@phdthesis{Schiffczyk2017, author = {Schiffczyk, Eva-Maria}, title = {„Katamnestische Untersuchung der Behandlungszufriedenheit kindlicher Patientinnen und Patienten mit Anorexia nervosa nach station{\"a}rem Klinikaufenthalt"}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156165}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Summary The aims of the current "Catamnestic examination of treatment satisfaction of patients with anorexia nervosa (AN) in childhood after inpatient treatment" were to extend the low data on AN in childhood in general and treatment satisfaction of this patient group in particular, and to use the knowledge gained to optimize future treatment concepts for patients with AN in childhood. To the best of our knowledge this is the first study retrospectively describing the treatment satisfaction of a patient population consisting exclusively of patients with a former AN in childhood. The central questions of the study were to find out whether and how many patients retrospectively found the treatment to be "satisfactory / unsatisfactory" or "helpful / harmful" and which elements of inpatient therapy produced "satisfaction / dissatisfaction" or subjective "help / harm" through the therapy. Further important aims of the study were to find out whether there is a correlation between the "treatment satisfaction / help / treatment amount" and various patient- and therapy-related parameters. The recent catamnestic study shows that former patients with AN in childhood, as well as other groups of AN patients (children, adolescents, adults) in previous studies, appear to be critical about the medical treatment compared to patients with other mental illnesses, with only 55.8 \% of the total patients who were at least mediocrely satisfied showing rather moderate satisfaction rates in the context of closed questions. Most likely are also in patients with AN in childhood typical disease characteristics (e.g. ambivalence in recovery and treatment, fear of loss of control) and personality traits (e.g. rigidity) frequently observed in AN patients responsible for that. The majority of patients with AN in childhood (65.4 \%) considered the therapy to be helpful retrospectively, in accordance with retrospective evaluations of patients with AN (children, adolescents, adults) on treatment as predominantly helpful. As part of the therapy, socio-emotional therapy components such as one-to-one therapeutic sessions, contact with fellow patients and caregivers were of the utmost importance for the patients with AN in childhood. These treatment elements generated the most satisfaction and were considered by many to be the most helpful. The results are hypothesis-generating that childlike patients with AN seem to have a special care / support need in the context of social relationships during therapy. However, the central role of socio-emotional components in therapy has also been highlighted in many other treatment satisfaction studies with childlike / adolescent and adult AN patients, patients with eating disorders in general, child and adolescent psychiatric and general psychiatric patients and in scientific work about the help of therapy for AN patients of different age groups as well as for other patient groups. As part of the therapeutic relationship, the desire for close contact with the therapist (more one-to-one interviews) was expressed. In addition, some patients wanted a more personalized therapy. The therapeutic relationship also played a key role in comparative studies with childlike and adolescent AN patients and other groups of patients, with sufficient time and individualism in therapy being required by the patients. A certain degree of self-determination, a fixed caregiver, inclusion of the family in the therapy, group therapy, adequate feedback and sufficient follow-up care were also important for the patients in the context of treatment. Treatment elements aimed at overcoming eating disordered behavior and recovering from the disease were partly rated to be satisfactory and helpful, but partly unsatisfactory and unhelpful. The critical evaluation of restrictive therapy elements to overcome the symptoms of eating disorders and ambivalence of patients with regard to their willingness to recover, their motivation to change and the initiation and implementation of a treatment, which has been cited in some studies, is also expressed in a group of patients with AN in childhood. With regard to these essential therapeutic ingredients for the treatment of AN, it is probably the right dosage in the context of the therapy concept. A comprehensible correlation was found in the fact that the former childlike AN patients, who judged the treatment to be satisfactory, also perceived it as more helpful and vice versa. The assumption that socio-cultural comparison variables (age and BMI) correlate with treatment satisfaction could not be proven in the own study for the former childlike study collective. Due to very different previous study results, further research on the relationship between socio-demographic variables and patient satisfaction is necessary in order to be able to draw clearer conclusions in this regard. However, an assumed association between the perceived help of the therapy and patient- / therapy-related variables could be confirmed, as patients with higher discharge BMI found treatment to be more helpful retrospectively than those with lower values. From a retrospective patient's perspective, this confirms the currently valid therapeutic guideline for not discharging patients from inpatient treatment until they achieve a body weight appropriate for their age and height (DGPM 2011). In addition, the perceived help from treatment at the different university hospitals showed significant differences, presumably due to the different specialization of the facilities with regard to eating disorders, as previous study results suggest that the treatment in an eating disorder clinic is more helpful than in a non-specialized hospital. With regard to the assessment of the treatment amount, the present catamnestic study showed contradictory results in relation to the long-term (presence of an eating disorder at the time of the catamnestic examination) or short-term treatment result (BMI at discharge) of the former AN patients. On average, patients who rated the amount of treatment as too low reported a higher BMI at hospital discharge (better short-term treatment outcome) than those who judged the treatment amount to be too high. This means that patients with better treatment results in the short term would have wished to receive more treatment quantitatively in the retrospective, than those with worse results. However, in return, more frequently, patients who still had an eating disorder (worse long-term outcome) at the time of study wished to have more treatment quantitatively, than recovered subjects at the time of the study (better long-term outcome). On this basis, it can be hypothesized that the patient group with lower discharge BMI may have had less disease insight than the group with higher discharge BMI, thus less able to engage in therapy with less benefit from it as a result of a poorer treatment outcome. It can also be speculated that in the meantime patients with a still ongoing eating disorder at the time of catamnesis had sufficient insight into the disease and therefore would have wished for more treatment retrospectively. Another plausible result of the current study is that patients who rated the treatment as satisfactory / helpful would have wanted more treatment quantitatively and patients who rated the treatment as unsatisfactory / harmful also judging the treatment amount to be too high. In summary, it becomes clear from our own results that it is a particular challenge to provide a therapy for patients with AN that finds their acceptance and satisfaction (Gulliksen et al., 2012). Accordingly, it is important to refine existing therapies and provide treatments that are adapted to the needs of the patient population. This requires a systematic knowledge of what generates satisfaction and dissatisfaction in patients with AN (Gulliksen et al., 2012). To our knowledge, the present study is the first study on treatment satisfaction that examined exclusively patients with former AN in childhood as a patient collective. Therefore, the results could only be compared with study data from other groups of patients (general psychiatric, child and adolescent psychiatric, eating disorder, adult and adolescent or partly childlike AN patients). Further studies with patients with AN in childhood are useful and desirable to validate the results presented here and to draw practical conclusions for an individualized treatment that meets the needs of the young patients.}, subject = {Anorexia nervosa}, language = {de} } @phdthesis{BuechsenschuetzGoebeler2017, author = {B{\"u}chsensch{\"u}tz-G{\"o}beler, Annekathrin}, title = {Parodontitis und kardiovaskul{\"a}re Erkrankungen - Einfluss der Ver{\"a}nderung des subgingivalen Mikrobioms nach systematischer Parodontaltherapie auf Parameter der arteriellen Gef{\"a}ßsteifigkeit}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154415}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Es l{\"a}sst sich feststellen, dass in der vorliegenden Untersuchung eine nichtchirurgische systemische Parodontaltherapie mit und ohne adjuvante Antibiose die beobachteten Keimzahlen der parodontitisassoziierten Keime Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis und Tannerella forsythia signifikant reduzieren konnte. Es konnte jedoch kein direkter Zusammenhang zwischen der beobachteten Keimreduktion des subgingivalen Mikrobioms und der Ver{\"a}nderung der erfassten Parameter der arteriellen Gef{\"a}ßsteifigkeit festgestellt werden. Weitere Interventionsstudien mit h{\"o}heren Patientenzahlen und einer hierdurch m{\"o}glichen differenzierteren Subanalyse des Patientenguts bez{\"u}glich Risikofaktoren wie Tabakkonsum, Medikation oder Lebensalter, sowie der Unterscheidung zwischen aggressiver und chronischer Parodontitis sind erforderlich, um die m{\"o}gliche Existenz eines kausalen Zusammenhangs beider Erkrankungen definitiv abkl{\"a}ren zu k{\"o}nnen.}, subject = {Parodontitis}, language = {de} } @phdthesis{Mahdiani2017, author = {Mahdiani, Maryam}, title = {Quantitative analysis of fatty acids, cholesterol and oxidation products thereof in human breast adipose tissues}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156102}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {The aim of the present work was to determine the breast adipose tissue composition regarding fatty acids, cholesterol and (aut)oxidation products of cholesterol in women without breast cancer and to identify associated variables. Thus the necessary methods were optimized and validated where required and the breast adipose tissues of women without breast cancer were collected and analyzed. The gas chromatography with flame ionization detection was optimized for detection and separation of 37 relevant fatty acids. Fifty breast adipose tissues were analyzed using the optimized method. 26 fatty acids were detected in breast adipose tissues. The median proportion of saturated (sum of 11 fatty acids), monounsaturated (sum of 5 fatty acids), polyunsaturated (sum of 9 fatty acids) and one trans fatty acid were 34.6\%, 53.2\%, 12.1\% and 0.3\% respectively. Moreover, absolute levels of pentadecanoic acid (median: 0.37 mg/g, range: 0.08 - 1.31 mg/g), elaidic acid (median: 0.50 mg/g, range: 0.09 - 1.92 mg/g), linolenic acid (median: 0.88 mg/g, range: 0.10 - 3.06 mg/g) and docosahexaenoic acid (median: 0.31 mg/g, range: 0.04 - 1.80 mg/g) were determined in breast adipose tissues for the first time. These four fatty acids are indicative for consumption of dairy products, processed fats, vegetable oils such as flax seed oil and fish respectively. Furthermore, for the investigation of cholesterol in breast adipose tissues a gas chromatography was optimized and validated. The accuracies of the method in three independent spiked samples with low, medium and high levels of cholesterol were 99.1 ± 10.1\%, 87.0 ± 11.2\%, and 103.4 ± 4.6\% with precisions of 2.1, 2.1, and 0.8\% respectively. Using external calibration with internal standard cholesterol was quantified in samples (median: 1.1 mg/g, range: 0.7 - 1.5 mg/g). In order to detect (aut)oxidation products of cholesterol, gas chromatography coupled triple quadrupole mass spectrometry was optimized and validated. The accuracy was between 81.6\% and 115.7\% and precisions for low, medium and high oxy-cholesterols levels were below 10.0\%. The quantitative determination of (aut)oxidation products of cholesterol was established using external calibration with an internal standard. The most abundant oxy-cholesterol was 5,6β-Epoxy- (median: 147.2 ng/g, range: 25.7 - 624.2 ng/g), followed by 5,6α-Epoxy- (median: 34.6 ng/g, range: 9.9 - 124.7 ng/g), 7-Keto- (median: 19.1 ng/g, range: 7.9 - 220.6 ng/g), 7α-Hydroxy- (median: 10.2 ng/g, range: 3.8 - 111.3 ng/g) and 7β-Hydroxy-Cholesterol (median: 3.5 ng/g, range: 1.0 - 45.6 ng/g) respectively. Median oxy-cholesterol/cholesterol ratios ranged from 0.0001 (5,6β-Epoxy-Cholesterol) to 0.000003 (7β-Hydroxy-Cholesterol). Finally the associations between fatty acids, cholesterol and oxy-cholesterol were investigated using Spearman's rank correlation. Absolute levels of elaidic acid were positively correlated with levels of linolenic and docosahexaenoic acid (R = 0.79, 0.68, p < 0.01). Absolute levels of linolenic acid were positively associated with levels of docosahexaenoic acid (R = 0.81, p < 0.01). Moreover, relative proportions of saturated fatty acids capric, myristic, palmitic and stearic acid were negatively correlated with oleic acid (R = -0.36, -0.71, -0.65, -0.39, p < 0.05). Tissue levels of cholesterol were not correlated with levels of 5,6α/β-Epoxy-Cholesterols but were negatively associated with that of 7α-Hydroxy-, 7β-Hydroxy- and 7-Keto-Cholesterol (R = -0.29, -0.32, -0.29 p = 0.04, 0.02, 0.04). Levels of 7-Keto- and 7-Hydoxy-Cholesterol were strongly correlated with each other (R = 0.81, 0.91, p < 0.01) and, weaker, with 5,6α/β-Epoxy-Cholesterols (R = 0.60-0.70, p < 0.01). 5,6α/β-Epoxy-Cholesterols were associated positively with each other (R = 0.90, P < 0.01). Total oxy-cholesterol, 7β-Hydroxy-Cholesterol, and 5,6β-Epoxy-Cholesterol levels were correlated with relative proportions of elaidic acid (R = 0.30, 0.30, and 0.31 respectively, p = 0.04, 0.03, 0.03, respectively), whereas no correlation was observed between levels of oxy-cholesterols and relative proportion of pentadecanoic acid, linolenic acid and docosahexaenoic acid. Furthermore, Spearman's rank correlation was performed to investigate the relationship of fatty acids, cholesterol and oxy-cholesterol with age and body mass index. The relative proportions of total saturated fatty acids were negatively correlated with age (R = -0.47, p < 0.01) and body mass index (R = -0.29, p = 0.05). A positive significant correlation was observed between proportions of oleic acid and body mass index (R = 0.32, p = 0.02). There was no correlation between levels of cholesterol and body mass index or age. Likewise, no correlations of oxy-cholesterol levels with age or body mass index were observed. In sum, in this work the quantification methods of cholesterol and oxy-cholesterol were validated. The validation data met the criteria according to the FDA guideline. Using the validated methods the absolute levels of cholesterol and oxy-cholesterols were determined in breast adipose tissue of human females for the first time.}, subject = {Lebensmittelchemie}, language = {en} } @phdthesis{Scholz2017, author = {Scholz, Franca}, title = {Einfluss verschiedener Untersuchungsbedingugen auf die Messwerte der bioelektrischen Impedanzanalyse (EULE)}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156032}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {HINTERGRUND. In zahlreichen epidemiologischen Studien, so auch in der bev{\"o}lkerungsbasierten W{\"u}rzburger Kohortenstudie STAAB (STAdien A und B der Herzinsuffizienz) mit prim{\"a}ren kardiologischen Fragestellungen, wird die K{\"o}rperzusammensetzung mittels bioelektrischer Impedanzanalyse (BIA) gemessen. In einer Pilotstudie wurden das Messprotokoll und die Reproduzierbarkeit der Messungen {\"u}berpr{\"u}ft. Außerdem wurde untersucht, wie sich die Verletzung bestimmter Protokollvorschriften (Messung am n{\"u}chternen Probanden im Ruhezustand) verzerrend auf die Messwerte auswirken. METHODEN. Die Probanden (16 M{\"a}nner, 18 Frauen) waren vollj{\"a}hrig, hatten keine mit dem Protokoll unvertr{\"a}glichen Erkrankungen oder Medikationen und erteilten ihre schriftliche informierte Einwilligung. In sechs konsekutiven BIA-Messungen wurden mittels Seca® mBCA 515 fettfreie Masse, Muskelmasse, Fettmasse, Fettanteil, Gesamtk{\"o}rperwasser und extrazellul{\"a}res Wasser unter verschiedenen Bedingungen bestimmt. Zun{\"a}chst wurden unter den vorgeschriebenen Standardbedingungen zwei direkt aufeinander folgende Messungen durchgef{\"u}hrt, zwischen denen die Probanden das Ger{\"a}t verließen. Die dritte Messung erfolgte unmittelbar nach dem Trinken von 500mL Mineralwasser, die vierte nach 20-30min Wartezeit. Anschließend unterzogen sich die Probanden unterzogen einer k{\"o}rperlichen Belastung (Laufen im Stand, Springen, Kniebeugen) bis zum Einsetzen einer deutlichen Schweißproduktion. Die f{\"u}nfte BIA-Messung erfolgte im unmittelbaren Anschluss an die Belastung, die sechste nach weiteren 5min Ruhepause. ERGEBNISSE. Die beiden unter Standardbedingungen durchgef{\"u}hrten Messungen lieferten bei den Probanden jeweils fast identische Werte. Die Wasseraufnahme wurde vom Ger{\"a}t bei M{\"a}nnern nur marginal (+100g), bei Frauen gar nicht als solche registriert. Vielmehr wurde eine signifikante Zunahme der Fettmasse angezeigt (M{\"a}nner +300g, Frauen +500g, siehe Abbildung). Die Fehlzuordnung des aufgenommenen Wassers verschob sich nach der Wartezeit nur geringf{\"u}gig. Nach der k{\"o}rperlichen Belastung wurde bei den M{\"a}nnern eine gestiegene Fettmasse gemessen (+400g, siehe Abbildung), die sich nach der kurzen Ruhepause wieder reduzierte (-300g), w{\"a}hrend sich die angezeigte K{\"o}rperwassermasse genau gegenl{\"a}ufig verhielt. Bei den Frauen waren die Ver{\"a}nderungen unter Belastung und nach der Ruhepause geringf{\"u}gig. Die Verlaufsprofile der Geschlechter unterschieden sich in allen Messvariablen signifikant (Interaktionstest). SCHLUSSFOLGERUNG. Die Messwerte des BIA-Ger{\"a}ts sind unter den definierten Standardbedingungen gut reproduzierbar. Die experimentellen Ver{\"a}nderungen der Protokollstandards simulierten allt{\"a}glich vorkommende Einflussfaktoren wie Wasserzufuhr oder k{\"o}rperliche Belastung kurz vor der Untersuchung. Die Ergebnisse zeigen, dass die Nichteinhaltung der Standards zu messbaren Verzerrungen f{\"u}hren. Dies ist umso gravierender, da die Verzerrungen in den vom Ger{\"a}t angezeigten Messwerten physikalisch nicht ihren kausalen Ursachen entsprechen und zudem bei den Geschlechtern verschieden ausgepr{\"a}gt sind. Vor dem Hintergrund dieser Ergebnisse sollten bei der epidemiologischen Interpretation statistischer Zusammenh{\"a}nge von BIA-Werten mit anderen Messgr{\"o}ßen auch immer die m{\"o}glichen Auswirkungen fehlerhafter Zuordnung von K{\"o}rperanteilen kritisch gepr{\"u}ft und er{\"o}rtert werden.}, subject = {Impedanzmessung}, language = {de} } @phdthesis{Karl2017, author = {Karl, Franziska}, title = {The role of miR-21 in the pathophysiology of neuropathic pain using the model of B7-H1 knockout mice}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156004}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {The impact of microRNA (miRNA) as key players in the regulation of immune and neuronal gene expression and their role as master switches in the pathophysiology of neuropathic pain is increasingly recognized. miR-21 is a promising candidate that could be linked to the immune and the nociceptive system. To further investigate the pathophysiological role of miR-21 in neuropathic pain, we assesed mice deficient of B7 homolog 1 (B7-H1 ko), a protein with suppressive effect on inflammatory responses. B7-H1 ko mice and wildtype littermates (WT) of three different age-groups, young (8 weeks), middle-aged (6 months), and old (12 months) received a spared nerve injury (SNI). Thermal withdrawal latencies and mechanical withdrawal thresholds were determined. Further, we investigated anxiety-, depression-like and cognitive behavior. Quantitative real time PCR was used to determine miR-21 relative expression in peripheral nerves, dorsal root ganglia and white blood cells (WBC) at distinct time points after SNI. Na{\"i}ve B7-H1 ko mice showed mechanical hyposensitivity with increasing age. Young and middle-aged B7-H1 ko mice displayed lower mechanical withdrawal thresholds compared to WT mice. From day three after SNI both genotypes developed mechanical and heat hypersensitivity, without intergroup differences. As supported by the results of three behavioral tests, no relevant differences were found for anxiety-like behavior after SNI in B7-H1 ko and WT mice. Also, there was no indication of depression-like behavior after SNI or any effect of SNI on cognition in both genotypes. The injured nerves of B7-H1 ko and WT mice showed higher miR-21 expression and invasion of macrophages and T cells 7 days after SNI without intergroup differences. Perineurial miR-21 inhibitor injection reversed SNI-induced mechanical and heat hypersensitivity in old B7-H1 ko and WT mice. This study reveals that reduced mechanical thresholds and heat withdrawal latencies are associated with miR-21 induction in the tibial and common peroneal nerve after SNI, which can be reversed by perineurial injection of a miR-21 inhibitor. Contrary to expectations, miR-21 expression levels were not higher in B7-H1 ko compared to WT mice. Thus, the B7-H1 ko mouse may be of minor importance for the study of miR-21 related pain. However, these results spot the contribution of miR-21 in the pathophysiology of neuropathic pain and emphasize the crucial role of miRNA in the regulation of neuronal and immune circuits that contribute to neuropathic pain.}, subject = {neuropathic pain}, language = {en} } @phdthesis{Ritter2017, author = {Ritter, Cathrin}, title = {Scientific basics for new immunotherapeutic approaches towards Merkel cell carcinoma}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124162}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer that has been associated with the Merkel cell polyomavirus (MCPyV). Indeed, MCC is one of the cancers with the best-established viral carcinogenesis. Despite persistence of the virus in MCC cells and the subsequent expression of viral antigens, the majority of MCC tumors are able to escape the surveillance of the immune system. Therefore the aim of the here presented thesis was to scrutinize immune escape mechanisms operative in MCC. A better understanding of their underlying molecular processes should allow to improve immunotherapeutic treatment strategies for MCC patients. The manuscripts included in this thesis characterize three novel immune evasion strategies of MCC. I) the epigenetic silencing of the NKG2D ligands MICA and MICB via histone H3 hypoacetylation II) reduced HLA class I surface expression via epigenetic silencing of the antigen processing machinery (APM) III) the activation of the PI3K-AKT pathway in a mutation independent manner as potential immune escape strategy MCC tumors and MCC cell lines were analyzed for their expression of MICA/B, HLA and components of the antigen processing machinery as well as for the activation of the PI3K-AKT pathway in situ and in vitro. These analysis reviled MICA and MICB, as well as HLA class I were not expressed or at least markedly reduced in ~80\% of MCCs in situ. The PI3K-AKT pathway, that had only recently been demonstrated to play a significant role in tumor immune escape, was activated in almost 90\% of MCCs in situ. To determine the underlying molecular mechanisms of these aberrations well characterized MCC cell lines were further analyzed in vitro. The fact that the PI3K-AKT pathway activation was due to oncogenic mutations in the PIK3CA or AKT1 gene in only 10\% of MCCs, suggested an epigenetic regulation of this pathway in MCC. In line with this MICA/B as well as components of the APM were indeed silenced epigenetically via histone hypoacetylation in their respective promoter region. Notably MICA/B and HLA class I expression on the cell surface of MCC cells could be restored after treatment with HDAC inhibitors in combination with the Sp1 inhibitor Mithramycin A in all analyzed MCC cell lines in vitro and in a xenotransplantation mouse model in vivo. Moreover inhibition of HDACs increased immune recognition of MCC cell lines in a MICA/B and HLA class I dependent manner. Several studies have accumulated evidence that immunotherapy is a promising treatment option for MCC patients due to the exquisite immunogenicity of this malignancy. However, current immunotherapeutic interventions towards solid tumors like MCC have to account for the plentitude of tumor immune escape strategies, in order to increase response rates. The immune escape mechanisms of MCC described in this thesis can be reverted by HDAC inhibition, thus providing the rationale to combine 'epigenetic priming' with currently tested immunotherapeutic regimens.}, subject = {Merkel-Zellkarzinom}, language = {en} } @phdthesis{Weis2017, author = {Weis, Michael}, title = {Rassismuskritische Fortbildung von Lehrerinnen und Lehrern}, edition = {1. Auflage}, publisher = {W{\"u}rzburg University Press}, address = {W{\"u}rzburg}, isbn = {978-3-95826-068-9 (Print)}, doi = {10.25972/WUP-978-3-95826-069-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-153527}, school = {W{\"u}rzburg University Press}, pages = {XXII, 224}, year = {2017}, abstract = {Rassismus wirkt in der Schule auf individueller, unterrichtlicher und institutioneller Ebene - h{\"a}ufig in subtilen und versteckten Formen. Zwar besitzt das Ph{\"a}nomen einen spezifischen historischen Ausgangspunkt und ist dadurch in seinen Wirkungsweisen (gerade auch in p{\"a}dagogischen Kontexten) gut zu analysieren und somit folglich auch zu dekonstruieren, allerdings st{\"o}ßt die f{\"u}r eine p{\"a}dagogische Auseinandersetzung zentrale Voraussetzung einer selbst- und machtreflexiven Herangehensweise bei P{\"a}dagoginnen h{\"a}ufig auf Widerst{\"a}nde und Ablehnung. Auch aufgrund der langj{\"a}hrigen Tabuisierung des Begriffs fand eine intensivere Auseinandersetzung mit Rassismus im deutschsprachigen Raum sowohl in der erziehungswissenschaftlichen Theorie wie auch in der p{\"a}dagogischen Praxis erst ab den 1990er-Jahren statt. Bis heute besteht allerdings ein virulenter Forschungsbedarf f{\"u}r dieses Praxis- und Forschungsfeld in der spezifischen Schnittmenge der Gegenstandsbereiche Lehrerinnenfortbildung und Rassismus. Die hier vorgelegte explorative Studie hatte zum Ziel, dieses Forschungsdefizit aufzuholen und besch{\"a}ftigte sich deshalb mit der aktuellen Praxis der rassismusrelevanten Lehrerinnen- und Lehrerfortbildung in Deutschland, d.h. mit jenen Konzepten und Angeboten der sogenannten Dritten Phase, in welchen das Thema ‚Rassismus' eine explizite wie implizite inhaltliche Relevanz besitzt. Eine empirische Datenbasis konnte auf Grundlage von qualitativen Interviews mit Expertinnen, die f{\"u}r die Konzeption und/oder Durchf{\"u}hrung solcher Fortbildungen verantwortlich sind, erhoben und mit Hilfe der Qualitativen Inhaltsanalyse ausgewertet werden. Durch eine Verdichtung des analysierten Materials konnten am Ende des Auswertungsprozesses f{\"u}nf Kernhypothesen formuliert werden, welche belastbare Aussagen zur aktuellen Praxis der rassismusspezifischen Lehrerinnenfortbildung - also jener Seminare, in denen Rassismus explizit thematisiert wird - darstellen und somit Ankn{\"u}pfungspunkte f{\"u}r m{\"o}glichen Folgestudien bieten.}, subject = {Rassismus}, language = {de} } @phdthesis{Schmitt2017, author = {Schmitt, Franziska}, title = {Neuronal basis of temporal polyethism and sky-compass based navigation in \(Cataglyphis\) desert ants}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142049}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Desert ants of the genus Cataglyphis (Formicinae) are widely distributed in arid areas of the palearctic ecozone. Their habitats range from relatively cluttered environments in the Mediterranean area to almost landmark free deserts. Due to their sophisticated navigational toolkit, mainly based on the sky-compass, they were studied extensively for the last 4 decades and are an exceptional model organism for navigation. Cataglyphis ants exhibit a temporal polyethism: interior workers stay inside the dark nest and serve as repletes for the first ∼2 weeks of their adult life (interior I). They then switch to nursing and nest maintenance (interior II) until they transition to become day-active outdoor foragers after ∼4 weeks. The latter switch in tasks involves a transition phase of ∼2-3 days during which the ants perform learning and orientation walks. Only after this last phase do the ants start to scavenge for food as foragers. In this present thesis I address two main questions using Cataglyphis desert ants as a model organism: 1. What are the underlying mechanisms of temporal polyethism? 2. What is the neuronal basis of sky-compass based navigation in Cataglyphis ants? Neuropeptides are important regulators of insect physiology and behavior and as such are promising candidates regarding the regulation of temporal polyethism in Cataglyphis ants. Neuropeptides are processed from large precursor proteins and undergo substantial post-translational modifications. Therefore, it is crucial to biochemically identify annotated peptides. As hardly any peptide data are available for ants and no relevant genomic data has been recorded for Cataglyphis, I started out to identify the neuropeptidome of adult Camponotus floridanus (Formicinae) workers (manuscript 1). This resulted in the first neuropeptidome described in an ant species - 39 neuropeptides out of 18 peptide families. Employing a targeted approach, I identified allatostatin A (AstA), allatotropin (AT), short neuropeptide F (sNPF) and tachykinin (TK) using mass spectrometry and immunohistology to investigate the distribution of AstA, AT and TK in the brain (manuscript 2). All three peptides are localized in the central complex, a brain center for sensory integration and high-order control of locomotion behavior. In addition, AstA and TK were also found in visual and olfactory input regions and in the mushroom bodies, the centers for learning and memory formation. Comparing the TK immunostaining in the brain of 1, 7 and 14 days old dark kept animals revealed that the distribution in the central complex changes, most prominently in the 14 day old group. In the Drosophila central complex TK modulates locomotor activity levels. I therefore hypothesize that TK is involved in the internal regulation of the interior I-interior II transition which occurs after ∼2 weeks of age. I designed a behavioral setup to test the effect of neuropeptides on the two traits: 'locomotor activity level' and 'phototaxis' (manuscript 3). The test showed that interior I ants are less active than interior II ants, which again are less active than foragers. Furthermore, interior ants are negatively phototactic compared to a higher frequency of positive phototaxis in foragers. Testing the influence of AstA and AT on the ants' behavior revealed a stage-specific effect: while interior I behavior is not obviously influenced, foragers become positively phototactic and more active after AT injection and less active after AstA injection. I further tested the effect of light exposure on the two behavioral traits of interior workers and show that it rises locomotor activity and results in decreased negative phototaxis in interior ants. However, both interior stages are still more negatively phototactic than foragers and only the activity level of interior II ants is raised to the forager level. These results support the hypothesis that neuropeptides and light influence behavior in a stage-specific manner. The second objective of this thesis was to investigate the neuronal basis of skycompass navigation in Cataglyphis (manuscript 4). Anatomical localization of the sky-compass pathway revealed that its general organization is highly similar to other insect species. I further focused on giant synapses in the lateral complex, the last relay station before sky-compass information enters the central complex. A comparison of their numbers between newly eclosed ants and foragers discloses a rise in synapse numbers from indoor worker to forager, suggesting task-related synaptic plasticity in the sky-compass pathway. Subsequently I compared synapse numbers in light preexposed ants and in dark-kept, aged ants. This experiment showed that light as opposed to age is necessary and sufficient to trigger this rise in synapse number. The number of newly formed synapses further depends on the spectral properties of the light to which the ants were exposed to. Taken together, I described neuropeptides in C. floridanus and C. fortis, and provided first evidence that they influence temporal polyethism in Cataglyphis ants. I further showed that the extent to which neuropeptides and light can influence behavior depends on the animals' state, suggesting that the system is only responsive under certain circumstances. These results provided first insight into the neuronal regulation of temporal polyethism in Cataglyphis. Furthermore, I characterized the neuronal substrate for sky-compass navigation for the first time in Cataglyphis. The high level of structural synaptic plasticity in this pathway linked to the interior-forager transition might be particularly relevant for the initial calibration of the ants' compass system.}, subject = {Cataglyphis}, language = {en} } @phdthesis{Popp2017, author = {Popp, Hanna Margitta}, title = {Ver{\"a}nderung der Emotionsverarbeitung depressiver Patienten - eine EEG-Studie -}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-155211}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {In der vorliegenden Studie soll die Ver{\"a}nderung emotionaler Verarbeitung depressiver Patienten im Vergleich zu einer gesunden Kontrollgruppe untersucht werden. Als Messinstrument dient uns das EEG, welches als eine nicht invasive, sensitive Methode, die Ver{\"a}nderung der emotionalen Reaktion mittels EKPs darstellbar macht. So soll in dieser Studie ein Paradigma entwickelt werden, welches die Ver{\"a}nderung der emotionalen Verarbeitung von depressiven Patienten erfassen kann, um zuk{\"u}nftig die Effektivit{\"a}t von Psychotherapie anhand objektivierbarer Maße zu evaluieren.}, subject = {Elektroencephalogramm}, language = {de} } @phdthesis{Haller2017, author = {Haller, Elisabeth}, title = {Postoperatives Outcome nach offener Herzoperation mit begleitender Amputation des linken Vorhofohres zur Thrombembolieprophylaxe bei Patienten mit Vorhofflimmern : eine retrospektive Studie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154391}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Im Rahmen der vorliegenden Studie an der Klinik und Poliklinik f{\"u}r Herz-, Thorax- und thorakale Gef{\"a}ßchirurgie der Uniklinik W{\"u}rzburg im Zeitraum von Januar 2010 bis Mai 2013 wurden 148 kardiochirurgische konsekutive Patienten mit Vorhofflimmern und Amputation des linken Vorhofohres retrospektiv untersucht. Zielsetzung war zu evaluieren inwiefern die Vorhofohramputation ein sicheres Verfahren darstellt. 2,7\% des Patientenkollektivs erlitten perioperativ einen Apoplex. Die Tatsache, dass alle Patienten in der Aufwachphase bzw. direkt post extubationem mit einem fokal-neurologischen Defizit auff{\"a}llig geworden waren und in allen F{\"a}llen ein isch{\"a}mischer cerebraler Insult radiologisch nachweisbar war, legt nahe, dass es sich um embolische Infarkte im direkten Zusammenhang mit der Operation handelte. Die Apoplexpatienten, bei denen perioperativ eine TAA nachweisbar war (50\%), hatten das cerebrale Ereignis bereits vor Auftreten der TAA. 50\% der Apoplexpatienten entsprechen mit der Kombination aus operativer Myokardrevaskularisation und einem Eingriff an der Aortenklappe dem in der Literatur beschriebenen h{\"o}chsten Risiko f{\"u}r einen Apoplex bei kardiochirurgischen Eingriffen [4]. Aufgrund der geringen Fallzahl der Studie war die Erhebung von bestimmten Risikoprofilen f{\"u}r das Auftreten eines Apoplex nicht m{\"o}glich, auff{\"a}llig war jedoch, dass 75\% der Apoplexpatienten an intermittierendem Vorhofflimmern litten. Dar{\"u}berhinaus zeigten die Apoplexpatienten eine signifikant (p=0,008) l{\"a}ngere Nachbeatmungszeit. Eine Aussage {\"u}ber die Effektivit{\"a}t der Vorhofohramputation in Hinblick auf die Prophylaxe eines Apoplex ist in der vorliegenden Studie aufgrund des kurzen Beobachtungszeitraums bis zum Zeitpunkt der Entlassung nicht m{\"o}glich. Zu diesem Zweck bedarf es weiteren Studien, in der das Patientenkollektiv postoperativ in Intervallen hinsichtlich eines cerebralen Insults und der Antikoagulation nachverfolgt wird. Dar{\"u}ber hinaus kann - wie in der Literatur beschrieben - vermutet werden, dass Patienten mit pr{\"a}operativem Vorhofflimmern ein erh{\"o}htes perioperatives Mortalit{\"a}ts- und Morbidit{\"a}tsrisiko haben. Die Letalit{\"a}t war mit 8,1\% in der untersuchten Patientenkohorte deutlich h{\"o}her als in der Literatur, bei genauerer Betrachtung der Auswahl der Patienten zeigt sich jedoch, dass das Einschlusskriterium der Diagnose Vorhofflimmern als Risikofaktor eine große Rolle spielt [4]. Des Weiteren wurde mit 11,8\% bei den Kombinationsoperationen eine deutlich h{\"o}here Letalit{\"a}t im Gegensatz zu den isolierten CABG-OPs mit 4,8\% festgestellt. Es konnte gezeigt werden, dass die perioperativ verstorbenen Patienten gem{\"a}ß den Risikostratifizierungen aus der Literatur ein deutlich erh{\"o}htes Risikoprofil f{\"u}r Morbidit{\"a}t besaßen [25-30]. Insbesondere das mit 76 (SD±9) Jahren signifikant (p=0,001) h{\"o}here Lebensalter der Patienten und die signifikant (0,001) l{\"a}ngere Operationszeit, v.a. eine mit 197 Minuten (SD±11) signifikant l{\"a}ngere EKZ-Dauer, scheinen eine entscheidende Rolle in der Betrachtung der perioperativen Morbidit{\"a}t zu spielen. Eine TAA trat perioperativ bei 31,1\% der Patienten auf. Im Hinblick auf eine Kardioversion konnte festgestellt werden, dass die medikament{\"o}se Kardioversion 94,7\% Sinusrhythmus bei Entlassung der elektrischen Kardioversion mit 61,1\% Sinusrhythmus bei Entlassung {\"u}berlegen war. Des Weiteren zeigte die vorliegende Studie, dass eine Cryoablation mit einer Steigerung der Rate an Sinusrhythmus von pr{\"a}operativ 53,0\% auf 69,7\% bei Entlassung erfolgreich zu sein scheint. Zur weiteren Evaluation der Cryoablation m{\"u}ssen jedoch gesonderte Studien durchgef{\"u}hrt werden, da in der vorliegenden Studie zu beachten ist, dass sowohl Patienten mit chronischem Vorhofflimmern als auch Patienten mit intermittierendem Vorhofflimmern ber{\"u}cksichtigt wurden. Die Revisionsrate aufgrund einer Blutung war mit 7,4\% h{\"o}her als Vegleichswerte in der Literatur [37-39]. Die Kombinationsoperationen hatten mit 11,3\% eine mehr als doppelt so hohe Revisionsrate als die isolierten Koronarchirurgieeingriffe mit 3,9\%. Herzchirurgische Kombinationseingriffe werden in der Literatur mit einem erh{\"o}hten Revisionsrisiko beschrieben. In der vorliegenden Studie scheint, wie auch in der Literatur [40,41], die Dauer der Herzlungenmaschinenzeit eine Rolle zu spielen. In der vorliegenden Studie war diese mit 152 Minuten (±52,35) bei den Kombinationsoperationen im Gegensatz zu 106 Minuten (±54,76) bei den isolierten CABG-OPs deutlich l{\"a}nger und entspricht mit >150 Minuten auch einer in der Literatur beschriebenen Zeitgrenze f{\"u}r ein signifikant h{\"o}heres Risiko einer Revision [41]. Auf der Basis der im Rahmen dieser Untersuchung genannten Ergebnisse kann davon ausgegangen werden, dass die chirurgische Amputation des linken Vorhofohres ein sicheres Verfahren ist, das die Operationszeit nur unwesentlich verl{\"a}ngert. Inwieweit die chirurgische Vorhofohramputation auch einen benefiziellen Aspekt im Sinne der Reduktion der Rate von postoperativ neuaufgetretenen Apoplexen eine Rolle spielt bzw. das Verzichten auf eine Antikoagulationstherapie bei Patienten mit Vorhofflimmern m{\"o}glich macht, m{\"u}ssen weiterf{\"u}hrende prospektiv-randomisierte Studien zeigen.}, subject = {Vorhofflimmern}, language = {de} }