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  • 1
    Language: English
    In: Biotechnology Journal, August 2012, Vol.7(8), pp.1002-1007
    Description: The stability of therapeutic antibodies during downstream processing and storage is important for functionality and quality. To determine functional antibody performance, the UNIchip high‐density protein microarray with 384 recombinant antigenic targets was developed; this allows characterization of antibody specificity by generating standardized quantitative binding profiles. In this study, we used UNIchip to test the efficacy of a novel protein stabilizing and protecting solution (SPS) to preserve the binding specificity and binding strength of a therapeutic anti‐TNF‐α antibody (Adalimumab; Humira). Our results show that reconstituted SPS‐formulated and lyophilized Adalimumab elicits significantly less off‐target activity after reconstitution and preserves binding strength even after six weeks of storage at 40°C compared with Adalimumab that underwent the same treatment with the original formulation. By means of UNIchip, we were able to confirm the protein stabilizing effects of SPS as shown by preserved antibody functionality. Stabilization and protecting solution (SPS) enables improvement of antibody binding profiles even after thermal stress and prolonged storage. Results from the current study demonstrate that SPS‐formulated antibodies exhibit better antigen binding profiles (specificity and binding intensity) after lyophilization, thermal stress, and reconstitution as shown by means of a protein microchip array.
    Keywords: Antibody ; Diagnostics ; Microarray ; Proteins ; Stability
    ISSN: 1860-6768
    E-ISSN: 1860-7314
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  • 2
    Language: English
    In: Critical care (London, England), 2011, Vol.15(1), pp.R20
    Description: Deregulated apoptosis and overshooting neutrophil functions contribute to immune and organ dysfunction in sepsis and multiple organ failure (MOF). In the present study, we determined the role of soluble Fas (sFas) in the regulation of posttraumatic neutrophil extrinsic apoptosis and the development of sepsis. Forty-seven major trauma patients, 18 with and 29 without sepsis development during the first 10 days after trauma, were enrolled in this prospective study. Seventeen healthy volunteers served as controls. Blood samples from severely injured patients were analyzed at day 1, day 5 and day 9 after major trauma. sFas levels, plasma levels of neutrophil elastase (PMNE) and levels of interleukin (IL)-6 were quantified by enzyme-linked immunosorbent assay and related to patients' Sequential Organ Failure Assessment (SOFA) score and Multiple Organ Dysfunction Score (MODS). Neutrophil apoptosis was determined by propidium iodide staining of fragmented DNA and flow cytometry. sFas-mediated effects on neutrophil apoptosis were investigated in cells cultured with agonistic anti-Fas antibodies in the presence of recombinant sFas, sFas-depleted serum or untreated serum from septic patients. Serum levels of sFas in patients who later developed sepsis were significantly increased at day 5 (P 〈 0.01) and day 9 (P 〈 0.05) after trauma compared with patients with uneventful recovery. Apoptosis of patient neutrophils was significantly decreased during the observation period compared with control cells. Moreover, Fas-mediated apoptosis of control neutrophils was efficiently inhibited by recombinant sFas and serum from septic patients. Depletion of sFas from septic patient sera diminished the antiapoptotic effects. In septic patients, sFas levels were positively correlated with SOFA at day 1 (r = 0.7, P 〈 0.001), day 5 (r = 0.62, P 〈 0.01) and day 9 (r = 0.58, P 〈 0.01) and with PMNE and leukocyte counts (r = 0.49, P 〈 0.05 for both) as well as MODS at day 5 (r = 0.56, P 〈 0.01) after trauma. Increased sFas in patients with sepsis development impairs neutrophil extrinsic apoptosis and shows a positive correlation with the organ dysfunction scores and PMNE. Therefore, sFas might be a therapeutic target to prevent posttrauma hyperinflammation and sepsis.
    Keywords: Apoptosis -- Physiology ; Fas Ligand Protein -- Blood ; Neutrophils -- Physiology ; Sepsis -- Etiology ; Wounds and Injuries -- Blood
    ISSN: 13648535
    E-ISSN: 1466-609X
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  • 3
    Language: English
    In: Turkish neurosurgery, 2017, Vol.27(5), pp.837-841
    Description: There are a number of different surgical approaches in middle cerebral artery (MCA) aneurysm surgery. Evolution from the classical pterional approach towards smaller modified approaches took place over the years. In the present report, we describe a new modified approach in the treatment of MCA aneurysms, which is almost exclusively subfrontal. A modified approach was used on three patients with MCA bifurcation aneurysms. Craniotomy was subfrontal and suprapterional with minimal dissection of the temporal muscle and no drilling of the pterion. In all three cases, after establishing proximal control and dissecting the M1 carefully, retraction of the frontal lobe elevated the sylvian fissure and allowed opening of the fissure. The aneurysm could be identified easily and clips were applied. There was no infection and complete aneurysm clipping was achieved in all 3 patients. The described minimal craniotomy to the MCA through a subfrontal-suprapterional approach allows dissection of peripheral MCA bifurcation aneurysms without any problems.
    Keywords: Craniotomy -- Methods ; Intracranial Aneurysm -- Surgery ; Microsurgery -- Methods ; Temporal Muscle -- Surgery
    ISSN: 1019-5149
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  • 4
    Language: English
    In: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 17 June 2016, Vol.106(7), pp.687-8
    Description: In patients with C2 rheumatoid pannus with spinal cord compression the treatment of choice is extensive surgery either through a transoral resection of the dens axis or a dorsal stabilisation, or both. We present a case of an 11-mm rheumatoid pannus with significant compression of the spinal cord, which failed surgical treatment with respect to dorsal stabilisation. Therefore, rigid cervical collar for 8 weeks followed by soft collar for another 4 weeks was chosen as a treatment option. During the follow-up period of 1 year, the pannus reduced significantly and the spinal cord decompressed. In cases where surgery is not an option or is technically very demanding, the alternative of cervical collar immobilisation is a satisfying option.
    Keywords: Orthotic Devices ; Arthritis, Rheumatoid -- Complications ; Immobilization -- Methods ; Spinal Cord Compression -- Etiology
    ISSN: 0256-9574
    E-ISSN: 20785135
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  • 5
    Language: English
    In: Clinical Neurology and Neurosurgery, 2010, Vol.112(3), pp.252-257
    Description: The authors discuss a rare case of hemorrhage in a filum terminale ependymoma presenting with acute paraparesis and transient hydrocephalic dementia in association with long-term phenprocoumon anticoagulation. The CT scan of the brain revealed the presence of blood in both occipital horns and communicating hydrocephalus. The symptoms gradually resolved after tumor removal and there was no need for shunting. This is a complex clinical presentation of a spinal cord tumor associated hemorrhage, which further illustrates the possibility of retrograde passage of blood from the lumbosacral region to the ventricles.
    Keywords: Intraventricular Hemorrhage ; Hydrocephalus ; Filum Terminale Ependymoma ; Oral Anticoagulation ; Hemorrhagic Spinal Cord Tumor ; Medicine
    ISSN: 0303-8467
    E-ISSN: 1872-6968
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  • 6
    Language: English
    In: Head & neck oncology, 05 July 2010, Vol.2, pp.16
    Description: The skull base surgery is one of the most demanding surgeries. There are different structures that can be injured easily, by operating in the skull base. It is very important for the neurosurgeon to choose the right approach in order to reach the lesion without harming the other intact structures. Due to the pioneering work of Cushing, Hirsch, Yasargil, Krause, Dandy and other dedicated neurosurgeons, it is possible to address the tumor and other lesions in the anterior, the mid-line and the posterior cranial base. With the transsphenoidal, the frontolateral, the pterional and the lateral suboccipital approach nearly every region of the skull base is exposable.In the current state many different skull base approaches are described for various neurosurgical diseases during the last 20 years. The selection of an approach may differ from country to country, e.g., in the United States orbitozygomaticotomy for special lesions of the anterior skull base or petrosectomy for clivus meningiomas, are found more frequently than in Europe.The reason for writing the review was the question: Are there keyhole approaches with which someone can deal with a vast variety of lesions in the neurosurgical field?In my opinion the different surgical approaches mentioned above cover almost 95% of all skull base tumors and lesions. In the following text these approaches will be described.These approaches are:1) pterional approach2) frontolateral approach3) transsphenoidal approach4) suboccipital lateral approachThese approaches can be extended and combined with each other. In the following we want to enhance this philosophy.
    Keywords: Neurosurgical Procedures -- Methods ; Skull Base -- Surgery
    E-ISSN: 1758-3284
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  • 7
    Language: English
    In: International Journal of Surgery, September 2016, Vol.33, pp.72-77
    Description: Based upon our excellent previous experience with 151 adult patients and 39 children whom had the peritoneal catheter in ventriculoperitoneal shunting placed laparoscopically, we continued following this technique as a first-line-procedure in ventriculoperitoneal shunting. Now we analyzed our experience with additional 405 cases for a better comprehension of the complications, advantages and disadvantages of this procedure on this high number of patients. A strict interdisciplinary setting with the maximum of medical intraoperative competence was our goal and therefore better results. N = 405 patients with intraperitoneal shunt insertion from the years 2006–2013 (Follow-up period ranges from 2 to 9 years with a 5,9-year mean follow-up period) were retrospectively analyzed with a special focus on the possible peritoneal catheter complications after laparoscopical shunt insertion. In our department all the peritoneal catheters in ventriculoperitoneal shunting are inserted laparoscopically, when there is no contraindication for this technique. We had 0% peritoneal catheter misplacement rate with help of the laparoscopic technique. In two cases (0.49%) injury of the small bowel could be repaired immediately with no further action required. In two cases umbilical hernias have been accidently discovered and the repair of the hernias took place in the same surgical session. As this technique helps us to control the shunt position intraperitoneally by direct laparoscopic vision, the patients spared an extra radiation exposure, to control the position of the peritoneal catheter. A diagnostic laparoscopy is also possible if needed. The time of the operation is shortened in comparison with the needed time, which is mentioned in literature, for the open laparotomy and of course the needed anesthesia and its possible risks and complications decreased. No revision surgeries were required because of any misplacement of the peritoneal catheter, no additional technique related risks compared to the open surgical technique, no abdominal x-rays were needed, the operation time is shortened and the dose of anesthesia needed is decreased and of course its possible side effects' rate is also decreased. Another great benefit of this technique is the possibility of accidental diagnosis of intra-abdominal pathologies. Also, if a surgical treatment of this accidentally discovered intra-abdominal pathologies is needed, it can take place in the same surgical session. No prolonged surgery time as the laparoscopic technique is much easier, controllable and fast.
    Keywords: Hydrocephalus ; Ventriculoperitoneal Shunt ; Laparoscopy ; Peritoneal Catheter ; Complications
    ISSN: 1743-9191
    E-ISSN: 1743-9159
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  • 8
    Language: English
    In: Acta neurochirurgica, October 2012, Vol.154(10), pp.1821-3
    Keywords: Postoperative Complications ; Hypersensitivity -- Complications ; Internal Fixators -- Adverse Effects ; Lumbar Vertebrae -- Surgery ; Wound Infection -- Complications
    ISSN: 00016268
    E-ISSN: 0942-0940
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  • 9
    Language: English
    In: Journal of neurosurgery, September 2014, Vol.121(3), pp.688-99
    Description: Neuroendoscopy is used more and more frequently in neurosurgical procedures and has become an important tool in the neurosurgical armamentarium. However, the main restriction of neuroendoscopy is the limited field of view. A better overview of the area of interest would increase surgical safety and decrease procedure-related morbidity rates. In the present study, the authors aimed to improve this restriction by using and comparing two algorithms to create endoscopic panoramic images, which increase the field of view during neuroendoscopic procedures. Different endoscopic methods with or without a stand and with linear or circular endoscope movements were performed in cadaveric ventricles. Video of the endoscopy was used to create image mosaics of the lateral ventricle with the help of the Kourogi or LogSearch (LS) algorithm. In the LS algorithm, different template sizes were used. Three observers graded the quality of the image mosaic in terms of usefulness in surgery. The fastest frame rate was 3-4 frames/second. The LS algorithm with a larger template size showed significantly better results for the creation of image mosaics than the Kourogi algorithm in linear endoscopic movement with or without a stand. In circular endoscopic movements, the results seemed to be better with the LS algorithm but were not significantly different from those obtained with the Kourogi algorithm. In summary, image quality in the experimental paradigms was satisfying. Results in the study showed that the creation of image mosaics is possible and reliable with the featured algorithms. Image mosaicking is an applicable device for neuroendoscopy and can increase the field of view during endoscopic procedures. Its use can increase the safety and the field of application of neuroendoscopy. However, faster frame rates will be required to create a smooth image for practical use during surgery.
    Keywords: Ls = Logsearch ; Algorithm ; Fps = Frames Per Second ; Image Mosaic ; Neuroendoscopy ; Optical Flow ; Algorithms ; Image Processing, Computer-Assisted -- Methods ; Imaging, Three-Dimensional -- Methods ; Neuroendoscopy -- Methods
    ISSN: 00223085
    E-ISSN: 1933-0693
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  • 10
    Language: English
    In: Acta Neurochirurgica, 2013, Vol.155(2), pp.319-320
    Description: Byline: Athanasios K. Petridis (1), Homajoun Maslehaty (1), Thomas Eichenhofer (1), Sebastian Gillner (1), Martin Scholz (1) Author Affiliation: (1) Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of University Essen-Duisburg, Zu den Rehwiesen 9--11, 47055, Duisburg, Germany Article History: Registration Date: 05/12/2012 Received Date: 09/10/2012 Accepted Date: 05/12/2012 Online Date: 22/12/2012
    Keywords: Polymethyl Methacrylate ; Pulmonary Embolism ; Orthopedic Surgery;
    ISSN: 0001-6268
    E-ISSN: 0942-0940
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