Non-selective cutaneous sensory neurectomy as an alternative treatment for auto-mutilation lesion following arthrodesis in three dogs

OBJECTIVE: To describe an alternative method for the treatment of non-responsive self-mutilation injuries in three dogs after carpal/tarsal arthrodesis. STUDY DESIGN: Case series ANIMALS: Two dogs with carpal injury and one dog with tarsal injury treated by arthrodesis METHODS: All dogs developed self-mutilation injuries due to licking and/or chewing of the toes within 21-52 days of surgery. Clinical signs did not resolve within one week after conservative treatment with wound debridement and protective bandages. Following general anaesthesia, a deep horseshoe-shaped skin incision, including the subdermal tissue, was performed proximal to the self-mutilation injury transecting the sensory cutaneous afferent nerves. The skin incision was closed with simple interrupted sutures. RESULTS: All wounds healed without complication. Self-mutilation resolved completely within 24 hours after surgery in all dogs. No recurrence was observed (5 months to 3 years). CONCLUSION: Non-selective cutaneous sensory neurectomy may lead to resolution of self-mutilation following arthrodesis in dogs. CLINICAL RELEVANCE: Failure of conservative treatment in self-mutilation injuries often leads to toe or limb amputation as a last resort. The technique described in this case series is a simple procedure that should be considered prior to amputation. The outcome of this procedure in dogs self-multilating due to neurological or behavioral disturbances unrelated to carpal or tarsal arthrodesis is not known.

Emergenz & (Auto)-Poïesis. Schwarmdynamik und performativ gebildete Gemeinschaft in der ‚improvisierten Choreographie’ You’ve Changed

Der Schweizer Tänzer und Choreograph Thomas Hauert und seine 1998 gegründeten Kompanie ZOO arbeiten seit Jahren mit Tanzimprovisation. Sie nutzen diese als choreographische Methode, als Mittel zur Bewegungsfindung während des Probenprozesses und als Kompositionsmittel während der Live-Aufführungen. In der Improvisation geht es immer um ein gemeinschaftliches Tun, um ein Miteinander, um Interaktion und gegenseitige Rücksichtnahme. In meinem Vortrag möchte ich diskutieren, inwiefern sich die Improvisation im Stück You’ve Changed (2010) dezidiert als kollaborative und gemeinschaftliche Praxis zeigt und wie hierin die Generierung eines interaktiv erzeugten Ereignisses evident wird. Um zu verdeutlichen, wie sich in diesem Tanzstück Gruppen bilden, wie Sozialität, Kollektivität und Gemeinschaft performativ hervorgebracht und verhandelt werden, benutze ich den Tierschwarm als Metapher und Denkfigur. Der Schwarm als performatives, dynamisches Gebilde, als Bewegungskollektiv von gleichberechtigten Teilnehmern, bietet sich als Erklärungsmodell an. Ähnlich wie der Tierschwarm wird auch die hier stattfindende Live-Improvisation durch Unvorhersehbarkeit, Performativität, Ephemeralität, Dynamik und kinästhetische Übertragungsbewegungen zwischen den einzelnen Mitgliedern charakterisiert. Ausgehend von Jean- Luc Nancys Schrift Singulär plural sein werden des Weiteren philosophische Überlegungen zur Gemeinschaft hergestellt und die Frage verhandelt, wie sich der Begriff der Singularität für die Betrachtung der ‚choreographierten Improvisation’ You’ve Changed fruchtbar machen lässt.

L’hépatite auto-immune

Autoimmune hepatitis is a systemic disease, difficult to diagnose due the high variability of the clinical presentation and some non specific histological features. The recent identification of additional autoantibodies used as serological markers, as well as simplified diagnostic criteria should help the primary care physician to advance with the diagnostic process. These progresses are crucial as undiagnosed and therefore untreated autoimmune hepatitis has a poor prognosis, whereas immunosuppressive therapy leads to remission in a majority of cases.

Auto de fé and Jew

by Elkan Nathan Adler

Immune cell trafficking across the barriers of the central nervous system in multiple sclerosis and stroke

Each year about 650,000 Europeans die from stroke and a similar number lives with the sequelae of multiple sclerosis (MS). Stroke and MS differ in their etiology. Although cause and likewise clinical presentation set the two diseases apart, they share common downstream mechanisms that lead to damage and recovery. Demyelination and axonal injury are characteristics of MS but are also observed in stroke. Conversely, hallmarks of stroke, such as vascular impairment and neurodegeneration, are found in MS. However, the most conspicuous common feature is the marked neuroinflammatory response, marked by glia cell activation and immune cell influx. In MS and stroke the blood-brain barrier is disrupted allowing bone marrow-derived macrophages to invade the brain in support of the resident microglia. In addition, there is a massive invasion of auto-reactive T-cells into the brain of patients with MS. Though less pronounced a similar phenomenon is also found in ischemic lesions. Not surprisingly, the two diseases also resemble each other at the level of gene expression and the biosynthesis of other proinflammatory mediators. While MS has traditionally been considered to be an autoimmune neuroinflammatory disorder, the role of inflammation for cerebral ischemia has only been recognized later. In the case of MS the long track record as neuroinflammatory disease has paid off with respect to treatment options. There are now about a dozen of approved drugs for the treatment of MS that specifically target neuroinflammation by modulating the immune system. Interestingly, experimental work demonstrated that drugs that are in routine use to mitigate neuroinflammation in MS may also work in stroke models. Examples include Fingolimod, glatiramer acetate, and antibodies blocking the leukocyte integrin VLA-4. Moreover, therapeutic strategies that were discovered in experimental autoimmune encephalomyelitis (EAE), the animal model of MS, turned out to be also effective in experimental stroke models. This suggests that previous achievements in MS research may be relevant for stroke. Interestingly, the converse is equally true. Concepts on the neurovascular unit that were developed in a stroke context turned out to be applicable to neuroinflammatory research in MS. Examples include work on the important role of the vascular basement membrane and the BBB for the invasion of immune cells into the brain. Furthermore, tissue plasminogen activator (tPA), the only established drug treatment in acute stroke, modulates the pathogenesis of MS. Endogenous tPA is released from endothelium and astroglia and acts on the BBB, microglia and other neuroinflammatory cells. Thus, the vascular perspective of stroke research provides important input into the mechanisms on how endothelial cells and the BBB regulate inflammation in MS, particularly the invasion of immune cells into the CNS. In the current review we will first discuss pathogenesis of both diseases and current treatment regimens and will provide a detailed overview on pathways of immune cell migration across the barriers of the CNS and the role of activated astrocytes in this process. This article is part of a Special Issue entitled: Neuro inflammation: A common denominator for stroke, multiple sclerosis and Alzheimer's disease, guest edited by Helga de Vries and Markus Swaninger.

E. A. Powell: Mit Auto und Kamel zum Pfauenthron [Rezension]

Eugen Höflich

Erik Wirl, Brustbild, im Auto

Signatur des Originals: S 36/F07259