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Prostaglandin E2 is the major prostaglandin involved in colorectal carcinogenesis. The biosynthesis of prostaglandin E2 is accomplished by several terminal prostaglandin E synthases through catalytical conversion of the cyclooxygenase product prostaglandin H2. Among the known terminal prostaglandin E synthases, microsomal prostaglandin E synthase type 1 and type 2 were found to be overexpressed in colorectal cancer, however the role and regulation of these enzymes in this tumor entity are yet not fully understood. Here we report that the cyclopentenone prostaglandins 15-deoxy-D12,14-prostaglandin J2 and prostaglandin A2, which have been shown to modulate cell growth and neoplasia, selectively down-regulate microsomal prostaglandin E synthase type 2 mRNA and protein expression in the human colorectal carcinoma cell lines Caco-2 and HCT 116. This effect appeared to be PPARgamma independent and was not found to require G-protein-coupled receptor activation. Instead, inhibition of microsomal prostaglandin E synthase type 2 by cyclopentenone prostaglandins may be mediated by covalent binding of the cyclopentenone ring to cysteine residues on signalling molecules or via a redox-dependent mechanism. Inhibition of microsomal prostaglandin E synthase type 2 was subsequently followed by decreased prostaglandin E synthase activity, which in turn contributed at least in part to the anti-proliferative action of cyclopentenone prostaglandins in HCT 116 cells. Collectively, these data unravel a novel mechanism for the growth-inhibitory effects of cyclopentenone prostaglandins and expose microsomal prostaglandin E synthase type 2 as a new potential target for pharmacological intervention in the treatment of colorectal cancer.
This thesis presents a model for the dynamical description of deconfined quark matter created in ultra-relativistic heavy ion collisions, treating quarks and antiquarks as classical point particles subject to a colour-dependent, Cornell-type potential interaction. The model provides a dynamical handle for hadronization via the recombination of quarks and antiquarks in colour neutral clusters. Gluons are not included explicitly in the model,but are described in an effective manner by the means of the potential interaction. The model includes four different quark flavours (up, down, strange and charm) and uses current masses for the quarks. The dynamical evolution of a system of colour charges subject to the Hamiltonian equations of motion of the model yields the formation of colour neutral clusters of quarks and antiquarks, which are subject only to a small remaining interaction, the strong interquark potential notwithstanding. These clusters can be mapped onto hadrons and hadronic resonances. Thus, the model allows a dynamical description of quarks degrees of freedom in heavy ion collisions, including a recombination scheme for hadronization. The thermal properties of the model turn pout to be very satisfying. The model shows a transition from a confining phase to a deconfined phase with rising temperature, going hand in hand with a softest point in the equation of state and a rise of energy density and pressure to the Stefan-Boltzmann limit of a gas of quarks and antiquarks. Moreover, the potential interaction is screened in the deconfined phase. For the dynamical description of ultra-relativistic heavy ion collision, the qMD model is coupled to UrQMD as a generator for its initial conditions. In this way, a fully dynamical description of the expansion and hadronization of the fireball created in such collisions can be achieved. Non-equilibrium aspects of the expansion dynamics and hadronization by recombination of quarks and antiquarks are discussed in detail, and a comparison with experimental data of collisions at the CERN-SPS is presented. The big advantage of the qMD model is the possibility to study cluster formation, including exotic clusters, and fluctuations in a dynamical manner. As an example, event-by-event fluctuations in electric charge are studied. Such fluctuations have been proposed as a clear criterion to distinguish a deconfined system from a hadrons gas. However, experimental data show hadron gas fluctuation measures even at RHIC, where deconfinement is taken for granted. We will see how the dynamics of quark recombination washes out the quark-gluon plasma signal in the fluctuation criterion. Moreover, we will discuss briefly the problem of entropy at recombination. In a second application, the formation of exotic hadronic clusters, larger than usual mesons and baryons, is studied. Such clusters could provide new measures for the thermalization and homogenization of a deconfined gas of colour charges. Moreover, number estimates for exotic clusters from recombination are considerably lower than corresponding predictions from thermal models, providing a clear difference between statistical hadronization and hadronization via quark recombination. A detailed analysis is provided for pentaquark candidates such as the Theta-Plus. It turns out that the distribution of exotic states over strangeness, isospin, and spin could provide a sensitive measure for thermalization and decorrelation in the deconfined quark phase, if it could be measured.
In der vorliegenden Arbeit wurde die Arzt-Patient-Beziehung von HIV-Patienten im Hinblick auf bestehende Adherence-Probleme mithilfe qualitativer Methoden untersucht. Dieser Aspekt wurde in der Adherence-Forschung im HIV-Bereich entgegen den Tendenzen der allgemeinen Adherence-Forschung, im Rahmen derer die Arzt-Patient-Beziehung als bedeutsamer Einflussfaktor gilt, bislang nur wenig berücksichtigt. 20 an der Untersuchung teilnehmende Patienten wurden in der HIV-Ambulanz der Universität Frankfurt dergestalt rekrutiert, dass durch ärztliche Zuordnung zwei vergleichbare Gruppen, adhärente und wenig adhärente Patienten, entstanden. Gleichzeitig schätzen die behandelnden Ärzte und die Patienten das Medikamenteneinnahmeverhalten mithilfe von Fragebögen ein. Die Einstufung der Ärzte in eine der beiden Gruppen „adhärent/nicht adhärent“ zeigte in der vorliegenden Untersuchung eine relative Übereinstimmung mit der Selbstbeurteilung der Patienten (Exakter Test nach Fisher: p=0,017). Den Patienten schien es ungeachtet ihrer Adherence schwer zu fallen, sich an ein exaktes zeitliches Einnahmeschema zu halten. Das Mittel der eingenommenen Medikamente lag nach ärztlicher Schätzung für die Patienten der adhärenten Gruppe bei 97% (SD=4) der verordneten Medikamente und für die der nicht adhärenten Gruppe bei 69% (SD=17). Bei der Auswertung des Ärztefragebogens fiel auf, dass der Schwellenwert der Adherence für die befragten Ärzte nicht klar definiert zu sein scheint. Eine wissenschaftlich gesicherte (Neu-)Bestimmung dieses Schwellenwertes der Adherence könnte eine Entlastung von den aus dieser Unsicherheit resultierenden Konflikten für den Patienten bedeuten. Zur Exploration der Arzt-Patient-Beziehung aus der Patientensichtweise wurde auf die handlungsorientierte Methode des Psychodramas zurückgegriffen. Die mittels Rollentausch ermöglichten Inszenierungen eines Arzt-Patient-Gespräches wurden mit Videokameras dokumentiert. Die Auswertung der transkribierten Videos geschah mithilfe der Methode der objektiven Hermeneutik. Aus der Stichprobe wurde durch Kontrastierung eine Auswahl von vier Patienten getroffen. Dies geschah nach den Kriterien „adhärent“ vs. „nicht adhärent“ und „Rollentausch möglich“ vs. „kein Rollentausch möglich“. Es konnte eine Spezifität der untersuchten Patienten abgebildet werden, die nach Heranziehung einschlägiger Literatur durchaus als HIV-typisch verstanden werden kann: In den Darstellungen der Arzt-Patient-Beziehungen imponierten diffuse Nähe-Distanz-Regelungen sowie eine Nicht-Einhaltung des traditionellen asymmetrischen Arzt-Patient-Verhältnisses. Die Patienten traten in übertragungsreichen Beziehungen mit Vergemeinschaftungstendenzen an den Arzt heran. Erklärungsansätze hierfür könnten sein: Eine Traumatisierung durch die HIV-Infektion, eventuell ein kumulatives Trauma einschließend; eine vermeintliche, auf bereits bestehende subkulturelle Identitäten aufbauende „HIV-Identität“; die besondere Stellung der HIV-Infektion im Gesundheitssystem sowie das Fortdauern bereits der Prä-HAART-Ära entstammender Strukturen; ein allgemeinen Wandel des Gesundheitssystems und/oder ein einrichtungsspezifischer Einfluss. Aufbauend auf diese strukturellen Besonderheiten wurde eine Hypothese für die weitere Beschäftigung mit dem Thema „Adherence bei HIV-infizierten Patienten“ generiert: Entsprechend der Kontrastierung nach adhärenten vs. nicht adhärenten Patienten ließe sich als Erklärungsmodell folgern, dass die HIV-Patienten unter der Bedingung, dass ihr Verhältnis zum Arzt ein Besonderes ist, bereit sind, den ärztlichen Anweisungen zu folgen. Daraus könnte ein individueller Grad der Bedürftigkeit bzw. eines Wunsches, als etwas Besonderes in der Beziehung zu ihrem Arzt anerkannt zu werden, resultieren, bei dessen Überschreitung der Patient sich adhärent verhielte. Demnach könnte sich die Zufriedenheit mit der Arzt-Patient-Beziehung als Befriedigung der Bedürftigkeit bzw. o.g. Wunsches verstehen lassen. Die Hypothese legt weiterhin nahe, dass Adherence-Probleme vornehmlich auf einen Selbstwertkonflikt als Konfliktmuster bzw. eine Selbstwertregulierung innerhalb der bestehenden Arzt-Patient-Beziehung zurückführbar wären. Inwieweit die Ausprägung dieser Konfliktstruktur für adhärentes bzw. nicht adhärentes Verhalten verantwortlich ist, ist in weiterführenden Untersuchungen zu klären. Im Rahmen der Einzelfallanalysen offenbarten sich Probleme, die in einer normalen Arzt-Patient-Beziehung kaum lösbar sind. Den hohen Erwartungen an die Adherence entsprechend sollten demnach Strategien ausgebildet werden, mittels derer nach hinreichender Diagnostik eine Behandlung der nicht zur Adherence fähigen Patienten durch verschiedene Interventionen möglich wird. Diese sollten dem individuellen Problem gebührend von psychoedukativen Herangehensweisen über psychotherapeutischen Maßnahmen bis hin zu speziellen Projekten, innerhalb derer eine Behandlung der nicht zur der Adherence fähigen Patienten angeboten wird, reichen.
Nucleotide-binding domains (NBDs), roughly 27 kDa in size, are conservative components of the large family of ABC (ATP-binding cassette) transporters, which includes importers, exporters, and receptors. NBDs or ABC-ATPases supply energy for the translocation of a vast variety of substrates across biological membranes. Despite their hydrophilic sequence, many NBDs tend to aggregate and precipitate in solution upon isolation from the complete transporter. The conditions stabilizing an extremely labile NBD component of the E.coli HlyA transporter, HlyB-NBD, were developed. As a result, the pure highly concentrated enzyme was protected from precipitation for months that allowed screening of the unlimited crystallization conditions in the presence of different substrates and performance of the reproducible functional assays. HlyB-NBD was characterized in regard to its uncoupled ATPase activity, oligomeric state, and stability in solution. Comparative analysis of protein stability and ATPase activity in various buffers suggested an inverse relationship between the two. Kinetic analysis of ATPase activity revealed ATP-induced protein dimerization. Gel-filtration experiments with the wild type protein and H662A-mutant of HlyB-NBD provided further evidence of protein dimerization in the presence of ATP. The crystal structures in post- and pre-hydrolysis nucleotide-bound states of HlyB-NBD were determined at 1.6Å and 2.5Å resolution, respectively. While the hydrolytically deficient H662A mutant of HlyB-NBD was crystallized as a stable dimer in the presence of ATP or ATP-Mg2+, with two nucleotide molecules sandwiched between the two monomers, the same protein was shown to be a monomer in the ADP-loaded state. The wild type protein failed to develop crystals with bound ATP, yet formed ADP-bound crystals identical to those of the H662A-mutant. The X-ray structures of HlyB-NBD in various states of the hydrolytic cycle and the functional studies of the enzyme have provided an opportunity to characterize enzyme-substrate complexes and protein-protein interactions between the NBD subunits in great detail. Comparison of the nucleotide-free, the ADP-, and the ATP-loaded states revealed oligomeric and conformational changes of the protein upon substrate binding and resulted in a molecular picture of the catalytic cycle. The correlated results of the structural and functional investigations of HlyB-NBD are discussed with relation to the mechanism of action of ABC transporters.
Zielsetzung dieser Arbeit war die Klärung der Frage inwieweit Schlafstörungen, die schon während der Trinkphase auftreten, in einem Zusammenhang mit Schlafstörungen im Entzug stehen. Ebenso sollte untersucht werden, ob Schlafstörungen in der Trinkphase eine Vorhersage über die Schwere des Entzugs gestatten und damit als Indikator für den Entgiftungsverlauf und möglicher Komplikation dienen können. Der Anspruch dieser Arbeit war dabei, die Grundlagen für die Entwicklung eines Instrumentariums für die Indikationsstellung stationäreversus ambulante Entgiftungstherapie zu schaffen. Zur Klärung der Fragen wurden im Rahmen einer explorativen Untersuchung Patienten befragt und klinisch- neurologisch sowie labortechnisch untersucht. Die Stichprobe wurde rekrutiert aus konsekutiv im Zeitraum von Juni 2002 bis August 2003 zur Entgiftung im Zentrum der Psychiatrie des Klinikums der J.W. Goethe- Universität Frankfurt aufgenommenen Patienten. Sie umfasste 100 Alkoholkranke, die die ICD-10 Kriterien für eine Alkoholabhängigkeit (Dilling et al., 2000) erfüllten. Ausschlußkriterium war hierbei eine Verweildauer von weniger als 72 Stunden. Eine weitere Voraussetzung war die Fähigkeit und die freiwillige Bereitschaft, an einer in etwa insgesamt 30minütigen Befragung teilzunehmen. Für die Untersuchung wurde ein spezieller Fragenkatalog aus 5 unterschiedlichen Fragebögen erstellt. Die Antwortkategorien waren abgestufte Antworten, sowie größtenteils Multiple- Choice- Fragen. Lediglich die Anamnese wurde anhand eines standardisierten Anamnesebogens in offener Frageform erfasst. Es wurden soziodemographische Daten sowie Daten zum bisherigen Verlauf der Alkoholerkrankung und der Schlafqualität erhoben.
We present a biologically-inspired system for real-time, feed-forward object recognition in cluttered scenes. Our system utilizes a vocabulary of very sparse features that are shared between and within different object models. To detect objects in a novel scene, these features are located in the image, and each detected feature votes for all objects that are consistent with its presence. Due to the sharing of features between object models our approach is more scalable to large object databases than traditional methods. To demonstrate the utility of this approach, we train our system to recognize any of 50 objects in everyday cluttered scenes with substantial occlusion. Without further optimization we also demonstrate near-perfect recognition on a standard 3-D recognition problem. Our system has an interpretation as a sparsely connected feed-forward neural network, making it a viable model for fast, feed-forward object recognition in the primate visual system.
The analysis of doxorubicin-loaded poly(butyl cyanoacrylate) nanoparticles in in vitro glioma models
(2005)
The use of doxorubicin for the treatment of glioma tumours would be an important approach in the chemotherapy treatment since doxorubicin is a very effective neoplastic agent. However, one problem faced by the use of doxorubicin for the treatment of brain tumours is the fact that doxorubicin is a substrate of an efflux pump protein, P-glycoprotein (P-gp), which is located on the luminal side of the brain capillary endothelium and in many tumour cells, which acts pumping out of the cell such substrate, and blocking its transport into the cell. A strategy to enhance the doxorubicin delivery into the brain would be the use of nanoparticles. This work showed, that the treatment of doxorubicin bound to poly(butyl cyanoacrylate) nanoparticles decreased the viability of the three glioma cell lines, the GS-9L, the RG-2, and the F-98 cell lines significantly in comparison to doxorubicin in solution, indicating an improvement of the nanoparticles-bound doxorubicin transport into the cells. The modification of the nanoparticles surface with different surfactants may even enhance the delivery of the drug into the cells. Searching for an improvement of the doxorubicin internalization, the nanoparticles surface was modified using polysorbate 80, poloxamer 188 and poloxamine 908 surfactants. The poloxamer 188 and polaxamine 908 surfactant modified nanoparticles did not show a significant enhancement of the doxorubicin internalization. Contrary, the treatment of polysorbate 80 surfactant modified nanoparticles led in some cases to a significant decrease of cancer cell viability. The use of doxorubicin in the three glioma cell lines allowed the measurement of different responses towards doxorubicin treatment. The different responses were due to the entry of various amounts of doxorubicin into the glioma cells, which express the P-glycoprotein in their cellular membrane. A higher level of the P-gp expression correlated with a weaker response towards the doxorubicin treatment. The GS-9L cell line showed a significant higher level of P-gp expression than the F-98, and RG-2 cell lines, and consequently, the GS-9L cell line presented the highest resistance to doxorubicin with the highest viability values after doxorubicin treatment. Due to the fact that the transport of doxorubicin is governed by the activity of the P-gp in the studied glioma cells, the use of poloxamer 185 as a P-gp inhibitor resulted in an enhancement of the uptake as well as of the accumulation of doxorubicin into the cells. The effect of poloxamer 185 on the doxorubicin uptake was significant marked in the case of doxorubicin-resistance cells, as the GS-9L cell line. In some cases, the presence of the nanoparticles formulation showed also an influence on such uptake improvement. The use of a P-gp inhibitor in combination with chemotherapeutic agents leads to encouraging results. Because of the wide spectrum of substances acting as P-gp inhibitors, the exact inhibitory mechanisms remain still unclear. For instance in our results the evaluation of a described P-gp inhibitor, polysorbate 80 did not show an important improvement in the doxorubicin uptake in the P-gp-expressing cell line, GS-9L. On the other hand, the Polysorbate 80-Dox-PBCA nanoparticles formulation decreased in greater extend the viability of the glioma cells than the poloxamer185-Dox-PBCA nanoparticles. Although, the P-gp inhibition was undoubtedly higher in the presence of poloxamer 185, polysorbate 80 showed a main effect on the disruption of the cellular membrane, resulting in an important cellular viability decrease. It seems that poloxamer 185 presents a direct effect on the functionality of the P-gp protein, which would be of great importance in the sensitization of resistant cancer cells. The range of concentration of poloxamer 185 is very important to yield an inhibitory effect on the P-gp-mediated transport mechanism. The accumulation of Rhodamine-123 (Rho-123), a known P-gp substrate, increased in a range of concentration from 0.001 % to 0.01, whereas at 0.1 % poloxamer 185 the accumulation significantly decreased. A maximal Rho-123 accumulation was reached at 0.01 % poloxamer 185.
In this paper we derive a formula for the energy loss due to elastic N to N particle scattering in models with extra dimensions that are compactified on a radius R. In contrast to a previous derivation we also calculate additional terms that are suppressed by factors of frequency over compactification radius. In the limit of a large compactification radius R those terms vanish and the standard result for the non compactified case is recovered.
Kongressbericht: Auf der Tagung der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin e.V. (DEGAM) 2004 entstand die Idee, E-Learning-Aktivitäten in der Allgemeinmedizin sichtbar zu machen und zu bündeln. Ein Kongress sollte die allgemeinmedizinischen Vertreter aus Lehre und Forschung sowie Industrievertreter zusammenbringen, um das Spektrum der Möglichkeiten und laufende Projekte kennen zu lernen. Mit motivierten Referenten, über 60 aktiven Teilnehmern und einem positiven Feedback, kann der Kongress in Frankfurt am 8. und 9. Juli 2005 als erster dieser Art in Deutschland als erfolgreich bezeichnet werden.
Background: Depression is a disorder with high prevalence in primary health care and a significant burden of illness. The delivery of health care for depression, as well as other chronic illnesses, has been criticized for several reasons and new strategies to address the needs of these illnesses have been advocated. Case management is a patient-centered approach which has shown efficacy in the treatment of depression in highly organized Health Maintenance Organization (HMO) settings and which might also be effective in other, less structured settings. Methods/Design: PRoMPT (PRimary care Monitoring for depressive Patients Trial) is a cluster randomised controlled trial with General Practice (GP) as the unit of randomisation. The aim of the study is to evaluate a GP applied case-management for patients with major depressive disorder. 70 GPs were randomised either to intervention group or to control group with the control group delivering usual care. Each GP will include 10 patients suffering from major depressive disorder according to the DSM-IV criteria. The intervention group will receive treatment based on standardized guidelines and monthly telephone monitoring from a trained practice nurse. The nurse investigates the patient's status concerning the MDD criteria, his adherence to GPs prescriptions, possible side effects of medication, and treatment goal attainment. The control group receives usual care – including recommended guidelines. Main outcome measure is the cumulative score of the section depressive disorders (PHQ-9) from the German version of the Prime MD Patient Health Questionnaire (PHQ-D). Secondary outcome measures are the Beck-Depression-Inventory, self-reported adherence (adapted from Moriskey) and the SF-36. In addition, data are collected about patients' satisfaction (EUROPEP-tool), medication, health care utilization, comorbidity, suicide attempts and days out of work. The study comprises three assessment times: baseline (T0) , follow-up after 6 months (T1) and follow-up after 12 months (T2). Discussion: Depression is now recognized as a disorder with a high prevalence in primary care but with insufficient treatment response. Case management seems to be a promising intervention which has the potential to bridge the gap of the usually time-limited and fragmented provision of care. Case management has been proven to be effective in several studies but its application in the private general medical practice setting remains unclear.