract
Attentional deficits are prominent in schizophrenia, affecting nearly all cognitive functions. Human attention comprises three essential components: alerting, orienting and executive control. For the assessment of these functions, the attention network test (ANT) has been proposed and used in healthy controls and patients. In schizophrenia, the ANT has revealed behavioral deficits; however, the corresponding neural correlates have not been examined. In the present study, neural correlates of attention were investigated in 17 schizophrenia patients and 17 healthy controls using the ANT with fMRI. Behavioral deficits emerged in the alertness system with a reduced efficiency for temporal cues. In fMRI, changes were observed for all three domains-alerting, orienting and conflict-and revealed hyper- as well as hypoactivation in patients. Affected regions during alerting comprised a broad fronto-temporo-parieto-occipito-cerebellar network, while differences during orienting mainly tapped fronto-parietal regions and during conflict processing a thalamo-frontal-temporal occipital network including the postcentral regions. In general, hyperactivations were positively correlated with more severe psychopathologial symptoms.
- Published
- 2011
- Full Text
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16. Effects of inpatient rehabilitation for children with atopic dermatitis: a prospective controlled evaluation study.
- Author
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Holling H, Depner C, Musekamp G, Stachow R, and Janssen H
- Subjects
- Adult, Child, Child, Preschool, Female, Humans, Male, Outcome Assessment, Health Care, Prospective Studies, Dermatitis, Atopic rehabilitation, Inpatients
- Published
- 2010
- Full Text
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17. Perioperative management of Glanzmann's syndrome: how we did it!
- Author
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Depner C, Schmid R, Kirchhoff P, and Oertli D
- Subjects
- Antifibrinolytic Agents therapeutic use, Factor VIIa therapeutic use, Humans, Male, Platelet Transfusion, Recombinant Proteins therapeutic use, Thrombasthenia drug therapy, Tranexamic Acid therapeutic use, Young Adult, Hernia, Inguinal surgery, Thrombasthenia therapy
- Abstract
Thrombasthenia Glanzmann, named after the Swiss paediatrician Eduard Glanzmann (1887-1959), is a rare disease of platelet dysfunction. This disease is characterized by a deficiency or defect of the fibrinogen receptor (GPIIb-IIIa) on the platelet surface. The GPIIb-IIIa receptor has an essential function in the adhesion and aggregation of the platelets. The platelets of these patients cannot bind fibrinogen and aggregation does not occur. Patients have a severe lifelong risk of bleeding, especially during surgical procedures. These patients require a special perioperative regimen for an adequate function of the coagulation system to prevent intraoperative and postoperative bleeding. In this study, we present the perioperative management of a patient with thrombasthenia Glanzmann during elective inguinal hernia repair.
- Published
- 2010
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18. Young Investigator's Prizewinner 2001. Direct visualization of the influence of normothermic as opposed to hypothermic cardiopulmonary bypass on the systemic microcirculation in neonatal piglets.
- Author
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Wagner FM, Schiller W, Dilg G, Depner C, Welz A, and Lacour-Gayet F
- Subjects
- Animals, Animals, Newborn, Awards and Prizes, Cardiology, Interleukin-2 blood, Ischemia etiology, Lactic Acid blood, Microcirculation immunology, Microcirculation physiology, Microscopy, Fluorescence methods, Models, Animal, Societies, Medical, Swine, Tumor Necrosis Factor-alpha analysis, Cardiopulmonary Bypass methods, Hypothermia, Induced adverse effects, Inflammation etiology
- Abstract
The direct visualization of systemic microcirculation using intravitalmicroscopy permits the classification of proinflammatory and ischemic microvascular alterations during normothermic and hypothermic cardiopulmonary bypass in neonates. We used seven newborn piglets, on average aged 9 days, and weighing 3200g, as a control group. In addition, we studied nine piglets subjected to 60 minutes of constant nonpulsatile flow using hypothermic extracorporeal circulation at 28 degrees C, and five piglets using normothermic conditions at 37 degrees C. The microvascular network of the greater omentum and the subcutaneous tissue was directly visualized using intravitalmicroscopy. We analysed interactions between leukocytes and endothelial cells, microvascular morphology, and microrheological conditions, focussing on signs of ischemic and proinflammatory alterations. During normothermic cardiopulmonary bypass, the numbers of activated leukocytes were elevated compared to hypothermic cardiopulmonary bypass (p > 0.05). Arteriolar diameter decreased during hypothermia. Capillaries were markedly dilated during normothermia. Patterns of microvascular perfusion, for both types of cardiopulmonary bypass, showed signs of ischemic damage, revealed by a reduced functional capillary density. Perfusion dependent levels of lactate were higher during normothermic cardiopulmonary bypass (p > 0.05). This new experimental approach revealed that non-pulsatile cardiopulmonary bypass, independent of temperature, induces a proinflammatory and ischemic response compared to an unaltered control group. The markedly elevated numbers of activated adherent leukocytes, the reduced capillary density, and the high lactate levels in those undergoing bypass in normothermic conditions indicate a more pronounced inflammatory stimulus and tissue hypoperfusion compared to the possible protective effect of hypothermia for children undergoing cardiopulmonary bypass.
- Published
- 2001
- Full Text
- View/download PDF
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