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S Scheffler

Publications and source records attributed to S Scheffler.

6 recordsLinked to original sources

[Transplant selection for primary replacement of the anterior cruciate ligament].

Various graft choices have evolved over the past few decades for the primary reconstruction of the anterior cruciate ligament (ACL). Three predominant autologous graft choices exist today: patellar, hamstring, and quadriceps tendons. Clinical studies have as yet failed to demonstrate significant differences in clinical outcome among these grafts, irrespective of their varying fixation techniques. Therefore, other factors such as graft harvest morbidity have become more important when comparing different grafts. These factors can differ substantially between the grafts, depending on the type of patients' activities, the injury pattern, and the associated injuries of the knee joint. A basic knowledge of these factors and the parameters that affect the mechanical and biological behavior of the reconstructed ACL can help to find the appropriate graft choice for each individual patient. Factors such as harvest site morbidity, fixation techniques, osseous integration, and tunnel widening are discussed based on current clinical and basic science studies. Finally, an outlook is given for future alternatives with evolving techniques for tissue-engineered grafts, allografts, or the transplantation of xenogeneic donor tissue.

Anterior Cruciate Ligament↗

Diagnostic importance of anti-proteasome antibodies.

20S proteasome represents the proteolytic core complex for cytoplasmic protein degradation that is involved in the activation and regulation of the immune response. In this context, proteasome generates antigenic peptides for the MHC class I pathway and activates NF-kappaB. In a recent analysis, we could identify a frequent humoral autoimmune response directed against specific proteasomal subunits in patients with autoimmune myositis, systemic lupus erythematosus and primary Sjögren's syndrome. The outer ring subunit HC9(alpha3) was identified as the predominant target of the anti-proteasome response in these entities. In addition to the reactivity against HC9(alpha3), patients with primary Sjögren's syndrome expressed a more polyspecific recognition pattern of proteasomal subunits involving the active inner ring proteins. In follow-up analysis, anti-proteasome antibody titers revealed a correlation with disease activity in patients with autoimmune myositis and systemic lupus erythematosus. The current review summarizes recent data providing evidence that the 20S proteasome represents an important target of the humoral autoimmune response in systemic autoimmune diseases and extends insight into pathogenic aspects of these diseases.

Adenosine Triphosphatases↗

Autoantibodies in primary Sjögren's syndrome are directed against proteasomal subunits of the alpha and beta type.

OBJECTIVE: The proteasome subunit HC9 (alpha3) has recently been identified as a major target of the humoral autoimmune response in patients with autoimmune myositis and systemic lupus erythematosus. Since B cell hyperreactivity is a common feature of systemic autoimmune diseases, patients with primary Sjögren's syndrome (SS) and other control groups were investigated to evaluate the significance of autoantibodies against the proteasome. METHODS: Analyses of autoantibodies directed against the 20S proteasome were performed using enzyme-linked immunosorbent assay, immunoblot, and 2-dimensional electrophoresis. Forty-three patients with primary SS, 47 patients with rheumatoid arthritis including 9 with secondary SS, 19 patients with gastrointestinal tumors, and 80 healthy controls were tested for antiproteasome antibodies. RESULTS: Antiproteasome antibodies were detected in 39% of patients (17 of 43) with primary SS. In contrast, only 1 of 47 patients with rheumatoid arthritis showed positive reactivity (P < 0.001). Serum samples from 19 tumor patients (P < 0.003) and 80 healthy controls (P < 0.001) were serologically negative. Moreover, immunoblotting and 2-dimensional analysis of the antiproteasome response revealed a polyspecific recognition pattern in 7 patients with primary SS. Different proteasomal subunits of the alpha and beta type, including subunits that carried the proteolytic active sites, were recognized by the patients' sera. CONCLUSION: The humoral antiproteasome response in primary SS, in contrast to its secondary form, is characterized by an extensive recognition pattern of several subunits, indicating a polyspecific B cell activation against the 20S proteasome. Moreover, proteolytically active beta-type subunits, which are important for the generation of major histocompatibility complex class I-restricted antigens, appear to be targets of the autoimmune response. The data indicate that the proteasome itself may stand on a cross point of pathways that links mechanisms of the immune defense with features of systemic autoimmunity.

Antibodies, Antinuclear↗

Influenza immunization rates for Louisiana Medicare beneficiaries (1993-1995): a need for interventions.

Influenza is a disease, especially in the elderly, with potentially serious health and fiscal consequences. Vaccines, even though available and proven to be efficacious for prevention, appear to be underutilized in the Medicare population. This paper highlights influenza immunization rates from 1993-1995 for Louisiana Medicare eligible beneficiaries served by Louisiana providers. The authors discuss some of the current efforts underway to increase the number of influenza vaccinations. This was a retrospective study of claims based data on Medicare beneficiaries in Louisiana. Rates were also compared to other states from published Health Care Financing Administration data over the study period. In Louisiana, from 1993-1995, approximately 31% of Medicare beneficiaries age 65 years or older received an influenza vaccination that was paid for by Health Care Financing Administration. This finding indicates an attainment of half of the Department of Health and Human Services Year 2000 goal of 60% influenza immunization rate. The rate for Medicare African-American beneficiaries was approximately one half that of Caucasian beneficiaries. Overall, the billing data indicated that female beneficiaries received influenza immunization slightly more often than male. Medicare beneficiaries aged 75 to 84 years were immunized proportionally more than other age groups. The age group with the smallest percentage of immunized beneficiaries was 85 years or older. These results and rates obtained from the National Health Information Survey and Behavioral Risk Factor Surveillance System for the state collectively indicate marked opportunity for improvement in immunization rates for the State of Louisiana. Health care providers can assist and play an integral role in interventions designed to impact on this vulnerable population in order to meet the Department of Health and Human Services Year 1996 overall goal of 56% influenza immunization rate for all persons age 65 years or older.

Aged↗

[Common memory aids of younger and older people].

This study investigates the use of internal and external mnemonics in everyday life. External mnemonics were assumed to be less capacity demanding than internal ones. Additionally, we expected the use of internal techniques to be reduced in western societies because of an environment changing towards a "world of external storing devices". Thirty students and 20 institutionalized old people were interviewed about their everyday use of mnemonics. The interviews were based on Harris' mnemonics questionnaire (1980). Our results indicate students using internal as well as external mnemonics, although for more external ones. In general, the same is true for the institutionalized elderly. However, 1) they mainly use external aids, and 2) in total, they use fewer mnemonics than students. These results contradict the general assumption of old people compensating for memory problems by increasingly relying on mnemonics. Instead, the dominance of external aids indicates a tendency to process information more economically. Overall, the results suggest the necessity of further investigating the conditions for a successful use of external aids in everyday life.

Adult↗