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Postoperative thrombotic thrombocytopenic purpura (TTP) shows clinical presentation similar to classical TTP, whereas exact pathophysiological contexts remain unexplained. In this study, we investigated intraoperative and postoperative changes in ADAMTS-13 (a disintegrin and metalloprotease with thrombospondin type 1 motifs, member 13), von Willebrand factor (VWF), large VWF multimers, and interleukin-6 (IL-6) in vascular surgery patients. The objective was to compare the impact of endovascular, peripheral, and aortic surgery on target parameters which are supposed to play a role in surgery-associated TTP. A total of 93 vascular surgery patients were included and divided into 4 groups according to the specific type of intervention they underwent. Blood samples were taken preoperatively, intraoperatively, and postoperatively on days 2 and 4. The ADAMTS-13 activity decreased significantly in 3 of the 4 groups during surgery (from median 81% to 49%, P < .001, in the group undergoing aortoiliacal interventions), whereas the percentage of large VWF multimers increased in all groups of patients. von Willebrand factor antigen increased significantly in all groups on postoperative day 2 and IL-6 increased significantly in the intraoperative and early postoperative period. There was no significant correlation between the intraoperative decrease in ADAMTS-13 and the increase in VWF or IL-6. No patient in this study showed clinical picture of TTP; the precise cause and clinical significance of moderately reduced ADAMTS-13 activity in the perioperative setting have not yet been definitely determined.
Background: Macrophage Migration Inhibitory Factor (MIF) is highly elevated after cardiac surgery and impacts the postoperative inflammation. The aim of this study was to analyze whether the polymorphisms CATT5–7 (rs5844572/rs3063368,“-794”) and G>C single-nucleotide polymorphism (rs755622,-173) in the MIF gene promoter are related to postoperative outcome. Methods: In 1116 patients undergoing cardiac surgery, the MIF gene polymorphisms were analyzed and serum MIF was measured by ELISA in 100 patients. Results: Patients with at least one extended repeat allele (CATT7) had a significantly higher risk of acute kidney injury (AKI) compared to others (23% vs. 13%; OR 2.01 (1.40–2.88), p = 0.0001). Carriers of CATT7 were also at higher risk of death (1.8% vs. 0.4%; OR 5.12 (0.99–33.14), p = 0.026). The GC genotype was associated with AKI (20% vs. GG/CC:13%, OR 1.71 (1.20–2.43), p = 0.003). Multivariate analyses identified CATT7 predictive for AKI (OR 2.13 (1.46–3.09), p < 0.001) and death (OR 5.58 (1.29–24.04), p = 0.021). CATT7 was associated with higher serum MIF before surgery (79.2 vs. 50.4 ng/mL, p = 0.008). Conclusion: The CATT7 allele associates with a higher risk of AKI and death after cardiac surgery, which might be related to chronically elevated serum MIF. Polymorphisms in the MIF gene may constitute a predisposition for postoperative complications and the assessment may improve risk stratification and therapeutic guidance.
Simple Summary: Glioblastomas are very malignant and essentially incurable brain tumors. One problem is the extensive penetration of tumor cells into the adjacent normal brain tissue. Thus, the testing of novel drugs requires appropriate tumor models, preferentially avoiding animal studies. This paper describes so-called brain tissue slice tandem-culture systems. They consist of a slice of normal brain tissue and a second layer of tumor tissue. The microscopic analysis of these slice tandem-cultures allows for the simultaneous assessment of single cells invading into the normal brain tissue and the space occupying growth of the total tumor mass. It is shown that the direct application of test drugs onto the slices exerts inhibitory effects on both mechanisms. We thus describe a system mimicking the situation in glioblastoma patients. It reduces animal studies, allows for the direct application of test drugs and the precise quantitation of their inhibitory effects on tumor growth and invasion.
Abstract: Glioblastomas (GBMs) are the most malignant brain tumors and are essentially incurable even after extensive surgery, radiotherapy, and chemotherapy, mainly because of extensive infiltration of tumor cells into the adjacent normal tissue. Thus, the evaluation of novel drugs in malignant glioma treatment requires sophisticated ex vivo models that approach the authentic interplay between tumor and host environment while avoiding extensive in vivo studies in animals. This paper describes the standardized setup of an organotypic brain tissue slice tandem-culture system, comprising of normal brain tissue from adult mice and tumor tissue from human glioblastoma xenografts, and explore its utility for assessing inhibitory effects of test drugs. The microscopic analysis of vertical sections of the slice tandem-cultures allows for the simultaneous assessment of (i) the invasive potential of single cells or cell aggregates and (ii) the space occupying growth of the bulk tumor mass, both contributing to malignant tumor progression. The comparison of tissue slice co-cultures with spheroids vs. tissue slice tandem-cultures using tumor xenograft slices demonstrates advantages of the xenograft tandem approach. The direct and facile application of test drugs is shown to exert inhibitory effects on bulk tumor growth and/or tumor cell invasion, and allows their precise quantitation. In conclusion, we describe a straightforward ex vivo system mimicking the in vivo situation of the tumor mass and the normal brain in GBM patients. It reduces animal studies and allows for the direct and reproducible application of test drugs and the precise quantitation of their effects on the bulk tumor mass and on the tumor’s invasive properties
Der 3D‐Druck von geometrisch komplexen Nanostrukturen ist auf dem Weg zu ersten Anwendungen. Die Auswahl an geeigneten Materialien ermöglicht metallische, halbleitende, isolierende, supraleitende und exotische magnetische Eigenschaften. Das 3D‐FEBID‐Verfahren schreibt mit dem Elektronenstrahl eines Raster‐Elektronenmikroskops wie mit einem Nanostift. Das Material wird als Gasstrom von Precursor‐Molekülen über eine Hohlnadel zugeführt. Der Elektronenstrahl ermöglicht die hochlokale Fragmentierung dieser Moleküle, die meist metallische Zielatome enthalten. Die lokale Verweildauer des Strahls steuert den Strukturaufbau in der Vertikalen, während seine seitliche Bewegung zu geneigten, freistehenden Strukturen führt. Eine Herausforderung ist die definierte Strahlsteuerung, um ein CAD‐Modell möglichst präzise in ein reales 3D‐Nanoobjekt zu überführen. Für die Zukunft soll eine simulationsgestützte Software zur Steuerung des Elektronenstrahls auch Laien die Anwendung erleichtern. 3D‐FEBID ist bereits heute ein zuverlässiges und in vielerlei Hinsicht einzigartiges Verfahren zur Direktabscheidung funktionaler Nanostrukturen.
This thesis investigates the acquisition pace and the typical developmental path in eL2 acquisition of selected phenomena of German morphosyntax and semantics and compared them to monolingual acquisition. In addition, the influence of ‘Age of Onset’ and of external factors on eL2 acquisition is examined.
To date, the most studies on eL2 acquisition focused on language production. Based on mostly longitudinal spontaneous speech data of only small number of children, they indicate that eL2 learners acquire sentence structure and subject-verb-agreement faster than monolingual children, whereas the acquisition of case marking causes them more difficulties. Moreover, similar developmental paths to those of monolingual children are claimed. Only several studies examined comprehension abilities in eL2 learners, however overwhelmingly in cross-sectional design. The findings from comprehension studies on telic and atelic verbs, and on wh-questions indicate that eL2 children acquire their target-like interpretation faster than monolingual children. The same acquisition stages towards target-like interpretation like in monolingual acquisition are assumed as well. Taking together, to date, no study exists, that examines comprehension and production abilities in a large group of eL2 learners of German in a longitudinal design.
This thesis extends the previous results by investigating pace of acquisition, impact of factors, and individual developmental paths in a longitudinal design with large groups of participants. Language data of 29 eL2 learners of German (age at T1: 3;7 years, LoE: 10 months) and 45 monolingual German-speaking children (age at T1: 3;7) are examined. The eL2 learners were tested in six test rounds (age at T6: 6;9 years). The monolingual children were tested in five test rounds (are at T5: 5;7). The standardized test LiSe-DaZ (Schulz & Tracy, 2011) was employed to examine children’s language skills.
eL2 learners show a significantly greater rate of change, thus faster acquisition pace, than monolingual children in the following scales: comprehension of telicity, comprehension of wh-questions, production of prepositions, and production of conjunctions. These phenomena are acquired early in monolingual children. No differences regarding acquisition pace between eL2 children and monolingual children are found for comprehension of negation, production of case marking, and production of focus particles. These phenomena are acquired late in monolingual development and involve semantic and pragmatic knowledge. The findings of faster acquisition pace of several phenomena are in line with several studies that reported that eL2 children develop faster than monolingual children.
Independent on whether a phenomenon is acquired early or late, no effects of external factors on eL2 children’s performance are found. These findings indicate that acquisition of core, rule-based phenomena is not sensitive to external factors if the first exposure to L2 takes place around the age of three.
Moreover, eL2 children show the same developmental stages and error types in comprehension of telicity, comprehension of negation, production of matrix and subordinate clauses. This is also independent on how fast they acquire a structure under consideration. Thus, these findings provide a further support for similar developmental paths of eL2 and monolingual children towards target-like comprehension and production.
Stanley Cavell is one of very few philosophers who systematically reflect on the impact and influence of autobiographical detail, experience, and preferences on their philosophical work. The aim of this essay is to show how Cavell’s use of autobiographical exploration is rooted in his early aesthetic theory, in particular his view of the similarities between philosophy and aesthetic criticism. Cavell argues that criticism starts by exploiting and incorporating a subjective vantage point, eventually bringing the reader to test the significance of a work on herself. In his ‘Aesthetic Problems of Modern Philosophy’, Cavell states exactly this form of appeal to the ‘We’ of author and reader as the basic move of his own version of ‘ordinary language philosophy’. It is because of the connections Cavell sees between criticism and philosophy that his aesthetic diagnosis harks back on his overall critical style of thinking.
The strictly anaerobic acetogenic bacterium Acetobacterium woodii is metabolically diverse and grows on variety of substrates which includes H2 + CO2, sugars, alcohols and diols. It is unique in producing bacterial microcompartments (BMC) during growth on different substrates such as 1,2-propanediol, 2,3-butanediol, ethanol or fructose. In this study, we analyzed the genetic organization and expression of the BMC genes within the A. woodii genome, the previously described 18 gene pdu cluster as well as four other cluster potentially encoding one or two shell proteins. Expression analysis of respective gene clusters revealed that the pdu gene cluster is highly expressed during growth on 1,2-PD, 2,3-BD, ethanol and ethylene glycol. The promoter region upstream of the pduA gene was identified and used to establish a reporter gene assay based on chloramphenicol acetyl transferase as a reporter protein. The reporter gene assay confirmed the qPCR data and demonstrated that 1,2-PD is superior over ethanol and ethylene glycol as inducer. BMCs were enriched from cells grown on 2,3- BD and 1,2-PD and shown to have typical structure in electron micrographs. Biochemical analyses revealed several of the protein encoded by the pdu cluster to be part of the isolated BMCs. These data demonstrate a very unique situation in A. woodii in which apparently one BMC gene cluster in expressed during growth on different substrates.
Background: Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value.
Methods: From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention.
Results: Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N-terminal fragment of pro-brain natriuretic peptide (p = 0.035) and 6-minute walking distance (p = 0.01).
Conclusions: Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.
Resistance exercise has been demonstrated to improve brain function. However, the optimal workout characteristics are a matter of debate. This randomized, controlled trial aimed to elucidate differences between free-weight (REfree) and machine-based (REmach) training with regard to their ability to acutely enhance cognitive performance (CP). A total of n = 46 healthy individuals (27 ± 4 years, 26 men) performed a 45-min bout of REfree (military press, barbell squat, bench press) or REmach (shoulder press, leg press, chest press). Pre- and post-intervention, CP was examined using the Stroop test, Trail Making Test and Digit Span test. Mann–Whitney U tests did not reveal between-group differences for performance in the Digit Span test, Trail Making test and the color and word conditions of the Stroop test (p > 0.05). However, REfree was superior to REmach in the Stroop color-word condition (+6.3%, p = 0.02, R = 0.35). Additionally, REfree elicited pre-post changes in all parameters except for the Digit Span test and the word condition of the Stroop test while REmach only improved cognitive performance in part A of the Trail Making test. Using free weights seems to be the more effective RE method to acutely improve cognitive function (i.e., inhibitory control). The mechanisms of this finding merit further investigation.
Obstructive Sleep Apnea is emerging as a global health epidemic, particularly due to the obesity pandemic. However, comprehensive prevalence data are still lacking and global OSA research has not yet been structurally evaluated. Using the latest comprehensive age/gender-specific BMI and obesity data, a global landscape estimating the risk/burden of OSA was created. Results were presented in relation to an in-depth analysis of OSA research and countries’ socioeconomic/scientific background. While the USA, Canada, and Japan are the highest publishing countries on OSA, Iceland, Greece, and Israel appeared at the forefront when relating the scientific output to socioeconomic parameters. Conversely, China, India, and Russia showed relatively low performances in these relations. Analysis of the estimated population at risk (EPR) of OSA showed the USA, China, India, and Brazil as the leading countries. Although the EPR and OSA research correlated strongly, major regional discrepancies between the estimated demand and actual research performances were identified, mainly in, but not limited to, developing nations. Our study highlights regional challenges/imbalances in the global activity on OSA and allows targeted measures to mitigate the burden of undiagnosed/untreated OSA. Furthermore, the inclusion of disadvantaged countries in international collaborations could stimulate local research efforts and provide valuable insights into the regional epidemiology of OSA.
Space optimizations in deterministic and concurrent call-by-need functional programming languages
(2020)
In this thesis the space consumption and runtime of lazy-evaluating functional programming languages are analyzed.
The typed and extended lambda-calculi LRP and CHF* as core languages for Haskell and Concurrent Haskell are used. For each LRP and CHF* compatible abstract machines are introduced.
Too lower the distortion of space measurement a classical implementable garbage collector is applied after each LRP reduction step. Die size of expressions and the space measure spmax as maximal size of all garbage-free expressions during an LRP-evaluation, are defined.
Program-Transformations are considered as code-to-code transformations. The notions Space Improvement and Space Equivalence as properties of transformations are defined. A Space Improvement does neither change the semantics nor it increases the needed space consumption, for a space equivalence the space consumption is required to remain the same. Several transformations are shown as Space Improvements and Equivalences.
An abstract machine for space measurements is introduced. An implementation of this machine is used for more complex space- and runtime-analyses.
Total Garbage Collection replaces subexpressions by a non-terminating constant with size zero, if the overall termination is not affected. Thereby the notion of improvement is more independent from the used garbage collector.
Analogous to Space Improvements and Equivalences the notions Total Space Improvement and Total Space Equivalence are defined, which use Total Garbage Collection during the space measurement. Several Total Space Improvements and Equivalences are shown.
Space measures for CHF* are defined, that are compatible to the space measure of LRP. An algorithm with sort-complexity is developed, that calculates the required space of independent processes that all start and end together. If a constant amount of synchronization restrictions is added and a constant number of processors is used, the runtime is polynomial, if arbitrary synchronizations are used, then the problem is NP-complete.
Abstract machines for space- and time-analyses in CHF* are developed and implementations of these are used for space and runtime analyses.
Die CXCR4/CXCL12-Achse ist von entscheidender Bedeutung für die Entstehung und Aufrechterhaltung einer gesunden, reifen Hämatopoese. Erstmals beschrieben wurde der später als CXCR4 bezeichnete Rezeptor 1996 allerdings als Co-Rezeptor für den Eintritt humaner HI-Viren in Lymphozyten. Ein großes Interesse bestand daraufhin darin, sowohl natürliche Inhibitoren des G-Protein gekoppelten Rezeptors zu identifizieren, als auch synthetische herzustellen, um einen Eintritt des Virus in den menschlichen Organismus zu verhindern bzw. seine Ausbreitung zu unterbinden. Ein natürlich vorkommender CXCR4-Ligand, der 2015 von Zirafi und Kollegen erstmals beschrieben wurde, fand sich im Hämofiltrat von Dialysepatienten. Der im weiteren Verlauf als EPI-X4 bezeichnete CXCR4-Antagonist wurde als Spaltprodukt von Albumin identifiziert, welches über viele Spezies hochkonserviert ist. Diese Eigenschaft interpretieren wir als Hinweis auf eine relevante physiologische Funktion des Peptids. Da die Halbwertszeit von natürlich vorkommendem EPI-X4 beim Menschen vermutlich sehr kurz ist, sind in vivo- und darauffolgende in vitro-Analysen schwierig durchzuführen. In-vitro-Spike-Analysen von synthetischem EPI-X4 in humanem Plasma ergaben eine Halbwertszeit von nur 17 Minuten. Die geringen auftretenden Konzentrationen erschweren die Problematik zusätzlich. In dieser Arbeit sollen deshalb im Mausmodell in vivo-Analysen durchgeführt werden, um die Effekte von potentiell entstehendem EPI-X4 in verschiedenen experimentellen Ansätzen aufzudecken. Ein probates, hier verwendetes Mittel, ist die Analyse einer Knock-out (KO)-Maus. Die für die Bindung an CXCR4 entscheidende Aminosäure von EPI-X4, das am N-Terminus gelegene Leucin, wurde durch Alanin ersetzt, welches die Entstehung von EPI-X4 unterbindet und zusätzlich dessen Bindung an CXCR4 verhindert. Mit Hilfe zweier Mausmodelle können nun Analysen im EPI-X4-defizienten Modell durchgeführt werden, die im Umkehrschluss Informationen über die organismische Wirkung von EPI-X4 beinhalten. Zunächst wurde in beiden Modellen die physiologisch normale reife und unreife Hämatopoese charakterisiert. Hierbei zeigte sich kein signifikanter systematischer Einfluss von EPI-X4 auf reife Leukozyten (WBC), lediglich eine leichte Lymphozytose in der HR-Ala-Variante. Im weiteren Verlauf der homöostatischen Analyse der Hämatopoese der Ala-EPI-X4-Mäuse zeigten sich keine signifikanten Unterschiede zu wildtypischen Mäusen. Sowohl reife als auch unreife Zellen zeigten, außer in der T- und B-Zelllinie, keine zahlenmäßigen oder funktionalen Auffälligkeiten, weder im Blut, noch in der Milz oder im Knochenmark. Analysen der Zellzyklusaktivität unterschiedlicher Unreifestufen wiesen ebenfalls keine Auffälligkeiten auf. Diese Daten einer normalen, von einer C57Bl/6-Maus zu erwartenden Ergebnisse dienten als Grundlage zur Bewertung und Analyse von durchgeführten hämatopoetischen Stressmodellen. Hierfür wurden
zunächst hämatopoetische Stamm- und Vorläuferzellen (HSPC) mobilisiert. In den angewandten Mobilisierungsmodellen fanden sich lediglich unter G-CSF-Behandlung im Knochenmark eine größere Anzahl Granulozyten, was auf einen Einfluss von EPI-X4 auf HSPC schließen lässt. Um potentielle Auswirkungen von EPI-X4 im Knochenmark weiter zu untersuchen, wurde ein weiteres Stressmodell gewählt, welches ebenfalls mutmaßlich die Bedingungen zur EPI-X4-Generierung schafft: Subletale Bestrahlung der Mäuse sorgt für Schäden an allen Zellarten im Knochenmark, es wird ein steriles entzündliches Milieu kreiert. Unter diesen Umständen wurde die Regeneration von Blutzellen analysiert. Es zeigten sich keine nennenswerten Unterschiede sowohl in der akuten Phase des Schadens als auch in regelmäßigen Blutentnahmen während der Regenerierung.
Die Beschreibung von natürlich vorkommendem EPI-X4 in Vaginal- und Rektalschleimhaut zeigt seine Entstehung an Schleimhautbarrieren auf. Ala-EPI-X4-Muse werden deshalb auf deren Durchlässigkeit untersucht: LPS-Konzentrationen als Marker für eindringende pathogene Bakterien wurden im Plasma untersucht. Hierbei zeigten sich keine Unterschiede zwischen den Gruppen, eine Störung scheint hier nicht vorzuliegen. Zusätzlich wurde die Zusammensetzung des Mikrobioms im Darm untersucht, da beschrieben wurde, dass sich Mikrobiom und die Integrität der Darmschleimhaut gegenseitig beeinflussen. Im Falle der EPI-X4-defizienten Mäuse liegt zwar keine offensichtliche pathologische Veränderung vor, dennoch konnte in männlichen HR-Ala-Mäusen die Abwesenheit des Proteobakteriums Parasutterella nachgewiesen werden. Um eine mögliche Defizienz der Barrierefunktion weiter zu testen, wurden zwei Stressmodelle gewählt: Zunächst wurde den Mäusen eine akute, sterile Peritonitis zugefügt, woraufhin die Anzahl und Zusammensetzung der ins Peritoneum einströmenden Leukozyten analysiert wird. Die Reaktion auf diesen Entzündungsprozess war nicht verändert. Ähnliche Ergebnisse zeigten sich auch in einem akuten Colitis-Stressmodell.
Insgesamt konnte in dieser Arbeit mithilfe zweier KO-Mausmodelle die Rolle von EPI-X4 in der Hämatopoese und der Immunologie von Mäusen beginnend charakterisiert werden. Die homöostatische Hämatopoese scheint kaum von EPI-X4 abhängig zu sein, lediglich die Zahl der B- und T-Zellen, insbesondere der regulatorischen T-Zellen, scheint beeinflusst. Damit einhergehend konnten Veränderungen in Zytokinlevels bei inflammatorischen Ereignissen gezeigt werden. Experimente zur beeinflussten, eventuell gestörten Barrierefunktion von Ala-EPI-X4-Mäusen zeigten vielversprechende Ansätze und sollten in Zukunft weiter analysiert werden.
Natural science is only just beginning to understand the complex processes surrounding transcription. Epitranscriptional regulation is in large parts conveyed by transcription factors (TFs) and two recently discovered small RNA (smRNA) species: microRNAs (miRNAs) and transfer RNA fragments (tRFs). As opposed to the fairly well-characterised function of TFs in shaping the phenotype of the cell, the effects and mechanism of action of smRNA species is less well understood. In particular, the multi-levelled combinatorial interaction (many-to-many) of smRNAs presents new challenges to molecular biology. This dissertation contributes to the study of smRNA dynamics in mammalian cells in several ways, which are presented in three main chapters.
I) The exhaustive analysis of the many-to-many network of smRNA regulation is reliant on bioinformatic support. Here, I describe the development of an integrative database capable of fast and efficient computation of complex multi-levelled transcriptional interactions, named miRNeo. This infrastructure is then applied to two use cases. II) To elucidate smRNA dynamics of cholinergic systems and their relevance to psychiatric disease, an integrative transcriptomics analysis is performed on patient brain sample data, single-cell sequencing data, and two closely related in vitro human cholinergic cellular models reflecting male and female phenotypes. III) The dynamics between small and large RNA transcripts in the blood of stroke victims are analysed via a combination of sequencing, analysis of sorted blood cell populations, and bioinformatic methods based on the miRNeo infrastructure. Particularly, importance and practicality of smRNA:TF:gene feedforward loops are assessed.
In both analytic scenarios, I identify the most pertinent regulators of disease-relevant processes and biological pathways implicated in either pathogenesis or responses to the disease. While the examples described in chapters three and four of this dissertation are disease-specific applications of miRNeo, the database and methods described have been developed to be applicable to the whole genome and all known smRNAs.
Die CT-Diagnostik gewinnt auch über 100 Jahre nach der Entdeckung der Röntgenstrahlung noch immer weiter an Bedeutung im klinischen Alltag. Insbesondere im Bereich des Stagings und der onkologischen Follow-Up-Untersuchungen zählt die Ganzkörper-CT derzeit vielerorts als diagnostischer Goldstandard. Dabei muss jedoch in Kauf genommen werden, dass es zur Applikation nicht unerheblicher Dosiswerte kommt. Das Risiko von Folgeschäden ist dabei nicht von der Hand zu weisen, wobei das Folgemalignom als besonders gefürchtete Komplikation gilt. Die Optimierung der Computertomographie und die Minimierung möglicher Folgeschäden ist daher Gegenstand konstanter klinischer Forschung. Dennoch muss eine Reduktion der Strahlendosis nur äußerst feinfühlig erfolgen, da sie auf technischer Ebene eng mit der realisierbaren Bildqualität korreliert.
Ziel der vorliegenden Arbeit war es, die Nutzen eines 150 kV + Sn Zinnfilter- Protokolls am Gerät Siemens Somatom Force zu untersuchen. Hierbei sollte vor allem darauf eingegangen werden, wie viel Strahlendosis durch die Implementierung eines solchen Protokolls eingespart werden kann, wie sich das Protokoll auf die subjektive und objektive Bildqualität auswirkt, sowie welcher weitere klinische Nutzen zu erwarten ist. Bisher konnten sich ähnliche Protokolle bereits im Rahmen anderer Fragestellungen als nützlich beweisen.
Insgesamt 40 Patienten mit Ganzkörper-Staging im Rahmen eines Multiplen Myeloms wurden in die Studie inkludiert (28 Frauen, 12 Männer). Diese wurden im vereinbarten Untersuchungszeitraum mit dem durch die Ethikkomission genehmigten Studienprotokoll (150 kV + Sn Force) untersucht und waren jeweils retrospektiv auch Teil der anderen Gruppen gewesen (120 KV Definition AS, 120 KV Flash, 120 kV Force).
Auch wenn der intraindividuelle Vergleich inhärent mit einer höheren statistischen Power einhergeht, wurden sicherheitshalber an vordefinierten Stellen Querdurchmesser der Patienten erhoben, um biometrische Gleichheit zu beweisen.
Hier ließen sich keine signifikanten Unterschiede messen. Die Bilddaten der Patienten wurden randomisiert und doppelt verblindet von zwei dem Projekt fremden und berufserfahrenen Radiologen hinsichtlich der subjektiven Bildqualität ausgewertet. Ein Bezug zu den technischen Hintergrundinformationen der Aufnahme war zu keinem Zeitpunkt möglich.
Anschließend erfolgte die statistische Auswertung objektiver Daten. Zum Vergleich der Bildqualität wurden jeweils gemittelte Schwächungswerte aus Muskeln aus artefaktfreien und aus von Artefakten beladenen Arealen erhoben. Aufgrund des homogenen Charakters der Muskeln wurde die ebenso jeweils gemittelte Standardabweichung dieser Strukturen als Hintergrundrauschen definiert. Hieraus wurde eine SNR errechnet.
Der Vergleich von Dosiswerten erfolgte über die aus dem Patientenprotokoll entnehmbaren Angaben, insbesondere des CTDI. Gemeinsam mit den erhobenen Querdurchmessern wurde hieraus eine SSDE gebildet.
Bei allen subjektiven Vergleichen der Studiengruppe (150 kV + Sn Force) wurde bei jeweils starker Korrelation nach Spearman und starker bis sehr starker Übereinstimmung nach Cohen eine gute bis sehr gute Bildqualität attestiert. Damit stellt das Untersuchungsprotokoll Bilder durchweg besser als das Referenzprotokoll auf den Geräten Somatom Definition AS und Somatom Definition Flash dar. Im Direktvergleich zum Referenzprotokoll auf dem Somatom Force ist das Studienprotokoll jeweils mindestens gleichwertig.
Im objektiven Vergleich der Bildqualität zeigte sich als Gütekriterium zunächst, dass Muskeln artefaktfreier Areale in allen vier Gruppen gleich gut dargestellt werden. Bereits bei der Betrachtung der Schwächungswerte artefaktbeladener Muskeln wurde deutlich, dass die anderen Protokolle mit signifikant höherem Signalverlust zu kämpfen haben. Auch das Bildpunktrauschen war in der Studiengruppe (150 kV + Sn Force) überwiegend signifikant niedriger, als das der anderen Gruppen. Lediglich in Artefaktarealen des Untersuchungsabschnitts cCT/HWS konnte die Gruppe 120 kV Force vergleichbar niedrige Rauschwerte aufweisen (p = 1), der Vergleich der SNR wiederholte dieses Ergebnis.
CTDI und SSDE der Gruppe
150 kV Force zeigten im Untersuchungsabschnitt cCT/HWS insbesondere der Gruppe 120 kV Force gegenüber signifikante Dosiseinsparungen von ca. 42 %, im Abschnitt Tho-Knie sogar 64%.
Zusammenfassend zeigte sich durch die Implementierung des Studienprotokolls also mehrheitlich eine Verbesserung sowohl der subjektiven, als auch der objektiven Bildqualität. Bei einer durchschnittlichen Reduktion der applizierten Strahlendosis von ca. 40-60 % (gegenüber dem Referenzprotokoll am Somatom Force) ist der Einsatz des Studienprotokolls für die hier untersuchte Fragestellung im klinischen Alltag also uneingeschränkt zu empfehlen.
Diese Bachelorarbeit befasst sich mit der Themenklassifikation von unstrukturiertem Text. Aufgrund der stetig steigenden Menge von textbasierten Daten werden automatisierte Klassifikationsmethoden in vielen Disziplinen benötigt und erforscht. Aufbauend auf dem text2ddc-Klassifikator, der am Text Technology Lab der Goethe-Universität Frankfurt am Main entwickelt wurde, werden die Auswirkungen der Vergrößerung des Trainingskorpus mittels unterschiedlicher Methoden untersucht. text2ddc nutzt die Dewey Decimal Classification (DDC) als Zielklassifikation und wird trainiert auf Artikeln der Wikipedia. Nach einer Einführung, in der Grundlagen beschrieben werden, wird das Klassifikationsmodell von text2ddc vorgestellt, sowie die Probleme und daraus resultierenden Aufgaben betrachtet. Danach wird die Aktualisierung der bisherigen Daten beschrieben, gefolgt von der Vorstellung der verschiedenen Methoden, das Trainingskorpus zu erweitern. Mit insgesamt elf Sprachen wird experimentiert. Die Evaluation zeigt abschließend die Verbesserungen der Qualität der Klassifikation mit text2ddc auf, diskutiert die problematischen Fälle und gibt Anregungen für weitere zukünftige Arbeiten.
The p38α mitogen-activated protein kinase (MAPK) is activated through stress stimuli such as heat shock or hypoxia. In the nucleus, p38α modulates the activity of other kinases and transcription factors, a process that regulates the expression of specific target genes, most importantly pro-inflammatory cytokines. Dysregulation of p38α therefore plays a major role in the development of inflammatory diseases such as rheumatoid arthritis. Despite many years of intensive research, no p38 small-molecule inhibitors have been approved yet. Several inhibitor design strategies have been reported, leading to >100-fold selective compounds for α/β over the γ and δ isoforms. Achieving such a selectivity among the two structurally most related α and β isoforms, however, remains a challenging task. Targeting an inactive DFG-out conformation offers another strategy for the development of potent kinase inhibitors (type-II), exemplified by the BCR/ABL-inhibitor Imatinib. Achieving selectivity with type-II binders is challenging, because many kinases can adopt an inactive DFG-out conformation. This is exemplified by the p38 type-II inhibitor BIRB-796, which exhibits picomolar on-target affinity but only a poor kinome-wide selectivity. A potent and selective type-II chemical probe for p38α/β was still lacking at the start of this thesis.
The promising hit VPC-00628, was chosen for a combinatorial synthetic approach to develop a type-II chemical probe. The studies covered the optimization of the hinge-binding head group, the hydrophobic region I and the DFG-out deep pocket of the lead compound VPC-00628. Selectivity for the p38α and p38β isoforms was monitored during the optimization process, which identified several inhibitors with favorable isoform selectivity, providing valuable insights into the potential of isoform-selective inhibitor design for p38. A potent and highly selective p38 MAPK probe (SR-318) was discovered, which showed IC50 values in the low nanomolar range in HEK293T cells. An unusual P-loop conformation induced upon binding of SR-318 to p38α contributed most likely to the impressive selectivity profile within the kinome that surpassed both the parent compound and BIRB-796. A negative control compound, SR-321, was developed, to distinguish between on-target effects and non-specific effects due to cross-reactivity with other cellular proteins. Studies of the metabolic stability in human liver microsomes revealed a high stability of the compounds, with only a small amount of metabolites formed over several hours. Compound SR-318 also exhibited a good in vitro efficacy, quantitatively reducing the LPS-stimulated TNF-α release in whole blood. Taken together, SR-318 is a highly potent and selective type-II p38α/β chemical probe, which will help to gain a better understanding of the catalytic and non-catalytic functions of these key signaling kinases in physiology and pathology.
The next studies focused on the exploration of the highly dynamic allosteric back pocket of p38 MAPK, and allosteric BIRB-796 derived compounds for targeting the αC- and DFG-out pockets were synthesized. Kinase activities of allosteric pyrazole-urea fragments were analyzed against a comprehensive set of 47 diverse kinases by differential scanning fluorimetry (DSF), revealing that BIRB-796 off-targets remain a problem when targeting this back-pocket binding motif. Revisiting the recently published compound MCP-081, which combines the allosteric part of BIRB-796 with the active-site directed part of VPC-00628, showed that it displays a clean selectivity profile in our kinase panel. Because the potency of MCP-081 was slightly reduced compared with VPC-00628 and the allosteric tert-butyl pyrazole moiety seemed suboptimal, a set of VPC-00628 derivatives for targeting the αC-out pocket region was synthesized. Through structure-guided extension of the terminal amide of VPC-00628 toward this allosteric site, the potent and selective compound SR-43 was developed, which showed excellent cellular activity on p38 MAPK in NanoBRETTM assays (IC50 [p38α/β] = 14.0 ± 0.1/ 16.8 ± 0.1 nM). SR-43 showed a dose-dependent inhibition of activating phosphorylation of p38 in HCT-15 cells as well as inhibition of phosphorylation of p38 downstream substrates MK2 and Hsp27. In addition, SR-43 induced an anti-inflammatory response by blocking TNF-α release in whole blood and displayed a high metabolic stability. Selectivity profiling of SR-43 revealed a narrow selectivity for additional targets such as the discoidin domain receptor kinases (DDR1/2). DDR kinases play a central role in fibrotic disorders, such as renal and pulmonale fibrosis, atherosclerosis and different forms of cancer. Since selective and potent inhibitors for these important therapeutic targets are largely lacking and the existing inhibitors are of low scaffold diversity, the next study focused on the optimization of SR-43 toward DDR1/2 kinase inhibition. The synthetic work covered the optimization of the hinge-binding head group and the allosteric part of SR-43 toward DDR1/2 kinase inhibition. These studies provided novel insights into the P-loop folding process of p38 MAPK and how targeting of non-conserved amino acids affects inhibitor selectivity. Importantly, they led to the development of a selective dual DDR/p38 inhibitor probe, SR-302, with picomolar affinity for DDR2. SR-302 was efficient in vitro and showed a destabilizing effect on the surface adhesion protein E-cadherin in epithelial cells. In summary, SR-302 and its negative control SR-301 provide a valuable tool set for studying the phenotypic effects of DDR1/2 signaling, e.g., in cancer cell lines.