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W Kurre

Publications and source records attributed to W Kurre.

4 recordsLinked to original sources

[Endovascular treatment for intracranial stenoses. A common statement by neurologists and neuroradiologists].

Intracranial stenoses cause 5-10% of all strokes and are increasingly detected by means of modern imaging methods. The stroke danger of high-grade symptomatic stenoses is relatively high, with an annual risk of approximately 10% under medical treatment. Coumadin increases the risk of hemorrhage, and after risk/benefit considerations, antiplatelets should be preferred for antithrombotic therapy. Despite optimized medical treatment, a small group of patients with recurrent symptoms or symptomatic stenoses without adequate collateral supply probably carry higher spontaneous stroke risk and may be considered for intracranial stenting, which itself is associated with procedural risks of up to 10%. Currently published case series show relatively high complication rates as a major drawback of endovascular treatment, mainly strokes after occlusion of perforating branches extending from the stenotic vessel segment or hemorrhagic complications. According to data from smaller feasibility studies, stroke rates in follow-up after successful stenting seem to be low. The average rate of high-grade restenosis with possible indication for reintervention is 10%. Improvements in endovascular treatment aim at reducing vessel wall trauma during balloon angioplasty by underdilatation or the use of self-expanding stents. Until complication rates are dependably reduced to values of 5-6%, indication for endovascular treatment should be restricted to patients without therapeutic alternatives. According to limited data with large variation between different studies, a prospective multicentric registry is proposed for systematic evaluation and further development of the method.

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Development of the osteoblast phenotype in primary human osteoblasts in culture: comparison with rat calvarial cells in osteoblast differentiation.

In rat osteoblast-like cells, a time-dependent sequence of growth and differentiation-dependent genes has been identified and a model of osteoblast differentiation in culture suggested. We investigated the expression of the bone matrix-associated proteins osteonectin and procollagen I and of the bone cell phenotype-related proteins alkaline phosphatase and osteocalcin during cell culture in primary human osteoblast like cells. Primary human explant cultures from nine young healthy donors were established under highly standardized conditions. Cells in the second passage were analyzed on different days from day 1 to 32, comparing cells growing under the influence of ascorbate with controls. Gene expression was determined by Northern blot analysis or polymerase chain reaction. Osteocalcin expression was also investigated after 1,25-(OH)(2)D(3) stimulation. On the protein level, newly synthesized collagen I, alkaline phosphatase activity, and secretion of osteocalcin were analyzed at all time points. On comparing our findings to the pattern of gene expression suggested for the rat calvarial osteoblast system, we found a similar developmental sequence for the so-called "proliferation" as well as a similar, but lengthened, sequence for the "matrix maturation stage." During "matrix maturation," we found an ongoing proliferation despite increased alkaline phosphatase and decreased procollagen I gene expression. Our study, therefore, shows that in pHOB the gene expression profile proceeded to the "matrix maturation stage," as defined by Owen and colleagues, independent of ongoing proliferation. We were unable to observe the mineralization period as demonstrated by the missing increase of osteocalcin expression and lack of nodule formation in our human osteoblast model. In contrast to the rat system, we found a proliferation stimulating influence of ascorbate, suggesting species-specific differences in response to differentiation factors. From these data, we conclude that general considerations on physiology and pathophysiology of bone cell differentiation have to be confirmed in the human osteoblastic cell system.

Adult↗

Analysis of human primary bone cells by fluorescence activated cell scanning: methodological problems and preliminary results.

We describe the development of flowcytometrical methods to analyse human primary osteoblast-like cultures obtained from trabecular bone explants in comparison to the human osteosarcoma cell line HOS 58. Two antigens typical of osteoblasts were studied: bone alkaline phosphatase and collagen/procollagen I; the non-specific attachment protein fibronectin served as control. The morphology of all different antigens is shown by immunocytochemistry before flowcytometrical analysis. The establishment of flowcytometry is described in detail. While all antigens tested were nearly 100% positive in the HOS 58 cells in immunocytochemistry and flowcytometry, in primary osteoblast-like cells results varied widely between both methods. Cell permeabilisation before flowcytometry improved the homogeneity of results, probably by increasing the accessibility of the specific antibody to intracellular compartments. Though up to 80% of cells were lost during preparation the ratio of positive versus negative cells in specific experiment was not dependent on the cell recovery. Therefore, the cells finally analysed seemed to be representative of the total population.

Adult↗

In vitro differentiation potential of a new human osteosarcoma cell line (HOS 58).

Cultured rodent osteoblastic cells reiterate the phenotypic maturation of osteoblasts seen in vivo. Under appropriate culture conditions this maturation is a stepwise sequence of phenotypic changes culminating in the production of a mineralised matrix. Although individual components of the osteoblast phenotype are apparent in transformed osteosarcoma cell lines, the co-ordination of the maturation sequence appears to be compromised. Because to date no comparable human cell differentiation system has been developed we investigated the recently introduced HOS 58 osteosarcoma cell line up to 3 months in culture. Proliferation, the secretion of osteoblast specific proteins, gene expression and mineralisation were analysed at different time points. Low-density HOS 58 cultures exhibit rapid proliferation and high levels of c-myc, collagen type I and osteopontin mRNAs. This phenotypic stage was maximum between the 4th and 5th days of culture. As cell density increased expression of these genes declined and by day 14 the predominant mRNAs was alkaline phosphatase. Osteocalcin secretion was detected after confluence at an increasing level. In the presence of ascorbate and beta-glycerophosphate the production of alkaline phosphatase and collagen type I increased coincident with the elaboration of a Von Kossa staining matrix. Nevertheless no proper mineralisation of the collagenous matrix was detectable by electron microscopy. Hence, the human osteosarcoma cell line HOS 58 expressed a rather differentiated phenotype with further maturation during a culture period of 21 days. We conclude that the developmental sequence exhibited by the HOS 58 human osteosarcoma cell line is comparable to that described for primary rat osteoblasts. However, in detailed analysis considerable differences to other species are evident. Further evaluation of the HOS 58 system and comparison to other human osteoblast cell lines will be necessary to establish the most appropriate differentiation model for human bone cell cultures.

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