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- hippocampal sclerosis (2)
- histological validation (2)
- histone deacetylase (2)
- histone deacetylase inhibitor (2)
- historical statistics (2)
- home education (2)
- homeostatic adaption (2)
- homogeneity (2)
- hormones (2)
- hot spots (2)
- household income (2)
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- household survey (2)
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- hudobná avantgarda (2)
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- hydrogen bonds (2)
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- hydrology (2)
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- hyperalgesia (2)
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- hypertrophy (2)
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- identidade (2)
- identité (2)
- ideology critique (2)
- ideología (2)
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- immune therapy (2)
- immunmodulierende Effekte (2)
- immunocytochemistry (2)
- immunomodulatory effects (2)
- impact factor (2)
- implied correlation (2)
- implied volatility (2)
- implied volatility skew (2)
- impostor phenomenon (2)
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- in-Medium Modifikation (2)
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- incidence (2)
- inclination compass (2)
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- information processing theory (2)
- information transfer (2)
- infrared-A radiation (2)
- inhibitor (2)
- inhibitors (2)
- inhibitory control (2)
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- internalin B (2)
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- internationale Organisationen (2)
- interpersonal closeness (2)
- intersubjectivité (2)
- intervention study (2)
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- kinase inhibitor (2)
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- laboratory experiment (2)
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- lapatinib (2)
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- miR (2)
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- soziale Integration (2)
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Die Gamma-Glutamyl-Carboxylase spielt eine Schlüsselrolle im menschlichen Organismus, da sie für die posttranslationale Modifikation sämtlicher Vitamin-K-abhängiger Proteine verantwortlich ist. Ein hereditärer Mangel aller Vitamin-K-abhängigen Faktoren aufgrund eines Defekts in der Gamma-Glutamyl-Carboxylase (VKCFD1) ist sehr selten und geht mit einer gesteigerten Blutungsneigung einher. Aktuelle Arbeiten zeigen eine weitere Manifestation von Mutationen im Gamma-Glutamyl-Carboxylase-Gen, die ein dermatologisches Krankheitsbild, ähnlich der Pseudoxanthoma elasticum, darstellt. In diesen Fällen zeigen die Patienten sowohl dermatologische Effloreszenzen im Sinne der PXE als auch eine Verminderung der Vitamin-K-abhängigen Faktoren. Es wird vermutet, dass die PXE-ähnlichen Hautveränderungen auf eine Funktionsstörung des Matrix-Gla-Proteins zurückzuführen sein könnten. In der vorliegenden Arbeit wurde eine Mutationsdiagnostik bei vier Patienten mit kongenitalem Mangel aller Vitamin-K-abhängigen Gerinnungsfaktoren durchgeführt. Insgesamt wurden dabei fünf Mutationen nachgewiesen, davon vier Missense-Mutationen und eine Stopp-Mutation. Zwei der Patienten wiesen eine „compound Heterozygotie“ auf. Bei den gefunden Mutationen wurden drei im Rahmen dieser Arbeit erstmals aufgezeigt, die anderen zwei waren in der Literatur bereits beschrieben. Bei einer der Mutationen konnte ein „Founder“-Effekt in Bezug auf einen anderen Patienten aus der Literatur nachgewiesen werden. Sollte zukünftig diese Mutation in Deutschland vorkommen und sich auch auf die „Founder“-Mutation zurückführen lassen, böte sich dieser Mechanismus als eine Erklärung für das gehäufte Vorkommen der VKCFD Typ 1 in Deutschland an. Ein Hinweis auf eine PXE-like Disorder konnte bei keinem der Patienten nachgewiesen werden. Zusätzlich wurde die genetische Variabilität des Gamma-Glutamyl-Carboxylase-Gens in der Normalbevölkerung untersucht. Für die Untersuchungen wurde zunächst die DNA einer phänotypisch unauffälligen Kontrollgruppe, bestehend aus 200 gesunden Blutspendern, auf Genvariationen im GGCX-Gen analysiert. Nach der Isolierung und der Amplifikation der DNA wurde mit sämtlichen Proben zunächst ein Mutations-Screening mittels dHPLC durchgeführt. Auffällige Abschnitte und solche, bei denen häufige und/oder mehrere Polymorphismen bereits bekannt waren, wurden sequenziert. Auf diese Weise wurden acht Polymorphismen in den codierenden bzw. die Exone flankierenden Genabschnitten nachgewiesen. Davon wurden zwei erstmals beschrieben (c.43+33T>A; c.1288-38T>C). Schließlich sollte mit dieser Arbeit versucht werden zu klären, wie eine möglichst effiziente Diagnostik von Mutationen bzw. Polymorphismen des GGCX-Gens möglich ist. In unseren Untersuchungen wurde sowohl mit der dHPLC (Wave-System) als Screening-Methode gearbeitet als auch Genabschnitte sequenziert. Mittels der dHPLC kann ein hohes Probenaufkommen in kurzer Zeit mit vergleichsweise geringem Aufwand und vergleichsweise geringeren Kosten (ca. 30 € pro Genuntersuchung vs. Komplettsequenzierung ca. 300 €) bewältigt werden. Bei Genabschnitten mit vielen oder häufigen Polymorphismen ist dies ineffektiv, weil es nur das Vorhandensein einer Veränderung, nicht jedoch die Veränderung selbst beschreiben kann. Daher empfiehlt es sich, beide Methoden zu kombinieren, welches sich als die effizienteste und rationalste Methode für die Mutationsdiagnostik darstellt. Die Ergebnisse der vorliegenden Arbeit sind von grundsätzlichem Interesse für die biomedizinische Forschung. Eventuell wird es damit dann möglich sein, Krankheitsentstehungen und ihre Verläufe bei Mutationen der Gamma-Glutamyl-Carboxylase besser zu verstehen und damit eine noch effektivere und nebenwirkungsärmere Therapie einzusetzen.
In der vorliegenden Arbeit wurde in einer Fall-Kontroll-Studie mit 483 Fällen und 300 Kontrollen das Risiko für die berufsbedingte Supraspinatussehnenruptur durch Arbeiten auf oder über Schulterniveau untersucht. Dabei ergab sich eine statistisch signifikante Risikoerhöhung durch das Arbeiten auf oder über Schulterniveau. Eine Dosis-Antwortbeziehung zeigte einen Zusammenhang der Ereignisse. Am stärksten war die Risikoerhöhung bei Patienten, die lebenslang kumulativ mindestens 3195 Stunden auf oder über Schulterniveau arbeiteten. Die adjustierte Odds Ratio dafür betrug 2,1 (CI 1,2-3,7), das Ergebnis ist statistisch signifikant. Neben dem beruflichen Arbeiten auf oder über Schulterniveau gibt es andere Faktoren, die die Entstehung einer Rotatorenmanschettenruptur begünstigen. Dabei sind Alter, Heben/Tragen von Lasten über 20 kg und Arbeiten mit handgeführten vibrierenden Werkzeugen zu nennen. Deshalb wurden die Daten hinsichtlich dieser Faktoren adjustiert. Auch einige Sportaktivitäten können das Risiko für die Rotatorenmanschettenruptur erhöhen. Deshalb wurden die Daten auch für Geräteturnen, Kugelstoßen, Speer- und Hammerwerfen, Ringen und Tennis adjustiert, und die sportliche Anstrengung wurde als Confounder behandelt. Die Ergebnisse stehen im Einklang mit Ergebnissen früherer Studien, die ebenfalls eine Risikoerhöhung für die Entstehung der Rotatorenmanschettenruptur durch Arbeiten auf oder über Schulterniveau zeigen. Eine genaue Dosis, die zu dieser Risikoerhöhung führt, wurde in der Literatur bisher nicht genannt. Die vorliegende Arbeit liefert die Evidenz für die Annahme eines erhöhten Risikos der Ruptur der Sehne des M. supraspinatus bei Arbeiten auf oder über Schulterniveau. Weiterhin besteht ein Potential für eine primäre Prävention, indem Arbeiten auf oder über Schulterniveau möglichst ganz vermieden wird. Daher sollte die Ruptur der Sehne des M. supraspinatus als eigene Berufskrankheit in die Liste der Berufskrankheiten aufgenommen und die Betroffenen bei kumulativem Arbeiten von mindestens 3200 Stunden auf oder über Schulterniveau entschädigt werden.
Therapy of hemorrhagic shock with following resuscitation-induced liver injury : in vivo study
(2010)
Shock resulting from life-threatening blood-loss (hemorrhagic shock) represents the most frequent injury pattern after a traumatic insult. Hemorrhagic shock induces inflammatory changes, characterized by highly complex pathophysiological pathways often resulting in death. In this study, we establish an experimental in vivo model of H/R in rats and study the mechanisms which determine the hepatic injury after H/R. Furthermore, we show that hemorrhagic shock with following resuscitation is accompanied with release of systemic and local pro-inflammatory mediators, increased infiltration of hepatic neutrophils in the liver, increased oxidative and nitrosative stress, enhanced cell death of both types, apoptosis and necrosis, conspicuous cytoskeletal rearrangements, loss of hepatic integrity and finally high general mortality rates, up to 80%. In addition, the effects of two potential therapeutic interventions to prevent the H/R induced liver injury are explored in a model of H/R in rats. First, the role of JNK and its inhibition by D-JNKI-1 in preservation of hepatic integrity following H/R was analyzed. Second, we investigated the potential of simvastatin to prevent the disturbed inflammatory response and hepatic injury after H/R. The effects of both therapeutic interventions were studied by looking at several inflammatory parameters, markers of oxidative and nitrosative stress, cytoskeleton integrity, microcirculatory parameters, underlying signaling cascades, liver damage and mortality. Highly specific blockade of JNK with the potent, inhibitory peptide D-JNKI-1 revealed the crucial role of the JNK signaling pathway in the H/R induced pathophysiology and strong protective effects of DJNKI- 1 in H/R induced liver injury, when the peptide was applied before and even after hemorrhagic shock. The other therapeutic intervention tested in this study was the use of simvastatin which also revealed protective effects after H/R and even a remarkable improvement in survival after H/R. We show that H/R induced release of pro-inflammatory cytokines, hepatic PMNL infiltration, increased oxidative and nitrosative stress, apoptosis and necrosis can be diminished by treatment with D-JNKI-1 but also with simvastatin in vivo. Furthermore, simvastatin reduces H/R induced cytoskelatal rearrangements, loss of liver integrity and the mortality rate after H/R. The key pathway which underlies these beneficial effects of simvastatin is the Rho kinase pathway. Identification of both mechanisms as well as the effectiveness of both substances provide new insights in the close interaction between hypoxia and the immune system and present a promising basis for the anti-inflammatory, hepatoprotective treatment after H/R.
Zur Korrektur der Myopie bietet die refraktive Chirurgie prinzipiell die Möglichkeiten entweder die Kornea zu modulieren oder eine phake Intraokularlinse einzusetzen. Bei der Beseitigung einer hochgradigen Myopie von über 6 dpt haben sich jedoch die pIOL durchgesetzt. Besonders irisfixierte Linsen weisen sehr gute Refraktionsergebnisse bei einem geringen Komplikationsprofil auf. Zwei Modelle der Artisan-Linse (optische Zone 5 mm n = 48, optische Zone 6 mm n = 264) wurden in 312 Augen von 176 hochgradig myopen Probanden in der Universitätsaugenklinik Frankfurt am Main eingesetzt. Die Untersuchung und Auswertung erfolgte hinsichtlich der Refraktionsqualität und Komplikationsrate. Zur Beurteilung der Refraktion wurden die Standardparameter der refraktiven Chirurgie (Sicherheit, Wirksamkeit, Vorhersagbarkeit und Stabilität) gemessen und analysiert. Bei Erhebung und Analyse des Komplikationsprofils wurde besonderes Augenmerk auf den Verlust der EZD gerichtet. Die Untersuchungen wurden präoperativ, nach einem Tag, einer Woche, einem Monat und anschließend im Jahresrhythmus durchgeführt. Der präoperative mittlere BKSM von 0,82 wurde bei keiner Folgeuntersuchung unterschritten, so dass der Sicherheitsindex stets über 1 betrug. Kein Patient verlor mehr als eine Zeile beim BKSM. Ein UKSM von 0,8 oder mehr wurde nach einem Jahr in 78%, nach zwei Jahren in 81%, nach drei Jahren in 76%, nach vier Jahren in 60% und nach fünf Jahren in 65% der Fälle beobachtet. Im Vergleich dazu betrug der präoperative BKSM bei 78% der Augen 0,8 oder mehr. Die Vorhersagbarkeit erwies sich innerhalb des gesamten Beobachtungszeitraums als sehr hoch. Bei vier der fünf Jahreskontrollen lagen alle Augen (98% bei der 3-Jahresuntersuchung) innerhalb einer Spannweite von ± 2 dpt und stets mindestens 86% der Augen innerhalb von ± 1 dpt der angestrebten refraktiven Korrektur. Das mittlere sphärische Äquivalent betrug präoperativ -11,24 ±4,46 dpt. Einen Monat nach der Implantation der irisfixierten Linse ergab sich ein Wert von -0,54 ±0,55 dpt. Es kam zu keinen größeren Veränderungen der Refraktion während des Nachbeobachtungszeitraums (Minimum: -0,78 dpt nach fünf Jahren; Maximum: -0,41 dpt nach einem Jahr). Im Mittel betrug die präoperative Endothelzellzahl 2751 ±331 Zellen/mm2 (2004 bis 3508) und verringerte sich durchschnittlich um 2,6% / Jahr auf 2387 ±322 Zellen/mm2 (1605 bis 3164) nach fünf Jahren. Bei Auswertung der EZD der konsekutiven Kohorte wurde an zwei Augen ein Verlust von über 30% registriert (34% bzw. 38%). An keinem Auge wurde ein intrastromales Korneaödem oder eine Trübung der Hornhaut festgestellt. Eine signifikante Assoziation zwischen Pigmentdispersion und erhöhtem intraokularem Druck konnte beobachtet werden (p = 0,047). Schwere Nebenwirkungen wie eine chronische Entzündung oder Glaukom sind nicht aufgetreten. An 9 Augen mußte eine Reenklavation erfolgen, ursächlich hierfür war in einem Fall eine Dezentrierung, in einem anderen eine Iritis und in den übrigen Fällen zu wenig eingehaktes Irisgewebe in den Linsenhaptiken. Eine Explantation war an keinem Auge indiziert. Um ein besseres Refraktionsergebnis zu erzielen, wurde in 21 Augen mittels LASIK und in 9 Augen mittels LRI nachkorrigiert. Diese Langzeitergebnisse der irisfixierten Linse zur Korrektur einer hochgradigen Myopie erweisen sich hinsichtlich Sicherheit, Wirksamkeit, Vorhersagbarkeit und Stabilität als sehr gut. Im Vergleich zum natürlichen Verlust der EZD ist dieser nach Einsatz der pIOL signifikant erhöht, so dass bei jüngeren Patienten strengere Ausschlusskriterien eingeführt werden sollten. Insgesamt erweist sich aber die irisfixierte Linse als eine sehr sichere und komplikationsarme Option zur Beseitigung einer hochgradigen Myopie.
One of the earliest and most striking observations made about HIV is the extensive genetic variation that the virus has within individual hosts, particularly in the hypervariable regions of the env gene which is divided into 5 variable regions (V1-V5) and 5 more constant (C1-C5) regions. HIV evolves at any time over the course of an individual’s infection and infected individuals harbours a population of genetically related but non-identical viruses that are under constant change and ready to adapt to changes in their environment. These genetically heterogeneous populations of closely related genomes are called quasispecies [65]. Tuberculosis or tubercle forming disease is an acute and/or chronic bacterial infection that primarily attacks the lungs, but which may also affect the kidneys, bones, lymph nodes, and brain. The disease is caused by Mycobacterium tuberculosis (MTB), a slow growing rod-shaped, acid fast bacterium. It is transmitted from person to person through inhalation of bacteria-carrying air droplets. Worldwide, one person out of three is infected with Mycobacterium tuberculosis – two billion people in total. TB currently holds the seventh place in the global ranking of causes of death [73]. In 2008, there were an estimated 9.4 (range, 8.9–9.9 million) million incident cases (equivalent to 139 cases per 100 000 population) of TB globally [75]. A complex biological interplay occurs between M. tuberculosis and HIV in coinfected host that results in the worsening of both pathologies. HIV promotes progression of M. tuberculosis either by endogenous reactivation or exogenous reinfection [77, 78] and, the course of HIV-1 infection is accelerated subsequent to the development of TB [80]. Active TB is associated with an increase in intra-patient HIV-1 diversity both systemically and at the infected lung sites [64,122]. The sustainability or reversal of the HIV-1 quasispecies heterogeneity after TB treatment is not known. Tetanus toxoid vaccinated HIV-1 infected patients developed a transient increase in HIV-1 heterogeneity which was reversed after few weeks [121]. Emergence of a heterogeneous HIV-1 population within a patient may be one of the mechanisms to escape strong immune or drug pressure [65,128]. The existence of better fitting and/or immune escape HIV-variants can lead to an increase in HIV-1 replication [129,130]. It might be that TB favourably selected HIV-1 variants which are sources for consistent HIV-1 replication. Understanding the mechanisms underlying the impacts of TB on HIV-1 is essential for the development of effective measures to reduce TB related morbidity and mortality in HIV-1 infected individuals. In the present study we studied whether the increase in HIV-1 quasispecies diversity during active TB is reversed or preserved throughout the course of antituberculous chemotherapy. For this purpose Two time point HIV-1 quasispecies were evaluated by comparing HIV-1 infected patients with active tuberculosis (HIV-1/TB) and HIV-1 infected patients without tuberculosis (HIV-1/non TB). Plasma samples were obtained from the Frankfurt HIV cohort and HIV-1 RNA was isolated. C2V5 env was amplified by PCR and molecular cloning was performed. Eight to twenty five clones were sequenced from each patient. Various phylogenetic analyses were performed including tree inferences, intra-patient viral diversity and divergence, selective pressure, co-receptor usage prediction and two time point identity of quasispecies comparison using Mantel’s test. We found out from this study that: 1) Active TB sustains HIV-1 quasispecies diversity for longer period 2. Active TB increases the rate of HIV-1 divergence 3) TB might slow down evolution of X4 variants And we concluded that active TB has an impact on HIV-1 viral diversity and divergence over time. The influence of active TB on longitudinal evolution of HIV- 1 may be predominant for R5 viruses. The use of CCR5-coreceptor inhibitors for HIV-1/TB patients as therapeutic approach needs further investigation.
Background: New drugs are constantly sought after to improve the survival of patients with malignant gliomas. The ideal substance would selectively target tumor cells without eliciting toxic side effects. Here, we report on the anti-proliferative, anti-migratory, and anti-invasive properties of the natural, nontoxic compound Curcumin observed in five human glioblastoma (GBM) cell lines in vitro. Methods: We used monolayer wound healing assays, modified Boyden chamber trans-well assays, and cell growth assays to quantify cell migration, invasion, and proliferation in the absence or presence of Curcumin at various concentrations. Levels of the transcription factor phospho-STAT3, a potential target of Curcumin, were determined by sandwich-ELISA. Subsequent effects on transcription of genes regulating the cell cycle were analyzed by quantitative real-time PCR. Effects on apoptosis were determined by caspase assays. Results: Curcumin potently inhibited GBM cell proliferation as well as migration and invasion in all cell lines contingent on dose. Simultaneously, levels of the biologically active phospho-STAT3 were decreased and correlated with reduced transcription of the cell cycle regulating gene c-Myc and proliferation marking Ki-67, pointing to a potential mechanism by which Curcumin slows tumor growth. Conclusions: Curcumin is part of the diet of millions of people every day and is without known toxic side effects. Our data show that Curcumin bears anti-proliferative, anti-migratory, and anti-invasive properties against GBM cells in vitro. These results warrant further in vivo analyses and indicate a potential role of Curcumin in the treatment of malignant gliomas.
Östlich des Rwenzori Gebirges im Westen Ugandas wurden magnetotellurische Messungen durchgeführt. An 23 Stationen wurden Übertragungsfunktionen und Phasen Tensor Elemente zwischen den gemessenen magnetischen- und tellurischen Feldern im Periodenbereich von 10s bis 10000s geschätzt. Die Übertragungsfunktionen deuten eine komplexe drei dimensionale Leitfähigkeitsstruktur innerhalb der Kruste an, insbesondere in der Verbindungszone zwischen dem Rwenzori Gebirge und der östlichen Riftschulter. In dieser Arbeit wird eine alternative Darstellung der Phasen Tensor Ellipsen als Balken eingeführt. Für Perioden größer 100s zeigen die maximalen Phasen der Phasen Tensor Balken aller Stationen einheitlich in SSW-NNE und die Phasen Tensor Invarianten f min und f max weisen eine Differenz von mindestens 20° auf. Dieses auffällige Verhalten und die kleinen vertikalen magnetischen Feldr im gleich Periodenbereich kann mit einer anisotropen Leitfähigkeit in einer Tiefenbereich zwischen 30-50km mit der gut leitenden Richtung senkrecht zur Riftachse erklärt werden. Die Anisotropie könnte ihren Ursprung in orientierten Olivien Kristallen im oberen Mantel haben, wobei die Orientierungsrichtung mit der Delamination der Unterkruste unter den Rwenzoris zusammen hängen kann. Eine gut leitende Zone süd-östlich der Rwenzoris wurde in 15km Tiefe gefunden, die mit einer seismischen low velocity zone übereinstimmt und partielle Schmelzen innerhalb der Kruste andeutet. An allen Stationen steigt die minimale Phase bei der Periode 200s über 45° und zeigt einen Anstieg der elektrischen Leitfähigkeit unterhalb der Lithosphäre an.
This dissertation introduces in chapter 1 a new comparative approach to model-based research and policy analysis by constructing an archive of business cycle models. It includes many well-known models used in academia and at policy institutions. A computational platform is created that allows straightforward comparisons of models’ implications for monetary and fiscal stabilization policies. Chapter 2 applies business cycle models to forecasting. Several New Keynesian models are estimated on historical U.S. data vintages and forecasts are computed for the five most recent recessions. The extent of forecast heterogeneity for models and professional forecasts is analysed. Chapter 3 extends the forecasting analysis to a long sample and to the evaluation of density forecasts. Weighted forecasts are computed using a variety of weighting schemes. The accuracy of forecasts is evaluated and compared to professional forecasts and forecasts from nonstructural time series methods. Chapter 4 adds a new feature to existing business cycle models. Specifically, a medium-scale New Keynesian model is constructed that allows for strategic complementarities in price-setting. The role of trade integration for monetary policy transmission is explored. A new dimension of the exchange rate channel is highlighted by which monetary policy directly impacts domestic inflation. Chapter 5 tests whether simple symmetric monetary policy rules used in most business cycle models are a sufficient description of reality. I use quantile regressions to estimate policy parameters and find asymmetric reactions to inflation, the output gap and past interest rates.
Zeit und Antike
(1926)
Thema der vorliegenden Studie ist die Evaluation der Betazellfunktion bei Patienten mit Diabetes mellitus Typ 2, für deren Bestimmung es bisher keine einfach anwendbare Methode gibt. Die Clamp-Methode erfordert eine kontinuierliche Überwachung und ist daher nicht geeignet für die Anwendung in der täglichen Klinikroutine. Nateglinide ist ein Derivat der Aminosäure D-Phenylalanin, das durch direkte Wirkung an den Betazellen der Langerhanns’schen Inseln des Pankreas die Insulinsekretion vor allem in der frühen Phase der Freisetzung stimuliert. Ziel der Arbeit war die Überprüfung eines Nateglinide-stimulierten oralen Glucosetole-ranztests als Instrument zur ambulanten Bestimmung der stimulierbaren Betazellkapa-zität sowie sekundär die Bestimmung von Grenzwerten für Blutzucker und Insulinsek-retion für die Entscheidung der Therapieeskalation einer oralen Therapie hin zu einer Insulin(unterstützten) Therapie. Im Rahmen dieser Studie führten wir an 30 gesunden Kontrollpersonen und 45 Patien-ten mit Diabetes mellitus Typ 2, die entweder diätetisch oder mit oralen Antidiabetika behandelt wurden, einen modifizierten oralen Glucosetoleranztest (50g) von dreistün-diger Dauer durch, der mit der Gabe von 120mg Nateglinide kombiniert wurde. Es erfolgte die Bestimmung der Basalwerte von Glucose, Insulin und C-Peptid sowie der Spiegel nach 30, 60, 120 und 180 Minuten. Aus den Ergebnissen wurden der HOMA-IR, HOMA-ß-cell-Index sowie die AUC von Insulin, C-Peptid und Glucose bestimmt. Die gesunden Kontrollpersonen wiesen zu allen Testzeitpunkten signifikant niedrigere Glucosewerte auf als die Patienten mit Typ-2-Diabetes (Maximum Glucose: 125,05±25,97 vs. 234,78±64,58mg/dl, p<0,001 und AUC Glucose: 15197,25±2798,9 vs. 34022,05±11142,17mg/dl, p=0,02), die zudem ihr Blutzuckermaximum zu einem späteren Testzeitpunkt erreichten (35,25±17,61 vs. 63,33±31,76 min, p<0,001). Zum Testzeitpunkt 120 Minuten konnte bei 18 Patienten mit Typ-2-Diabetes ein norm-wertiger Blutglucosespiegel <120mg/dl bestimmt werden, 7 hatten Werte vereinbar mit einer IGT und 20 wiesen diabetische Blutglucosespiegel >200mg/dl auf. Es fiel eine signifikante Korrelation vom Zeitpunkt der maximalen Insulinsekretion und dem Blutglucosemaximum auf. Je später der Zeitpunkt der maximalen Insulin- bzw. C-Peptid-Sekretion erreicht wird, desto höher ist die maximale Blutglucosekonzentration. Adipöse Patienten (BMI >30kg/m2) hatten während des gesamten Testverlaufs höhere Blutglucosewerte und eine geringere stimulierbare Insulinsekretionsleistung als die Patienten mit einem niedrigeren BMI. Die untersuchten Patienten mit Typ-2-Diabetes lassen sich in drei Gruppen unterteilen: eine mit vorherrschendem Insulinsekretionsdefizit (Maximum C-Peptid <4ng/ml, n=6), eine mit führender Insulinresistenz (HOMA-IR>2,5, n=16) und eine Gruppe mit einer Kombination aus beiden Störungen (n=3). Die Patienten mit kombinierter Störung hat-ten einen höheren HbA1c als die anderen Gruppen (10,2%±2,38 vs. 6,66%±0,46 und 6,91%±1,24, n.s.) und wiesen über den gesamten Testverlauf höhere Blutglucosewerte auf. Mit dem Ziel, eine Hilfestellung bei der Entscheidung einer Therapieintensivierung bzw. –umstellung auf eine Insulintherapie zu geben, wurde ein Score aufgestellt, der die Parameter Blutzuckerspiegel zum Testzeitpunkt 120 min, maximaler C-Peptidspiegel, HOMA-IR sowie den Steigerungsfaktor von basalem zu maximalem C-Peptidspiegel umfasst. Beurteilt anhand der dort erreichten Punktzahl zeigen einerseits 23 der unter-suchten Patienten ein suffizientes Ansprechen auf die orale antihyperglykämische The-rapie, was die Fortführung der oralen Diabetestherapie unterstützt. Andererseits er-reichten auch 6 Patienten einen Punktebereich, bei dem von einer unzureichenden Betazellsekretion auszugehen ist und somit ein hohes Risiko für ein Sekundärversagen der oralen Diabetestherapie besteht, so dass eine Therapieumstellung auf eine Insu-lin(unterstützte) Therapie empfohlen wird. Basierend auf der limitierten Anzahl an Daten, die wir erhoben haben, empfehlen wir die Umstellung auf eine Insulintherapie, wenn im Nateglinide-Test mindestens drei der folgenden vier Punkte zutreffen: • Blutglucose zum Zeitpunkt 120min >200mg/dl • HOMA-IR >4 • Maximales C-Peptid <4ng/ml • Stimulierte C-Peptid-Steigerung <2fach Die hiesige Studie zeigt, dass der Nateglinide-Test ein in der täglichen Klinikroutine praktikables Instrument zur Evaluation der residualen Betazellfunktion darstellt. Er er-möglicht die gleichzeitige Beurteilung der noch vorhandenen Insulinsekretionskapazität und der Insulinresistenz bei Patienten mit Typ-2-Diabetes. In Kombination mit dem vorgestellten Score kann er helfen, eine Progression des Diabetes mellitus Typ 2 zu verhindern, indem der Zeitpunkt für den Beginn einer Insulintherapie genauer definiert wird.
In the following Magisterarbeit I am going to develop a Concept Empiricist model of conceptual thought, which is in its technical core primarily inspired and motivated by Larry Barsalou‘ s Perceptual Symbol Systems Theory (PSST) (1999, 2008a). But it is not a theory of concepts in the genuine sense only, but it also expands naturally on related topics like the ontology of mind and the problem of intentionality. This is not arbitrarily chosen, but a natural consequence of any contemporary Concept Empiricist theory, for those theories are in kind direct outgrowths of an embodied approach to cognition which yields these consequences – the natural extension to related topics – as will be shown. The roadmap for the Magisterarbeit is going to look like this: First I will delineate the embodied cognition framework. Within embodied cognition there is a plethora of differing attempts at explaining the diverse phenomena of higher and lower cognition which differ in the meanwhile tremendously from each other. Therefore it will be very useful to set clear boundaries between the differing approaches, which range from strong neural embodiment on the one side to a very promiscuous extended mind hypothesis on the other side, in order to make a clear case for Concept Empiricism. It will be also very helpful to set my favoured version of grounded cognition off against classical attempts at the phenomena which are to be explained. Following that I am going to present Larry Barsalou‘s Perceptual Symbol Systems Theory in more detail. I will do that to an extent which allows for an appropriate discussion of concept related phenomena, but which is not too lengthy. I will spare the reader with unnecessary psychological or neurobiological details as long as it is not really necessary for explaining or clarifying the phenomena with which I deal here. Having done this I will discuss at great length conceptual meaning. In doing so I will present a presentational theory of meaning which is anti-realist, internalist and imaginistic. In advertising for this theory I will recur to conceptual methods, intuition as well as to the empirical record. Next and related to this I will develop a resemblance based theory of intentionality which differs also widely from the already established theories of intentionality so far given. Indeed it possess a feature which makes it very distinct and this is, besides its reliance on pattern mapping, the statistical grounding of resemblance which allows a cognitive theory of resemblance which is definite and therefore not open to the counterarguments generally mashalled against related theories, which stress the importance of resemblance. A very distinctive feature of this theory of intentionality is additionally that intentionality is seen as a capacity which emerges naturally form the mental mechanism involved. As we will see, this is a distinctive advantage of it in comparison to other proposal in the field. A discussion of the ontology of mental states follows which is however primarily a discussion of mechanistic explanations and Bechtel‘s and McCauley‘s Heuristic Identity Theory (HIT). Those theories from philosophy of science and philosophy of cognitive science do not only deliver models for the ontology of mental states, but also epistemic criteria for evaluating a theory as superior or inferior. Especially the idea of productive continuity plays a role of pivotal importance in my Magisterarbeit. It might be a bit unfortunate that that an important consideration is discussed nearly at the end of the Magisterarbeit, since I refer to it very often, however, I considered it as equally unfortunate to delay the discussion of meaning and intentionality, which is already protruded by the overview chapter and the more technical parts, even more. Therefore I plead the reader to refer to later parts of the Magisterarbeit when it is necessary in order to understand earlier parts. In the course of writing I have gotten second thoughts regarding the adequacy of an ontology of mental states altogether, especially from the background of the theory of meaning and intentionality delivered here. Therefore I tried to accommodate for ontological concepts by means of a tentative phenomenological interpretation of them. Similar ideas influenced my deliberations regarding meaning too. I hope that this transition towards Phenomenology runs smoothly and that the high level of coherence which is my primary concern and something which I always strive for first is preserved. Further, I have dedicated a main chapter of the Magisterarbeit for possible and actual critics of the ideas brought forth by me. Besides the more classic standard objections there you can find a recent critique of the authors on which I refer most often. Naturally I try to refute any single criticism brought forth and I hope that the reader will approve my objection to the objections. I will round off the Magisterarbeit with some concluding remarks and prospects for future research.
Die vorliegende Untersuchung vergleicht den politischen Sprachgebrauch von CDU, SPD, Bündnis90/DIE GRÜNEN sowie deren Jugendorganisationen während der 13. Wahlperiode (1994-1998). Unter Verwendung einer computergestützten Textanalysemethode wird dazu ein Textcorpus, bestehend aus 18 parteiprogrammatischen Äußerungen, auf sprachliche Strategien der Persuation und Verhaltensteuerung hin untersucht. Im Kern der Untersuchung steht die Frage, welche sprachlichen Werkzeuge Parteien verwenden, um die Wahlentscheidung junger Wähler und Erstwähler zu beeinflussen. So können Modalverben auf appellative Strukuren verweisen, Konjunktionen (aber , dennoch) ein Indiz für eine dogmatische Denkweise sein, Personal- und Possesivpronomen über Distanziertheit, Verbundenheit und den Gruppenbezug Auskunft erteilen. Inhaltliche Nähe zu den zentralen Problemfelder der Jugendlichen erhebt der Vergleich mit den Ergebnissen der 12. Shell-Jugendstudie des Jahres 1997.
Background: The faunal and floral relationship of northward-drifting India with its neighboring continents is of general biogeographic interest as an important driver of regional biodiversity. However, direct biogeographic connectivity of India and Southeast Asia during the Cenozoic remains largely unexplored. We investigate timing, direction and mechanisms of faunal exchange between India and Southeast Asia, based on a molecular phylogeny, molecular clock-derived time estimates and biogeographic reconstructions of the Asian freshwater crab family Gecarcinucidae. Results: Although the Gecarcinucidae are not an element of an ancient Gondwana fauna, their subfamily Gecarcinucinae, and probably also the Liotelphusinae, evolved on the Indian Subcontinent and subsequently dispersed to Southeast Asia. Estimated by a model testing approach, this dispersal event took place during the Middle Eocene, and thus before the final collision of India and the Tibet-part of Eurasia. Conclusions: We postulate that the India and Southeast Asia were close enough for exchange of freshwater organisms during the Middle Eocene, before the final Indian--Eurasian collision. Our data support geological models that assume the Indian plate having tracked along Southeast Asia during its move northwards.
Background: Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has proposed a framework for the development and evaluation of complex interventions that will be used to develop and evaluate a primary care-based complex care management program for chronically ill patients at high risk for future hospitalization in Germany. Methods and design: We present a multi-method procedure to develop a complex care management program to implement interventions aimed at reducing potentially avoidable hospitalizations for primary care patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, or chronic heart failure and a high likelihood of hospitalization. The procedure will start with reflection about underlying precipitating factors of hospitalizations and how they may be targeted by the planned intervention (pre-clinical phase). An intervention model will then be developed (phase I) based on theory, literature, and exploratory studies (phase II). Exploratory studies are planned that entail the recruitment of 200 patients from 10 general practices. Eligible patients will be identified using two ways of 'case finding': software based predictive modelling and physicians' proposal of patients based on clinical experience. The resulting subpopulations will be compared regarding healthcare utilization, care needs and resources using insurance claims data, a patient survey, and chart review. Qualitative studies with healthcare professionals and patients will be undertaken to identify potential barriers and enablers for optimal performance of the complex care management program. Discussion: This multi-method procedure will support the development of a primary care-based care management program enabling the implementation of interventions that will potentially reduce avoidable hospitalizations.
The central difference between objectivist cognitivist semantics and embodied cognition consists in the fact that the latter is, in contrast to the former, mindful of binding meaning to context-sensitive mental systems. According to Lakoff/Johnson's experientialism, conceptual structures arise from preconceptual kinesthetic image-schematic and basic-level structures. Gallese and Lakoff introduced the notion of exploiting sensorimotor structures for higherlevel cognition. Three different types of X-schemas realise three types of environmentally embedded simulation: Areas that control movements in peri-personal space; canonical neurons of the ventral premotor cortex that fire when a graspable object is represented; the firing of mirror neurons while perceiving certain movements of conspecifics. ...
In the present work, the problem of protein folding is addressed from the point of view of equilibrium thermodynamics. The conformation of a globular protein in solution at common temperatures is quite complicated without any geometrical symmetry, but it is an ordered state in the sense of its biological activity. This complicated conformation of a single protein molecule is destroyed upon increasing the temperature or by the addition of appropriate chemical agents, as is revealed by the loss of its activity and change of the physical properties, and so on. Once the complicated native structures having biological activity are lost, it would be natural to suppose that the native structure could hardly be restored. Nevertheless, pioneers, such as Anson and Mirsky, recognized as early as in 1925 that this was not always the case. If one defines the folded and unfolded states of a protein as two distinct phases of a system, then under the variation of temperature the system is transformed from one phase state into another and vice versa. The process of protein folding is accompanied by the release or absorption of a certain amount of energy, corresponding to the first-oder-type phase transitions in the bulk. Knowing the partition function of the system one can evaluate its energy and heat capacity under different temperatures. This task was performed in this work. The results of the developed statistical mechanics model were compared with the results of molecular dynamic simulations of alanine poylpeptides. In particular, the dependencies on temperature of the total energy of the system and heat capacity were compared for alanine polypeptides consisting of 21, 30, 40, 50 and 100 amino acids. The good correspondence of the results of the theoretical model with the results of molecular dynamics simulations allowed to validate the assumptions made about the system and to establish the accuracy range of the theory. In order to perform the comparison of the results of theoretical model and the molecular dynamics simulations it is necessary to perform the efficient analysis of the results of molecular dynamics simulations. This task was also addressed in the present work. In particular, different ways to obtain dependence of the heat capacity on temperature from molecular dynamics simulations are discussed and the most efficient one is proposed. The present thesis reports the result of molecular dynamic simulations for not only alanine polypeptides by also for valine and leucine polypeptides. In valine and leucine polypeptides, it is also possible to observe the helix↔random coil transitions with the increase of temperature. The current thesis presents a work that starts with the investigation of the fundamental degrees of freedom in polypeptides that are responsible for the conformational transitions. Then this knowledge is applied for the statistical mechanics description of helix↔coil transitions in polypeptides. Finally, the theoretical formalism is generalized for the case of proteins in water environment and the comparison of the results of the statistical mechanics model with the experimental measurements of the heat capacity on temperature dependencies for two globular proteins is performed. The presented formalism is based on fundamental physical properties of the system and provides the possibility to describe the folding↔unfolding transitions quantitatively. The combination of these two facts is the major novelty of the presented approach in comparison to the existing ones. The “transparent” physical nature of the formalism provides a possibility to further apply it to a large variety of systems and processes. For instance, it can be used for investigation of the influence of the mutations in the proteins on their stability. This task is of primary importance for design of novel proteins and drug delivering molecules in medicine. It can provide further insights into the problem of protein aggregation and formation of amyloids. The problem of protein aggregation is closely associated with various illnesses such as Alzheimer and mad cow disease. With certain modifications, the presented theoretical method can be applied to the description of the protein crystallization process, which is important for the determination of the structure of proteins with X-Rays. There many other possible applications of the ideas described in the thesis. For instance, the similar formalism can be developed for the description of melting and unzipping of DNA, growth of nanotubes, formation of fullerenes, etc.
Das Ziel dieser retrospektiven Untersuchung ist, die medikamentöse Therapie des neonatalen Entzugsyndroms mittels Clonidin und Chloralhydrat mit der sehr häufig angewendeten Kombinationstherapie aus Morphin und Phenobarbital zu vergleichen. Im dem Zeitraum zwischen 1998 und 2008 wurden in unserer Klinik 133 Neugeborene mit einem neonatalen Entzugssyndrom behandelt. Bei allen Patienten handelte es sich um Neugeborene drogenabhängiger Mütter, welche während der Schwangerschaft mit Methadon substituiert wurden. Bei 29 Patienten wurde eine Therapie mit Clonidin und Chloralhydrat und bei 64 Patienten eine Entzugstherapie mittels Morphin und Phenobarbital durchgeführt. In der Clonidingruppe konnte eine signifikant kürzere Behandlungsdauer (Median: 14 d vs. 35 d) festgestellt werden. Entsprechend war auch die gesamte Aufenthaltsdauer in der Clonidingruppe deutlich kürzer (Median: 32 d vs. 44 d). Außerdem konnte in der Clonidingruppe ein deutlich milderer Verlauf der Entzugssymptomatik festgestellt werden.