Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapse
Identifieur interne : 002764 ( PascalFrancis/Checkpoint ); précédent : 002763; suivant : 002765Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapse
Auteurs : Georg Becker [Allemagne] ; Daniela Berg [Allemagne] ; Niels Kruse [Allemagne] ; Ute Schröder [Allemagne] ; Monika Warmuth-Metz [Allemagne] ; Peter Rieckmann [Allemagne] ; Markus Naumann [Allemagne] ; Karlheinz Reiners [Allemagne]Source :
- Movement disorders [ 0885-3185 ] ; 2002.
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Abstract
Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.
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Wurtzbourg</orgName></affiliation></author><author><name sortKey="Berg, Daniela" sort="Berg, Daniela" uniqKey="Berg D" first="Daniela" last="Berg">Daniela Berg</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Kruse, Niels" sort="Kruse, Niels" uniqKey="Kruse N" first="Niels" last="Kruse">Niels Kruse</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Schroder, Ute" sort="Schroder, Ute" uniqKey="Schroder U" first="Ute" last="Schröder">Ute Schröder</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Warmuth Metz, Monika" sort="Warmuth Metz, Monika" uniqKey="Warmuth Metz M" first="Monika" last="Warmuth-Metz">Monika Warmuth-Metz</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Division of Neuroradiology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Rieckmann, Peter" sort="Rieckmann, Peter" uniqKey="Rieckmann P" first="Peter" last="Rieckmann">Peter Rieckmann</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Naumann, Markus" sort="Naumann, Markus" uniqKey="Naumann M" first="Markus" last="Naumann">Markus Naumann</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author><author><name sortKey="Reiners, Karlheinz" sort="Reiners, Karlheinz" uniqKey="Reiners K" first="Karlheinz" last="Reiners">Karlheinz Reiners</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Wurtzbourg</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region></placeName><orgName type="university">Université de Wurtzbourg</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Cervical spine</term><term>Complication</term><term>Dystonia</term><term>Echography</term><term>Exeresis</term><term>Hernia</term><term>Intervertebral disk</term><term>Nucha</term><term>Pain</term><term>Pathophysiology</term><term>Shoulder</term><term>Transcranial route</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dystonie</term><term>Epaule</term><term>Hernie</term><term>Disque intervertébral</term><term>Rachis cervical</term><term>Exérèse</term><term>Douleur</term><term>Nuque</term><term>Echographie</term><term>Voie transcrânienne</term><term>Complication</term><term>Traitement</term><term>Physiopathologie</term><term>Adulte</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>17</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapse</s1></fA08><fA11 i1="01" i2="1"><s1>BECKER (Georg)</s1></fA11><fA11 i1="02" i2="1"><s1>BERG (Daniela)</s1></fA11><fA11 i1="03" i2="1"><s1>KRUSE (Niels)</s1></fA11><fA11 i1="04" i2="1"><s1>SCHRÖDER (Ute)</s1></fA11><fA11 i1="05" i2="1"><s1>WARMUTH-METZ (Monika)</s1></fA11><fA11 i1="06" i2="1"><s1>RIECKMANN (Peter)</s1></fA11><fA11 i1="07" i2="1"><s1>NAUMANN (Markus)</s1></fA11><fA11 i1="08" i2="1"><s1>REINERS (Karlheinz)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="02"><s1>Division of Neuroradiology, Bayerische Julius-Maximilians-Universität Würzburg</s1><s3>DEU</s3><sZ>5 aut.</sZ></fA14><fA20><s1>710-716</s1></fA20><fA21><s1>2002</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000108922560110</s5></fA43><fA44><s0>0000</s0><s1>© 2002 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>21 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>02-0456856</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.</s0></fC01><fC02 i1="01" i2="X"><s0>002B25I</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Dystonie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Dystonia</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Distonía</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Epaule</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Shoulder</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Hombro</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Hernie</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Hernia</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Hernia</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Disque intervertébral</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Intervertebral disk</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Disco intervertebral</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Rachis cervical</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Cervical spine</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Raquis cervical</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Exérèse</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Exeresis</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Exéresis</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Douleur</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Pain</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Dolor</s0><s5>10</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Nuque</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Nucha</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Nuca</s0><s5>11</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Echographie</s0><s5>13</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Echography</s0><s5>13</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Ecografía</s0><s5>13</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Voie transcrânienne</s0><s5>14</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Transcranial route</s0><s5>14</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Vía transcraneana</s0><s5>14</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Complication</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Complication</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Complicación</s0><s5>17</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Traitement</s0><s5>18</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Treatment</s0><s5>18</s5></fC03><fC03 i1="12" i2="X" l="SPA"><s0>Tratamiento</s0><s5>18</s5></fC03><fC03 i1="13" i2="X" l="FRE"><s0>Physiopathologie</s0><s5>19</s5></fC03><fC03 i1="13" i2="X" l="ENG"><s0>Pathophysiology</s0><s5>19</s5></fC03><fC03 i1="13" i2="X" l="SPA"><s0>Fisiopatología</s0><s5>19</s5></fC03><fC03 i1="14" i2="X" l="FRE"><s0>Adulte</s0><s5>20</s5></fC03><fC03 i1="14" i2="X" l="ENG"><s0>Adult</s0><s5>20</s5></fC03><fC03 i1="14" i2="X" l="SPA"><s0>Adulto</s0><s5>20</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Homme</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Human</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Hombre</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Muscle strié pathologie</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Striated muscle disease</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Músculo estriado patología</s0><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Trouble neurologique</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Neurological disorder</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Trastorno neurológico</s0><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Mouvement involontaire</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Involuntary movement</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Movimiento involuntario</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>41</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Système ostéoarticulaire pathologie</s0><s5>45</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Diseases of the osteoarticular system</s0><s5>45</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Sistema osteoarticular patología</s0><s5>45</s5></fC07><fC07 i1="08" i2="X" l="FRE"><s0>Rachis pathologie</s0><s5>46</s5></fC07><fC07 i1="08" i2="X" l="ENG"><s0>Spine disease</s0><s5>46</s5></fC07><fC07 i1="08" i2="X" l="SPA"><s0>Raquis patología</s0><s5>46</s5></fC07><fC07 i1="09" i2="X" l="FRE"><s0>Chirurgie</s0><s5>53</s5></fC07><fC07 i1="09" i2="X" l="ENG"><s0>Surgery</s0><s5>53</s5></fC07><fC07 i1="09" i2="X" l="SPA"><s0>Cirugía</s0><s5>53</s5></fC07><fC07 i1="10" i2="X" l="FRE"><s0>Exploration ultrason</s0><s5>69</s5></fC07><fC07 i1="10" i2="X" l="ENG"><s0>Sonography</s0><s5>69</s5></fC07><fC07 i1="10" i2="X" l="SPA"><s0>Exploración ultrasonido</s0><s5>69</s5></fC07><fN21><s1>266</s1></fN21><fN82><s1>PSI</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li></country><region><li>Bavière</li><li>District de Basse-Franconie</li></region><settlement><li>Wurtzbourg</li></settlement><orgName><li>Université de Wurtzbourg</li></orgName></list><tree><country name="Allemagne"><region name="Bavière"><name sortKey="Becker, Georg" sort="Becker, Georg" uniqKey="Becker G" first="Georg" last="Becker">Georg Becker</name></region><name sortKey="Berg, Daniela" sort="Berg, Daniela" uniqKey="Berg D" first="Daniela" last="Berg">Daniela Berg</name><name sortKey="Kruse, Niels" sort="Kruse, Niels" uniqKey="Kruse N" first="Niels" last="Kruse">Niels Kruse</name><name sortKey="Naumann, Markus" sort="Naumann, Markus" uniqKey="Naumann M" first="Markus" last="Naumann">Markus Naumann</name><name sortKey="Reiners, Karlheinz" sort="Reiners, Karlheinz" uniqKey="Reiners K" first="Karlheinz" last="Reiners">Karlheinz Reiners</name><name sortKey="Rieckmann, Peter" sort="Rieckmann, Peter" uniqKey="Rieckmann P" first="Peter" last="Rieckmann">Peter Rieckmann</name><name sortKey="Schroder, Ute" sort="Schroder, Ute" uniqKey="Schroder U" first="Ute" last="Schröder">Ute Schröder</name><name sortKey="Warmuth Metz, Monika" sort="Warmuth Metz, Monika" uniqKey="Warmuth Metz M" first="Monika" last="Warmuth-Metz">Monika Warmuth-Metz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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