[Effects of knee pain on postural control excluding the musculature of the craniomandibular system]. / Auswirkungen von Kniebeschwerden auf die posturale Kontrolle unter Ausschluss der Muskulatur des kraniomandibulären Systems.

BACKGROUND: Knee pain can influence postural control in addition to changes in the anatomical structure of the knee joints. OBJECTIVE: Because the influence of imbalances in the craniomandibular system has been proven multiple times, it is the aim of the present work to investigate the influence of various knee diagnoses on postural control excluding occlusal information by means of symmetrical packing using cotton rolls. MATERIALS AND METHODS: One hundred and fifteen patients (74 male/41 female) aged 18-75 years with an average BMI of 25.13 ± 3.66 kg/m2 took part in the study, among them 34 patients (26 male/8 female) with cruciate ligament injury, 26 (16 male/10 female) with meniscal lesions, 24 (13 male/11 female) with arthrosis, 21 (11 male/10 female) with patellar pain, and 10 (8 male/2 female) with other painful knee complaints. Postural control was increased using a force platform, the degree of severity of the disorder was recorded using the "Knee Injury and Osteoarthritis Outcome" questionnaire, and the occlusion packed on both sides with cotton rolls in the premolar area. RESULTS: With increasing age, patients with knee arthrosis are more likely to stand on the hindfoot. In those with patellar disorder, increased weight-bearing on the forefoot correlates with increasing BMI. An increase in weight-bearing on the forefoot on the side of the uninjured knee in people with patellar disorder results not only in a reduction in quality of life but also level of daily activity. DISCUSSION: The percentage weight-bearing on the zones of the feet differs in unilateral knee injuries (in particular, comparison of the side with the knee injury and the uninjured side). Age, BMI or gender are influencing factors. Because various correlations and/or effects in the subgroups of knee injuries are generated, an injury-specific analysis should be carried out. These effects are also identifiable in the subjective assessment of quality of life.

[Arthrosis: a scientometric analysis]. / Arthrose : Eine szientometrische Analyse.

BACKGROUND: In industrialized nations, arthrosis is one of the most frequent causes of physical disability and impaired quality of life in older people. OBJECTIVES: There are still no direct and curative therapies. In addition, the causative mechanisms of this disease have not been sufficiently deciphered and investigated so far. MATERIALS AND METHODS: For the present article, publications from 1900-2013 in the ISI Web of Science were reviewed. Quantitative and qualitative aspects are taken into account and are examined based on scientometric analysis methods. The illustrations demonstrate the global structure of the research and citation activity by Density Equalizing Map Projection. In addition, the radar charts illustrate the bi- and multilateral research and institutional cooperation. RESULTS: On the basis of the search criteria, a total of 46,212 publications were identified. Approximately 95 % of the publications date back to the last 25 years. In addition to the number of publications, the number of citations has increased continuously. The analysis of the country collaborations as well as the number of institutions indicates a predominance of the United States. Most articles about arthrosis concern the subject areas of rheumatology, orthopedics, and surgery. CONCLUSION: This study provides the first comprehensive, scientometric findings and illustrates corresponding representations of research activities, geographical contexts as well as research cooperation. It shows a great scientific interest, especially by North American and European scientists. The steady growth of research is explained by the high prevalence of arthrosis.

Dithranol in an emulsifying oil base (bio-wash-oil) for the treatment of psoriasis of the scalp.

On the scalp, dithranol has been studied in only a few trials. The dithranol molecule that contains both hydrophilic and lipophilic centers can be incorporated into detergents and allows easy removal from hair. This property has led to the incorporation of dithranol in an emulsifying oil base (bio-wash-oil). The formulation has been used routinely for more than two decades in East Germany. We reexamined the efficacy and safety of dithranol in bio-wash-oil and compared it to dithranol embedded in crystalline monoglycerides (Micanol) in patients with psoriasis of the scalp. In a prospective, parallel group study, 64 patients attending a day-care clinic were randomly allocated to 3 treatment groups: (1) dithranol in bio-wash-oil; (2) Micanol cream, and (3) Micanol cream in bio-wash-oil. Treatment was carried out for 3 weeks and results assessed using a modified Psoriasis Area and Severity Index score. Dithranol in bio-wash-oil resulted in a reduction in the score of 34% on day 7 and 57% on day 14. This was significantly better than in groups 2 and 3, as were the overall response and patients' assessment at the end of treatment (p < 0.05). Dithranol in a bio-wash-oil is an effective, well-tolerated and low-priced treatment in psoriasis of the scalp.

Oral isobutyramide reduces transfusion requirements in some patients with homozygous beta-thalassemia.

The butyrate derivative isobutyramide (IBT) increases fetal hemoglobin (HbF) in patients with beta-hemoglobinopathies, but little is known about its usefulness for prolonged therapeutic use. We treated 8 patients with transfusion-dependent beta-thalassemia with 350 mg/kg of body weight per day of oral IBT for 126 to 384 days. During the trial period, the hemoglobin level was maintained between 85 g/L (range 82-87 g/L) (pretransfusion) and 115 g/L (range 110-119 g/L) (post-transfusion) (median, interquartile range), corresponding to 4-week transfusion intervals in all patients during the pretreatment phase. Adverse effects (bitter taste, epigastric discomfort) did not cause discontinuation of IBT. HbF increased in all patients from 3.1% (range 1.9%-4.8%) to 6.0% (range 3.3%-8.7) (P =.0017), while free Hb dropped from 0.48 g/L (range 0.39-0.81 g/L) to 0.19 g/L (range 0.16-0.24 g/L) (P <.0001). Transfusion intervals were consistently extended to 8 or 9 weeks in 1 patient, resulting in a decrease of daily iron load from 455 microgram/kg per day (range 451-459 microgram/kg per day) before therapy to 211 microgram/kg per day (range 203-286 microgram/kg per day) during the 12-month treatment period. Prolongation of transfusion intervals achieved by IBT was less consistent in another patient, whose parenteral iron load nevertheless decreased from 683 microgram/kg per day (range 618-748 microgram/kg per day) to 542 microgram/kg per day (340-596 microgram/kg per day). In the other 6 patients, no prolongation of transfusion intervals was achieved. Response to treatment was associated with high pretreatment HbF (> 4.5%), high parental HbF, and increased erythropoietin levels (> 150 IU/L). We conclude that IBT prolongs transfusion intervals and reduces parenteral iron burden in some patients with transfusion-dependent beta-thalassemia.

The structure of the superantigen exfoliative toxin A suggests a novel regulation as a serine protease.

Exfoliative toxin A (ETA) causes staphylococcal scalded skin syndrome which is characterized by a specific intraepidermal separation of layers of the skin. The mechanism by which ETA causes skin separation is unknown although protease or superantigen activity has been implicated. The X-ray crystal structure of ETA has been solved in two crystal forms to 2.1 and 2.3 A resolution and R-factors of 17% and 19%, respectively. The structures indicate that ETA belongs to the chymotrypsin-like family of serine proteases and cleaves substrates after acidic residues. The conformation of a loop adjacent to the catalytic site is suggested to be key in regulating the proteolytic activity of ETA through controlling whether the main chain carbonyl group of Pro192 occupies the oxyanion hole. A unique amino-terminal domain containing a 15-residue amphipathic alpha helix may also be involved in protease activation through binding a specific receptor. Substitution of the active site serine residue with cysteine abolishes the ability of ETA to produce the characteristic separation of epidermal layers but not its ability to induce T cell proliferation.

Clinical experiences with magnetic drug targeting: a phase I study with 4'-epidoxorubicin in 14 patients with advanced solid tumors.

Anticancer drugs reversibly bound to magnetic fluids (ferrofluids) could be concentrated in locally advanced tumors by magnetic fields that are arranged at the tumor surface outside of the organism. If certain requirements are met, systemic toxicity might be minimized, and local tumor efficacy might be increased. We have conducted a Phase I clinical trial using this approach in patients with advanced and unsuccessfully pretreated cancers or sarcomas. Nine such patients received two treatment courses, 3 patients received one course, and 2 patients received three courses of magnetic drug targeting consisting of the infusion of epirubicin in increasing doses (from 5 to 100 mg/m2) that had been chemically bound to a magnetic fluid and the application of magnetic fields to the tumors for 60-120 min. In 2 of 14 patients, the same dose of epirubicin not bound to a magnetic fluid was administered systemically 3 weeks after drug targeting for intraindividual comparisons. Magnetic drug targeting with epirubicin was well tolerated. In one case, a planned second treatment was withdrawn, because of an episode of chills 130 min after infusion of the magnetic drug. Two patients received a third treatment because of good responses after the first two therapies. Based on magnetic resonance tomographic techniques, pharmacokinetics, and the histological detection of magnetites, it was shown that the ferrofluid could be successfully directed to the tumors in about one-half of the patients. Organ toxicity did not increase with the treatment, but epirubicin-associated toxicity appeared at doses greater than 50 mg/m2. Although treatment with magnetic drug targeting seems safe, improvements are necessary to make it more effective and independent of patient- or disease-related problems. A study design to compare conventional treatments with the new treatment form within one patient seems crucial to eliminate interindividual differences.

Structure of protocatechuate 3,4-dioxygenase from Pseudomonas aeruginosa at 2.15 A resolution.

Protocatechuate 3,4-dioxygenase catalyzes the aromatic ring cleavage of 3,4-dihydroxybenzoate by incorporating both atoms of molecular oxygen to yield beta-carboxy-cis,cis-muconate. The structure of this metalloenzyme from Pseudomonas aeruginosa (now reclassified as P. putida) has been refined to an R-factor of 0.172 to 2.15 A resolution. The structure is a highly symmetric (alpha beta Fe3+)12 aggregate with a root-mean-square (r.m.s.) difference of 0.18 A among symmetry-related atoms. The tertiary structure of the two polypeptides (alpha and beta) are highly homologous (r.m.s. difference of 1.05 A over 127 C alpha atoms), suggesting that the ancestral enzyme was originally a homodimer with two active sites. Indeed, a non-functional, vestigial active site retains many of the properties of the functional active site but does not bind iron. The coordination geometry of the non-heme iron catalytic cofactor can best be described as trigonal bipyramidal with Tyr447 (147 beta) and His462 (162 beta) serving as axial ligands, and Tyr408 (108 beta), His460 (160 beta) and Wat837 serving as equitorial ligands. The active site environment has a number of basic residues that may promote binding of the acidic substrate. Within the putative active site cavity which is located between alpha and beta chains, five approximately coplanar solvent molecules suggest a position for the planar substrate Trp449 (149 beta), Ile491 (191 beta), defined by Gly14 (14 alpha) and Pro15 (15 alpha). In this position the guanidino group of Arg457 (157 beta) would be buried by the substrate, suggesting a functional role in catalysis.

Structural studies of the retroviral proteinase from avian myeloblastosis associated virus.

The structure of the retroviral proteinase from avian myeloblastosis associated virus (MAV) has been determined and refined at 2.2 A resolution. This structure is compared with those of homologous proteinases from Rous sarcoma virus (RSV) and human immunodeficiency type 1 virus (HIV). Through comparison with the structure of a proteinase-inhibitor complex from HIV, a model of a complex between MAV proteinase and a peptide substrate has been generated. Examination of this model suggests structural basis for the diverse specifications of viral proteinases.

Structural origins of high-affinity biotin binding to streptavidin.

The high affinity of the noncovalent interaction between biotin and streptavidin forms the basis for many diagnostic assays that require the formation of an irreversible and specific linkage between biological macromolecules. Comparison of the refined crystal structures of apo and a streptavidin:biotin complex shows that the high affinity results from several factors. These factors include the formation of multiple hydrogen bonds and van der Waals interactions between biotin and the protein, together with the ordering of surface polypeptide loops that bury the biotin in the protein interior. Structural alterations at the biotin binding site produce quaternary changes in the streptavidin tetramer. These changes apparently propagate through cooperative deformations in the twisted beta sheets that link tetramer subunits.

Lipid and polypeptide components of the crystalline yolk system from Xenopus laevis.

The polypeptide and lipid components of the crystallinelipoprotein-phosphoprotein from the yolk system of Xenopus laevis are described. This lipoprotein complex contains 17% lipid of which 75% is phospholipid. The phospholipid fraction consists of mostly phosphatidylcholine and phosphatidylethanolamine. The neutral lipid fraction contains mainly triglyceride. The phosphoprotein, phosvitin, has been separated from the lipoprotein, lipovitellin, by classical methods. Three polypeptide chains can be observed in the lipoprotein and their molecular weights as determined by sodium dodecyl sulfate gel electrophoresis are 105,500, 35,500, and 32,000. Phosvitin behaves abnormally on these gels, but analysis of the results suggests Mr = approximately 16,000 to 19,000/polypeptide chain. The lipovitellin component of the yolk complex contains approximately 100 bound lipid molecules/dimer. The stoichiometry of the components of this crystalline lipoprotein system is discussed in terms of the results obtained in this study and those of other workers.