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Search Results: 1 - 10 of 10457 matches for " Hans-Joachim Kirschner "
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IGF2/H19 hypomethylation is tissue, cell, and CpG site dependent and not correlated with body asymmetry in adolescents with Silver-Russell syndrome
Kai Kannenberg, Karin Weber, Cathrin Binder, Christina Urban, Hans-Joachim Kirschner, Gerhard Binder
Clinical Epigenetics , 2012, DOI: 10.1186/1868-7083-4-15
Abstract: The ICR1 methylation status was analyzed in blood and in addition in buccal smear probes and cultured fibroblasts obtained from punch biopsies taken from the two body halves of 5 SRS patients and 3 controls. We found that the ICR1 hypomethylation in SRS patients was stronger in blood leukocytes and oral mucosa cells than in fibroblasts. ICR1 CpG sites were affected differently. The severity of hypomethylation was not correlated to body asymmetry. IGF2 expression and IGF-II secretion of fibroblasts were not correlated to the degree of ICR1 hypomethylation. SRS fibroblasts responded well to stimulation by recombinant human IGF-I or IGF-II, with proliferation rates comparable with controls. Clonal expansion of primary fibroblasts confirmed the complexity of the cellular mosaicism.We conclude that the ICR1 hypomethylation SRS is tissue, cell, and CpG site specific. The correlation of the ICR1 hypomethylation to IGF2 and H19 expression is not strict, may depend on the investigated tissue, and may become evident only in case of more severe methylation defects. The body asymmetry in juvenile SRS patients is not related to a corresponding ICR1 hypomethylation gradient, rendering more likely an intrauterine origin of asymmetry. Overall, it may be instrumental to consider not only the ICR1 methylation status as decisive for IGF2/H19 expression regulation.Silver-Russell syndrome (SRS; OMIM 180860) is a sporadically occurring, genetically and clinically heterogeneous disorder. It is diagnosed on the basis of the combination of intrauterine growth retardation, severe short stature, characteristic triangular face, relative macrocephaly, body asymmetry, underweight, and several minor abnormalities [1-3]. The relative limb length differences in asymmetric SRS patients are present at birth and stay stable during the growth process [4]. Short stature in SRS can be treated with pharmacological doses of recombinant growth hormone [5]. There is no apparent hormone deficiency. In contras
Pigmented villonodular synovitis of the hip in systemic lupus erythematosus: a case report
Hans-Joachim Anders
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-443
Abstract: The diagnosis of systemic lupus erythematosus was made in a 15-year-old Caucasian girl based on otherwise unexplained fatigue, arthralgia, tenosynovitis, leukopenia, low platelets and the presence of antinuclear and deoxyribonucleic antibodies. At the age of 20 a renal biopsy revealed lupus nephritis class IV and she went into complete remission with mycophenolate mofetil and steroids. She was kept on mycophenolate mofetil for maintenance therapy. At the age of 24 she experienced a flare-up of lupus nephritis with nephrotic syndrome and new onset of pain in her right hip. Magnetic resonance imaging, arthroscopy and subtotal synovectomy identified pigmented villonodular synovitis as the underlying diagnosis. Although her systemic lupus erythematosus went into remission with another course of steroids and higher doses of mycophenolate mofetil, the pigmented villonodular synovitis persisted and she had to undergo open synovectomy to control her symptoms.Systemic lupus erythematosus is associated with many different musculoskeletal manifestations including synovitis and arthritis. Pigmented villonodular synovitis has not previously been reported in association with systemic lupus erythematosus, but as its etiology is still unknown, the present case raises the question about a causal relationship between systemic lupus erythematosus and pigmented villonodular synovitis.Pigmented villonodular synovitis (PVNS) is a rare monoarticular proliferative synovial disorder of unknown etiology mostly affecting the knee, foot or the hip [1]. Metastatic disease was not observed in large cases series, therefore PVNS is considered to represent a benign synovial tumor [2]. However, the fibrocellular nature of PVNS tissue can cause pain, disability and progressive destruction of cartilage and bone, especially when the hips are affected [1-5]. The male to female ratio of patients with PVNS is around 2:3 [1,2]. Diffuse forms of PVNS in large joints frequently relapse even after synovectomy
The tribe Hippomaneae (Euphorbiaceae) in Brazil
Esser, Hans-Joachim;
Rodriguésia , 2012, DOI: 10.1590/S2175-78602012000100013
Abstract: the tribe hippomaneae (euphorbiaceae) in brazil. the tribe hippomaneae is discussed with respect to its taxonomic history, its placement within the euphorbiaceae, its diagnostic characters (particularly the floral buds), current data on phylogeny and subdivision, and its general pattern of diversity. the tribe is represented in brazil with 13 genera and ca. 120 species. a key to the brazilian genera is provided. all brazilian genera are discussed, citing relevant characters, recent taxonomic literature, and the current state of knowledge, sometimes pointing to unresolved problems. for five of the genera, published revisions exist; six genera have unpublished but completed revisions or are currently under revision. actinostemon and gymnanthes are currently the most difficult genera, mostly based on the absence of available up-to-date taxonomic references. for mabea and senefeldera, two genera with completed but currently unpublished revisions, additional data are given on aspects of their taxonomy, ecology and biogeography.
Tachyarrhythmias, bradyarrhythmias and acute coronary syndromes
Trappe Hans-Joachim
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: The incidence of bradyarrhythmias in patients with acute coronary syndrome (ACS) is 0.3% to 18%. It is caused by sinus node dysfunction (SND), high-degree atrioventricular (AV) block, or bundle branch blocks. SND presents as sinus bradycardia or sinus arrest. First-degree AV block occurs in 4% to 13% of patients with ACS and is caused by rhythm disturbances in the atrium, AV node, bundle of His, or the Tawara system. First- or second-degree AV block is seen very frequently within 24 h of the beginning of ACS; these arrhythmias are frequently transient and usually disappear after 72 h. Third-degree AV blocks are also frequently transient in patients with infero-posterior myocardial infarction (MI) and permanent in anterior MI patients. Left anterior fascicular block occurs in 5% of ACS; left posterior fascicular block is observed less frequently (incidence < 0.5%). Complete bundle branch block is present in 10% to 15% of ACS patients; right bundle branch block is more common (2/3) than left bundle branch block (1/3). In patients with bradyarrhythmia, intravenous (IV) atropine (1-3 mg) is helpful in 70% to 80% of ACS patients and will lead to an increased heart rate. The need for pacemaker stimulation (PS) is different in patients with inferior MI (IMI) and anterior MI (AMI). Whereas bradyarrhythmias are frequently transient in patients with IMI and therefore do not need permanent PS, there is usually a need for permanent PS in patients with AMI. In these patients bradyarrhythmias are mainly caused by septal necrosis. In patients with ACS and ventricular arrhythmias (VTA) amiodarone is the drug of choice; this drug is highly effective even in patients with defibrillation-resistant out-of-hospital cardiac arrest. There is general agreement that defibrillation and advanced life support is essential and is the treatment of choice for patients with ventricular flutter/fibrillation. If defibrillation is not available in patients with cardiac arrest due to VTA, cardiopulmonary resuscitation is mandatory.
Emergency therapy of maternal and fetal arrhythmias during pregnancy
Trappe Hans-Joachim
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: Atrial premature beats are frequently diagnosed during pregnancy (PR); supraventricular tachycardia (SVT) (atrial tachycardia, AV-nodal reentrant tachycardia, circus movement tachycardia) is less frequently diagnosed. For acute therapy, electrical cardioversion with 50-100 J is indicated in all unstable patients (pts). In stable SVT, the initial therapy includes vagal maneuvers to terminate tachycardias. For short-term management, when vagal maneuvers fail, intravenous adenosine is the first choice drug and may safely terminate the arrhythmia. Ventricular premature beats are also frequently present during PR and benign in most of the pts; however, malignant ventricular tachyarrhythmias (sustained ventricular tachycardia [VT], ventricular flutter [VFlut] or ventricular fibrillation [VF]) may occur. Electrical cardioversion is necessary in all pts who are in hemodynamically unstable situation with life-threatening ventricular tachyarrhythmias. In hemodynamically stable pts, initial therapy with ajmaline, procainamide or lidocaine is indicated. In pts with syncopal VT, VF, VFlut or aborted sudden death, an implantable cardioverter-defibrillator is indicated. In pts with symptomatic bradycardia, a pacemaker can be implanted using echocardiography at any stage of PR. The treatment of the pregnant patient with cardiac arrhythmias requires important modifications of the standard practice of arrhythmia management. The goal of therapy is to protect the patient and fetus through delivery, after which chronic or definitive therapy can be administered.
Treating critical supraventricular and ventricular arrhythmias
Trappe Hans-Joachim
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: Atrial fibrillation (AF), atrial flutter, AV-nodal reentry tachycardia with rapid ventricular response, atrial ectopic tachycardia and preexcitation syndromes combined with AF or ventricular tachyarrhythmias (VTA) are typical arrhythmias in intensive care patients (pts). Most frequently, the diagnosis of the underlying arrhythmia is possible from the physical examination (PE), the response to maneuvers or drugs and the 12-lead surface electrocardiogram. In unstable hemodynamics, immediate DC-cardioversion is indicated. Conversion of AF to sinus rhythm (SR) is possible using antiarrhythmic drugs. Amiodarone has a conversion rate in AF of up to 80%. Ibutilide represents a class III antiarrhythmic agent that has been reported to have conversion rates of 50-70%. Acute therapy of atrial flutter (Aflut) in intensive care pts depends on the clinical presentation. Atrial flutter can most often be successfully cardioverted to SR with DC-energies < 50 joules. Ibutilide trials showed efficacy rates of 38-76% for conversion of Aflut to SR compared to conversion rates of 5-13% when intravenous flecainide, propafenone or verapamil was administered. In addition, high dose (2 mg) of ibutilide was more effective than sotalol (1.5 mg/kg) in conversion of Aflut to SR (70 versus 19%). Drugs like procainamide, sotalol, amiodarone or magnesium were recommended for treatment of VTA in intensive care pts. However, only amiodarone is today the drug of choice in VTA pts and also highly effective even in pts with defibrillation-resistant out-of-hospital cardiac arrest (CA). There is a general agreement that bystander first aid, defibrillation and advanced life support is essential for neurologic outcome in pts after cardiac arrest due to VTA. Public access defibrillation in the hands of trained laypersons seems to be an ideal approach in the treatment of ventricular fibrillation (VF). The use of automatic external defibrillators (AEDs) by basic life support ambulance providers or first responder (FR) in early defibrillation programs has been associated with a significant increase in survival rates (SRs). However, use of AEDs at home cannot be recommended.
Concept of the five ′A′s for treating emergency arrhythmias
Trappe Hans-Joachim
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: Cardiac rhythm disturbances such as bradycardia (heart rate < 50/min) and tachycardia (heart rate > 100/min) require rapid therapeutic intervention. The supraventricular tachycardias (SVTs) are sinus tachycardia, atrial tachycardia, AV-nodal reentrant tachycardia, and tachycardia due to accessory pathways. All SVTs are characterized by a ventricular heart rate > 100/min and small QRS complexes (QRS width < 0.12 ms) during the tachycardia. It is essential to evaluate the arrhythmia history, to perform a good physical examination, and to accurately analyze the 12-lead electrocardiogram. A precise diagnosis of the SVT is then possible in more than 90% of patients. In ventricular tachycardia (VT) there are broad QRS complexes (QRS width > 0.12 s). Ventricular flutter and ventricular fibrillation are associated with chaotic electrophysiologic findings. For acute therapy, we will present the new concept of the five ′A′s, which refers to adenosine, adrenaline, ajmaline, amiodarone, and atropine. Additionally, there are the ′B,′ ′C,′ and ′D′ strategies, which refer to beta-blockers, cardioversion, and defibrillation, respectively. The five ′A′ concept allows a safe and effective antiarrhythmic treatment of all bradycardias, tachycardias, SVTs, VT, ventricular flutter, and ventricular fibrillation, as well as of asystole.
Die rechtspolitische Diskussion um den Mieterschutz der Nachkriegszeit
Hans-Joachim Lutz
Forum Historiae Iuris , 1998,
Effective Geothermal Utilisation close to the surface by the TT-Geothermal Radial Drilling (GRD-)Method
Hans-Joachim Bayer
Acta Montanistica Slovaca , 2007,
Abstract: In the late 1970-Years, Tracto-Technik developped a very effective radial-shaped percussion system for a geothermal heating, the ECOtherm-System, which was very well accepted by customers. Nowadays, a radial-shaped drilling system, operating some decameters below the surface, was developped by Tracto-Technik, which offers the chance of a very effective drilling for the use of geothermal energy. The main advantage of this development is the reduction of drilling costs by new constructions and new handling possibilities. Drilling processes like the rod connecting or the drill-hole enlargement were solved in other ways as usual, by very time-shortening and effective ways, which are presented in the paper. The new TT-Geothermal radial drilling methods need only a very small but highly effective drilling unit, which reduces the operational drilling cost in a enormous way. All operational drilling steps are reduced to less than a half time as usual. By these GRD-methods, the use of surface-close geothermal energy is simplified and less expansive.
New method of trenchless cable replacement by the new HDD wash over technology
Hans-Joachim Bayer
Acta Montanistica Slovaca , 2007,
Abstract: An enormous amount of underground electricity and telecommunication cables have become time-worn technical defects or need a capacity increase. Thus, new lines need to be installed. In urban areas, even in smaller communities and in nature reserves, open trenching is difficult and often not permitted.New patented methods of trenchless cable replacement by using the HDD equipment have been developed by the TT Group. The new technology is called “Wash-over-cable-replacement” and applies specially designed drill heads, reaming around the old cable string in various configurations (completely closed, U-shaped or sigmoidal embracing), depending on the coating structure of the old cable. The cable replacement drill heads separate the cable from adhesive or contacting soil or sand bedding, create a very small annular space around the cable which enables a pulling or dragging out of the old cable section between a start and an exit pit. After the old cable has been loosened from the surrounding soil by means of the wash over process and pulled out, the new cable is smoothly pulled into the void using the drill rods embedding the new cable into a rich bed of Bentonite.The replacement drill heads are slim and have inner and outer nozzles for Bentonite and bits in order to handle roots, pebbles, gravel and the like. These drill heads can very fast (up to 3 meters per minute) and effectively wash over existing cables without damaging the cable coating and prepare the ground for a fast new laying of a new cable in the existing line. Network owners also benefit from the fact that new geodetic or topographic surveys and documentations of the new cable are not necessary, only, the documents, remarks, technical codes and existing geodetic data need to be updated.The paper will outline the technological background and includes many practical job examples.
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