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ABSTRACT: Pulmonary sarcoidosis is characterised by a mononuclear alveolitis with a predominance of CD4+ T cells and macrophages. We determined the intracellular expression of interferon (IFN)gamma, interleukin (IL)-2, tumour necrosis factor (TNF)alpha, IL-4, IL-5 and IL-10 in CD4+ and CD8+, naive and memory lymphocytes from blood and bronchoalveolar lavage (BAL) fluid using three colour flow cytometry.
Eighteen untreated patients with pulmonary sarcoidosis were evaluated and stratified according to whether they had acute or chronic disease.
Significantly more T cells expressed Th1 than Th2 type cytokines in both BAL fluid and peripheral blood samples, regardless of clinical presentation. Significantly greater proportions of T cells secreted Th1 type cytokines in BAL fluid than in peripheral blood. Th1 type cytokines were more frequently expressed by peripheral and alveolar T cells in acute disease than in chronic disease. There were no significant differences between CD4+ and CD8+ T cells. Concerning naive and memory lymphocytes, significantly higher CD45RO:CD45RA ratios were found in BAL fluid than in blood, and increased expression of Th2 type cytokines was found in peripheral compared with alveolar memory T cells.
Our data support the immunopathogenetic concept of Th1/Th2 imbalance and compartmentalisation in pulmonary sarcoidosis and suggest that the cytokine patterns change during the course of disease. Expression of Th2 type cytokines in memory lymphocytes is decreased in the alveolar compartment compared with peripheral blood.
Thorax 07/2001; 56(6):487-93. · 6.84 Impact Factor
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ABSTRACT: We report on three arterial thromboses of the external iliac artery following total hip replacement. As a result of implanted cement/spongiosa or protrusion of the acetabular component, the iliac vessels were compressed. Furthermore, we report about one intraoperative arterial vessel lesion in a 65-year-old patient during a revision operation. We recommend that in case of acute ischemic syndromes of lower limbs following total hip replacement, an angiography should be performed in order to exclude an extravascular cause of thrombosis. For therapy in those cases extra-anatomic bypasses should be preferred to thrombectomies.
Der Unfallchirurg 08/1997; 100(7):531-5. · 0.61 Impact Factor
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ABSTRACT: Bericht über 3 arterielle Thrombosen der A. iliaca externa nach Totalendoprothetik der Hüfte. Ursächlich kam es durch eingebrachten
Knochenzement bzw. Spongiosa bzw. durch Pfannenprotrusion zur Kompression des iliakalen Gefäßbündels. Bei einer 65jährigen
Patientin kam es zu einer fulminanten intraoperativen Blutung aus der A. iliaca im Rahmen eines Pfannenwechsels. Bei akuten
Ischämiezeichen der unteren Extremität nach Hüftgelenkendoprothesenimplantation muß eine Angiographie zum Ausschluß extravaskulärer
Thromboseursachen erfolgen. Therapeutisch ist extraanatomischen Bypassverfahen bei Gefäßkomplikationen in derartigen Situationen
gegenüber einer alleinigen Thrombektomie der Vorzug zu geben.
We report on three arterial thromboses of the external iliac artery following total hip replacement. As a result of implanted
cement/spongiosa or protrusion of the acetabular component, the iliac vessels were compressed. Furthermore, we report about
one intraoperative arterial vessel lesion in a 65-year-old patient during a revision operation. We recommend that in case
of acute ischemic syndromes of lower limbs following total hip replacement, an angiography should be performed in order to
exclude an extravascular cause of thrombosis. For therapy in those cases extra-anatomic bypasses should be preferred to thrombectomies.
Der Unfallchirurg 04/1997; 100(7):531-535. · 0.61 Impact Factor
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ABSTRACT: In our hospital 334 patients were treated with a bipolar prosthesis for medial femoral neck fracture in the years 1990 and 1991. After an average of 54 months (minimum 48 months) informations about function could be obtained by examination and x-ray from 19 patients (5.7%), from 42 patients (12.6%) a questionnaire was analyzed. No function of the hip was described as poor, 2/3 of the patients had no pain, nearly 50% walked without crutches or other tools. No protrusio acetabuli or acetabular erosion was seen. Together with further follow-up examinations from another 230 patients out of 1365 patients treated with a bipolar prosthesis up to now, these results support the statement that bipolar prostheses play an important role in treatment of medial femoral neck fractures in the elderly.
Zentralblatt für Chirurgie 02/1997; 122(11):1028-32. · 1.02 Impact Factor
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Der Internist 10/1996; 37(9):931-5. · 0.30 Impact Factor
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ABSTRACT: In femoral neck fractures in the elderly, the least traumatic operative treatment is hemiarthroplasty. In our Trauma Unit, from August 1986 to December 1986 we implanted 22 concentric bipolar cups. During follow-up this cup proved to be associated with an unjustifiably high failure rate: system-caused interprosthetic dislocation in 4 patients (18%), and extraprosthetic dislocation in a further 3 (13%). In one of the latter, interprosthetic disconnection occurred during closed reduction. In all of these, i.e., in 31% out of the 22 patients, conversion to a total hip arthroplasty became necessary. Since March 1987 we have used a positive eccentric, self-centering bipolar head. Up to September 1990 322 such prostheses were implanted. Bearing in mind the reduced general physical condition of the patients, the complication rate is considered to be low (dislocations 3.4%, conversion to total hip arthroplasty 0.9%, deep wound infections 3.1%).
Der Unfallchirurg 06/1992; 95(5):224-9. · 0.61 Impact Factor
