@phdthesis{Deckelmann2018, author = {Deckelmann, Jana Verena}, title = {Einfluss bariatrischer Operationen auf das Geruchsempfinden morbid adip{\"o}ser Patienten}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157076}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {Weltweit steigt die Anzahl der morbid adip{\"o}sen Menschen stetig an. Dies f{\"u}hrt zu einer Zunahme der medizinischen und psychosozialen Komplikationen des Einzelnen und der gesundheits{\"o}konomischen Belastung der Gesellschaft. Kosteneffektive und langfristige Therapiekonzepte sind dringend notwendig. Die bariatrische Chirurgie stellt die einzige Therapieoption der morbiden Adipositas dar, mit der eine langfristige Gewichtsreduktion und damit eine signifikante Verbesserung der adipositasassoziierten Begleiterkrankungen erreicht werden kann. Die Mechanismen der Gewichtsabnahme im Rahmen einer bariatrischen Operation sind noch nicht ausreichend erforscht und verstanden. Hinweise Das Geruchsempfinden, als wichtiger Bestandteil der Nahrungsauswahl, k{\"o}nnte durch eine Ver{\"a}nderung in Folge einer bariatrischen Operation einen Einfluss auf die Gewichtsreduktion haben. In der vorliegenden Arbeit wurde mittels der Sniffin´sticks das Geruchsempfinden morbid adip{\"o}ser Menschen in Zusammenhang mit einer bariatrischen Operation (RYGB, n=15 vs. SG, n=15) untersucht (0-1-6-12-24 Wochen). Als Kontrollgruppe dienten morbid adip{\"o}se Probanden unter konservativer Therapie (n=12). Der Ausgangs-BMI der SG-Gruppe (56,04 ± 7,09 kg/m2) war im Vergleich zur RYGB- Gruppe (48,71 ± 6,49 kg/m2) und der konservativ behandelten Gruppe (50,35 ± 6,78 kg/m2) signifikant h{\"o}her (p= 0,011*). Das Ausmaß der Gewichtsabnahme der beiden operierten Gruppen zeigte keine signifikanten Unterschiede (p=0,87). Die konservativ behandelte Gruppe nahm praktisch kein Gewicht ab. Der Ausgangs-SDI-Wert der SG-Gruppe (27,09 ± 3,93) war im Vergleich zur RYGB- Gruppe (32,61 ± 3,64) und zur konservativ behandelten Gruppe (32,15 ± 5,32) signifikant niedriger. Die SG-Gruppe erreichte nach 6 Monaten SDI-Werte von 31,06 ± 3,49, was einen signifikanten Anstieg darstellt (p=0,040*). Die SG-Gruppe hatte anfangs signifikant niedrigere Schwellenwerte als die RYGB- Gruppe (p=0,0050**). Auch im Vergleich zu den Patienten der konservativ behandelten Gruppe erzielte die SG-Gruppe pr{\"a}operativ signifikant niedrigere Schwellenwerte (p=0,0026). Ein signifikanter Anstieg der Schwellenwerte innerhalb von 6 Monaten zeigte sich nur in der SG-Gruppe (p=0,00061***). Die Mittelwerte lagen pr{\"a}operativ bei 4,71 ± 1,31 und nach sechs Monaten bei 7,29 ± 2,11. Die RYGB-Gruppe erzielte pr{\"a}operativ Mittelwerte von 6,82 ± 1,85 und nach sechs Monaten von 7,8 ± 1,41, was ein knapp nicht signifikanter Anstieg ist (p=0,054). Im Vergleich der Diskriminationswerte zeigte sich lediglich ein knapp signifikanter Anstieg der konservativ behandelten Gruppe (p=0,035*). Alle weiteren Werte waren nicht signifikant. Bez{\"u}glich der Identifikationswerte konnten keine signifikanten Ver{\"a}nderungen beobachtet werden. Mit abnehmendem BMI nahm der SDI-Wert der SG-Gruppe signifikant zu (p=0,0074**), was bei der RYGB-Gruppe nicht zutraf (p=0,20). Die Ergebnisse dieser Arbeit zeigen, dass das Geruchsempfinden durch einen wesentlichen Gewichtsverlust an sich nicht beeinflusst wird. Die Daten deuten darauf hin, dass sich die Riechfunktion nach einer Sleeve Gastrectomy im Vergleich zu einer Roux-Y gastric bypass verbessert. Es scheint folglich Mechanismen zu geben, die von der Operationsmethode abh{\"a}ngen. In der Zukunft sind weitere Forschungsanstrengungen n{\"o}tig, um die Mechanismen der Gewichtsabnahme nach bariatrischer Operation und insbesondere die Ver{\"a}nderungen des Geruchsempfindens in Abh{\"a}ngigkeit des Operationsverfahrens besser verstehen zu k{\"o}nnen.}, subject = {Adipositas}, language = {de} } @phdthesis{Fehrmann2018, author = {Fehrmann, Marion Valerie}, title = {Inzidenz und Outcome von Teratomen des Ovars - eine retrospektive Datenanalyse}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-168988}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {In der vorliegenden Arbeit " Inzidenz und Outcome von Teratomen des Ovars - eine retrospektive Datenanalyse " werden die Ergebnisse einer retrospektiven Datenanalyse f{\"u}r ein Zeitfenster von 10 Jahren diskutiert. Gegenstand war die Auswertung der Patientenakten aller ovariellen Neubildungen, welche in den Jahren 2005-2015 in der Abteilung f{\"u}r Kinderchirurgie der chirurgischen Universit{\"a}tsklinik W{\"u}rzburg (Chirurgische Klinik I) behandelt wurden. Die Filterung der Datenbanken nach den erforderlichen Kriterien ergab einen Patientenstamm von 28 F{\"a}llen. Zentrale Untersuchungsparameter stellten das Patientenalter zum Erkrankungszeitpunkt, die diagnoseweisenden Symptome, die pr{\"a}operative Diagnostik, die Wahl der Operationsmethode, der postoperative Verlauf der Krankengeschichte, das Nachsorgeprogramm sowie die Untersuchung auf rezidivierende Prozesse dar. Die gewonnenen Ergebnisse des betrachteten Patientenstamms wurden objektiv zusammengefasst, auf m{\"o}gliche Gesetzm{\"a}ßigkeiten untersucht, pr{\"a}sentiert und durch Grafiken bildlich veranschaulicht. In der Diskussion erfolgte die Einordnung in die aktuelle wissenschaftliche Studienlage und der Vergleich mit themenspezifischen bekannten Erkenntnissen und Literatur.}, subject = {Teratom}, language = {de} } @article{GilbertSchneemannScholzetal.2018, author = {Gilbert, F. and Schneemann, C. and Scholz, C. J. and Kickuth, R. and Meffert, R. H. and Wildenauer, R. and Lorenz, U. and Kellersmann, R. and Busch, A.}, title = {Clinical implications of fracture-associated vascular damage in extremity and pelvic trauma}, series = {BMC Muscuskeletal Disorders}, volume = {19}, journal = {BMC Muscuskeletal Disorders}, number = {404}, doi = {10.1186/s12891-018-2333-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176252}, year = {2018}, abstract = {Background: Vascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed. Methods: This comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group. Results: Vascular damage occurred in 7\% of patients with upper and lower limb and pelvic fractures admitted to the trauma room. Overall survival was 80\% in pelvic fracture and 97\% in extremity fracture patients and comparable to non-vascular trauma patients. Additional arterial damage required substantial fluid administration and was visible as significantly anemia and disturbed coagulation tests upon admission. Open procedures were done in over 80\% of peripheral extremity vascular damage. Endovascular procedures were predominant (87\%) in pelvic injury. Conclusion: Vascular damage is associated with high mortality rates especially in combination with pelvic fractures. Initial anemia, disturbed coagulation tests and the need for extensive pre-clinical fluid substitution were observed in the cohort with vascular damage. Therefore, fast diagnosis and early interventional and surgical procedures are necessary to optimize patient-specific outcome.}, language = {en} } @article{BartmannJanakiRamanFloeteretal.2018, author = {Bartmann, Catharina and Janaki Raman, Sudha R. and Fl{\"o}ter, Jessica and Schulze, Almut and Bahlke, Katrin and Willingstorfer, Jana and Strunz, Maria and W{\"o}ckel, Achim and Klement, Rainer J. and Kapp, Michaela and Djuzenova, Cholpon S. and Otto, Christoph and K{\"a}mmerer, Ulrike}, title = {Beta-hydroxybutyrate (3-OHB) can influence the energetic phenotype of breast cancer cells, but does not impact their proliferation and the response to chemotherapy or radiation}, series = {Cancer \& Metabolism}, volume = {6}, journal = {Cancer \& Metabolism}, number = {8}, doi = {10.1186/s40170-018-0180-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175607}, year = {2018}, abstract = {Background: Ketogenic diets (KDs) or short-term fasting are popular trends amongst supportive approaches for cancer patients. Beta-hydroxybutyrate (3-OHB) is the main physiological ketone body, whose concentration can reach plasma levels of 2-6 mM during KDs or fasting. The impact of 3-OHB on the biology of tumor cells described so far is contradictory. Therefore, we investigated the effect of a physiological concentration of 3 mM 3-OHB on metabolism, proliferation, and viability of breast cancer (BC) cells in vitro. Methods: Seven different human BC cell lines (BT20, BT474, HBL100, MCF-7, MDA-MB 231, MDA-MB 468, and T47D) were cultured in medium with 5 mM glucose in the presence of 3 mM 3-OHB at mild hypoxia (5\% oxygen) or normoxia (21\% oxygen). Metabolic profiling was performed by quantification of the turnover of glucose, lactate, and 3-OHB and by Seahorse metabolic flux analysis. Expression of key enzymes of ketolysis as well as the main monocarboxylic acid transporter MCT2 and the glucose-transporter GLUT1 was analyzed by RT-qPCR and Western blotting. The effect of 3-OHB on short- and long-term cell proliferation as well as chemo- and radiosensitivity were also analyzed. Results: 3-OHB significantly changed the oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) in BT20 cells resulting in a more oxidative energetic phenotype. MCF-7 and MDA-MB 468 cells had increased ECAR only in response to 3-OHB, while the other three cell types remained uninfluenced. All cells expressed MCT2 and GLUT1, thus being able to uptake the metabolites. The consumption of 3-OHB was not strongly linked to mRNA overexpression of key enzymes of ketolysis and did not correlate with lactate production and glucose consumption. Neither 3-OHB nor acetoacetate did interfere with proliferation. Further, 3-OHB incubation did not modify the response of the tested BC cell lines to chemotherapy or radiation. Conclusions: We found that a physiological level of 3-OHB can change the energetic profile of some BC cell lines. However, 3-OHB failed to influence different biologic processes in these cells, e.g., cell proliferation and the response to common breast cancer chemotherapy and radiotherapy. Thus, we have no evidence that 3-OHB generally influences the biology of breast cancer cells in vitro.}, language = {en} } @article{KressBaurOttoetal.2018, author = {Kress, Sebastian and Baur, Johannes and Otto, Christoph and Burkard, Natalie and Braspenning, Joris and Walles, Heike and Nickel, Joachim and Metzger, Marco}, title = {Evaluation of a miniaturized biologically vascularized scaffold in vitro and in vivo}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, number = {4719}, doi = {10.1038/s41598-018-22688-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176343}, year = {2018}, abstract = {In tissue engineering, the generation and functional maintenance of dense voluminous tissues is mainly restricted due to insufficient nutrient supply. Larger three-dimensional constructs, which exceed the nutrient diffusion limit become necrotic and/or apoptotic in long-term culture if not provided with an appropriate vascularization. Here, we established protocols for the generation of a pre-vascularized biological scaffold with intact arterio-venous capillary loops from rat intestine, which is decellularized under preservation of the feeding and draining vascular tree. Vessel integrity was proven by marker expression, media/blood reflow and endothelial LDL uptake. In vitro maintenance persisted up to 7 weeks in a bioreactor system allowing a stepwise reconstruction of fully vascularized human tissues and successful in vivo implantation for up to 4 weeks, although with time-dependent decrease of cell viability. The vascularization of the construct lead to a 1.5× increase in cellular drug release compared to a conventional static culture in vitro. For the first time, we performed proof-of-concept studies demonstrating that 3D tissues can be maintained within a miniaturized vascularized scaffold in vitro and successfully implanted after re-anastomosis to the intrinsic blood circulation in vivo. We hypothesize that this technology could serve as a powerful platform technology in tissue engineering and regenerative medicine.}, language = {en} } @article{BankogluArnoldHeringetal.2018, author = {Bankoglu, Ezgi Eyluel and Arnold, Charlotte and Hering, Ilona and Hankir, Mohammed and Seyfried, Florian and Stopper, Helga}, title = {Decreased chromosomal damage in lymphocytes of obese patients after bariatric surgery}, series = {Scientific Reports}, volume = {8}, journal = {Scientific Reports}, number = {11195}, doi = {10.1038/s41598-018-29581-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177090}, year = {2018}, abstract = {The number of bariatric surgeries being performed worldwide has markedly risen. While the improvement in obesity-associated comorbidities after bariatric surgery is well-established, very little is known about its impact on cancer risk. The peripheral lymphocyte micronucleus test is a widely used method for the monitoring of chromosomal damage levels in vivo, and micronucleus frequency positively correlates with cancer risk. Therefore, the aim of this study was to compare the micronucleus frequency before and after bariatric surgery in obese subjects. Peripheral blood mononuclear cells were collected from 45 obese subjects before and at two time-points after bariatric surgery (6 and 12 months) to assess spontaneous micronucleus frequency. Consistent with the increased cancer risk previously shown, bariatric surgery-induced weight loss led to a significant reduction in lymphocyte micronucleus frequency after 12 months. Interestingly, comorbidities such as type 2 diabetes mellitus and metabolic syndrome further seemed to have an impact on the lymphocyte micronucleus frequency. Our findings may indicate a successful reduction of cancer risk in patients following weight loss caused by bariatric surgery.}, language = {en} } @article{BaurOttoStegeretal.2018, author = {Baur, Johannes and Otto, Christoph and Steger, Ulrich and Klein-Hessling, Stefan and Muhammad, Khalid and Pusch, Tobias and Murti, Krisna and Wismer, Rhoda and Germer, Christoph-Thomas and Klein, Ingo and M{\"u}ller, Nora and Serfling, Edgar and Avots, Andris}, title = {The transcription factor NFaTc1 supports the rejection of heterotopic heart allografts}, series = {Frontiers in Immunology}, volume = {9}, journal = {Frontiers in Immunology}, doi = {10.3389/fimmu.2018.01338}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221530}, year = {2018}, abstract = {The immune suppressants cyclosporin A (CsA) and tacrolimus (FK506) are used worldwide in transplantation medicine to suppress graft rejection. Both CsA and FK506 inhibit the phosphatase calcineurin (CN) whose activity controls the immune receptor-mediated activation of lymphocytes. Downstream targets of CN in lymphocytes are the nuclear factors of activated T cells (NFATs). We show here that the activity of NFATc1, the most prominent NFAT factor in activated lymphocytes supports the acute rejection of heterotopic heart allografts. While ablation of NFATc1 in T cells prevented graft rejection, ectopic expression of inducible NFATc1/αA isoform led to rejection of heart allografts in recipient mice. Acceptance of transplanted hearts in mice bearing NFATc1-deficient T cells was accompanied by a reduction in number and cytotoxicity of graft infiltrating cells. In CD8\(^+\) T cells, NFATc1 controls numerous intracellular signaling pathways that lead to the metabolic switch to aerobic glycolysis and the expression of numerous lymphokines, chemokines, and their receptors, including Cxcr3 that supports the rejection of allogeneic heart transplants. These findings favors NFATc1 as a molecular target for the development of new strategies to control the cytotoxicity of T cells upon organ transplantation.}, language = {en} } @article{AnanyKreckelFuellsacketal.2018, author = {Anany, Mohamed A. and Kreckel, Jennifer and F{\"u}llsack, Simone and Rosenthal, Alevtina and Otto, Christoph and Siegmund, Daniela and Wajant, Harald}, title = {Soluble TNF-like weak inducer of apoptosis (TWEAK) enhances poly(I:C)-induced RIPK1-mediated necroptosis}, series = {Cell Death \& Disease}, volume = {9}, journal = {Cell Death \& Disease}, doi = {10.1038/s41419-018-1137-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221104}, year = {2018}, abstract = {TNF-like weak inducer of apoptosis (TWEAK) and inhibition of protein synthesis with cycloheximide (CHX) sensitize for poly(I:C)-induced cell death. Notably, although CHX preferentially enhanced poly(I:C)-induced apoptosis, TWEAK enhanced primarily poly(I:C)-induced necroptosis. Both sensitizers of poly(I:C)-induced cell death, however, showed no major effect on proinflammatory poly(I:C) signaling. Analysis of a panel of HeLa-RIPK3 variants lacking TRADD, RIPK1, FADD, or caspase-8 expression revealed furthermore similarities and differences in the way how poly(I:C)/TWEAK, TNF, and TRAIL utilize these molecules for signaling. RIPK1 turned out to be essential for poly(I:C)/TWEAK-induced caspase-8-mediated apoptosis but was dispensable for this response in TNF and TRAIL signaling. TRADD-RIPK1-double deficiency differentially affected poly(I:C)-triggered gene induction but abrogated gene induction by TNF completely. FADD deficiency abrogated TRAIL- but not TNF- and poly(I:C)-induced necroptosis, whereas TRADD elicited protective activity against all three death inducers. A general protective activity against poly(I:C)-, TRAIL-, and TNF-induced cell death was also observed in FLIPL and FLIPS transfectrants.}, language = {en} }