Zerebrale Funktionen bei hirngeschädigten Patienten. Was bedeuten Koma, "vegetative state“, "minimally conscious state“, "Locked-in-Syndrom“ und Hirntod?

in Anaesthesist (2004), 53(12), 1195-1202

Comatose, vegetative, minimally conscious or locked-in patients represent a problem in terms of diagnosis, prognosis, treatment and everyday management at the intensive care unit. The evaluation of ... [more ▼]

Comatose, vegetative, minimally conscious or locked-in patients represent a problem in terms of diagnosis, prognosis, treatment and everyday management at the intensive care unit. The evaluation of possible cognitive functions in these patients is difficult because voluntary movements may be very small, inconsistent and easily exhausted. Functional neuroimaging cannot replace the clinical assessment of patients with altered states of consciousness. Nevertheless, it can describe objectively how deviant from normal the cerebral activity is and its regional distribution at rest and under various conditions of stimulation. The quantification of brain activity differentiates patients who sometimes only differ by a brief and incomplete blink of an eye. In the present paper, we will first try to define consciousness as it can be assessed at the patient's bedside. We then review the major clinical entities of altered states of consciousness encountered in the intensive care unit. Finally, we discuss the functional neuroanatomy of these conditions as assessed by positron emission tomography (PET) scanning. [less ▲]

Computer modeling of restrained reinforced concrete slabs in fire conditions

in Journal of Structural Engineering (2004), 130(12), 1964-1971

This paper describes the computer modeling of axially restrained, one-way reinforced concrete slabs in fire conditions. The study was carried out for slabs with pin supports and slabs with rotationally ... [more ▼]

This paper describes the computer modeling of axially restrained, one-way reinforced concrete slabs in fire conditions. The study was carried out for slabs with pin supports and slabs with rotationally restrained supports. A single span, 5 m slab, carrying a uniformly distributed load was analyzed using a special purpose, nonlinear finite element program, SAFIR. The study for pin-supported slabs considered the effects of the position of the thrust force at the supports and different axial restraint stiffnesses. The effects of axial restraint on slabs with rotationally restrained supports were also investigated. The analyses found that the behavior of pin-supported slabs is very sensitive to the position of the thrust force at the end supports and the axial restraint stiffnesses. Slabs with rotationally restrained supports are predicted to have much better fire resistance than equivalent pin-supported slabs due to moment redistribution. The behavior of rotationally restrained slabs in fire conditions is less sensitive to the different axial restraint stiffnesses than pin supported slabs. [less ▲]

Increased expression of receptor activator of NF-kappa B ligand (RANKL), its receptor RANK and its decoy receptor osteoprotegerin in the colon of Crohn's disease patients

in Clinical & Experimental Immunology (2004), 138(3), 491-498

Crohn's disease (CD) is associated with low bone mass due to chronic inflammation and other factors. Receptor activator of NF-kappaB ligand (RANKL), its receptor RANK and its decoy receptor ... [more ▼]

Crohn's disease (CD) is associated with low bone mass due to chronic inflammation and other factors. Receptor activator of NF-kappaB ligand (RANKL), its receptor RANK and its decoy receptor osteoprotegerin (OPG) are potentially involved in this process as they regulate osteoclastogenesis and are influenced by pro-inflammatory cytokines. The aim of this study was to determine the levels of soluble RANKL (sRANKL), RANK and OPG expression both in the serum and in the colon of CD patients. Levels of sRANKL and OPG were assessed in the serum and the supernatants of cultured colonic biopsies in patients with CD and controls by ELISA. RANK expression was explored by immunostaining and immunofluorescence of fixed colonic samples. OPG and sRANKL levels were higher in the serum of CD patients as compared to age- and sex-matched controls. Levels of sRANKL and OPG were significantly enhanced in cultured colonic biopsies from CD, and OPG levels correlated with histological inflammation, and pro- and anti-inflammatory cytokine levels. No significant correlation was found for sRANKL. RANK(+) cells were increased in the colon of CD, particularly in inflamed areas. These cells were positive for CD68 or S100 protein. We conclude that serum and local levels of sRANKL and OPG are increased in CD. Moreover, RANK is expressed in the colonic mucosa by subpopulations of activated macrophages or dendritic cells at higher levels in CD compared to normal colon. [less ▲]

L'image du mois. Ulcere perineal chez une patiente atteinte de spina bifida

in Revue Médicale de Liège (2004), 59(12), 688-90

Les batardeaux de maintenance, Rapport final, Projet barrages mobiles

Report (2004)

Technique de préfabrication et standardisation, Rapport final, Projet barrages mobiles

Report (2004)

Combination/Sequential Therapy in Osteoporosis

in Current Osteoporosis Reports (2004), 2(4), 123-30

Combination therapy includes the concomitant or sequential use of compounds sharing the same mode of action (eg, two or more inhibitors of bone resorption) or with distinct pathways of activity (eg, an ... [more ▼]

Combination therapy includes the concomitant or sequential use of compounds sharing the same mode of action (eg, two or more inhibitors of bone resorption) or with distinct pathways of activity (eg, an inhibitor of resorption plus an anabolic agent). Combination use of antiresorptive agents may generate concerns, because of the risk of inducing oversuppression of bone turnover. However, if low doses of estrogen, used for the management of climacteric symptoms, are insufficient to normalize bone turnover, the addition of a bisphosphonate to hormone therapy may prove to be useful to achieve this objective. Patients pretreated with inhibitors of resorption, who have not achieved a full therapeutic response, are good candidates for treatment with anabolic agents. The increase in bone turnover that comes after the introduction of parathyroid hormone (PTH) in patients treated with an antiresorptive agent is similar to that observed in treatment-naive patients and the pattern of bone mineral density (BMD) increase is also identical, with the exception of a 6 month delay in the spine and hip BMD changes observed in prior alendronate-treated subjects. Current data discourage the concomitant use of alendronate and PTH since the bisphosphonate appears to blunt (in men and women) the anabolic action of PTH. Whether this applies to other bisphosphonates or inhibitors of resorption, remains unknown. The use of an inhibitor of bone resorption after completion of PTH treatment seems an appropriate way to maintain the skeletal benefits gained during therapy. Long-term clinical studies, using fractures as an endpoint should be initiated to better understand the clinical and pharmaco-economic interest of combination therapies in the management of osteoporosis. [less ▲]

From protein interaction to cell population dynamics: A theoretical framework combining Boolean networks with Markov processes illustrated in an ovarian carcinoma

Poster (2004, December)

The Inflammatory Hypothesis of Ageing: Fascinating Concept or Confusing Dogma?

in Journal of Cosmetic Dermatology (2004), 3(4), 246

J.J.L. ten Kates 'Duitsche Zwaan'. Mozart in Nederland

in Negentiende Eeuw (2004), 28(4), 237-256