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La investigación sobre el desarrollo y la vida del derecho canónico en la América hispánica se ha visto enriquecida por la edición de los documentos de trabajo del Tercer Concilio Provincial Mexicano, celebrado en 1585. Esta monografía presenta las líneas de investigación que el autor está llevando a cabo en su tesis doctoral, confrontando los decretos promulgados con su iter redaccional de acuerdo a la información suministrada por los manuscritos editados. Los pedidos y memoriales presentados al concilio provincial pueden ser analizados, junto con la misma tarea legislativa, como un modo de resolución de conflictos por parte de la autoridad eclesiástica y su potestad de acuerdo con el derecho canónico entonces vigente.
New Zealand species of Iphimediidae, Amphipoda, are revised. Based on new material from the Chatham Rise, east of New Zealand, two new species are described in detail: Labriphimedia meikae sp. nov. and Labriphimedia martinae sp. nov. A key to the six species belonging to three genera of New Zealand Iphimediidae is provided.
Cytoprotective functions of amyloid precursor protein family members in stress signaling and aging
(2013)
Poster presentation: Molecular Neurodegeneration: Basic biology and disease pathways Cannes, France. 10-12 September 2013.
Background: The amyloid precursor protein (APP) is processed via two different metabolic pathways: the amyloidogenic and the non-amyloidogenic pathway, the latter of which leading to generation of the secreted N-terminal APP fragment sAPPα [1]. Previous studies from our group suggest that sAPPα exerts potent neuroprotective effects and inhibits stress-triggered cell death via modulation of gene expression, as well as by antagonizing different types of neurotoxic stress [2]. It was also observed that the biochemical processing of APP is downregulated during aging which in turn reduced the secretion of sAPPα [3]. Based on these observations, we have studied the potential physiological function of sAPPα/APP and APLPs (APP like proteins) on the regulation of age-associated, stress induced signaling pathways, apoptosis and senescence.
Materials and methods: SH-SY5Y, PC12, IMR90 cells were used as cellular models. Depletion of APP, APLP1 (APP like protein 1) and APLP2 (APP like protein 2) in SH-SY5Y cells was achieved by stable lentiviral knockdown. To analyze the protective function of sAPPα, we have used conditioned supernatants of wild type APP overexpressing HEK cells and recombinant His-tagged sAPPα purified from yeast. The cells were treated with sAPPα prior to the addition of different stress stimuli (MG132, epoxomicin, UV, H2O2) after which cell death, gene expression and senescence were analyzed by MTT assays, caspase activity assays, Western blots and X-Gal staining respectively.
Results: Our data show that sAPPα can antagonize premature senescence induced by repetitive short term induction of proteasomal stress in IMR-90 cells and apoptosis triggered by prolonged proteasomal stress and other death stimuli in PC12, SH-SY5Y and IMR90 cells which was accompanied by a sAPPα-dependent inhibition of the JNK stress signaling pathway. In contrast, no significant changes in cell viability and apoptosis were observed when APP knockdown cells were pretreated with sAPPα.
Conclusions: Our observations suggest that sAPPα can antagonize both apoptosis and cellular senescence and requires expression of holo-APP to mediate its cytoprotective effects. They also support the notion that the physiological function of APP is linked to modulation of neuronal and brain aging.
Artificial environments for the co-translational stabilization of cell-free expressed proteins
(2013)
An approach for designing individual expression environments that reduce or prevent protein aggregation and precipitation is described. Inefficient folding of difficult proteins in unfavorable translation environments can cause significant losses of overexpressed proteins as precipitates or inclusion bodies. A number of chemical chaperones including alcohols, polyols, polyions or polymers are known to have positive effects on protein stability. However, conventional expression approaches can use such stabilizing agents only post-translationally during protein extraction and purification. Proteins that already precipitate inside of the producer cells cannot be addressed. The open nature of cell-free protein expression systems offers the option to include single chemicals or cocktails of stabilizing compounds already into the expression environment. We report an approach for systematic screening of stabilizers in order to improve the solubility and quality of overexpressed proteins co-translationally. A comprehensive list of representative protein stabilizers from the major groups of naturally occurring chemical chaperones has been analyzed and their concentration ranges tolerated by cell-free expression systems have been determined. As a proof of concept, we have applied the method to improve the yield of proteins showing instability and partial precipitation during cell-free synthesis. Stabilizers that co-translationally improve the solubility and functional folding of human glucosamine 6-phosphate N-acetyltransferase have been identified and cumulative effects of stabilizers have been studied.
Liveblog München, 3. Februar
(2013)
Live von der Münchner Sicherheitskonferenz bloggen hier Christopher Daase, Tobias Bunde, Thomas Mohr und Ingo Henneberg und von der Friedenskonferenz Hans Georg Klee und das SiPoBlog–Team. Weitere Informationen gibt es hier. Die Kommentarfunktion ist natürlich zusätzlich geöffnet für alle.
Die Sicherheitskonferenz beginnt wieder um 9h mit einer Session zu aktuellen Krisen (Mali, Syrien). Bei der Friedenskonferenz ist um 11.30h das Friedensgebet angesetzt.
Liveblog München, 2. Februar
(2013)
Liveblog München, 1. Februar
(2013)
Live von der Münchner Sicherheitskonferenz bloggen hier Christopher Daase, Tobias Bunde, Thomas Mohr und Ingo Henneberg und von der Friedenskonferenz Hans Georg Klee und euer SiPo-Team. Weitere Informationen gibt es hier. Die Kommentarfunktion ist natürlich weiterhin offen.Die Sicherheitskonferenz wird um 15h eröffnet, erste Eindrücke unten.
Das Internet ist ja per definitionem ein eher unordentlicher Ort. Das finden alle genau dann gut, wenn sich 14jährige Mädchen in Pakistan dadurch ausdrücken und emanzipieren können (auch wenn sich hinter einer solchen internet persona gerne mal ein alter weißer Mann verbirgt). Eher schlecht findet man es dagagen, wenn sich auch Fundamentalisten jeglicher couleur diese Freiheit im Netz zunutze machen. Da wollen die Innen- und Familienminister dieser Welt gleich regulieren, überwachen und strafen, doch… siehe oben. Zwischen diesen beiden Extrempolen pendeln sich die meisten Debatten über das Für und Wider der Internetnutzung ein. Auch in der Geisteswissenschaft – und dies hieß im konkreten Fall überwiegend: der Geschichtswissenschaft, wie wir auf einer Tagung in München feststellen konnten...
Humanitäre Interventionen sind seit den neunziger Jahren wiederkehrend im Fokus öffentlicher wie wissenschaftlicher Debatten. Erklärungen, warum sich Staaten entschließen, unabhängig von geopolitischen Interessen humanitäre Interventionen zu fordern oder sich an ihnen zu beteiligen, bleiben nach wie vor umstritten. Geteilte Moralvorstellungen und die Bereitstellung eines Handlungsrahmens für die Umsetzungspraxis sind zwei zentrale Analysedimensionen einer internationalen, humanitäre Interventionen befördernden Sicherheitskultur. Eine Normentwicklung kann in diesem Sinne nur in der Kombination mit tatsächlicher Akteurspraxis und medial-öffentlicher Aufmerksamkeit verstanden und beurteilt werden.
Im Rahmen eines umfangreichen Projekts zu Übersetzungsmöglichkeiten der deutschen Modalverben ins Portugiesische – und nachdem wir schon den Fall sollen behandelt haben (siehe Hörster/Athayde/Carecho 2011) – stellen wir in dieser Studie einige wesentliche Ergebnisse unserer Untersuchung bezüglich des Modalverbs müssen dar. Ziel unserer Arbeit war nicht die semantische und pragmatische Beschreibung der einzelnen Modalverben, ein Thema, das immer wieder im Mittelpunkt der wissenschaftlichen Diskussion steht. Vielmehr war es unsere Absicht, einen Beitrag zur zweisprachigen Lexikografie, zur Fremdsprachendidaktik und vor allem zur Übersetzungsdidaktik zu leisten.
Objectives Tumour recurrence of glioblastoma multiforme (GBM) after initial treatment with surgical resection, radiotherapy and chemotherapy is an inevitable phenomenon. This retrospective cohort study compared the efficacy of interstitial high dose rate brachytherapy (HDR-BRT), re-resection and sole dose dense temozolomide chemotherapy (ddTMZ) in the treatment of recurrent glioblastoma after initial surgery and radiochemotherapy.
Design Retropective cohort study.
Setting Primary level of care with two participating centres. The geographical location was central Germany.
Participants From January 2005 to December 2010, a total of 111 patients developed recurrent GBM after initial surgery and radiotherapy with concomitant temozolomide. The inclusion criteria were as follows: (1) histology-proven diagnosis of primary GBM (WHO grade 4), (2) primary treatment with resection and radiochemotherapy, and (3) tumour recurrence/progression.
Interventions This study compared retrospectively the efficacy of interstitial HDR-BRT, re-resection and ddTMZ alone in the treatment of recurrent glioblastoma.
Primary and secondary outcome measures Median survival, progression free survival and complication rate.
Results Median survival after salvage therapy of the recurrence was 37, 30 and 26 weeks, respectively. The HDR-BRT group did significantly better than both the reoperation (p<0.05) and the ddTMZ groups (p<0.05). Moderate to severe complications in the HDR-BRT, reoperation and sole chemotherapy groups occurred in 5/50 (10%), 4/36 (11%) and 9/25 (36%) cases, respectively.
Conclusions CT-guided interstitial HDR-BRT attained higher survival benefits in the management of recurrent glioblastoma after initial surgery and radiotherapy with concurrent temozolomide in comparison with the other treatment modalities. The low risk of complications of the HDR-BRT and the fact that it can be delivered percutaneously in local anaesthesia render it a promissing treatment option for selected patients which should be further evaluated.
Persistent neuropathic pain is a frequent consequence of peripheral nerve injuries, particularly in the elderly. Using the IntelliCage we studied if sciatic nerve injury obstructed learning and memory in young and aged mice, each in wild type and progranulin deficient mice, which develop premature signs of brain aging. Both young and aged mice developed long-term nerve injury-evoked hyperalgesia and allodynia. In both genotypes, aged mice with neuropathic pain showed high error rates in place avoidance acquisition tasks. However, once learnt, these aged mice with neuropathic pain showed a significantly stronger maintenance of the aversive memory. Nerve injury did not affect place preference behavior in neither genotype, neither in young nor aged mice. However, nerve injury in progranulin deficient mice impaired the learning of spatial sequences of awarded places, particularly in the aged mice. This task required a discrimination of clockwise and anti-clockwise sequences. The chaining failure occurred only in progranulin deficient mice after nerve injury, but not in sham operated or wildtype mice, suggesting that progranulin was particularly important for compensatory adaptations after nerve injury. In contrast, all aged mice with neuropathic pain, irrespective of the genotype, had a long maintenance of aversive memory suggesting a negative alliance and possibly mutual aggravation of chronic neuropathic pain and aversive memory at old age.
The inner structural Gag proteins and the envelope (Env) glycoproteins of human immunodeficiency virus (HIV-1) traffic independently to the plasma membrane, where they assemble the nascent virion. HIV-1 carries a relatively low number of glycoproteins in its membrane, and the mechanism of Env recruitment and virus incorporation is incompletely understood. We employed dual-color super-resolution microscopy visualizing Gag assembly sites and HIV-1 Env proteins in virus-producing and in Env expressing cells. Distinctive HIV-1 Gag assembly sites were readily detected and were associated with Env clusters that always extended beyond the actual Gag assembly site and often showed enrichment at the periphery and surrounding the assembly site. Formation of these Env clusters depended on the presence of other HIV-1 proteins and on the long cytoplasmic tail (CT) of Env. CT deletion, a matrix mutation affecting Env incorporation or Env expression in the absence of other HIV-1 proteins led to much smaller Env clusters, which were not enriched at viral assembly sites. These results show that Env is recruited to HIV-1 assembly sites in a CT-dependent manner, while Env(ΔCT) appears to be randomly incorporated. The observed Env accumulation surrounding Gag assemblies, with a lower density on the actual bud, could facilitate viral spread . Keeping Env molecules on the nascent virus low may be important for escape from the humoral immune response, while cell-cell contacts mediated by surrounding Env molecules could promote HIV-1 transmission through the virological synapse.
Within the last 30 years the role of nitrogen in Central European forests has changed fundamentally from limiting resource to environmental problem. As the retrospective tracking of nutrient availability by soil chemical and biogeochemical measurements faces serious problems, bioindication based on understorey species composition is indispensable for monitoring broad-scale eutrophication. Based on a broad survey of more than 100,000 forest vegetation plots accessible in electronic data-bases from Germany and adjacent countries, we calculated unweighted average Ellenberg nutrient values (mN) as a proxy of plant-available macronutrients. Based on the quantiles of the frequency distribution of mN in a regionally stratified sample, we define five trophic classes, which can be used to compare dimensionless mN values. We studied spatial patterns of average nutrient values within 17 regions and compared the periods from 1899 to 1975 and 1976 to 2006. After 1975 eutrophic (mN > 5.67) and hypertrophic (mN > 6.28) conditions were common everywhere except in the Alps and Saxony-Anhalt, but very oligotrophic conditions (mN < 3.44) were still widespread in regions with nutrient-poor bedrock. Before 1975 mN of plots had been lower than after 1975 in all but the southeastern regions. Between the pre- and post-1975 data the proportion of hypertrophic plots increased from 5.7 to 11.8%, and that of very oligo-trophic plots decreased from 14.6 to 8.3%. To remove bias resulting from uneven distribution, the dataset was stratified by five tree layer dominance types, period and region and resampled. In pre-1975 plots medians of mN increased in the order Pinus sylvestris, Quercus spp., Picea abies, Fagus sylvatica and Alnus spp, whereas the increase of mN was highest in forest types with historically low nutrient values. Therefore, the widespread change in mN must be attributed to the pronounced vegetation changes in Quercus and Pinus stands, indicating the importance of land-use change, i.e. recovery of nutrient cycles after hundreds of years of exploitation through coppicing, grazing and litter use. The analysis confirms eutrophication as a megatrend of modern vegetation change and demonstrates the high research potential of linking vegetation plot databases across large regions.
Diabetes is characterized by a dysregulation of glucose homeostasis and platelets from patients with diabetes are known to be hyper-reactive and contribute to the accelerated development of vascular diseases. Since many of the deleterious effects of glucose have been attributed to its metabolite methylgyloxal (MG) rather than to hyperglycemia itself, the aim of the present study was to characterize the effects of MG on platelet function. Washed human platelets were pre-incubated for 15 min with MG and platelet aggregation, adhesion on matrix-coated slides and signaling (Western blot) were assessed ex vivo. In vivo, the effect of MG on thrombus formation was determined using the FeCl3-induced carotid artery injury model. MG potentiated thrombin-induced platelet aggregation and dense granule release, but inhibited platelet spreading on fibronectin and collagen. In vivo, MG accelerated thrombus formation but decreased thrombus stability. At the molecular level, MG increased intracellular Ca2+ and activated classical PKCs at the same time as inhibiting PI3K/Akt and the β3-integrin outside-in signaling. In conclusion, these findings indicate that the enhanced MG concentration measured in diabetic patients can directly contribute to the platelet dysfunction associated with diabetes characterized by hyperaggregability and reduced thrombus stability.
Novel treatment options are needed for the successful therapy of patients with high-risk neuroblastoma. Here, we investigated the cyclin-dependent kinase (CDK) inhibitor SNS-032 in a panel of 109 neuroblastoma cell lines consisting of 19 parental cell lines and 90 sublines with acquired resistance to 14 different anticancer drugs. Seventy-three percent of the investigated neuroblastoma cell lines and all four investigated primary tumor samples displayed concentrations that reduce cell viability by 50% in the range of the therapeutic plasma levels reported for SNS-032 (<754 nM). Sixty-two percent of the cell lines and two of the primary samples displayed concentrations that reduce cell viability by 90% in this concentration range. SNS-032 also impaired the growth of the multidrug-resistant cisplatin-adapted UKF-NB-3 subline UKF-NB-3rCDDP1000 in mice. ABCB1 expression (but not ABCG2 expression) conferred resistance to SNS-032. The antineuroblastoma effects of SNS-032 did not depend on functional p53. The antineuroblastoma mechanism of SNS-032 included CDK7 and CDK9 inhibition-mediated suppression of RNA synthesis and subsequent depletion of antiapoptotic proteins with a fast turnover rate including X-linked inhibitor of apoptosis (XIAP), myeloid cell leukemia sequence 1 (Mcl-1), baculoviral IAP repeat containing 2 (BIRC2; cIAP-1), and survivin. In conclusion, CDK7 and CDK9 represent promising drug targets and SNS-032 represents a potential treatment option for neuroblastoma including therapy-refractory cases.
Two new colourful species of direct-developing frogs of the genus Pristimantis are described from the summit of two isolated tepuis (sandstone table mountains) in the Eastern Pantepui District of the Guiana Shield highlands. Pristimantis jamescameroni sp. nov. is described from the summit of Aprada-tepui from 2557-2571 m elevation, and P. imthurni sp. nov. is described from the summit of Ptaritepui at 2471 m elevation. Both species share the absence of a differentiated tympanic membrane and external tympanic annulus (but presence of tiny pharyngeal ostia), the presence of nuptial pads in males, and the presence of lateral fringes on fingers and toes, a combination of characters that immediately distinguishes them from all other known Pantepui congeners. The two new species are morphologically similar to each other and are phylogenetically closely related, but they can be distinguished based on colour pattern and morphological characters such as head proportions, dorsal skin texture, and condition of the supratympanic fold. The IUCN conservation status of the new species is considered as Endangered (EN) owing to their apparent very restricted ranges. The number of described Pristimantis species occurring exclusively on tepui (and faunistically related granitic mountains) summits and upper slopes now reaches eleven.
Insurance guarantee schemes aim to protect policyholders from the costs of insurer insolvencies. However, guarantee schemes can also reduce insurers’ incentives to conduct appropriate risk management. We investigate stock insurers’ risk-shifting behavior for insurance guarantee schemes under the two different financing alternatives: a flat-rate premium assessment versus a risk-based premium assessment. We identify which guarantee scheme maximizes policyholders’ welfare, measured by their expected utility. We find that the risk-based insurance guarantee scheme can only mitigate the insurer’s risk-shifting behavior if a substantial premium loading is present. Furthermore, the risk-based guarantee scheme is superior for improving policyholders’ welfare compared to the flat-rate scheme when the mitigating effect occurs.
Es wird allgemein vermutet, dass Klassenfahrten bei den Schülern nachhaltige Veränderungen bewirken können und nur wenige empirische Befunde belegen die Wirksamkeit von Klassenfahrten. Diese defizitäre Forschungslage aufgreifend, beschäftigt sich die vorliegende Arbeit mit der sozial-integrativen Wirkung einer sportbezogenen Klassenfahrt (Skifahrt) auf empirischer Grundlage.
Mit Hilfe der Desintegrationstheorie von Anhut & Heitmeyer (2000) lässt sich das Konstrukt „Integration“ in allgemeinerer Form über das antinomische Begriffspaar „Anerkennung vs. Ablehnung“ operationalisieren, wobei zwischen positionaler, moralischer und emotionaler Anerkennung bzw. Ablehnung unterschieden werden kann. Neben individuellen Merkmalen erfolgt die Vergabe und Verweigerung von Anerkennung über kollektive Merkmale, die auf Zugehörigkeit zu einer Gruppe beruht. Im pädagogischen Kontext der Schulklasse ist daher von besonderem Interesse, wie sich die Anerkennungsverhältnisse zwischen Gruppen verändern, denen besondere Potenziale für heterogenitätsbedingte Ablehnung zugeschrieben wird (vgl. Gerecke, 2010). Hypothetisch sind dies Mädchen „vs.“ Jungen, Jugendliche mit „vs.“ Jugendliche ohne Migrationshintergrund und bezüglich Klassenfahrten die Gruppe der Schüler, die nicht teilnehmen konnten „vs.“ der Gruppe derer, die teilgenommen haben. Auf dieser Grundlage beschäftigt sich die vorliegende Arbeit mit den Effekten sportbezogenen Klassenfahrten auf die soziale Integration operationalisiert in Anerkennungsverhältnissen.
Mittels eines soziometrischen Wahlverfahrens wurden die Anerkennungs- und Ablehnungsverhältnisse von vier Schulklassen (N=95) zu drei Messzeitpunkten (Eingangs-, Ausgangs- und Behaltenstest nach sechs Wochen) computergestützt erhoben.
Die Betrachtung der Gesamtgruppe zeigt eine Steigerung der positiven Wahlen (eta²=0,210) bei einer gleichzeitigen Reduktion der negativen Wahlen (eta²=0,167). Diese Entwicklung ist über Post-hoc-Einzelvergleiche auf eine signifikante Veränderung innerhalb des Treatmentzeitraumes (ET AT) zurückzuführen. Das Intervall AT-BT nach Abschluss der Klassenfahrt ist nicht signifikant, so dass auf eine zeitliche Stabilität der Ergebnisse geschlossen werden kann. Allerdings sind große Unterschiede zwischen den einzelnen Klassen festzustellen, die nicht teilweise nicht mit dem Gesamtergebnis übereinstimmen. In der differenzierten Betrachtung der heterogenitätsbedingten Unterschiede ist in erster Linie ein Geschlechtereffekt zu erkennen. Insbesondere die positiven und negativen Wahlen zwischen Schülern verschiedenen Geschlechts verändern sich signifikant. Aber auch hier zeigen sie die bereits dargestellten klassenspezifischen Differenzen.
Während der Teilnahmestatus keinen Einfluss auf die Vergabe von negativen und positiven Wahlen besitzt, beeinflusst der Migrationsstatus hingegen die positiven Wahlen signifikant.
Mit Blick auf die theoretischen Grundlagen dieser Arbeit kann der Anstieg der positiven Wahlen als Zuwachs von Anerkennung und der Rückgang negativer Wahlen als eine Reduktion von Ablehnung interpretiert werden, wobei sich kein einheitliches Bild auf Klassenebene ergibt.
Anhut, R. & Heitmeyer, W. (2000). Desintegration, Konflikt und Ethnisierung. Eine Problemanalyse und theoretische Rahmenkonzeption. In W. Heitmeyer (Hrsg.), Bedrohte Stadtgesellschaft. Soziale Desintegrationsprozesse und ethnisch-kulturelle Konfliktkonstellationen (S. 17–73). Weinheim: Juventa-Verlag.
Gerecke, P. (2010). Heterogenitätsbedingte Unterschiede zwischen Ingroup- und Outgroup-Anerkennung bzw. -Ablehnung im Sportunterricht. Eine empirische Studie zum integrativen Einfluss des Kooperativen Lernens. Dissertation. Frankfurt am Main: Johann-Wolfgang Goethe Universität.
Durch RNAinterferenz (RNAi) läßt sich die Expression eines beliebigen Gens spezifisch unterdrücken. Dafür müssen in das Zytoplasma kurze, doppelsträngige RNA Moleküle (siRNA bzw. shRNA) eingebracht werden, die teilweise komplementäre Sequenzen zu dem Zielgen aufweisen. Um siRNAs mit einer hohen Effizienz und Kopienzahl in die Zielzelle einzubringen, wurden Transfersysteme unterschiedlicher Art entwickelt. Nicht-virale Transfersysteme können nur einen transienten Effekt auslösen - ein Umstand, der für Langzeitstudien eine mehrfache Transfektion bedingt. Zur Lösung dieses Problems wurden retrovirale Vektorsysteme entwickelt, die durch Integration der shRNA-Expressionskassette in das zelluläre Genom eine stabile Unterdrückung eines Zielgens erreichen können. Insbesondere für präklinische Studien in vivo ist jedoch ein System mit erhöhter Transferrate wünschenswert, um in möglichst vielen Zielzellen einen RNAi-Effekt zu bewirken. Sliva et al. konnten zeigen, dass das Murine Leukämie Virus (MLV) theoretisch diese Anforderung erfüllt. Dafür wurde eine shRNA-Expressionskassette in das Virusgenom eingefügt und in vitro ein RNAi-Effekt nachgewiesen. In der vorliegenden Arbeit wurde dieses System nun durch die Verwendung von microRNA-adaptierten shRNAs (shRNAmir) verbessert. In mehreren Publikationen wurde bestätigt, dass shRNAs, die endogenen microRNAs nachempfunden sind, eine höhere Effizienz und niedrigere Toxizität aufweisen. Zunächst wurde die für die genetische Stabilität optimale Orientierung der shRNAmir-Expressionskassette bestimmt. Das Konstrukt in reverser Orientierung wies eine Deletion in der shRNAmir Promotersequenz auf, die wahrscheinlich durch Interferenz mit dem 5’LTR Promoter entstanden ist. Mit dem genetisch stabilen Viruskonstrukt wurden Experimente zur Reduktion der Expression von Markergenen durchgeführt, um die Effizienz der RNAi-Aktivität leicht zu quantifizieren. Dafür wurden humane Fibrosarkom (HT1080) Zellen infiziert, die eGFP oder Luziferase stabil exprimieren.
Mit eGFP- und Luziferase-spezifischen shRNAmir-Expressionskassetten konnte nach Infektion eine Herunterregulation von eGFP auf etwa 20 % und für Luziferase auf unter 10% beobachtet werden. Das Kontrollvirus, das eine unspezifische shRNAmir kodiert, hatte keinen Einfluss auf die Expression beider Markerproteine. Die Kinetik mit der die Markerproteine herrunterreguliert wurden, war abhängig von der Virusdosis. Die Virusdosis hatte aber keinen Einfluß auf die Stärke des RNAi-Effekts, der nach Infektion aller Zellen festgestellt werden konnte. Dieses Ergebnis entspricht der Erwartung an ein replikatives Transfersystems, das je nach applizierter Virusdosis unterschiedlich schnell RNAi in der Zellkultur ausbreitet und induziert. Die Anwendbarkeit dieses RNAi-Transfersystems auch für endogene Gene wurde mit MMP14-spezifischen shRNAmirs gezeigt. Nach Infektion von HT1080 Zellen mit den entsprechenden Viren in HT1080 Zellen konnte eine verringerte Menge an MMP14 mRNA und Protein nachgewiesen werden. Dies konnte funktionell durch eine verringerte Menge an intermediärem MMP2 und durch eine reduzierte Invasivität bestätigt werden. Zudem war die Fähigkeit dieser Zellen subkutane Tumore zu bilden stark eingeschränkt.
Um die Anwendbarkeit dieses Systems für in vivo Applikationen zu zeigen, wurde in Mäuse, die Luziferase-exprimierenden Tumoren trugen, MLV-shLuc oder das Kontrollvirus systemisch appliziert. 21 Tage nach Virusgabe konnte in den Tumoren von MLV-shLuc infizierten Mäusen eine Abnahme der Luziferaseaktivität auf 15 % nachgewiesen werden. Auch in Mäusen, die systemisch applizierte Tumorzellen erhielten, konnte eine Tendenz von RNAi-vermittelter Luziferase-Reduktion beobachtet werden.
Damit wurde in dieser Arbeit ein neuartiges RNAi-Transfersystem geschaffen, das in der Lage ist, auch in vivo einen starken und lang andauernden RNAi-Effekt auszulösen. Die Einzigartigkeit besteht in der Kombination von shRNAmir und Replikations-kompetenten Retroviren. Dadurch konnte eine erweiterte Transferrate von shRNAmir in Tumorzellen erreicht werden, so dass nun Genfunktionsstudien mit sehr hoher Aussagekraft möglich sind.
Weimarer Beiträge 59/2013
(2013)
Die Weimarer Beiträge sind eine Zeitschrift für Literaturwissenschaft, aktuelle ästhetische Theorie und Kulturwissenschaft. Zu Ihren Schwerpunkten gehören moderne Literatur im Rahmen anderer Künste und Medien, die Wechselbeziehungen von Literatur, philosophischer und ästhetischer Reflexion sowie die kritische Analyse der Gegenwartskultur.
Diese Arbeit entstand im Rahmen eines größeren Forschungsprojektes zum Thema Bewältigung von Lebensenttäuschungen, initiiert von Prof. Dr. Siegfried Preiser am Institut für Psychologie der Universität Frankfurt am Main. In diesem Kontext wurde die vorliegende Studie entwickelt.
Ausgehend von interpersonalem Engagement wurden mögliche Verknüpfungen von Einflussfaktoren im Umgang mit unterschiedlichen kritischen Lebenssituationen und der sich daraus ergebenden Konsequenzen auf psychische und physische Gesundheit, d.h. persönliches Wohlbefinden untersucht. Das Konstrukt Wohlbefinden wurde in dieser Studie als eine latente Variable gebildet, die sich aus einer Konstellation von bereichsspezifischen und allgemeinen Lebenszufriedenheitsfaktoren, dem seelischen Gesundheitsempfinden und – mit negativem Gewicht - dem aktuellen Belastungsempfinden zusammensetzt.
Außer der Erfassung der Partizipation an sozialen Gemeinschaften bzw. des sozialen Engagements wurden intrapsychische, motivationale, biographische und soziale Faktoren erfasst sowie religiöse Aspekte einbezogen. Zielgruppen der Untersuchung waren Gruppierungen vorwiegend aus dem Selbsthilfebereich.
Zur Beachtung der Zeitperspektive war die Befragung als Längsschnittstudie in Form einer Zweifachmessung konzipiert.
Erhoben und untersucht wurden im einzelnen Belastungs-, Persönlichkeits-, Gesundheits- und Zufriedenheitsfaktoren, des Weiteren die Aspekte des sozialen Kontextes mit Differenzierung der Ebenen von sozialer Unterstützung sowie religiöse Aspekte als angenommene Einflussfaktoren auf Lebenszufriedenheit und persönliches Wohlbefinden.
Zusammenfassend hatten die Persönlichkeitsfaktoren Flexibilität und Selbstwirksamkeit den größten positiven Einfluss auf Wohlbefinden. Bzgl. des sozialen Engagements zeigte sich dagegen kein signifikanter Einfluss.
Neben den Variablen Flexibilität und Selbstwirksamkeit stellte sich die wahrgenommene Unterstützung als bedeutsamster Einflussfaktor auf das Wohlbefinden heraus.
Religiöse Vorstellungen konnten nach ihrer persönlichen positiven oder negativen Grundhaltung gegenüber Gott bzw. einer höheren Wirklichkeit differenziert werden. Eine positive religiöse Grundhaltung ist geprägt von der Vorstellung eines schützenden, fürsorglichen und hilfreichen Gottes. Ein negatives Gottesbild beinhaltet die Vorstellung eines bedrohlichen und strafenden Gottes. Nur für diese Betrachtungsweise konnten eindeutige - und zwar negative - Einflüsse auf das Wohlbefinden ermittelt werden
Inhaltlich gliedert sich die Arbeit in vier Blöcke:
In Kapitel 1 werden theoretische Grundlagen und untersuchungsrelevante Konzepte näher erläutert und daraus die konkreten Fragestellungen einschließlich der Hypothesen entwickelt.
In Kapitel 2 schließt sich der methodische Teil mit den Beschreibungen der Stichprobe, der Erhebungsinstrumente und des Untersuchungsverlaufes an.
Kapitel 3 enthält die Ergebnisse und deren Diskussion. Kapitel 4 beinhaltet ein Resümee und Ausblick. In Kapitel 5 befindet sich die für diese Arbeit verwendete Literatur, woran sich der Anhang anschließt. Der Anhang besteht zum einen aus weitergehenden Informationen und Erläuterungen, die Durchführung und Auswertung betreffend (Anhang I). Anhang II, der der Druckversion als CD beiliegt, listet zum anderen die Originalantworten der Probanden in strukturierter Form auf.
In vier aufeinander aufbauenden Studien wird den Fragen nachgegangen „Was sind Nicht-Ereignisse?“ und „Welche Verarbeitungshilfen sind effektiv für den Bewältigungsprozess?“. Am Beispiel der ungewollten Kinderlosigkeit wird aus gesundheitspsychologischer Sicht nach zwei Aspekten von psychosozialem Wohlbefinden gefragt: „globaler Lebenszufriedenheit“ und „negativen Emotionen“ (z.B. Scham und Schmerz).
Es werden Bewältigungsstrategien und Bewältigungsstile unterschieden. Die Bewältigungsstile „religiöses Coping“ sowie „hartnäckige Zielverfolgung“ und „flexible Zielanpassung“ werden als andauernde Einflussfaktoren im Bewältigungsprozess betrachtet. Die entwickelten Bewältigungsstrategien „planendes Problemlösen“, „Unterstützung durch Freunde“, „regenerative Strategien“ und „kognitive Umdeutung zur Akzeptanz“ sind erlernbare Vorgehensweisen.
In der Pilotstudie 1 wurden 22 Menschen interviewt, die sich im Nicht-Ereignis-Prozess befinden. In Studie 2 wurden qualitativ und quantitativ 76 Männer und Frauen mit ungewollter Kinderlosigkeit befragt. Studie 3 erhob online mit 216 Teilnehmern die Häufigkeit und eingeschätzte Effektivität von Verarbeitungshilfen. Studie 4 erfasste zu zwei Messzeitpunkten (n = 732, n = 409) vier Bewältigungsstrategien, vier Bewältigungsstile, „globale Lebenszufriedenheit“, „negative Emotionen“ und kinderwunschspezifische Antworten von Menschen mit Kinderwunsch.
Für eine gewünschte Schwangerschaft kann geschlussfolgert werden, dass ein bedeutsamer Prädiktor für die Eintrittswahrscheinlichkeit im frühen Prozess fertility awareness ist. Das Alter der Frau dagegen leistet keinen Beitrag zur Vorhersage. Die Prädiktoren „negatives religiöses Coping“ und „planendes Problemlösen“ im fortgeschrittenen Nicht-Ereignis-Prozess stellen Risikofaktoren für das psychosoziale Wohlbefinden dar. Die Schutzfaktoren „Unterstützung durch Freunde“, „kognitive Umdeutung zur Akzeptanz“ und „flexible Zielanpassung“ sind signifikante Prädiktoren für psychosoziales Wohlbefinden. Interaktionseffekte von „Flexibler Zielanpassung“ und „Hartnäckiger Zielverfolgung“ konnten nicht identifiziert werden.
Numerous reactive volatile organic compounds (VOCs) are emitted into the atmosphere by vegetation. Most biogenic VOCs are highly reactive towards the atmosphere's most important oxidant, the hydroxyl (OH) radical. One way to investigate the chemical interplay between biosphere and atmosphere is through the measurement of total OH reactivity, the total loss rate of OH radicals. This study presents the first determination of total OH reactivity emission rates (measurements via the comparative reactivity method) based on a branch cuvette enclosure system mounted on a Norway spruce (Picea abies) throughout spring, summer and autumn 2011. In parallel VOC emission rates were monitored by a second proton-transfer-reaction mass spectrometer (PTR-MS), and total ozone (O3) loss rates were obtained inside the cuvette. Total OH reactivity emission rates were in general temperature and light dependent, showing strong diel cycles with highest values during daytime. Monoterpene emissions contributed most, accounting for 56–69% of the measured total OH reactivity flux in spring and early summer. However, during late summer and autumn the monoterpene contribution decreased to 11–16%. At this time, a large missing fraction of the total OH reactivity emission rate (70–84%) was found when compared to the VOC budget measured by PTR-MS. Total OH reactivity and missing total OH reactivity emission rates reached maximum values in late summer corresponding to the period of highest temperature. Total O3 loss rates within the closed cuvette showed similar diel profiles and comparable seasonality to the total OH reactivity fluxes.
Total OH reactivity fluxes were also compared to emissions from needle storage pools predicted by a temperature-only-dependent algorithm. Deviations of total OH reactivity fluxes from the temperature-only-dependent emission algorithm were observed for occasions of mechanical and heat stress. While for mechanical stress, induced by strong wind, measured VOCs could explain total OH reactivity emissions, during heat stress they could not. The temperature-driven algorithm matched the diel variation of total OH reactivity emission rates much better in spring than in summer, indicating a different production and emission scheme for summer and early autumn. During these times, unmeasured and possibly unknown primary biogenic emissions contributed significantly to the observed total OH reactivity flux.
Kompetenzen bezeichnen „erlernbare kontextspezifische Leistungsdispositionen, die sich funktional auf Situationen und Anforderungen in bestimmten Domänen beziehen“ (Klieme & Hartig, 2007, S. 17). Für den Bereich der Lehrerbildung wurden durch die Kultusministerkonferenz (2004) Standards für die Lehrerbildung: Bildungswissenschaften formuliert, die als Explikation professioneller pädagogischer Kompetenzen gelten können. Durch die Formulierung dieser Standards sieht sich die Lehrerbildung mit der Aufgabe konfrontiert, Studierende des Lehramts so auszubilden, dass die resultierenden Kompetenzen den genannten Standards genügen. Dies impliziert eine standard- und somit kompetenzorientierte Evaluation der Lehrerbildung. Bislang wird eine Evaluation der Lehrerbildung jedoch meist durch Selbsteinschätzungsverfahren umgesetzt – eine Methodik, die im Bereich der Kompetenzdiagnostik kritisch diskutiert wird (z. B. Nerdinger et al, 2008).
Der Situational Judgement Test als kompetenzdiagnostisches Instrumentarium weist die Vorteile situationsorientierter Verfahren auf und kann zusätzlich aufgrund der schriftlichen Darbietung problemlos auf große Stichproben angewandt werden. In der vorliegenden Studie wurde ein solcher Test entwickelt, um die professionelle pädagogische Kompetenz Lehramtsstudierender kontextnah und ökonomisch erfassen zu können. Die Studie hatte zum Ziel, den entwickelten standardorientierten Situational Judgement Test anhand verschiedener Außenkriterien konvergent und diskriminant zu validieren. Hierbei wurden konvergente Validitätsnachweise lediglich teilweise signifikant, wobei diskriminante Validitätsnachweise anhand des Studienfachs (Lehramtsstudium vs. Studium technisch-naturwissenschaftlicher Fächer) deutliche Signifikanzen und Effektstärken zeigten.
The creation of entirely synthetically derived bone substitute materials which are as effective as autologous bone grafts is desirable. Osteogenesis involves the concerted action of several proteins within a signaling cascade. Hedgehog proteins act upstream of this cascade, inducing the expression of various bone morphogenetic proteins (BMPs) and promoting physiological bone healing. Therefore, the hypothesis that hedgehog signaling in bone defects improves bone healing more than BMP signaling alone was tested. Recombinant N-terminal sonic hedgehog protein (N-SHh), BMP-2 or a combination of the two was added to β-tricalcium phosphate (β-TCP) and 5-mm femoral midshaft defects in nude rats were filled with these composites. The defects were stabilized with mini-plates. After eight weeks, the animals were sacrificed and the femora were explanted. The radiological evaluation was followed by a three-point bending test and histological examination. BMP-2/β-TCP composites showed a trend of increased stiffness compared with the controls (β-TCP without protein). N-SHh/β-TCP composites had lower stiffness compared with the control group and the N-SHh/BMP-2/β-TCP composites also had lower average stiffness compared with the controls (all not significant). Histomorphometry, however, revealed abundant cartilage and bone core formation in the N-SHh-composite groups. The sum of the new cartilage and bone was highest in the combination group N-SHh/BMP-2 (not significant). The addition of N-SHh to bone substitute materials appears to delay bone healing at the applied concentration and observation time but also showed a trend for higher amounts of ossifying cartilage.
The concept of focal epilepsies includes a seizure origin in brain regions with hyper synchronous activity (epileptogenic zone and seizure onset zone) and a complex epileptic network of different brain areas involved in the generation, propagation, and modulation of seizures. The purpose of this work was to study functional and effective connectivity between regions involved in networks of epileptic seizures. The beginning and middle part of focal seizures from ictal surface EEG data were analyzed using dynamic imaging of coherent sources (DICS), an inverse solution in the frequency domain which describes neuronal networks and coherences of oscillatory brain activities. The information flow (effective connectivity) between coherent sources was investigated using the renormalized partial directed coherence (RPDC) method. In 8/11 patients, the first and second source of epileptic activity as found by DICS were concordant with the operative resection site; these patients became seizure free after epilepsy surgery. In the remaining 3 patients, the results of DICS / RPDC calculations and the resection site were discordant; these patients had a poorer post-operative outcome. The first sources as found by DICS were located predominantly in cortical structures; subsequent sources included some subcortical structures: thalamus, Nucl. Subthalamicus and cerebellum. DICS seems to be a powerful tool to define the seizure onset zone and the epileptic networks involved. Seizure generation seems to be related to the propagation of epileptic activity from the primary source in the seizure onset zone, and maintenance of seizures is attributed to the perpetuation of epileptic activity between nodes in the epileptic network. Despite of these promising results, this proof of principle study needs further confirmation prior to the use of the described methods in the clinical praxis.
The live attenuated yellow fever (YF) vaccine has an excellent record of efficacy and one dose provides long-lasting immunity, which in many cases may last a lifetime. Vaccination stimulates strong innate and adaptive immune responses, and neutralizing antibodies are considered to be the major effectors that correlate with protection from disease. Similar to other flaviviruses, such antibodies are primarily induced by the viral envelope protein E, which consists of three distinct domains (DI, II, and III) and is presented at the surface of mature flavivirions in an icosahedral arrangement. In general, the dominance and individual variation of antibodies to different domains of viral surface proteins and their impact on neutralizing activity are aspects of humoral immunity that are not well understood. To gain insight into these phenomena, we established a platform of immunoassays using recombinant proteins and protein domains that allowed us to dissect and quantify fine specificities of the polyclonal antibody response after YF vaccination in a panel of 51 vaccinees as well as determine their contribution to virus neutralization by serum depletion analyses. Our data revealed a high degree of individual variation in antibody specificities present in post-vaccination sera and differences in the contribution of different antibody subsets to virus neutralization. Irrespective of individual variation, a substantial proportion of neutralizing activity appeared to be due to antibodies directed to complex quaternary epitopes displayed on the virion surface only but not on monomeric E. On the other hand, DIII-specific antibodies (presumed to have the highest neutralizing activity) as well as broadly flavivirus cross-reactive antibodies were absent or present at very low titers. These data provide new information on the fine specificity as well as variability of antibody responses after YF vaccination that are consistent with a strong influence of individual-specific factors on immunodominance in humoral immune responses.
Author Summary: The live-attenuated yellow fever vaccine has been administered to more than 600 million people worldwide and is considered to be one of the most successful viral vaccines ever produced. Following injection, the apathogenic vaccine virus replicates in the vaccinee and induces antibodies that mediate virus neutralization and subsequent protection from disease. In principle, many different antibodies are induced by viral antigens, but it is becoming increasingly clear that only a subset of them is capable of inactivating the virus, and some antibody populations appear to dominate the immune response. However, to date there has been very little information on individual-specific variations of immunodominance and how such variations can affect the functionality of antibody responses. In our study, we addressed these issues and analyzed the fine specificities of antibodies induced by YF vaccination as well as the contribution of different antibody subsets to virus neutralization in 51 vaccinees. We demonstrate an extensive degree of individual variation with respect to immunodominance of antibody populations and their contribution to virus neutralization. Such variations can have an impact on vaccine-mediated protection, and thus insight into this phenomenon can provide leads for novel strategies in modern vaccine design.
The elliptic, v2, triangular, v3, and quadrangular, v4, azimuthal anisotropic flow coefficients are measured for unidentified charged particles, pions, and (anti-)protons in Pb–Pb collisions at √sNN=2.76 TeV with the ALICE detector at the Large Hadron Collider. Results obtained with the event plane and four-particle cumulant methods are reported for the pseudo-rapidity range |η|<0.8 at different collision centralities and as a function of transverse momentum, pT, out to pT=20 GeV/c. The observed non-zero elliptic and triangular flow depends only weakly on transverse momentum for pT>8 GeV/c. The small pT dependence of the difference between elliptic flow results obtained from the event plane and four-particle cumulant methods suggests a common origin of flow fluctuations up to pT=8 GeV/c. The magnitude of the (anti-)proton elliptic and triangular flow is larger than that of pions out to at least pT=8 GeV/c indicating that the particle type dependence persists out to high pT.
The production cross section of electrons from semileptonic decays of beauty hadrons was measured at mid-rapidity (|y|<0.8) in the transverse momentum range 1<pT<8 GeV/c with the ALICE experiment at the CERN LHC in pp collisions at a center of mass energy √s=7 TeV using an integrated luminosity of 2.2 nb−1. Electrons from beauty hadron decays were selected based on the displacement of the decay vertex from the collision vertex. A perturbative QCD calculation agrees with the measurement within uncertainties. The data were extrapolated to the full phase space to determine the total cross section for the production of beauty quark–antiquark pairs.
The inclusive transverse momentum (pT) distributions of primary charged particles are measured in the pseudo-rapidity range |η|<0.8 as a function of event centrality in Pb–Pb collisions at √sNN=2.76 TeV with ALICE at the LHC. The data are presented in the pT range 0.15<pT<50 GeV/c for nine centrality intervals from 70–80% to 0–5%. The results in Pb–Pb are presented in terms of the nuclear modification factor RAA using a pp reference spectrum measured at the same collision energy. We observe that the suppression of high-pT particles strongly depends on event centrality. The yield is most suppressed in central collisions (0–5%) with RAA≈0.13 at pT=6–7 GeV/c. Above pT=7 GeV/c, there is a significant rise in the nuclear modification factor, which reaches RAA≈0.4 for pT>30 GeV/c. In peripheral collisions (70–80%), only moderate suppression (RAA=0.6–0.7) and a weak pT dependence is observed. The measured nuclear modification factors are compared to other measurements and model calculations.
The gauge principle is fundamental in formulating the Standard Model. Fermion–gauge-boson couplings are the inescapable consequence and the primary determining factor for observable phenomena. Vertices describing such couplings are simple in perturbation theory and yet the existence of strong-interaction bound-states guarantees that many phenomena within the Model are nonperturbative. It is therefore crucial to understand how dynamics dresses the vertices and thereby fundamentally alters the appearance of fermion–gauge-boson interactions. We consider the coupling of a dressed-fermion to an Abelian gauge boson, and describe a unified treatment and solution of the familiar longitudinal Ward–Green–Takahashi identity and its less well known transverse counterparts. Novel consequences for the dressed-fermion–gauge-boson vertex are exposed.
Cellular cytotoxicity is the hallmark of NK cells mediating both elimination of virus-infected or malignant cells, and modulation of immune responses. NK cytotoxicity is triggered upon ligation of various activating NK cell receptors. Among these is the C-type lectin-like receptor NKp80 which is encoded in the human Natural Killer Gene Complex (NKC) adjacent to its ligand, activation-induced C-type lectin (AICL). NKp80-AICL interaction promotes cytolysis of malignant myeloid cells, but also stimulates the mutual crosstalk between NK cells and monocytes.
While many activating NK cell receptors pair with ITAM-bearing adaptors, we recently reported that NKp80 signals via a hemITAM-like sequence in its cytoplasmic domain. Here we molecularly dissect the NKp80 hemITAM and demonstrate that two non-consensus amino acids, in particular arginine 6, critically impair both hemITAM phosphorylation and Syk recruitment. Impaired Syk recruitment results in a substantial attenuation of cytotoxic responses upon NKp80 ligation. Reconstituting the hemITAM consensus or Syk overexpression resulted in robust NKp80-mediated responsiveness. Collectively, our data provide a molecular rationale for the restrained activation potential of NKp80 and illustrate how subtle alterations in signaling motifs determine subsequent cellular responses. They also suggest that non-consensus alterations in the NKp80 hemITAM, as commonly present among mammalian NKp80 sequences, may have evolved to dampen NKp80-mediated cytotoxic responses toward AICL-expressing cells.
Background: The activating NK receptor NKp80 triggers cytotoxicity by human NK cells via a cytoplasmic hemITAM sequence.
Results: A non-consensus hemITAM residue impairs the capacity of NKp80 to recruit Syk kinase and to trigger cytotoxicity.
Conclusion: Unlike typical hemITAM receptors, NKp80 does not efficiently recruit Syk kinase resulting in attenuated effector responses.
Significance: An attenuated cytotoxic responsiveness critically impacts on the immunomodulatory function of NKp80.
In the stomach, neoplastic lesions often arise in the setting of precursor conditions such as gastritis, intestinal metaplasia, or adenomatous lesions. Biopsies may, therefore, underestimate disease severity or even miss the diagnosis (sampling error). Endomicroscopy is able to visualize typical features of such pathologies. It enables in vivo microscopy of gastritis with definition of enhanced vascularity and vascular leakage, but the typical cobblestone appearance of the gastric mucosa is preserved. The presence of intestinal metaplasia is confirmed by columnar absorptive cells with brush border and goblet cells within villiform foveolar epithelium. Gastric neoplasia is characterized by crowded glands with intraluminal folding and glandular budding and branching accompanied by increased density of dilated and distorted capillaries. Finally, in gastric cancer, gland and overall mucosal architecture is progressively lost. These features are shown side by side with white-light endoscopic findings. Endomicroscopy is used in such a setting to rapidly screen larger areas (optical biopsies) and subsequently target tissue sampling to areas with highly suspicious microscopic patterns. In experienced hands, it therefore constitutes an important part especially in the presence of neoplastic lesions within noncircumscript gastric premalignant conditions. This article is part of an expert video encyclopedia.
Dieulafoy's lesion (DL) is a rare source of gastrointestinal tract bleeding that may occur at any site in the gastrointestinal tract and may be difficult to detect by endoscopy. DL is characterized by a large, tortuous arteriole in the submucosa. This is a case of duodenal DL that is detected and treated by endoscopy. This article is part of an expert video encyclopedia.
Peutz–Jeghers syndrome (PJS) is a rare autosomal-dominant inherited disorder characterized by gastrointestinal hamartomas, mucocutaneous pigmentation, and an elevated cancer risk. Moreover, intussusception risk may be as high as 50% at the age of 20 years and is caused by large polyps. There is some evidence that endoscopic surveillance of PJS patients with removal of small intestinal polyps with a diameter of more than 15 mm efficiently prevents intussusceptions. In recent years, capsule endoscopy (CE) has largely replaced small-bowel radiography techniques to screen for small-bowel polyps. Magnetic resonance imaging may be equally efficient as CE for screening of large polyps. Balloon enteroscopy may be used for endoscopic snare resection of polyps. This article is part of an expert video encyclopedia.
The author presents the case of a patient with severe bleeding from a duodenal ulcer that could not be controlled by endoscopic application of metal clips and injection of fibrin glue. Angiographic embolization with placement of coils into the feeding vessel stopped the bleeding. However, 3 days later, a fistula emerged from coil material penetrating into the dorsal duodenum and a peritoneal leakage developed. The fistula was completely closed by placing an over-the-scope clip on the enteral opening of the fistula. This article is part of an expert video encyclopedia.
Small-bowel tumors are rare and account for approximately 5% of all gastrointestinal tumors. Approximately 65% of small-bowel tumors are malignant, and approximately 40% of these tumors are adenocarcinomas. Similar to colorectal adenocarcinoma, premalignant adenomas of the small bowel may progress to carcinoma. This occurs both sporadically and in the context of hereditary tumor syndromes such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer (Lynch syndrome). Herein cases with small-bowel adenocarcinomas visualized with both capsule endoscopy and double-balloon enteroscopy are presented. This article is part of an expert video encyclopedia.
A rare cause of recurrent melena was identified by capsule endoscopy: arteriovenous malformation
(2013)
Small bowel endoscopy is indicated for patients with an unidentified bleeding site in esophagogastroduodenoscopy and ileocolonoscopy and symptoms of intestinal blood loss or unexplained anemia. In approximately two-thirds of these cases, capsule endoscopy (CE) detects a lesion within the small bowel that explains the patient's symptoms.
The case of an 80-year-old female patient with recurrent melena and anemia is presented here by the authors. Endoscopy of the upper gastrointestinal tract as well as ileocolonoscopy did not show any pathological findings. CE revealed an area with abnormal mucosa in the middle third of the small bowel, which was strongly suspected of having malignant origin. Surgical exploration led to resection of a small jejunal segment with a palpable mass and increased blood flow. Surprisingly, the final diagnosis determined by the pathologist was arteriovenous malformation (AVM). This article is part of an expert video encyclopedia.
Characteristically, most solid tumors exhibit an increased tumor interstitial fluid pressure (TIFP) that directly contributes to the lowered uptake of macromolecular therapeutics into the tumor interstitium. Abnormalities in the tumor-associated lymph vessels are a central brick in the development and prolonged sustaining of an increased TIFP. In the current study, vascular endothelial growth factor C (VEGF-C) was used to enhance tumor-associated lymphangiogenesis as a new mechanism to actively reduce the TIFP by increased lymphatic drainage of the tumor tissue. Human A431 epidermoid vulva carcinoma cells were inoculated in NMRI nu/nu mice to generate a xenograft mouse model. Seven days after tumor cell injection, VEGF-C was peritumorally injected to induce lymphangiogenesis. Tumor growth and TIFP was lowered significantly over time in VEGF-C-treated tumors in comparison to control or VEGF-A-treated animals. These data demonstrate for the first time that actively induced lymphangiogenesis can lower the TIFP in a xenograft tumor model and apparently reduce tumor growth. This model represents a novel approach to modulate biomechanical properties of the tumor interstitium enabling a lowering of TIFP in vivo.
Hepatology highlights
(2013)
The ALICE detector is ideally suited to study the production of anti- and hyper-matter due to its excellent particle identification capabilities. The measurement of the He¯4-nucleus in Pb–Pb collisons at sNN=2.76TeV is presented. We further show the performance for the reconstruction of the (anti-)hypertriton in the decay to He3+π− (He¯3+π+). In addition to this, two searches have been performed, one for the H-Dibaryon →Λpπ− and one for the Λn bound state (Λn¯→d¯π+). No signals are observed for these exotic states and upper limits have been determined.
The width of the ω meson in cold nuclear matter is computed in a hadronic many-body approach, focusing on a detailed treatment of the medium modifications of intermediate πρ states. The π and ρ propagators are dressed by their self-energies in nuclear matter taken from previously constrained many-body calculations. The pion self-energy includes Nh and Δh excitations with short-range correlations, while the ρ self-energy incorporates the same dressing of its 2π cloud with a full 3-momentum dependence and vertex corrections, as well as direct resonance-hole excitations; both contributions were quantitatively fit to total photo-absorption spectra and πN→ρN scattering. Our calculations account for in-medium decays of type ωN→πN(⁎),ππN(Δ), and 2-body absorptions ωNN→NN(⁎),πNN. This causes deviations of the in-medium ω width from a linear behavior in density, with important contributions from spacelike ρ propagators. The ω width from the ρπ cloud may reach up to 200 MeV at normal nuclear matter density, with a moderate 3-momentum dependence. This largely resolves the discrepancy of linear T–ϱ approximations with the values deduced from nuclear photoproduction measurements.
We investigate the modification of the pion self-energy at finite temperature due to its interaction with a low-density, isospin-symmetric nuclear medium embedded in a constant magnetic background. To one loop, for fixed temperature and density, we find that the pion effective mass increases with the magnetic field. For the π−, interestingly, this happens solely due to the trivial Landau quantization shift ∼|eB|, since the real part of the self-energy is negative in this case. In a scenario in which other charged particle species are present and undergo an analogous trivial shift, the relevant behavior of the effective mass might be determined essentially by the real part of the self-energy. In this case, we find that the pion mass decreases by ∼10% for a magnetic field |eB|∼mπ2, which favors pion condensation at high density and low temperatures.
We investigate the phase structure of strongly interacting matter at non-vanishing isospin before the onset of pion condensation in the framework of the unquenched Polyakov–Quark-Meson model with 2+1 quark flavors. We show results for the order parameters and all relevant thermodynamic quantities. In particular, we obtain a moderate change of the pressure with isospin at vanishing baryon chemical potential, whereas the chiral condensate decreases more appreciably. We compare the effective model to recent lattice data for the decrease of the pseudo-critical temperature with the isospin chemical potential. We also demonstrate the major role played by the value of the pion mass in the curvature of the transition line, and the need for lattice results with a physical pion mass. Limitations of the model at nonzero chemical potential are also discussed.
For the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologist will assure the clinician that the observed hepatic changes are compatible with DILI, but this information is less helpful due to lack of specificity. Rather, the pathologist should assess liver biopsies blindly, without knowledge of prior treatment by drugs. This will result in a detailed description of the histological findings, associated with suggestions for potential causes of these hepatic changes. Then, it is up to the physician to reassess carefully the differential diagnoses, if not done before. At present, liver histology is of little impact establishing the diagnosis of DILI with the required degree of certainty, and this shortcoming also applies to herb induced liver injury (HILI). To reach at the correct diagnoses of DILI and HILI, clinical and structured causality assessments are therefore better approaches than liver histology results obtained through liver biopsy, an invasive procedure with a low complication rate.
The small intestine is a part of the gastrointestinal tract in which digestion and absorption of nutrients takes place. The small bowel follows the stomach and is followed by the large intestine, reaching from the pylorus to the valve of Bauhin and is separated into the duodenum, the jejunum, and the ileum.
Capsule endoscopy (CE) has the potential to offer a perfect overview of the small-bowel mucosa and complete visualization of the entire small bowel is achieved in most cases. In this video, there is an overview offered on normal findings in small-bowel CE and typical anatomical landmarks are indicated. This article is part of an expert video encyclopedia.
The TolC-like protein HgdD of the filamentous, heterocyst-forming cyanobacterium Anabaena sp. PCC 7120 is part of multiple three-component "AB-D" systems spanning the inner and outer membranes and is involved in secretion of various compounds, including lipids, metabolites, antibiotics, and proteins. Several components of HgdD-dependent tripartite transport systems have been identified, but the diversity of inner membrane energizing systems is still unknown. Here we identified six putative resistance-nodulation-cell division (RND) type factors. Four of them are expressed during late exponential and stationary growth phase under normal growth conditions, whereas the other two are induced upon incubation with erythromycin or ethidium bromide. The constitutively expressed RND component Alr4267 has an atypical predicted topology, and a mutant strain (I-alr4267) shows a reduction in the content of monogalactosyldiacylglycerol as well as an altered filament shape. An insertion mutant of the ethidium bromide-induced all7631 did not show any significant phenotypic alteration under the conditions tested. Mutants of the constitutively expressed all3143 and alr1656 exhibited a Fox(-) phenotype. The phenotype of the insertion mutant I-all3143 parallels that of the I-hgdD mutant with respect to antibiotic sensitivity, lipid profile, and ethidium efflux. In addition, expression of the RND genes all3143 and all3144 partially complements the capability of Escherichia coli ΔacrAB to transport ethidium. We postulate that the RND transporter All3143 and the predicted membrane fusion protein All3144, as homologs of E. coli AcrB and AcrA, respectively, are major players for antibiotic resistance in Anabaena sp. PCC 7120.
There is ample epidemiologic evidence for an association of chronic hepatitis C virus (HCV) infection with B-cell non-Hodgkin lymphoma (B-NHL). B-NHL subtypes most frequently associated with HCV are marginal zone lymphoma and diffuse large B-cell lymphoma. The most convincing evidence for a causal relationship between HCV infection and lymphoma development is the observation of B-NHL regression after HCV eradication by antiviral therapy (AVT). In fact, for indolent HCV-associated B-NHL, first-line AVT instead of standard immune-chemotherapy might be considered. Molecular mechanisms of HCV-NHL development are still poorly understood. Three general theories have emerged to understand the HCV-induced lymphomagenesis: (1) continuous external stimulation of lymphocyte receptors by viral antigens and consecutive proliferation; (2) HCV replication in B cells with oncogenic effect mediated by intracellular viral proteins; (3) permanent B-cell damage, e.g., mutation of tumor suppressor genes, caused by a transiently intracellular virus (“hit and run” theory). This review systematically summarizes the data on epidemiology, interventional studies, and molecular mechanisms of HCV-associated B-NHL.
A low potential electron carrier ferredoxin (E0′ ≈ −500 mV) is used to fuel the only bioenergetic coupling site, a sodium-motive ferredoxin:NAD+ oxidoreductase (Rnf) in the acetogenic bacterium Acetobacterium woodii. Because ferredoxin reduction with physiological electron donors is highly endergonic, it must be coupled to an exergonic reaction. One candidate is NADH-dependent caffeyl-CoA reduction. We have purified a complex from A. woodii that contains a caffeyl-CoA reductase and an electron transfer flavoprotein. The enzyme contains three subunits encoded by the carCDE genes and is predicted to have, in addition to FAD, two [4Fe-4S] clusters as cofactor, which is consistent with the experimental determination of 4 mol of FAD, 9 mol of iron, and 9 mol of acid-labile sulfur. The enzyme complex catalyzed caffeyl-CoA-dependent oxidation of reduced methyl viologen. With NADH as donor, it catalyzed caffeyl-CoA reduction, but this reaction was highly stimulated by the addition of ferredoxin. Spectroscopic analyses revealed that ferredoxin and caffeyl-CoA were reduced simultaneously, and a stoichiometry of 1.3:1 was determined. Apparently, the caffeyl-CoA reductase-Etf complex of A. woodii uses the novel mechanism of flavin-dependent electron bifurcation to drive the endergonic ferredoxin reduction with NADH as reductant by coupling it to the exergonic NADH-dependent reduction of caffeyl-CoA.
This is the case report of a 58-year-old male patient who presented with recurring abdominal pain of 4 months duration. He had undergone multiple investigations including upper and lower gastrointestinal tract endoscopies and diagnostic laparoscopy, but there were no significant findings detected.
Capsule endoscopy revealed a submucosal small bowel tumor that was suspected to originate from the distal third of the small bowel. Surgery was indicated and a highly differentiated neuroendocrine tumor was found at laparotomy at the distal ileum. An ileocecal resection was performed confirming a neuroendocrine tumor of the small bowel (G2T2N1M1). This article is part of an expert video encyclopedia.
Previous experimental measurements from nuclear collisions have indicated modifications of jets by interaction with the medium created in the collision. Observables from particle correlations in the ALICE detector continue to provide access to key properties of the hot deconfined nuclear matter. New results from two- and three-particle number and transverse momentum correlations are discussed. Specifically, correlation function properties are characterized as a function of transverse momentum and centrality and for different charge combinations. Fourier decompositions are performed, identified particle ratios are studied in the jet-like peak and in the bulk, and the away-side shape is looked at in three-particle correlations.
The proportion of elderly women in the population is rising, and in tandem, the incidence of breast cancer rises with age. Because of health and tolerability concerns, as well as life expectancy, physicians may be reluctant to advise a standard treatment regimen for elderly patients with metastatic breast cancer. To elucidate this issue, we performed a literature review of clinical studies that included women with metastatic breast cancer who were over the age of 65. Our results show that although little clinical evidence exists, what is available suggests that standard treatment is tolerated and beneficial for patients meeting certain criteria. A geriatric assessment may identify specific patient groups (independent, dependent, or frail) and thereby guide treatment. Treatment recommendations for elderly patients with metastatic breast cancer are sparse, although first-line endocrine treatment, usually aromatase inhibitors or tamoxifen, is recommended for hormone-sensitive disease. In general, the evidence from clinical studies suggests that aromatase inhibitors are more effective than either tamoxifen or megestrol acetate as first- or second-line treatment in postmenopausal women with metastatic breast cancer. Ultimately, quality of life, treatment effects, and comorbidities are important aspects in this population and may guide treatment choice. To provide evidence-based treatment guidance, future clinical trials should include more patients over the age of 65 years.
The antineoplastic alkaloid ellipticine is a prodrug, the pharmacological efficiency of which is dependent on its cytochrome P450 (CYP)- and/or peroxidase-mediated activation to species forming DNA adducts in target tissues. Here, we found that this compound is cytotoxic to human BHT-101, B-CPAP and 8505-C thyroid cancer cells and blocks one or more phases of cell cycle in these cancer cells. Ellipticine toxicity to the thyroid cancer cells corresponded to levels of DNA adducts generated by the CYP- and/or peroxidase-mediated ellipticine metabolites, 12-hydroxy- and 13-hydroxyellipticine, in these cells. Cultivation of all tested cells under hypoxic conditions (1 % oxygen) led to a decrease in ellipticine toxicity. Such a lower sensitivity of cells to ellipticine correlates with a decrease in the formation of ellipticine-derived DNA adducts in these cells. Using Western blotting, the expression of CYP1A1, 1B1, 3A4, thyroid peroxidase (TPO), cyclooxygenase-1 (COX-1) and cytochrome b5, the enzymes that catalyze, and/or influence ellipticine metabolism, was investigated in the cancer cells. Furthermore, the effects of ellipticine treatment on the expression levels of these proteins in thyroid cancer cells were also examined. The results indicate that the highest expression levels of cytochrome b5 together with CYP1A1 and 3A4 determine the highest DNA adduct formation and cytotoxicity of ellipticine in B-CPAP cells. They also demonstrate that formation of covalent DNA adducts by ellipticine is the predominant mechanism responsible for its cytotoxicity in studied cells.
Herbal hepatotoxicity is a rare but highly disputed disease because numerous confounding variables may complicate accurate causality assessment. Case evaluation is even more difficult when the WHO global introspection method (WHO method) is applied as diagnostic algorithm. This method lacks liver specificity, hepatotoxicity validation, and quantitative items, basic qualifications required for a sound evaluation of hepatotoxicity cases. Consequently, there are no data available for reliability, sensitivity, specificity, positive and negative predictive value. Its scope is also limited by the fact that it cannot discriminate between a positive and a negative causality attribution, thereby stimulating case overdiagnosing and overreporting. The WHO method ignores uncertainties regarding daily dose, temporal association, start, duration, and end of herbal use, time to onset of the adverse reaction, and course of liver values after herb discontinuation. Insufficiently considered or ignored are comedications, preexisting liver diseases, alternative explanations upon clinical assessment, and exclusion of infections by hepatitis A-C, cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella zoster virus (VZV). We clearly prefer as alternative the scale of CIOMS (Council for International Organizations of Medical Sciences) which is structured, quantitative, liver specific, and validated for hepatotoxicity. In conclusion, causality of herbal hepatotoxicity is best assessed by the liver specific CIOMS scale validated for hepatotoxicity rather than the obsolete WHO method that is liver unspecific and not validated for hepatotoxicity. CIOMS based assessments will ensure the correct diagnosis and exclude alternative diagnosis that may require other specific therapies.
The relationship between achievement of a pathologic complete response (pCR) and favorable long-term outcome varies among breast cancer subtypes. We aimed to highlight which neoadjuvant treatment strategy could be most successful in each breast cancer subtype. A recent FDA meta-analysis on randomized neoadjuvant breast cancer trials suggests that the survival differences of patients with or without a pCR were less pronounced in luminal A-like tumors, despite the overall favorable prognosis of these patients. Moreover, even though the strong prognostic effect of pCR in HER2 positive and TNBC, the NOAH study was the only trial which showed a trend in surrogacy of pCR for long-term outcome in HER2-positive subtype. Results from GeparTrio study suggest that patients with hormone-positive tumors might need a response-guided approach, with either an intensification of treatment in case of an early response or a change to other chemotherapy in case of no early response. Furthermore, data from German neoadjuvant trials confirm that an increasing number of chemotherapy cycles is associated with a higher pCR rate, especially in patients with HER2-positive/hormone-positive tumors. In line with these suggestions, Tryphaena study showed a pCR rate that exceeding the 60% threshold, the highest pCR results presented in a large multicenter study. In TNBC, the highest pCR rate in the German neoadjuvant studies was obtained with the simultaneous application of docetaxel, doxorubicin and cyclophosphamide for 6 cycles. However, as shown in GaparQuinto and NSABP 40 trials, treatment effect in TNBC might be further maximized by adding bevacizumab, and two randomized neoadjuvant trials are expected this year to report data on the efficacy of carboplatin.
Identification of the intermediates and determination of their structures in the reduction of dioxygen to water by cytochrome c oxidase (CcO) are particularly important to understanding both O2 activation and proton pumping by the enzyme. In this work, we report the products of the rapid reaction of O2 with the mixed valence form (CuA(2+), heme a(3+), heme a3(2+)-CuB(1+)) of the enzyme. The resonance Raman results show the formation of two ferryl-oxo species with characteristic Fe(IV)=O stretching modes at 790 and 804 cm(-1) at the peroxy oxidation level (PM). Density functional theory calculations show that the protein environment of the proximal H-bonded His-411 determines the strength of the distal Fe(IV)=O bond. In contrast to previous proposals, the PM intermediate is also formed in the reaction of Y167F with O2. These results suggest that in the fully reduced enzyme, the proton pumping ν(Fe(IV)=O) = 804 cm(-1) to ν(Fe(IV)=O) = 790 cm(-1) transition (P→F, where P is peroxy and F is ferryl) is triggered not only by electron transfer from heme a to heme a3 but also by the formation of the H-bonded form of the His-411-Fe(IV)=O conformer in the proximal site of heme a3. The implications of these results with respect to the role of an O=Fe(IV)-His-411-H-bonded form to the ring A propionate of heme a3-Asp-399-H2O site and, thus, to the exit/output proton channel (H2O) pool during the proton pumping P→F transition are discussed. We propose that the environment proximal to the heme a3 controls the spectroscopic properties of the ferryl intermediates in cytochrome oxidases.
Background: Understanding the coupling of O2 reduction to proton pumping by CcO requires detection of reaction intermediates.
Results: We have detected two oxoferryl intermediates at the PM oxidation state.
Conclusion: The H-bonding properties of the proximal heme a3 His ligand control the strength of the oxoferryl species.
Significance: The role of His-411, Thr-389, Gly-386, and Asp-399 residues in the proton pumping P→F transition is outlined.
In high-energy nuclear collisions, heavy quark potential at finite temperature controls the quarkonium suppression. Including the relaxation of the medium induced by the relative velocity between quarkonia and the deconfined expanding matter, the Debye screening is reduced and the quarkonium dissociation takes place at a higher temperature. As a consequence of the velocity-dependent dissociation temperature, the quarkonium suppression at high transverse momentum is significantly weakened in high-energy nuclear collisions at RHIC and LHC.
In this article, the video demonstrated is an example of a 76-year-old male patient who presented with recurrent intestinal bleeding of unknown origin at the university hospital. Previously performed upper and lower gastrointestinal tract endoscopy did not reveal a bleeding lesion. Capsule endoscopy revealed small-bowel angiectasia that were treated by argon plasma coagulation at subsequent balloon enteroscopy. This article is part of an expert video encyclopedia.
Small bowel varices may be found in less than 5% of patients with suspected small bowel bleeding. These varices are associated with portal hypertension or thrombosis of mesenteric venous vessels and with altered abdominal vascular anatomy with or without prior small bowel surgery. In bleeding small bowel varices, therapeutic options include endoscopic injection of tissue adhesives, endovascular approaches such as balloon-occluded retrograde transvenous or percutaneous obliteration and transjugular intrahepatic portosystemic shunt, and surgical resection. This is a case report of a 53-year-old patient with ethylic liver cirrhosis who presented with severe, life-threatening hematochezia due to small bowel varices. This article is part of an expert video encyclopedia.
This is an example of capsule endoscopy (CE) revealing terminal ileitis in an young male patient with recurrent abdominal pain who had previously been investigated with colonoscopy and esophagogastroduodenoscopy without any significant findings. CE revealed severe inflammation of the terminal ileum. This article is part of an expert video encyclopedia.
Operatively altered anatomy such as Billroth II gastroenterostomy represents a challenge in endoscopic retrograde cholangiopancreatography and might require dedicated instruments. In this article, the authors demonstrate the technique of endoscopic retrograde cholangiography and sphincterotomy in a patient with Billroth's operation-II. Sphincterotomy is performed with a specially designed Billroth papillotome to enable papillotomy in the direction of the papillary roof. This article is part of an expert video encyclopedia.
Here the authors report the case of an elderly woman who had upper abdominal pain, upper gastrointestinal hemorrhage, and jaundice (a symptomatic triad termed the ‘Quincke’ triad) a few days after endoscopic sphincterotomy. Abdominal ultrasonography demonstrated an echo-rich filling of the choledochus consistent with hemobilia. Endoscopic retrograde cholangiography was immediately performed and blood clots were removed from the common bile duct. A nasobiliary catheter was placed to irrigate the bile duct for prevention of recurring obstruction of the bile ducts from blood clots. Further follow-up of the patient was uneventful. This article is part of an expert video encyclopedia.
Small bowel endoscopy is indicated for patients with an unidentified bleeding site in esophagogastroduodenoscopy and ileocolonoscopy and symptoms of intestinal blood loss or unexplained anemia. In approximately two-thirds of these cases, capsule endoscopy (CE) detects a lesion within the small bowel that explains the patient's symptoms. In few cases, though, lesions outside of the small bowel might be revealed by CE. Therefore, attention to all intestines that are visualized by CE might be necessary not to overlook bleeding sites that had not been discovered by prior flexible endoscopy.
Here the case of a 71-year-old male patient with unexplained anemia is presented by the authors. Small-bowel CE revealed minor bleeding from a neoplastic mass in the cecum. The final diagnosis of an adenocarcinoma of the ascending colon was established after the patient underwent a right hemicolectomy. This article is part of an expert video encyclopedia.
Small bowel endoscopy is indicated for patients with an unidentified bleeding site in esophago-gastro-duodenoscopy and ileo-colonoscopy and symptoms of intestinal blood loss or unexplained anemia. In approximately two-thirds of these cases, capsule endoscopy (CE) detects a lesion within the small bowel that explains the patient's symptoms. In few cases, though, lesions outside of the small bowel might be revealed by CE. Therefore, attention to all intestines that are visualized by CE might be necessary not to overlook bleeding sites that had not been discovered by prior flexible endoscopy.
The authors present the case of a 71-year-old male patient who presented to their outpatient clinic for unexplained anemia. Small bowel CE revealed minor bleeding from an adenocarcinoma in the cecum. This article is part of an expert video encyclopedia.
Stent insertion is an established technique of endoscopic retrograde cholangiopancreatography (ERCP) to treat symptomatic malignant or benign biliary strictures, and stent placement is accomplished by using the over-the-wire (OTW) method. In some cases, however, it might be challenging and sometimes time consuming to pass a complex biliary stricture with the guidewire. Stent-exchange technique with a guidewire left in place during stent removal might therefore be helpful to guarantee successful and time-sparing interventions.
A simple method is presented to remove the stent with the guidewire left in place, using the OTW stent-exchange method in ERCP. This technique simplifies stent OTW exchange by using a simple endoscopy snare. This article is part of an expert video encyclopedia.
Operatively altered anatomy might provide a challenge for endoscopic retrograde cholangiopancreatography. However, with the support of the balloon-assisted enteroscopy technique the access route to the biliary system even in long-limb Roux-Y anastomosis is feasible in most cases.
In this video case report, an 81-year-old woman was symptomatic for stone obstruction of the common bile duct (CBD). Complete gastrectomy had been performed in this patient for stomach cancer many years earlier. Balloon-assisted enteroscopy was used for retrograde access of the duodenum via a Roux-Y anastomosis. There was major difficulty in intubating the CBD via the native papilla in this case because access was prevented by the tangential approach of the enteroscope. After performing an incomplete papillectomy, the insertion of a guidewire into the CBD was feasible and the bile duct stone was removed. This article is part of an expert video encyclopedia.
Purpose: Metabolic changes upon antiangiogenic therapy of recurrent glioblastomas (rGBMs) may provide new biomarkers for treatment efficacy. Since in vitro models showed that phospholipid membrane metabolism provides specific information on tumor growth we employed in-vivo MR-spectroscopic imaging (MRSI) of human rGBMs before and under bevacizumab (BVZ) to measure concentrations of phosphocholine (PCho), phosphoethanolamine (PEth), glycerophosphocholine (GPC), and glyceroethanolamine (GPE).
Methods: 1H and 31P MRSI was prospectively performed in 32 patients with rGBMs before and under BVZ therapy at 8 weeks intervals until tumor progression. Patients were dichotomized into subjects with long overall survival (OS) (>median OS) and short OS (<median OS) survival time from BVZ-onset. Metabolite concentrations from tumor tissue and their ratios were compared to contralateral normal-appearing tissue (control).
Results: Before BVZ, 1H-detectable choline signals (total GPC and PCho) in rGBMs were elevated but significance failed after dichotomizing. For metabolite ratios obtained by 31P MRSI, the short-OS group showed higher PCho/GPC (p = 0.004) in rGBMs compared to control tissue before BVZ while PEth/GPE was elevated in rGBMs of both groups (long-OS p = 0.04; short-OS p = 0.003). Under BVZ, PCho/GPC and PEth/GPE in the tumor initially decreased (p = 0.04) but only PCho/GPC re-increased upon tumor progression (p = 0.02). Intriguingly, in normal-appearing tissue an initial PEth/GPE decrease (p = 0.047) was followed by an increase at the time of tumor progression (p = 0.031).
Conclusion: An elevated PCho/GPC ratio in the short-OS group suggests that it is a negative predictive marker for BVZ efficacy. These gliomas may represent a malignant phenotype even growing under anti-VEGF treatment. Elevated PEth/GPE may represent an in-vivo biomarker more sensitive to GBM infiltration than MRI.
Friedrich Flick zählt zweifellos zu den umstrittensten Protagonisten der deutschen Wirtschafts- und Unternehmensgeschichte des 20. Jahrhunderts – und mittlerweile auch zu den am besten erforschten. Zwischen 2004 und 2008 erschienen gleich vier teilweise recht umfangreiche Arbeiten zur Konzern- und zur Familiengeschichte. Was macht diesen Mann für Geschichtswissenschaft und politisch interessierte Öffentlichkeit so interessant? Ein kühner Unternehmensgründer vom Schlage eines Thyssen oder Siemens – das machen die vier Autoren gleich in der Einleitung deutlich – war er jedenfalls nicht, auch kein genialer Erfinder oder sozialpolitischer Pionier. Sein Name sei vielmehr zum "Synonym für politischen Opportunismus und den skrupellosen Einsatz wirtschaftlicher Macht geworden" (S. 8). Einen gewissermaßen widerwilligen Respekt nötigt allenfalls seine Fähigkeit ab, unter vier verschiedenen politischen Systemen wirtschaftlich erfolgreich zu sein. Schon aus diesem Grund erscheint es den Autoren angezeigt, Flick "als Unternehmer ernst zu nehmen" (S. 9). ...
Men and women differ substantially regarding height, weight, and body fat. Interestingly, previous work detecting genetic effects for waist-to-hip ratio, to assess body fat distribution, has found that many of these showed sex-differences. However, systematic searches for sex-differences in genetic effects have not yet been conducted. Therefore, we undertook a genome-wide search for sexually dimorphic genetic effects for anthropometric traits including 133,723 individuals in a large meta-analysis and followed promising variants in further 137,052 individuals, including a total of 94 studies. We identified seven loci with significant sex-difference including four previously established (near GRB14/COBLL1, LYPLAL1/SLC30A10, VEGFA, ADAMTS9) and three novel anthropometric trait loci (near MAP3K1, HSD17B4, PPARG), all of which were significant in women, but not in men. Of interest is that sex-difference was only observed for waist phenotypes, but not for height or body-mass-index. We found no evidence for sex-differences with opposite effect direction for men and women. The PPARG locus is of specific interest due to its link to diabetes genetics and therapy. Our findings demonstrate the importance of investigating sex differences, which may lead to a better understanding of disease mechanisms with a potential relevance to treatment options.
Gene therapy on the move
(2013)
The first gene therapy clinical trials were initiated more than two decades ago. In the early days, gene therapy shared the fate of many experimental medicine approaches and was impeded by the occurrence of severe side effects in a few treated patients. The understanding of the molecular and cellular mechanisms leading to treatment- and/or vector-associated setbacks has resulted in the development of highly sophisticated gene transfer tools with improved safety and therapeutic efficacy. Employing these advanced tools, a series of Phase I/II trials were started in the past few years with excellent clinical results and no side effects reported so far. Moreover, highly efficient gene targeting strategies and site-directed gene editing technologies have been developed and applied clinically. With more than 1900 clinical trials to date, gene therapy has moved from a vision to clinical reality. This review focuses on the application of gene therapy for the correction of inherited diseases, the limitations and drawbacks encountered in some of the early clinical trials and the revival of gene therapy as a powerful treatment option for the correction of monogenic disorders.
Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by impaired antimicrobial activity in phagocytic cells. As a monogenic disease affecting the hematopoietic system, CGD is amenable to gene therapy. Indeed in a phase I/II clinical trial, we demonstrated a transient resolution of bacterial and fungal infections. However, the therapeutic benefit was compromised by the occurrence of clonal dominance and malignant transformation demanding alternative vectors with equal efficacy but safety-improved features. In this work we have developed and tested a self-inactivating (SIN) gammaretroviral vector (SINfes.gp91s) containing a codon-optimized transgene (gp91(phox)) under the transcriptional control of a myeloid promoter for the gene therapy of the X-linked form of CGD (X-CGD). Gene-corrected cells protected X-CGD mice from Aspergillus fumigatus challenge at low vector copy numbers. Moreover, the SINfes.gp91s vector generates substantial amounts of superoxide in human cells transplanted into immunodeficient mice. In vitro genotoxicity assays and longitudinal high-throughput integration site analysis in transplanted mice comprising primary and secondary animals for 11 months revealed a safe integration site profile with no signs of clonal dominance.
The project focuses on the efficiency of combined technologies to reduce the release of micropollutants and bacteria into surface waters via sewage treatment plants of different size and via stormwater overflow basins of different types. As a model river in a highly populated catchment area, the river Schussen and, as a control, the river Argen, two tributaries of Lake Constance, Southern Germany, are under investigation in this project. The efficiency of the different cleaning technologies is monitored by a wide range of exposure and effect analyses including chemical and microbiological techniques as well as effect studies ranging from molecules to communities.
Angiogenesis, the formation of new blood vessels from existing ones, is a fundamental biological process required for embryonic development; it also plays an important role during postnatal organ development and various physiological and pathological remodeling processes in the adult organism. Vascular endothelial growth factor (VEGF) and its main receptor, VEGF receptor-2 (VEGFR-2), play a central role in angiogenesis. VEGFR-2 expression is strongly upregulated in angiogenic vessels, but the mechanisms regulating VEGFR-2 expression are not well understood. We found in this study that the G-protein α subunit Gα13 plays an important role in the regulation of VEGFR-2 expression. In vitro, we found that knockdown of Gα13 reduced VEGFR-2 expression in human umbilical vein endothelial cells and impaired responsiveness to VEGF-A. This phenotype was rescued by adenoviral normalization of VEGFR-2 expression. Gα13-dependent VEGFR-2 expression involved activation of the small GTPase RhoA and transcription factor NF-κB; it was abrogated by deletion of the NF-κB binding site at position -84 of the VEGFR-2 promoter. In vivo, endothelial cell-specific loss of Gα13 resulted in reduced VEGFR-2 expression, impaired responsiveness towards VEGF-A in Matrigel assays, and reduced retinal angiogenesis. Importantly, also tumor vascularization was diminished in the absence of endothelial Gα13, resulting in reduced tumor growth. Taken together, we identified Gα13-dependent NF-κB activation as a new pathway underlying the transcriptional regulation of VEGFR-2 during retinal and tumor angiogenesis.
Data are presented for 29 chrysomelid species (Coleoptera: Chrysomelidae) occurring in the Cayman Islands, West Indies, 26 of these not having been reported from these islands previously. Altica occidentalis Suffrian is removed from the genus Lysathia Bechyné and reinstated in Altica Geoffroy. Chaetocnema perplexa Blake is synonymized with Chaetocnema confinis Crotch, new synonymy. Omophoita cyanipennis octomaculata (Crotch) is synonymized with Omophoita cyanipennis (Fabricius), new synonymy. The following nine species are named and described: Apraea luciae, Apraea priscilae, Cryptocephalus catharinae, Cryptocephalus kirki, Cryptocephalus paulotigrinus, Longitarsus alisonae, Megistops adiae, Nyctiplanctus bifasciatus, Syphrea thurstonae, all are new species. Taxonomic notes and a key to species, as well as information on plant associations and extralimital distribution, are also provided.
The prize-collecting vehicle routing problem with single and multiple depots and non-linear cost
(2013)
In this paper, we propose a new routing problem to model a highly relevant planning task in small package shipping. We consider the Prize-Collecting Vehicle Routing Problem with Non-Linear cost in its single and multi-depot version, which integrates the option of outsourcing customers to subcontractors instead of serving them with the private fleet. Thereby, a lower bound on the total customer demand to be served by the private fleet guarantees a high utilization of the fleet capacity. To represent the practical situation, where a discount is given by a subcontractor if larger amounts of packages are outsourced, subcontracting costs follow a non-linear function. The considered problem is NP-hard and we propose an Adaptive Variable Neighborhood Search algorithm to solve instances of realistic size. We propose new benchmark sets for the single and the multi-depot problem, which are adapted from test instances of the capacitated VRP and the closely related Multi-Depot VRP with Private fleet and Common carrier. In numerical studies, we investigate the performance of our algorithm on the newly generated test instances and on standard benchmark problems of related problems. Moreover, we study the effect of different cost functions and different values of the minimal demand to be served by the private fleet on the routing solutions obtained.
Bei der Ionenstrahltherapie bestimmt die Energie der Ionen die Eindringtiefe in das Gewebe und damit die Lage des Braggpeaks, in dem der größte Teil der Ionisationsenergie deponiert wird.
Um die gewünschte Dosis möglichst genau im Tumor zu lokalisieren, müssen in den aufeinanderfolgenden Extraktionen die gewünschten unterschiedlichen Energien möglichst genau sein.
In der Beschleunigungsphase werden die Magnetfelder der Magnete im Synchrotron bis zum vorgegebenen Exktraktionswert hochgefahren. Dieser bestimmt zusammen mit der Synchrotronfrequenz die Strahlenergie. Während und insbesondere am Ende dieser Phase, Rampe genannt, sollte das Magnetfeld daher sehr genau dem berechneten Sollwert folgen, um Strahlverluste zu minimieren und die geforderte Strahlqualität zu erreichen.
In der zeitlichen Steuerung der Magnetströme müssen magnetische Effekte, die hauptsächlich im Eisen der Magnete auftreten, wie Wirbelströme und die Hysterese berücksichtigt werden, da sie das Feld verfälschen und damit den Strahl in unerwünschter Weise beeinflussen. Die während der Rampe entstehenden Wirbelströme stören das Magnetfeld, so dass bisher vor der Extraktion des Strahls eine Wartezeit eingeführt wurde, bis die Wirbelströme abgeklungen waren.
Bei beliebig wählbaren Abfolgen der vordefinierten Zyklen kommt es durch die Hysterese des Eisens zu unterschiedlichen Remanenzfeldern, die das Magnetfeld verändern. Um dem vorzubeugen, durchliefen die Magnete eine vordefinierte Hystereseschleife. Ist die geforderte Energie des Strahls erreicht, wird das Magnetfeld konstant gehalten und die Teilchen aus dem Synchrotron extrahiert. Der Rest der Hystereseschleife wurde am Ende des Zyklus durchlaufen.
Die im Rahmen dieser Dissertation entwickelte dynamische Magnetfeldregelung misst das integrale Magnetfeld sehr genau und korrigiert die Feldfehler. Das integrale Magnetfeld folgt damit jederzeit seiner Vorgabe, unabhängig von den dynamischen Störeffekten. Die Wirbelströme und die Hysterese sind zwar immer noch vorhanden, die dadurch verursachten Feldfehler können aber durch eine Rückkopplung auf den Strom des Magneten korrigiert werden.
Es werden verschiedene Verfahren zur Messung der Magnetfelder untersucht. Am besten eignet sich für die dynamische Magnetfeldregelung die Kombination aus einer Hallsonden- und einer Induktionsspulenmessung. Die Messung muss das integrale Magnetfeld des Magneten BL, also das gesamte Feld entlang des Strahlwegs, bestimmen. Die Induktionsspule, oder Pickupspule, liegt deshalb entlang des Strahlrohrs im Magneten und liefert eine Spannung in Abhängigkeit von der Änderung des magnetischen Flusses. Durch die Integration dieser Spannung erhält man das integrale Feld des Magneten. Die Messung wird mit einer Hallsondenmessung zu Beginn des Beschleunigerzyklus auf einen absoluten Messwert geeicht.
Der Hauptteil dieser Arbeit beschäftigt sich mit der Entwicklung des sogenannten HIT Integrators, der die Integration der Pickupspulenspannung übernimmt. Bisher verfügbare Integratoren konnten die notwendigen Anforderungen an Genauigkeit, Echtzeitfähigkeit, automatische Kalibrierung, ständige Messbereitschaft, Temperaturunabhängigkeit und hohe Verfügbarkeit nicht erfüllen. Der neu entwickelte HIT Integrator wurde diesen Anforderungen entsprechend entwickelt. Der Integrator mit dem neuartigen Konzept der gleichzeitigen Messung und Kalibrierung in Echtzeit ist als Patent angemeldet worden. Neben der Entwicklung und Verwirklichung des Gesamtkonzepts war die numerische Integration des stark verrauschten Pickupspulensignals und die sofortige Umsetzung des integralen Werts in ein Steuersignal für die Dipolmagnetstromgeräte eine besondere technische Herausforderung.
Die elektronischen Schaltungen für die dynamische Magnetfeldregelung sind in der Baugruppe des HIT Integrators zusammengefasst. Die Ansteuerung der Hallsonde mit einer temperaturkompensierten Stromquelle, der Signalaufbereitung und Analog-Digital-Wandlung, sowie der Integrator und der Regler bilden eine technische Einheit.
Der HIT Integrator ist speziell für den Einsatz im bestehenden Beschleunigerkontrollsystem und den Magnetnetzgeräten entwickelt worden.
Die Regler der Magnetnetzgeräte wurden so verändert, dass sie einen Zusatzsollwert verarbeiten können, der auf den berechneten Sollwert der Datenversorgung addiert wird.
Die Magnetfeldregelung wurde in den Therapiebeschleuniger integriert, dazu wurde die Datenversorgung und das Kontrollsystem angepasst. Die Magnetfeldregelung stellt ein neues Gerät im Beschleuniger dar, das in die Netzgeräte der Synchrotronmagnete eingebaut worden ist. Die Datenversorgung dieser Geräte beinhaltet u.a. eine neue Methode der Kalibrierung.
Es konnte durch Messungen gezeigt werden, dass die Magnetfeldregelung mit hoher Genauigkeit funktioniert. Es wird eine Genauigkeit von besser als 10^{-4} des maximalen Feldes von 1.5 T erreicht, also weniger als 150uT, der dreifachen Stärke des Erdmagnetfelds. Vor allem die Bestrahlungszeit mit Protonen und die Bestrahlung bei niedrigen Energien profitiert von der Magnetfeldregelung, da hier das Extraktionsniveau der Magnete relativ gering ist und das Durchlaufen der vordefinierten Hystereseschleife prozentual mehr Zeit im Zyklus in Anspruch nimmt. Durch den Wegfall dieser Phase wird daher pro Zyklus mehr Zeit eingespart. Die Messungen zeigen, dass im Beschleunigerzyklus trotz der fehlenden Wartezeiten, die bis zu 24% betragen, eine gleichbleibend gute Strahlqualität erreicht wird. Dies wurde mit Vergleichsmessungen gezeigt, bei denen der Strahl mit und ohne Feldregelung vermessen wurde. Untersucht wurde eine große Stichprobenmenge aus dem Parameterraum, gegeben durch zwei Ionensorten mit jeweils 255 Strahlenergien, 10 verschiedenen Teilchenraten und 4 Strahlbreiten. Außerdem wurde die Energie des Strahls nachgemessen.
Für die Einführung in den Therapiebetrieb musste eine Impactanalyse gemacht werden, die mögliche Auswirkungen des neuen Verfahrens behandelt. Das Risiko für Patienten, Mitarbeiter und Dritte darf durch die Magnetfeldregelung nicht erhöht werden. Daraus entstand auch die Forderung nach einem redundanten System, das Fehler erkennt und die Bestrahlung abbricht.
Die mittlere Leistungsaufnahme des Beschleunigers des Heidelberger Ionenstrahltherapiezentrums liegt bei etwa 1 MW, bei einem Jahresenergieverbrauch von 8 GWh mit Kosten von etwa 1 Million Euro. Dies entspricht einer deutschen Kleinstadt mit 10000 Einwohnern. Die Verkürzung der Zykluszeiten wirkt sich direkt auf die Bestrahlungszeit und auf die Energiekosten aus. Würde man die Anlage durch die Zeiteinsparungen kürzer betreiben, würde man etwa 2 GWh pro Jahr sparen, was die Stromkosten um etwa 250000 Euro reduziert.
Zusätzlich zu den eingesparten Kosten wird auch die Bestrahlungszeit kürzer und damit auch die Zeit, die der Patient bei der Behandlung fixiert wird. Die Behandlung für die Patienten wird angenehmer. Man kann aber auch durch die eingesparte Bestrahlungszeit pro Patient entsprechend mehr Patienten behandeln. Das heißt man kann an Stelle von 700 Patienten im Jahr 910 Patienten mit einem Tumor behandeln. Dieser für die Patienten willkommene Effekt bedeutet auf der anderen Seite für HIT aber auch Mehreinnahmen von 4.2 Millionen Euro im Jahr.
Das Konzept der Magnetfeldregelung kann auch an anderen Beschleunigeranlagen zum Einsatz kommen. Dazu müssen die Magnete mit den Sonden bestückt werden und die Magnetnetzgeräte einen Eingang für einen Zusatzsollwert bekommen. Das Beschleunigerkontrollsystem kann erweitert werden, damit es einen Sollwert mit allen notwendigen Kalibrierungen berechnen kann. Der HIT Integrator wird dann als eigenständiges Gerät in das Kontrollsystem eingebunden.
Das Heidelberger Ionenstrahl Therapiezentrum (HIT) ist die erste klinische Anlage in Europa, an der die Strahlentherapie zur Tumorbekämpfung mit schwereren Ionen als Protonen möglich ist. Seit November 2009 wurden mehr als 1500 Patienten bei HIT behandelt.
Dabei kommt das beim GSI Helmholtzzentrum für Schwerionenforschung GmbH in Darmstadt entwickelte Rasterscan-Verfahren zum Einsatz. In der Bestrahlungsplanung wird der Tumor in Schichten gleicher Ionen-Energie und jede Schicht in einzelne Rasterpunkte eingeteilt. Für jeden Rasterpunkt wird eine individuelle Teilchenzahl appliziert, die am Ende zu der gewünschten Dosisverteilung führt. Dabei kann sich die benötigte Teilchenbelegung der einzelnen Rasterpunkte auch innerhalb einer Schicht um mehr als zwei Größenordnungen unterscheiden.
Ein auf wenige Millimeter Durchmesser fokussierter Teilchenstrahl kann in allen Raumrichtungen variiert werden, so dass selbst für unregelmäßig geformte Tumoren eine hochgenaue Dosiskonformität erreicht wird. Messkammern, die in der Ionen-Flugbahn kurz vor dem Patienten installiert sind, überwachen kontinuierlich Position, Form und Intensität des Strahls und ermöglichen so die Rasterpunkt-abhängige Dosisabgabe.
Zur Bereitstellung des Teilchenstrahls ist eine komplexe Beschleunigeranlage nötig, die eine große Bibliothek an möglichen Strahlparametern erzeugen kann. Das Herzstück der Anlage ist ein Synchrotron, in dem die Ionen auf die gewünschte Energie beschleunigt und anschließend über mehrere Sekunden extrahiert werden. Diese langsame Extraktion ist nötig, um dem Bestrahlungssystem genug Zeit für die korrekte, punktgenaue Dosisabgabe zu geben. Die zeitliche Struktur der beim Patienten ankommenden Strahlintensität wird Spill genannt.
Der verwendete Extraktionsmechanismus ist die transversale RF-Knockout Extraktion, die auf dem Prinzip der langsamen Resonanzextraktion beruht. Die im Synchrotron umlaufenden Teilchen werden dabei transversal angeregt, bis nach und nach ihre Schwingungsamplitude so groß ist, dass sie in den Extraktionskanal gelangen. Das für diese Anregung verantwortliche Gerät ist der RF-KO-Exciter. Er ist so eingestellt, dass ein möglichst konstanter Teilchenstrom das Synchrotron verlässt.
Bereits beim Befüllen des Synchrotrons variiert jedoch die injizierte Teilchenzahl und deren Verteilung im Phasenraum, so dass die voreingestellte Amplitudenfunktion des RF-KO-Exciters keinen idealen Spill liefern kann. Es kommt unweigerlich zu Schwankungen der Intensität am Strahlziel. Die erreichbare Leistungsfähigkeit der Therapieanlage hängt jedoch in hohem Maße von der Spillqualität ab. Je besser diese ist, umso schneller kann die individuelle Bestrahlung erfolgen und um so mehr Patienten können in gleicher Zeit behandelt werden.
Die vorliegende Arbeit beschäftigt sich mit der Verbesserung der Spillqualität am Bestrahlungsplatz. Dazu wird ein Regelkreis zwischen den Strahl-detektierenden Messkammern und dem die Extraktion steuernden RF-KO-Exciter geschlossen. Ionisationskammern, die auch zur Dosisbestimmung verwendet werden, messen die aktuelle Intensität. Das Therapiekontrollsystem, das den gesamten Bestrahlungsprozess steuert, gibt den Sollwert vor und leitet alle Informationen zur Reglereinrichtung. Dort wird in Abhängigkeit der Abweichung aus gewünschter und tatsächlich vorhandener Intensität sowie dem Regelalgorithmus ein Korrektursignal errechnet und dem RF-KO-Exciter zugeführt. Eine der Herausforderungen bestand dabei im Auffinden der geeigneten Regelparameter, die entsprechend der Strahlparameter Energie und Intensität gewählt werden müssen.
In einem ersten Schritt kann so der extrahierte Teilchenstrahl auf dem jeweils geforderten, konstanten Niveau gehalten werden. Diese Stufe wird seit April 2013 vollständig im Routinebetrieb der Therapieanlage verwendet. Der zweite Schritt besteht in der Anpassung der Extraktionsrate an den individuellen Bestrahlungsplan. So können die Rasterpunkte, die eine hohe Dosis benötigen, mit einer höheren Intensität bestrahlt werden, was die Bestrahlungszeit deutlich reduziert. Die Vollendung dieser Stufe ist bis Ende 2013 vorgesehen.
Im Rahmen dieser Arbeit wurden zwei Testsysteme sowie die Implementierung in den Routinebetrieb des Therapiebeschleunigers einer solchen Intensitäts- oder Spillregelung realisiert. Dies beinhaltet den Aufbau der Systeme, die Bereitstellung von Soll- und Istwert sowie die Auslegung und Einstellung des Regelkreises. Der erste Testaufbau für ein Strahlziel des Beschleunigers diente generellen Studien zur Machbarkeit einer solchen Regelung. Die dabei gesammelten Erfahrungen über nötige Erweiterungen führten zur zweiten Generation einer Testumgebung auf Basis eines Echtzeit-Ethernet-Systems. Dieses ermöglichte bereits die Regelung an allen Strahlzielen der HIT-Anlage sowie die Verwendung von unterschiedlichen Regelalgorithmen.
Mit den Systemen wurden Messungen zur Charakterisierung der Spillregelung im Parameterraum des Beschleunigers durchgeführt, um so ihre Möglichkeiten und Grenzen zu untersuchen. Erkenntnisse aus dieser Testphase flossen direkt in die Implementierung des für den Patientenbetrieb eingesetzten Systems ein, für das ein hohes Maß an Betriebs-Stabilität erforderlich ist. Es wurde in das Beschleuniger-Kontrollsystem unter Berücksichtigung des Sicherheitskonzeptes der Anlage integriert.
Die reine Bestrahlungszeit wird durch die Realisierung der ersten Stufe um bis zu 25% reduziert, nach Vollendung der zweiten Stufe wird sie um weitere bis zu 50% verringert. Strahlzeiten für Nachjustierungen der Spillqualität werden ebenfalls zum Teil eingespart. Insgesamt konnte durch die Spillregelung die Effizienz der Anlage deutlich gesteigert werden.
We show that the optimal consumption of an individual over the life cycle can have the hump shape (inverted U-shape) observed empirically if the preferences of the individual exhibit internal habit formation. In the absence of habit formation, an impatient individual would prefer a decreasing consumption path over life. However, because of habit formation, a high initial consumption would lead to high required consumption in the future. To cover the future required consumption, wealth is set aside, but the necessary amount decreases with age which allows consumption to increase in the early part of life. At some age, the impatience outweighs the habit concerns so that consumption starts to decrease. We derive the optimal consumption strategy in closed form, deduce sufficient conditions for the presence of a consumption hump, and characterize the age at which the hump occurs. Numerical examples illustrate our findings. We show that our model calibrates well to U.S. consumption data from the Consumer Expenditure Survey.
Der Eintritt des Lesers in die Welt der "Wächter"-Romane Sergej Lukianenkos mutet geradezu konventionell an. Der Ich-Erzähler und Protagonist Anton Gorodezki, lichter "Anderer", Nachtwache Moskau, durchstreift die nächtlichen Straßen in wichtiger Mission: er folgt dem Ruf eines dunklen "Anderen", eines Vampirs, um das damit angelockte menschliche Opfer zu retten. Nach und nach entfaltet sich die Welt der Wächter. In der uns bekannten Welt leben neben den normalen Menschen die magiebegabten "Anderen", Vampire und Werwölfe, Hexen und Zauberer etc. Von den Menschen, zumindest den Menschen der Moderne, weitgehend unbemerkt leben sie unter uns und bestimmen wesentlich die Ereignisse der Weltgeschichte.
Gemeinsam ist allen "Anderen" die Fähigkeit, in die magische Parallelwelt des Zwielichts eintauchen zu können. Getrennt sind sie durch ihre Zugehörigkeit zu den Lichten beziehungsweise zu den Dunklen, die sich in einem immerwährenden Kampf gegeneinander und um die Seelen der Menschen befinden. Zu Nutz und Frommen der Menschen kämpft das Gute gegen das Böse, Magie ist auch im Spiel – ein bekanntes Muster der Fantasy.
In literaturwissenschaftlichen Analysen des Genres spielt "Gut gegen Böse" dennoch ein weitgehendes Schattendasein. Definitionsversuche der Fantasy etwa von Pesch und Weinreich nennen das Begriffspaar nicht, eben sowenig das Phantastikhandbuch unter dem Lemma "Fantasy", allerdings als Grundmotiv der Apokalypse. Abraham führt es nicht als Teil seiner Definition, aber immerhin als einen Unterpunkt von "Dichotomien abendländischer Fantastik". Wiewohl Abraham insbesondere für neuere Werke und Adaptionen ausführt, dass nicht "ein einfacher Schwarz-Weiß-Kontrast [...], sondern tatsächlich eine Dichotomie" zwischen Gut und Böse vorliege und einzelnen Figuren psychologische Tiefe in diesem Bereich verliehen werde, so mag das relative Desinteresse an diesem Bereich auch daran liegen, dass ein oft recht holzschnittartig gearbeiteter Gegensatz ein wenig ergiebiges Arbeitsfeld oder Definitionskriterium darstellt. Auffällig ist, dass Abrahams vergleichsweise ausführliches Eingehen auf das Thema in einer "Einführung für Schule und Hochschule", unter einer spezifisch "medien- und rezeptionsorientierten Perspektive" stattfindet.
Background: Vitamin D insufficiency has been associated with the occurrence of various types of cancer, but causal relationships remain elusive. We therefore aimed to determine the relationship between genetic determinants of vitamin D serum levels and the risk of developing hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).
Methodology/Principal Findings: Associations between CYP2R1, GC, and DHCR7 genotypes that are determinants of reduced 25-hydroxyvitamin D (25[OH]D3) serum levels and the risk of HCV-related HCC development were investigated for 1279 chronic hepatitis C patients with HCC and 4325 without HCC, respectively. The well-known associations between CYP2R1 (rs1993116, rs10741657), GC (rs2282679), and DHCR7 (rs7944926, rs12785878) genotypes and 25(OH)D3 serum levels were also apparent in patients with chronic hepatitis C. The same genotypes of these single nucleotide polymorphisms (SNPs) that are associated with reduced 25(OH)D3 serum levels were found to be associated with HCV-related HCC (P = 0.07 [OR = 1.13, 95% CI = 0.99–1.28] for CYP2R1, P = 0.007 [OR = 1.56, 95% CI = 1.12–2.15] for GC, P = 0.003 [OR = 1.42, 95% CI = 1.13–1.78] for DHCR7; ORs for risk genotypes). In contrast, no association between these genetic variations and liver fibrosis progression rate (P>0.2 for each SNP) or outcome of standard therapy with pegylated interferon-α and ribavirin (P>0.2 for each SNP) was observed, suggesting a specific influence of the genetic determinants of 25(OH)D3 serum levels on hepatocarcinogenesis.
Conclusions/Significance: Our data suggest a relatively weak but functionally relevant role for vitamin D in the prevention of HCV-related hepatocarcinogenesis.
Background: After induction of DNA double strand breaks (DSBs), the DNA damage response (DDR) is activated. One of the earliest events in DDR is the phosphorylation of serine 139 on the histone variant H2AX (gH2AX) catalyzed by phosphatidylinositol 3-kinases-related kinases. Despite being extensively studied, H2AX distribution[1] across the genome and gH2AX spreading around DSBs sites[2] in the context of different chromatin compaction states or transcription are yet to be fully elucidated.
Materials and methods: gH2AX was induced in human hepatocellular carcinoma cells (HepG2) by exposure to 10 Gy X-rays (250 kV, 16 mA). Samples were incubated 0.5, 3 or 24 hours post irradiation to investigate early, intermediate and late stages of DDR, respectively. Chromatin immunoprecipitation was performed to select H2AX, H3 and gH2AX-enriched chromatin fractions. Chromatin-associated DNA was then sequenced by Illumina ChIP-Seq platform. HepG2 gene expression and histone modification (H3K36me3, H3K9me3) ChIP-Seq profiles were retrieved from Gene Expression Omnibus (accession numbers GSE30240 and GSE26386, respectively).
Results: First, we combined G/C usage, gene content, gene expression or histone modification profiles (H3K36me3, H3K9me3) to define genomic compartments characterized by different chromatin compaction states or transcriptional activity. Next, we investigated H3, H2AX and gH2AX distributions in such defined compartments before and after exposure to ionizing radiation (IR) to study DNA repair kinetics during DDR. Our sequencing results indicate that H2AX distribution followed H3 occupancy and, thus, the nucleosome pattern. The highest H2AX and H3 enrichment was observed in transcriptionally active compartments (euchromatin) while the lowest was found in low G/C and gene-poor compartments (heterochromatin). Under physiological conditions, the body of highly and moderately transcribed genes was devoid of gH2AX, despite presenting high H2AX levels. gH2AX accumulation was observed in 5’ or 3’ flanking regions, instead. The same genes showed a prompt gH2AX accumulation during the early stage of DDR which then decreased over time as DDR proceeded.
Finally, during the late stage of DDR the residual gH2AX signal was entirely retained in heterochromatic compartments. At this stage, euchromatic compartments were completely devoid of gH2AX despite presenting high levels of non-phosphorylated H2AX.
Conclusions: We show that gH2AX distribution ultimately depends on H2AX occupancy, the latter following H3 occupancy and, thus, nucleosome pattern. Both H2AX and H3 levels were higher in actively transcribed compartments. However, gH2AX levels were remarkably low over the body of actively transcribed genes suggesting that transcription levels antagonize gH2AX spreading. Moreover, repair processes did not take place uniformly across the genome; rather, DNA repair was affected by genomic location and transcriptional activity. We propose that higher H2AX density in euchromaticcompartments results in high relative gH2AXconcentration soon after the activation of DDR, thus favoring the recruitment of the DNA repair machinery to those compartments. When the damage is repaired and gH2AX is removed, its residual fraction is retained in the heterochromatic compartments which are then targeted and repaired at later times.
Ziel dieser Arbeit war, die Reaktion von biologischen Gewebeproben auf dünn- und dicht-ionisierende Strahlung zu evaluieren. Dafür wurden die Gewebeproben konventioneller Röntgenstrahlung sowie einem ausgedehnten 12C-Ionen Bragg-Peak ausgesetzt. Zur Bestrahlung der biologischen Proben mit 12C wurde mit dem GSI-eigenen Simulationsprogramm TRiP98 ein Tiefendosisprofil eines ausgedehnten Bragg-peaks erstellt. Ein weiteres Ziel dieser Arbeit war, dieses Tiefendosisprofil mit drei anderen Simulationsprogrammen (ATIMA, MCHIT, TRIM) zu reproduzieren und zu vergleichen.
ATIMA und TRIM sind allgemeine Programme für den Energieverlust von Ionen in Materie. Sie können das von TRiP98 berechnetet Tiefendosisprofil nur ungenügend reproduzieren, da sie aufgrund fehlender Fragmentierung ein linear ansteigendes Tiefendosisprofil berechnen. Das Monte Carlo-Programm MCHIT, welches speziell für die Wechselwirkung von Ionen mit Materie in medizinischer Anwendung entwickelt wurde, zeigt die beste Übereinstimmung mit der TRiP98-Referenzkurve. Bis auf eine leicht höhere Durchschnittsdosis um 0.1 Gy konnte das Tiefendosisprofil nahezu exakt reproduziert werden.
Die biologischen Proben bestanden aus Schnittkulturen gesunder Maus-Lebern und Explantatkulturen gesunder Maus-Pankreata, um Nebenwirkungen ionisierender Strahlen abzuschätzen. Zusätzlich wurde die Reaktion auf 12C-Bestrahlung in neoplastischem Lebergewebe transgener c-myc/TGF-α Mäuse mit induzierbarem Lebertumor bestimmt. Um eine mögliche Tageszeitabhängigkeit der Gewebereaktion auf die Bestrahlung zu untersuchen, wurden die Schnitt- und Explantatkulturen zu zwei unterschiedlichen Tageszeiten präpariert: zur Mitte des subjektiven Tages und zur Mitte der subjektiven Nacht.
Die Präparate wurden für mehrere Tage auf einer Membran an einer Grenzschicht von Flüssigkeit und Luft kultiviert. Leber- und Pankreaskulturen gesunder C3H wildtyp Mäuse wurden mit einer Dosis von 2 Gy, 5 Gy oder 10 Gy Röntgenstrahlen bestrahlt. Leber- und Pankreaskulturen transgener Mäuse wurden mit ausgedehnten C-Ionen Bragg Peaks gleicher Dosen bestrahlt. Als Kontrolle dienten unbestrahlte Proben. Alle Proben wurden 1 h bzw. 24 h nach der Bestrahlung fixiert und immunhistochemisch auf Marker für Proliferation (Ki67), Apoptose (Caspase3) und DNA- Doppelstrangbrüche (γH2AX) untersucht.
Während die Pankreas-Präparate im Hinblick auf die untersuchten Parameter leider keine auswertbaren Ergebnisse ergaben, zeigten die untersuchten Parameter im gesunden Lebergewebe deutliche Tag-Nacht Unterschiede: die Proliferationsrate war zur Mitte des subjektiven Tages signifikant höher als zur Mitte der subjektiven Nacht. Umgekehrt waren die Raten für DNA-Doppelstrangbrüche zur Mitte der subjektiven Nacht signifikant erhöht. Diese Tag-Nacht Unterschiede ließen sich in neoplastischem Lebergewebe nicht nachweisen. Unabhängig von der Art und Dosis, hatte die Bestrahlung im gesunden Lebergewebe keinen Einfluss auf die untersuchten Parameter. In neoplastischem Lebergewebe hingegen wird die Rate an DNA-Doppelstrangbrüchen durch eine Bestrahlung dosisabhängig erhöht.
Die Auswirkungen ionisierender Strahlen auf das circadiane Uhrwerk wurden in Gewebeproben transgener Per2luc-Mäuse überprüft. Per2luc-Mäuse exprimieren das Enzym Luziferase unter der Kontrolle des Promoters von Per2, einem wichtigen Bestandteil des circadianen Uhrwerks. Daher erlaubt die Analyse dieser Tiere, den circadianen Rhythmus des molekularen Uhrwerks in Leber und anderen Geweben durch Messung der Luziferase-Aktivität in Echtzeit aufzuzeichnen. Wie in Leber- und Nebennierenkulturen dieser Tiere gezeigt werden konnte, führten ioniserende Strahlen dosisabhängig zu einem Phasenvorsprung des circadianen Uhrwerks.
Die Ergebnisse erlauben die Schlussfolgerung, dass ionisierende Strahlen das circadiane Uhrwerk verstellen, Proliferation und Apoptose in gesundem Lebergewebe jedoch kaum beeinflussen.
The six species of Siricidae (Hymenoptera: Symphyta) occurring in Florida and one species of regulatory concern introduced to North America are reviewed. Included are diagnoses of Eriotremex formosanus (Matsumura), Sirex areolatus (Cresson), Sirex nigricornis Fabricius, Tremex columba (Linnaeus), Urocerus cressoni Norton, Urocerus taxodii (Ashmead) and Sirex noctilio (Fabricius). A key to species, photographs of morphological features, biological notes and distribution data are provided. For the species T. columba, S. nigricornis, U. taxodii, and U. cressoni, a total of eight new state records are presented.
We present new southeastern United States distributional records for Stictoleptura canadensis (Olivier, 1795), Leptura subhamata Randall, 1838 (Coleoptera: Cerambycidae: Lepturinae), and Heterosternuta cocheconis (Fall, 1917) (Coleoptera: Dytiscidae: Hydroporinae) which extend the southernmost limits of the known distributions for these species. We present new state records for these species.
Quand un professeur atteint l’âge de la retraite, il est de coutume de lui offrir un volume en son honneur. Le cas le plus fréquent est un volume d’hommages, de ses collègues et anciens étudiants. Plus rarement, c’est un recueil des articles rédigés par luimême qui est proposé. On peut débattre de la meilleure solution, mais la seconde a l’avantage d’offrir au souscripteur ou à l’acheteur un ensemble d’études publiées dans des revues ou des actes de colloque divers, et c’est celle qui a été choisie par les étudiants de Heribert Müller, à l’occasion de ses soixantecinq ans, le 16 mars 2011. ...
Le livre, issu d’un colloque tenu en 2010 dans l’enceinte de l’Historisches Kolleg, relève de la gageure. Il entend déporter l’accent de la première décennie du concile de Bâle, celle de son apogée, vers la seconde, quand l’assemblée perd peu à peu le soutien des princes et voit fondre ses rangs jusqu’à son autodissolution finale. La difficulté ne tient pas seulement au peu d’intérêt qu’inspire de prime abord cet échec annoncé. Elle réside aussi dans les lacunes de la documentation: passé 1443, s’interrompent à la fois les protocoles du concile et la chronique de Jean de Ségovie, qui fournissaient jusquelà un indispensable fil conducteur. Il vaut pourtant la peine d’étudier »Bâle après Bâle« autrement que sous les couleurs fanées d’un lent et irrésistible déclin. Même affaibli, le concile a continué à peser sur le jeu politique et sur les débats du temps, ce qui a contraint la papauté de Nicolas V à des accommodements. Aussi bien sa dispersion en 1449 ne sonnetelle pas le glas du conciliarisme, puisque celuici demeura vivace jusqu’à Vatican I. On ne peut que féliciter Heribert Müller d’avoir voulu ainsi, comme il s’en explique dans l’introduction, prendre toute la mesure d’un concile unique dans l’histoire par sa durée. ...
Le dernier livre du professeur Heribert Müller s’inscrit dans l’ample projet encyclopédique que le spécialiste de Bismarck Lothar Gall mène depuis 1988 et dont les 100 volumes retracent l’histoire de l’espace politique allemand, du Moyen Âge au XXe siècle. La crise ecclésiastique de la fin du Moyen Âge est étudiée dans une perspective à la fois synthétique et scientifique. Dans l’"Enzyklopädie deutscher Geschichte" (EDG), fidèle à la collection "Oldenbourg Grundriss der Geschichte", l’analyse se déploie en trois temps. À la synthèse chronologique de faits historiques (p. 1–58), succède le commentaire historiographique des principaux travaux de recherche (p. 59–123); enfin, la bibliographie thématique rassemble les sources éditées et les principaux ouvrages cités (p. 125–152). Le cheminement du lecteur dans l’ouvrage est facilité par des rubriques marginales et un triple index (p. 153–163). Que chacune des trois parties suive, à quelques nuances près, le même plan permet de faire une lecture transversale du livre. L’auteur paraît y inciter, qui émaille la synthèse historique de quelques remarques historiographiques. Dans le paysage éditorial français, la collection "Nouvelle Clio", publiée aux Presses universitaires de France depuis 1966, suit la même orientation synthétique et scientifique, qui s’avère précieuse pour les étudiants comme pour les spécialistes. Mais à la différence des manuels français, les volumes de l’"EDG" forment, grâce au travail d’édition et au soin apporté à la mise en page, de véritables essais
Selbst Spezialisten der Geschichte des Basler Konzils (1431–1449) und des Herzogtums Burgund im 15. Jahrhundert dürfte Nicolas Jacquier, ein Mönch aus dem Predigerkonvent zu Dijon, allenfalls dem Namen nach bekannt sein. Kaum mehr weiß man über ihn, als dass er sich für seine Person Anfang 1433 in die Synode inkorporierte, um dort fortan – recht erstaunlich für einen Burgunder, aber auch für einen Dominikaner – radikal antirömische Positionen zu beziehen, was – nicht minder erstaunlich – den papstverbundenen Philipp den Guten keineswegs daran hinderte, ihn fast zur selben Zeit, 1435, in eine Gesandtschaft zum englischen König zu berufen, wie er auch später noch mehrfach herzogliche Missionen übernahm, so 1451 zum römisch-deutschen König, 1455 nach Ungarn und schließlich 1467 in das zur Krone Böhmen gehörende Schlesien. Gegen die Hussiten hatte der Herzog selber bereits in den zwanziger Jahren das Kreuz nehmen wollen, und vier Jahrzehnte später erschien die häretische Gefahr angesichts eines "Ketzerkönigs" Georg von Podiebrad wiederum virulent, zumal sich der Böhme mit Philipps ärgstem Gegner, Ludwig XI. von Frankreich, zu verbünden trachtete (vgl. S. 20f.). Überdies mahnten, wie ebenfalls schon in den Zwanzigern, erneut häretische Umtriebe im Süden der burgundischen Niederlande (la »vauderie« d’Arras) zu erhöhter Wachsamkeit. ...
Wenn eine ungedruckte Habilitationsschrift fast vier Jahrzehnte nach ihrer Abfassung publiziert wird, muss sie eigentlich von zwar erst spät entdecktem, doch außerordentlichem Interesse für die Fachwelt sein. Und mehr noch, hier bringt deren Herausgeber gleich eine höhere Macht ins Spiel, wenn er meint, der Zeitpunkt der Drucklegung genau 20 Jahre nach dem frühen Tod des Verfassers (1992) könne »durchaus auch als kleines Indiz für die Fügung des einzigen Herrn der Geschichte« angesehen werden (S. V). Da sei doch an die gelassen-relativierende rheinische Lebensweisheit erinnert: »Dat kann mer so, aber auch so sehen.« Für meinen Teil neigte ich schon Ende der 1970er Jahre zum zweiten »so«, als Leinweber mir freundlicherweise Auszüge seiner Arbeit in Kopie zukommen ließ, die ursprünglich in geradezu utopischem Ausgriff »Die Synoden in Italien, Deutschland und Frankreich von 1215 bis zum Tridentinum« erfassen sollte und unter solchem Titel wiederholt, auch von ihm selbst, angekündigt wurde; s. etwa Annuarium Historiae Conciliorum 4 (1972), S. 5 (dies zum Tadel des Herausgebers wegen entsprechender Zitierung u. a. durch mich, welche die tatsächliche Unkenntnis des Manuskripts offenbare; S. XVIII, Anm. 47). Damals mit einer Studie »Die Franzosen, Frankreich und das Basler Konzil (1431–1449)« (erschienen 1990), also einer Nachbarthematik, befasst, hielt ich nach Lektüre jener Auszüge eine vertiefende, insbesondere den Stand der französischen Forschung angemessen rezipierende Überarbeitung für unabdingbar, doch das Werk liegt nunmehr unverändert und damit in einer Form vor, die zudem aus dem Abstand mehrerer Dezennien recht befremdlich wirkt. ...
Oral presentation: 23rd World Congress of the World Society of Cardio-Thoracic Surgeons. Split, Croatia. 12-15 September 2013.
Background: Partial upper sternotomy (PUS) is established less invasive approach for single and double valve surgery. Reports of aortic surgery performed through PUS are rare.
Methods: The records of 52 patients undergoing primary elective surgery on the proximal aorta through PUS between 2005 and 2011 were reviewed. Patients mean age was 57 years, 35% were in NYHA Class III or IV, 59% had recent cardiac decompensation, and 17% had pulmonary hypertension. The PUS was taken down to the 4th left intercostal space in 44 patients (85%).
Results: No conversion to full sternotomy was necessary. The aortic cross-clamp, cardiopulmonary bypass and operative times averaged 136 ± 20 min., 186 ± 36 min. and 327 ± 83 min., respectively. In eight patients, the right axillary artery was cannulated for establishing cardiopulmonary bypass; the others were cannulated centrally. All patients except one received a procedure on the ascending aorta, either replacement in 30 (58%) or reduction aortoplasty in 21 (40%). Aortic root replacement was additionally performed in 31 patients (60%), including David in 20 (38%) and Ross procedure in 6 (11.5%). The aortic arch was replaced either partially in 5 (10%) or totally in 3 (6%) patients, in moderate hypothermia employing antegrade cerebral perfusion. Additional procedures, included mitral valve repair in 15 (29%) patients and coronary grafting. Ventilation time, intensive care unit and hospital stay averaged 17 ± 12 hours, 2 ± 1, and 11 ± 9 days. Chest drainage was 470 ± 380 ml/24 hours. Permanent neurologic deficit did not occur. Wound dehiscence was observed in a single patient (2%). Thirty-day and hospital mortality were not observed.
Conclusions: Less invasive surgery on the aortic root, ascending aorta and aortic arch can be performed safely and reproducibly. Potential benefits include a minimized risk of wound dehiscence and reduced postoperative bleeding. The PUS does not compromise the quality of the operation.
Background. Incomplete revascularization negatively affects survival after coronary artery bypass surgery (CABG). Since gender and classification technique might impact outcome and reporting, we investigated their effect on revascularization patterns and mortality. Methods. A cohort of bypass patients (N = 1545, 23% women) was enrolled prospectively. The degree of revascularization was determined as mathematical difference between affected vessels upon diagnosis and number of grafts or the surgeon’s rating on the case file. Results. Although men displayed more triple-vessel disease, they obtained complete revascularization more frequently than women (85% versus 77%, P < 0.001). The two calculation methods identified analogous percentages of incompletely revascularized patients, yet there was only a 50% overlap between the two groups. Mathematically, more women, older patients, and patients with NYHA class III/IV appeared incompletely revascularized, while the surgeons identified more patients undergoing technically challenging procedures. Regardless of the definition, incompleteness was a significant risk factor for mortality in both genders (mathematical calculation: HR 2.62, 95% CI 1.76–3.89, P < 0.001; surgeon: HR 2.04, 95% CI 1.35–3.89, P = 0.001). Conclusions. Given the differences in identification patterns, we advise that the mathematical calculation be performed after-procedure in all patients regardless of the surgeons’ rating to uncover additional subjects at increased risk.
Background and Aims: In patients with advanced liver cirrhosis due to chronic hepatitis C virus (HCV) infection antiviral therapy with peginterferon and ribavirin is feasible in selected cases only due to potentially life-threatening side effects. However, predictive factors associated with hepatic decompensation during antiviral therapy are poorly defined.
Methods: In a retrospective cohort study, 68 patients with HCV-associated liver cirrhosis (mean MELD score 9.18±2.72) were treated with peginterferon and ribavirin. Clinical events indicating hepatic decompensation (onset of ascites, hepatic encephalopathy, upper gastrointestinal bleeding, hospitalization) as well as laboratory data were recorded at baseline and during a follow up period of 72 weeks after initiation of antiviral therapy. To monitor long term sequelae of end stage liver disease an extended follow up for HCC development, transplantation and death was applied (240weeks, ±SD 136weeks).
Results: Eighteen patients (26.5%) achieved a sustained virologic response. During the observational period a hepatic decompensation was observed in 36.8%. Patients with hepatic decompensation had higher MELD scores (10.84 vs. 8.23, p<0.001) and higher mean bilirubin levels (26.74 vs. 14.63 µmol/l, p<0.001), as well as lower serum albumin levels (38.2 vs. 41.1 g/l, p = 0.015), mean platelets (102.64 vs. 138.95/nl, p = 0.014) and mean leukocytes (4.02 vs. 5.68/nl, p = 0.002) at baseline as compared to those without decompensation. In the multivariate analysis the MELD score remained independently associated with hepatic decompensation (OR 1.56, 1.18–2.07; p = 0.002). When the patients were grouped according to their baseline MELD scores, hepatic decompensation occurred in 22%, 59%, and 83% of patients with MELD scores of 6–9, 10–13, and >14, respectively. Baseline MELD score was significantly associated with the risk for transplantation/death (p<0.001).
Conclusions: Our data suggest that the baseline MELD score predicts the risk of hepatic decompensation during antiviral therapy and thus contributes to decision making when antiviral therapy is discussed in HCV patients with advanced liver cirrhosis.
Within the scope of the Wildlife Conservation Programme of the Botanical Society for the Nature Conservation in Hesse, a comprehensive survey was carried out of a comparatively common species, the Common Pasque Flower (Pulsatilla vulgaris). It still occurs in large populations on the nutrient poor chalk meadows of the Vorderhoen and Kuppenhoen. Other populations are known from the Wetterau and the Schluechterner Becken. A few other populations are known, but they only have a few individuals. Altogether 64 populations were recorded, five with more than 1,000 plants. The largest population, with over 50,000 individuals, is in the Weinberg nature reserve, Molzbach (near Huenfeld).
Environmental change impacts on the C- and N-cycle of European forests: a model comparison study
(2013)
Forests are important components of the greenhouse gas balance of Europe. There is considerable uncertainty about how predicted changes to climate and nitrogen deposition will perturb the carbon and nitrogen cycles of European forests and thereby alter forest growth, carbon sequestration and N2O emission. The present study aimed to quantify the carbon and nitrogen balance, including the exchange of greenhouse gases, of European forests over the period 2010–2030, with a particular emphasis on the spatial variability of change. The analysis was carried out for two tree species: European beech and Scots pine. For this purpose, four different dynamic models were used: BASFOR, DailyDayCent, INTEGRATOR and Landscape-DNDC. These models span a range from semi-empirical to complex mechanistic. Comparison of these models allowed assessment of the extent to which model predictions depended on differences in model inputs and structure. We found a European average carbon sink of 0.160 ± 0.020 kgC m−2 yr−1 (pine) and 0.138 ± 0.062 kgC m−2 yr−1 (beech) and N2O source of 0.285 ± 0.125 kgN ha−1 yr−1 (pine) and 0.575 ± 0.105 kgN ha−1 yr−1 (beech). The European average greenhouse gas potential of the carbon sink was 18 (pine) and 8 (beech) times that of the N2O source. Carbon sequestration was larger in the trees than in the soil. Carbon sequestration and forest growth were largest in central Europe and lowest in northern Sweden and Finland, N. Poland and S. Spain. No single driver was found to dominate change across Europe. Forests were found to be most sensitive to change in environmental drivers where the drivers were limiting growth, where changes were particularly large or where changes acted in concert. The models disagreed as to which environmental changes were most significant for the geographical variation in forest growth and as to which tree species showed the largest rate of carbon sequestration. Pine and beech forests were found to have differing sensitivities to environmental change, in particular the response to changes in nitrogen and precipitation, with beech forest more vulnerable to drought. There was considerable uncertainty about the geographical location of N2O emissions. Two of the models BASFOR and LandscapeDNDC had largest emissions in central Europe where nitrogen deposition and soil nitrogen were largest, whereas the two other models identified different regions with large N2O emission. N2O emissions were found to be larger from beech than pine forests and were found to be particularly sensitive to forest growth.