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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Scandinavian journal of medicine & science in sports 7 (1997), S. 0 
    ISSN: 1600-0838
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Sports Science
    Notes: Sixty 60-day-old Sprague-Dawley male rats were subjected to exhaustive and non-exhaustive exercise treatment over a period of 3, 5 and 7 weeks. Moderate exercise consisted of running on the treadmill at 10% grade at 10 m/min for 20 min for 5 days per week, while exhaustive running consisted of running at 10% grade at 15 m/min with an increase of 5 m/min every 5 min for 5 days per week. Half of the exercised rats were subjected to immersion in 4°C water for 5 min after each exercise bout. Histological analyses of the gastrocnemius showed that ultrastructural damage of myofibrils occurred after 5 weeks of exhaustive running and 7 weeks of moderate running. With post-exercise immersion in 4°C water for 5 min, the occurrence of ultrastructural damage advanced by 2 weeks in both treatments. It was concluded that the application of cryotherapy to the exercise groups was deleterious. Muscle damage occurred earlier in the treatment group and the degree of damage was also more serious over the same time period. This study supports the recommendation that the use of cryotherapy to reduce pain and haematoma formation should be coupled with rest for at least 48 hours.
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  • 2
    ISSN: 1433-0431
    Keywords: Schlüsselwörter Gentransfer • Gelenkknorpel • Wachstumsfaktoren • Kollagen • Matrixsynthese ; Key words ; Gene transfer • Hyaline cartilage • Growth factors • Collagen • Proteoglycan synthesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary TGFβ-1 has been shown to upregulate matrix synthesis in articular chondrocytes. TGFβ-gene transfer to chondrocytes has the potential to increase the local production of this key component within regenerating cartilage after trauma and could support the repair process in articular cartilage laesions. Primary rabbit articular chondrocytes were cultured and retrovirally transfected with the experimental TGFβ-1 and the lacZ marker gene for control purposes. After radioactive labeling of new synthesized matrix protiens results were compared with normal primary chondrocytes. After TGFβ-1 gene transfer the endogenous growth factor concentration was doubled compared to normal chondrocytes and decreased in the lacZ control group. The proteoglycan synthesis in TGFβ-1 transfected chondrocytes showed a 96 % increase compared to the basal production of normal chondrocytes. The LacZ transfected group revealed the opposite effect by a 44 % decrease. The collagen synthesis of TGFβ-1 transfected chondrocytes was 304 % compared to normal chondrocytes, predominantly type II collagen. The lacZ group collagen production was reduced by 35 %. We conclude that TGFβ-1 gene transfer overcomes the decreasing effect observed by transfection with the LacZ marker gene and increases matrix synthesis in articular chondrocytes. Genetically altered chondrocytes might improve the repair of cartilage lesions by stimulating matrix synthesis and supporting the expression of the hyaline phenotype.
    Notes: Zusammenfassung TGFβ-1 ist ein essentieller Wachstumsfaktor in der Gewebedifferenzierung und stimuliert auch die Syntheseaktivität in Knorpelzellen. Der Effekt einer Wachstumsfaktorsubstitution innerhalb eines biologischen Systems ist jedoch zeitlich stark limitiert, so dass der Transfer von Wachstumsfaktorgenen hier eine kontinuierliche lokale Bereitstellung des Zytokins ermöglichen würde und so zu verbesserten Resultaten in der Knorpelregeneration führen könnte. Gelenkknorpelzellen des Kaninchens wurden kultiviert und retroviral mit dem TGFβ-1 und dem LacZ-Gen transfiziert. Nach radioaktiver Markierung der Proteoglykan- und Kollagenneosynthese wurden die Ergebnisse der genveränderten Zellen mit unbehandelten Chondrozytenkulturen verglichen. Die TGFβ-1-Konzentration nach entsprechendem Gentransfer war im Vergleich zur unbehandelten Kontrollgruppe verdoppelt, nach LacZ-Gentransfer zeigte sich eine Reduktion der basalen TGFβ-1-Konzentration. Die Proteoglykansynthese in der TGFβ-1-Gruppe zeigte einen 96 %igen Anstieg verglichen zur normalen Knorpelzellproduktion. Bei der LacZ-Gruppe zeigte sich der gegenteilige Effekt in Form einer Reduktion der basalen Proteoglykansynthese um 44 %. Die Kollagenneosynthese in der TGFβ-1-transfizierten Gruppe betrug 304 % verglichen zur normalen Knorpelzellkultur und war um 35 % reduziert in der LacZ-Gruppe. Die Ergebnisse der TGFβ-1-transfizierten Gruppe unterschieden sich signifikant von den beiden Kontrollgruppen. Viraler Gentransfer in Chondrozyten ist möglich, jedoch werden die zellulären Syntheseleistungen beeinträchtigt. Der Transfer eines spezifischen Wachstumsfaktorgens hingegen überkompensiert diesen Effekt und bewirkt eine deutliche Steigerung in der Matrixneosynthese kultivierter Chondrozyten.
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  • 3
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Gentransfer ; Patellarsehne ; Adenovirus ; Retrovirus ; Key words Gene ; Transfer ; Patellar tendon ; Adenovi-rus ; Retrovirus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Growth factors have the potential to enhance native repair responses in ligamentous and meniscal lesions. However, methods for applying these cytokines to sites of injury for extended periods are lacking. We suggest that local transfer of genes that encode the relevant healing factors merits investigation as a potential solution to this problem. In the present study, different viral vectors and liposomes are evaluated for their ability to deliver genes to cells of ligamentous and meniscal origin. The ACL, PCL, MCL, semitendinosus tendon, patellar tendon, and menisci were harvested from New Zealand white rabbits. Cells grown from these tissues were then investigated for their susceptibility to genetic alteration by these vectors. Based upon the ability of these vectors to convert cells in culture to a lacZ(+) phenotype, adenovirus was the most effective vector in short-term experiments. However, expression was transient. Although retrovirus gave lower initial transduction efficiencies, the percentage of transduced cells could be increased by the use of the selectable marker gene neor. Cells infected with adeno-associated virus containing the neor-gene could also be selected in this way. Liposomes showed low efficiency of gene transfer and expression. In an in vivo marker study, we injected adenovirus into the rabbit patellar tendon. Transduced cells could be observed preferentially in the subsynovial layer at a declining frequency over a 6-week period. The allogeneous transplantation of retrovirally transduced fibroblasts into the patellar tendon resulted in a greater number of transduced cells. Although the number of lacZ(+) cells declined with time, positive cells were still present 6 weeks after transplantation. Furthermore, the transplanted cells, unlike cells transduced in situ with adenovirus, migrated from the injection site and integrated into the crimp of the tendon.
    Notes: Wachstumsfaktoren sind für jeden Wundheilungsprozeß von essentieller Bedeutung. Experimentelle Untersuchungen haben gezeigt, daß die lokale Anwendung dieser Substanzen den natürlichen Heilungsprozeß bei ligamentären Verletzungen beschleunigen kann. Die Methoden für eine effiziente klinische Anwendung sind jedoch nicht ausreichend entwickelt, um eine dauerhaft hohe Konzentration an der Verletzungsstelle zu erzielen. Eine mögliche Lösung für dieses Problem ist die Synthese von Wachstumsfaktoren durch ortsständige Zellen im Kniegelenk, die hierzu durch lokalen Gentransfer angeregt werden könnten. In einem neuen experimentellen Ansatz untersuchen wir die Möglichkeit des lokalen Gentransfers in die Patellarsehne mit dem Ziel, ortsständige Zellen zur Produktion von Wachstumsfaktoren anzuregen. In einer experimentellen Studie wurden zunächst verschiedene Vektoren untersucht, die für den Gentransfer in Fibroblasten in Frage kommen. Virale Vektoren bieten neben non-viralen Vektoren, wie z. B. Liposomen, die Möglichkeit, das Genom von Zellen zu modifizieren. Hierzu wurden Zellkulturen aus dem VKB und HKB des Kaninchens angelegt. Diesen Zellkulturen wurden dann verschiedene Vektoren zugesetzt, die ein Markergen transportieren. Transduzierte Zellen sezernierten anschließend die histochemisch nachweisbare Substanz β-Galaktosidase. Die quantitative Expression dieser Substanz wurde bestimmt. Bei diesen In-vitro-Vorversuchen zeigte sich, daß Adenoviren sämtliche Wirtszellen transduzierten, wobei die Expression der Markersubstanz zeitlich begrenzt war. Retroviren hatten einen signifikant geringeren Effekt, der sich jedoch ebenso wie bei adenoassoziierten Viren durch weitere Selektionsschritte steigern ließ. Liposome zeigten generell die geringste Wirkung. In einem In-vivo-Versuch wurden Adenoviren in die Patellarsehnen von Kaninchen injiziert. Transduzierte Zellen wurden vorwiegend in der synovialen Schicht beobachtet. Die Expression ließ während des 6-wöchigen Untersuchungszeitraums nach. In einem Ex-vivo-Versuch wurden Fibroblasten zunächst mit Retroviren in vitro transduziert, anschließend selektiert und in die Patellarsehne injiziert. Dieses Verfahren resultierte in einer zahlenmäßig größeren Expression. Im Gegensatz zu der In-situ-Transduktion mit Adenoviren konnten transduzierte Zellen entfernt von der Injektionsstelle nachgewiesen werden, wo sich diese Zellen in das Crimp-Muster der Patellarsehne integrierten.
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  • 4
    ISSN: 1433-0431
    Keywords: Key words Gene-Transfer • Adenovirus • Retrovirus • ; Liposomes ; Schlüsselwörter Gentransfer • Adenovirus • Retrovirus • ; Liposome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine besondere Herausforderung ist die Therapie von Verletzungen der Kapsel-Band-Strukturen sowie des Gelenkknorpels. Nicht nur die spontane Heilungsfähigkeit, sondern auch die Reparation nach konservativer oder operativer Therapie ist begrenzt. In den letzten Jahren sind daher Zytokine als Modulatoren der Heilungsvorgänge in den Blickpunkt des Interesses gerückt. In diesem Übersichtsartikel versuchen wir, den zukünftigen Stellenwert für Zytokine einzuschätzen und Konzepte für eine klinische Anwendung zu erarbeiten. Aufgrund bestehender Probleme in der Anwendung von Zytokinen führen wir das Konzept der somatischen Gentherapie in diese Überlegung ein. Wir postulieren, daß die Gentherapie zur gezielten Applikation von Wachstumsfaktoren die Behandlung zahlreicher Verletzungen verändern kann.
    Notes: Summary Soft tissue injuries often represent the greatest clinical problem. Not only do many of the most frequently injured tissues, such as the cruciate ligaments and articular cartilage, have very limited capabilities for spontaneous repair, but they also respond poorly to surgical or non-surgical intervention. In this article we try to define the role of growth factors in these conditions and to outline concepts for future treatment based upon modulation of the native repair response. We suggest that gene transfer could improve the management of such injuries, particularly when used as vehicles for the targetted delivery of growth factors.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 2 (1994), S. 38-44 
    ISSN: 1433-7347
    Keywords: Cytokines ; Arthrosis ; Anterior cruciate deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Approximately 44% of patients develop osteoarthritis (OA) following rupture of the anterior cruciate ligament (ACL) if the injury is left unrepaired. Restoring knee stability through reconstruction, while providing symptomatic relief, has not been shown to reduce the incidence of degenerative changes. In fact, recent studies have shown that 50%–60% of ACL-reconstructed patients go on to develop degenerative changes or frank osteo-arthritis. In light of these data, our group suggests that the cause of post-traumatic osteoarthritis is not biomechanical but biochemical. To test this hypothesis, we measured levels of nine cytokines which are important in modulating physiological and pathophysiological metabolism of cartilage in knee joint synovial fluid following ACL rupture. Our patient population contained both acute und chronic ACL ruptures. A total of 84 samples were collected and analyzed by enzyme-linked immunosorbent assay. On the basis of the data collected, we were able to identify subgroups of patients who, on the basis of their synovial fluid cytokine profile, may be at greater or leasser risk of developing post-traumatic OA. In general, patients displayed concentrations of interleukin-1α (IL-1α), basic fibroblastic growth factor (bFGF), transforming growth factor-β (TGF-β), granulocyte/macrophage-colony stimulating factor (GM-CSF), IL-6, and IL-8 that we interpreted as being consistent with an inflammatory reaction. Of great interest is the fact that the levels of these cytokines were very similar in patients 4 weeks after injury and in chronic patients, leading us to hypothesize that a chronic smoldering inflammatory reaction persists after resolution of the acute effusion. This chronic inflammatory reaction could be the cause of cartilage degeneration seen in patients after ACL reconstruction. Furthermore, this study identified two distinct subpopulations of patients with dramatically differing levels of IL-1β and TNF-α in their synovial fluids. IL-1β and TNF-α were either high acutely and decreased to moderate levels over time, or they were zero acutely and remained zero or low. This is likely to be a very important observation as these two cytokines are key components of the inflammatory response and are the main intra-articular cytokines that provoke cartilage loss. It is our hypothesis that the group with high levels of IL-1β and TNF-α contains the 50%–60% of the patient population which goes on to develop OA, despite knee stabilization with ACL reconstruction. Conversely, we suggest that the group whose synovial fluid contains no IL-1β or TNF-α is protected from developing OA post-traumatically. IL-1-receptor antagonist protein (IRAP), the cytokine that antagonizes the biological effects of IL-1, was present acutely in our patient population; however, it was undetectable in chronic ACL-deficient knees. These data suggest the loss with time of an important cartilage-protective cytokine. The lack of IRAP chronically may allow IL-1β to act in an unrestrained manner resulting in cartilage loss. In addition, IL-1β promotes the secretion of many other inflammatory cytokines which may result in the chronic smoldering inflammatory reaction referred to above. These data encourage further study of the evaluation of cytokine concentrations in the ACL-deficient joint as a means of obtaining both prognostic and mechanistic information of clinical value to the physician.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 4 (1996), S. 180-187 
    ISSN: 1433-7347
    Keywords: Gene transfer ; Growth factors ; Ligaments ; Cartilage, articular ; Menisci
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract For the orthopedic sports medicine physician soft tissue injuries often present the greatest clinical problems. Not only do many of the most frequently injured tissues, such as the cruciate ligaments and articular cartilage, have very limited capabilities for spontaneous repair, but they also respond poorly to surgical or nonsurgical intervention. In this article we try to define the role of growth factors in these conditions and to outline concepts for future treatment based upon modulation of the native repair response. We suggest that gene transfer could improve the management of such injuries, particularly when used as vehicles for the targeted delivery of growth factors. The concept of gene therapy in orthopedic sports medicine can be extended to include disorders that present as laxity or mechanical weakness of ligaments. We speculate that subtle genetic differences between individuals may account for those who appear to be injury prone. In these cases it is likely that genes encoding the structural macromolecules of the matrix are defective. Local gene supplementation in such cases could be useful in the future.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 8 (2000), S. 159-162 
    ISSN: 1433-7347
    Keywords: Keywords Meniscus ; Transplantation ; Allograft ; Arthroscopy ; Surgical technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The important functions of the meniscus have been well described. Lack of a meniscus may lead to instability and early osteoarthrosis of the knee. Meniscal transplantation is an option following complete or subtotal meniscectomy in symptomatic patients with correct alignment, and mild to moderate chondrosis with the goal of preventing further degenerative sequelae to the knee. Since the first meniscus allograft implantation was performed 1984, there have been reported several open and arthroscopic techniques. We present our technique of arthroscopically assisted transplantation of a cryopreserved meniscal allograft with special consideration given to the technical details of this procedure. This technique employs creation of a circumferential osseocancellous trough in combination with transosseous tibial tunnel fixation and arthroscopic suture passage to both secure and enhance healing of the meniscal allograft.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 4 (1996), S. 121-124 
    ISSN: 1433-7347
    Keywords: Proprioception ; Kmesthesia ; Gymnasts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The role of proprioception as a protective mechanism has gained interest in recent years. From the clinical standpoint, several studies have dealt with ways to enhance proprioception following surgery and during rehabilitation. If kinesthesia (ability to detect passive motion) can be enhanced as a consequence of long-term athletic training, such training must be included as a part of the rehabilitation process to protect the patient from reinjury. Consequently, the purpose of this study was to compare the kinesthetic knee pattern between trained gymnasts and healthy nongymnasts. The proprioception testing device (PTD) was used to evaluate knee kinesthesia. From 45° of flexion, the knee was passively extended with the PTD. The device was stopped by the subject when this passive motion was detected. Fifteen healthy college-age female gymnasts (mean age 19.3 years) and 30 normal volunteers (mean age 20.7 years) comprised our study sample. A one-way analysis of variance (ANOVA) was used to compare the mean values of the dominant gymnastic knee to the dominant knee in the control group. Results revealed statistically significant mean differences between the trained gymnastic group and the untrained control group (F 1.34 (.95)=7.17.P=0.011). The results of this study suggest that extensive training has a positive influence on knee kinesthesia in addition to increasing muscle tone. According to the findings of this and other studies, highly trained athletes possess enhanced neurosensory pathways which are speculated to develop as a result of long-term athletic training. Although definite conclusions cannot be made from our investigation, prospective studies can determine the true role of athletic training in proprioceptive patterns.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 3 (1996), S. 199-201 
    ISSN: 1433-7347
    Keywords: Arthroscopy ; Temperature ; Knee
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Normal joint conditions are altered during arthroscopic surgery, and these changes have uncertain ultrastructural and biomechanical effects on articular cartilage. Experimental studies have shown that temperature variations affect the biomechanical properties of articular cartilage. We documented the temperature of the knee joint in 40 patients at the beginning and end of an arthroscopic procedure (anterior cruciate ligament reconstruction or meniscectomy). The intra-articular measurements were obtained using a digital thermometer connected to a sterile stainless steel probe. Correlation coefficients and linear regression techniques were used to determine which variables are independent predictors of joint temperature at the end of surgery. The mean knee joint temperature before surgery was 35.1°±1.0°C and at the end of surgery 24.6°±1.5°C. The joint temperature at the end of surgery was significantly affected by the temperature of the saline irrigant used and the length of arthroscopic procedure. The clinical implications of our findings must be clarified in animal models.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 3 (1996), S. 226-229 
    ISSN: 1433-7347
    Keywords: Biceps tendon ; Long head ; Mechanical properties
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract In this study, the geometric and mechanical properties of the long head of the biceps tendon were determined in order to elucidate its role in shoulder stability. We used a laser-micrometer system to measure the cross-sectional area and shape of seven fresh-frozen tendons at three levels: proximal, middle, and distal levels. The cross-sectional areas were found to be 22.7±9.3 mm2, 22.7±3.5 mm2, and 10.8±2.7 mm2, respectively. While statistically significant differences could not be demonstrated between the magnitudes of the areas, a consistent difference in shape was noted between the proximal and middle levels, the tendon being flatter as it progressed over the humeral head and more triangular as it passed through the bicipital groove. We then performed cyclic relaxation tests and uniaxial tensile testing of the tendons which revealed a cyclic stress relaxation of 18±4% over ten cycles. All tensile failures occurred within the midportion of the tendon substance. Additionally, the modulus was calculated between 3% and 6% strain and found to be 421±212 MPa, while the ultimate tensile strength, ultimate strain, and strain energy density were 32.5±5.3 MPa, 10.1±2.7%, and 1.9±0.4 MPa, respectively. These mechanical properties of the long head of the biceps tendon are of the same order of magnitude as tendons from other joints. The high stiffness of this tendon indicates that it has an ability to support the large load transferred to it by the muscle and to act as a humeral head depressor.
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