TY - JOUR A1 - Wimmer, Matthias D. A1 - Randau, Thomas M. A1 - Deml, Moritz C. A1 - Ascherl, Rudolf A1 - Forst, Raimund A1 - Gravius, Nadine A1 - Wirtz, Dieter A1 - Gravius, Sascha T1 - Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant JF - BMC Musculoskeletal Disorders N2 - Background: We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA) using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER) with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting) improves the stem survival. Methods: We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8%) received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2%) did not, and served as controls. The mean follow-up was 4.4 +/- 1.8 years (range, 2.1-9.6 years). There were no significant differences (p > 0.05) between the study and control group regarding age, body mass index (BMI), femoral defects (types I-III as described by Paprosky), and preoperative Harris Hip Score (HHS). Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results: There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05). Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 +/- 14.3 vs. 30.8 +/- 15.8; p <= 0.05). The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky) and stem diameters >= 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9%) and the rate of revisions (8.6% vs. 11%). The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years; control group 93.1% after 8.7 years]. Radiologic evaluation showed no significant change in axial implant migration (4.3% vs. 9.3%; p = 0.19) but a significant reduction in proximal stress shielding (5.7% vs. 17.9%; p < 0.05) in the study group. Periprosthetic radiolucencies were detected in 5.7% of the study group and in 9.8% of the control group (p = 0.30). Radiolucencies in the proximal zones 1 and 7 according to Gruen occurred significantly more often in the control group without allograft augmentation (p = 0.05). Conclusion: We present the largest analysis of the impaction grafting technique in combination with cementless distal diaphyseal stem fixation published so far. Our data provides initial evidence of improved bone regeneration after graft augmentation of metaphyseal bone defects. The data suggests that proximal metaphyseal graft augmentation is beneficial for large metaphyseal bone defects (Paprosky types IIC and III) and stem diameters of 17 mm and above. Due to the limitations of a retrospective and descriptive study the level of evidence remains low and prospective trials should be conducted. KW - prosthesis KW - replacement KW - collarless KW - surgery KW - allografts KW - porous-coated stems KW - femoral revision KW - roentgenographic assessment KW - tapered stem KW - follow-up KW - modular KW - revision KW - hip KW - arthroplasty KW - impaction bone grafting Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122061 SN - 1471-2474 VL - 14 IS - 19 ER - TY - JOUR A1 - Ljunggren, Osten A1 - Barrett, Annabel A1 - Stoykov, Ivaylo A1 - Langdahl, Bente L. A1 - Lems, Willem F. A1 - Walsh, J. Bernard A1 - Fahrleitner-Pammer, Astrid A1 - Rajzbaum, Gerald A1 - Jakob, Franz A1 - Karras, Dimitrios A1 - Marin, Fernando T1 - Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in postmenopausal women with osteoporosis: the European Forsteo Observational Study JF - BMC Musculoskeletal Disorders N2 - Background: To describe changes in health-related quality of life (HRQoL) of postmenopausal women with osteoporosis treated with teriparatide for up to 18 months and followed-up for a further 18 months, and to assess the influence of recent prior and incident fractures. Methods: The European Forsteo Observational Study (EFOS) is an observational, prospective, multinational study measuring HRQoL using the EQ-5D. The primary objective was to assess changes in HRQoL during 36 months in the whole study population. A secondary post-hoc analysis examined fracture impact on HRQoL in four subgroups classified based on recent prior fracture 12 months before baseline and incident clinical fractures during the study. Changes from baseline were analysed using a repeated measures model. Results: Of the 1581 patients, 48.4% had a recent prior fracture and 15.6% of these patients had an incident fracture during follow-up. 10.9% of the 816 patients with no recent prior fracture had an incident fracture. Baseline mean EQ-VAS scores were similar across the subgroups. In the total study cohort (n = 1581), HRQoL (EQ-VAS and EQ-5D index scores) improved significantly from baseline to 18 months and this improvement was maintained over the 18-month post-teriparatide period. Improvements were seen across all five EQ-5D domains during teriparatide treatment that were maintained after teriparatide was discontinued. Subjects with incident clinical fractures had significantly less improvement in EQ-VAS than those without incident fractures. Recent prior fracture did not influence the change in EQ-VAS during treatment. Conclusions: EFOS is the first longitudinal study in women with severe postmenopausal osteoporosis in the real world setting to show a substantial improvement in HRQoL during teriparatide treatment that was sustained during subsequent treatment with other medications. The increase in HRQoL was lower in the subgroups with incident fracture but was not influenced by recent prior fracture. The results should be interpreted in the context of the design of an observational study. KW - fracture KW - osteoporosis KW - quality of life KW - teriparatide KW - EQ-5D KW - database KW - alendronate KW - persistence KW - metaanalysis KW - prevalent fractures KW - bone-mineral density KW - vertebral fractures KW - back pain KW - impact KW - responsiveness Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122057 SN - 1471-2474 VL - 14 IS - 251 ER - TY - JOUR A1 - Dörhöfer, Lena A1 - Lammert, Alexander A1 - Krane, Vera A1 - Gorski, Mathias A1 - Banas, Bernhard A1 - Wanner, Christoph A1 - Krämer, Bernhard K. A1 - Heid, Iris M. A1 - Böger, Carsten A. T1 - Study design of DIACORE (DIAbetes COhoRtE) - a cohort study of patients with diabetes mellitus type 2 JF - BMC Medical Genetics N2 - Background: Diabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE). Methods: DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro-and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e. g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion: DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies. KW - chronic kidney-disease KW - stage renal-disease KW - glomerular-filtration-rate KW - genome-wide association KW - blood-glucose control KW - genetics KW - serum creatinine KW - cardiovascular disease KW - replacement therapy KW - United States KW - risk factors KW - diabetes mellitus type 2 KW - diabetic nephropathy KW - end stage renal disease KW - cardiovascular morbidity KW - diabetes complications KW - epidemiology Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122040 SN - 1471-2350 VL - 14 IS - 25 ER - TY - JOUR A1 - Schreiber, Olivia A1 - Schneiderat, Peter A1 - Kress, Wolfram A1 - Rautenstrauss, Bernd A1 - Senderek, Jan A1 - Schoser, Bendikt A1 - Walter, Maggie C. T1 - Facioscapulohumeral muscular dystrophy and Charcot-Marie-Tooth neuropathy 1A-evidence for "double trouble" overlapping syndromes JF - BMC Medical Genetics N2 - Background: We report on a patient with genetically confirmed overlapping diagnoses of CMT1A and FSHD. This case adds to the increasing number of unique patients presenting with atypical phenotypes, particularly in FSHD. Even if a mutation in one disease gene has been found, further genetic testing might be warranted in cases with unusual clinical presentation. Case presentation: The reported 53 years old male patient suffered from walking difficulties and foot deformities first noticed at age 20. Later on, he developed scapuloperoneal and truncal muscle weakness, along with atrophy of the intrinsic hand and foot muscles, pes cavus, claw toes and a distal symmetric hypoesthesia. Motor nerve conduction velocities were reduced to 20 m/s in the upper extremities, and not educible in the lower extremities, sensory nerve conduction velocities were not attainable. Electromyography showed both, myopathic and neurogenic changes. A muscle biopsy taken from the tibialis anterior muscle showed a mild myopathy with some neurogenic findings and hypertrophic type 1 fibers. Whole-body muscle MRI revealed severe changes in the lower leg muscles, tibialis anterior and gastrocnemius muscles were highly replaced by fatty tissue. Additionally, fatty degeneration of shoulder girdle and straight back muscles, and atrophy of dorsal upper leg muscles were seen. Taken together, the presenting features suggested both, a neuropathy and a myopathy. Patient's family history suggested an autosomal dominant inheritance. Molecular testing revealed both, a hereditary motor and sensory neuropathy type 1A (HMSN1A, also called Charcot-Marie-Tooth neuropathy 1A, CMT1A) due to a PMP22 gene duplication and facioscapulohumeral muscular dystrophy (FSHD) due to a partial deletion of the D4Z4 locus (19 kb). Conclusion: Molecular testing in hereditary neuromuscular disorders has led to the identification of an increasing number of atypical phenotypes. Nevertheless, finding the right diagnosis is crucial for the patient in order to obtain adequate medical care and appropriate genetic counseling, especially in the background of arising curative therapies. KW - D4Z4 partial deletion KW - sensory neuropathy KW - hereditary motor KW - disease KW - phenotype KW - FSHD KW - myopathy KW - patient KW - duplication KW - diagnosis KW - facioscapulohumeral muscular dystrophy KW - Charcot-Marie-Tooth neuropathy 1A KW - hereditary motor and sensory neuropathy KW - double trouble KW - overlapping syndrome Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121963 SN - 1471-2350 VL - 14 IS - 92 ER - TY - JOUR A1 - Wichmann, Dominic A1 - Poppert, Sven A1 - Von Thien, Heidrun A1 - Clerinx, Johannes A1 - Dieckmann, Sebastian A1 - Jensenius, Mogens A1 - Parola, Philippe A1 - Richter, Joachim A1 - Schunk, Mirjam A1 - Stich, August A1 - Zanger, Philipp A1 - Buchard, Gerd D. A1 - Tannich, Egbert T1 - Prospective European-wide multicentre study on a blood based real-time PCR for the diagnosis of acute schistosomiasis JF - BMC Infectious Diseases N2 - Background: Acute schistosomiasis constitutes a rare but serious condition in individuals experiencing their first prepatent Schistosoma infection. To circumvent costly and time-consuming diagnostics, an early and rapid diagnosis is required. So far, classic diagnostic tools such as parasite microscopy or serology lack considerable sensitivity at this early stage of Schistosoma infection. To validate the use of a blood based real-time polymerase chain reaction (PCR) test for the detection of Schistosoma DNA in patients with acute schistosomiasis who acquired their infection in various endemic regions we conducted a European-wide prospective study in 11 centres specialized in travel medicine and tropical medicine. Methods: Patients with a history of recent travelling to schistosomiasis endemic regions and freshwater contacts, an episode of fever (body temperature >= 38.5 degrees C) and an absolute or relative eosinophil count of >= 700/mu l or 10%, were eligible for participation. PCR testing with DNA extracted from serum was compared with results from serology and microscopy. Results: Of the 38 patients with acute schistosomiasis included into the study, PCR detected Schistosoma DNA in 35 patients at initial presentation (sensitivity 92%). In contrast, sensitivity of serology (enzyme immunoassay and/or immunofluorescence assay) or parasite microscopy was only 70% and 24%, respectively. Conclusion: For the early diagnosis of acute schistosomiasis, real-time PCR for the detection of schistosoma DNA in serum is more sensitive than classic diagnostic tools such as serology or microscopy, irrespective of the region of infection. Generalization of the results to all Schistosoma species may be difficult as in the study presented here only eggs of S. mansoni were detected by microscopy. A minimum amount of two millilitre of serum is required for sufficient diagnostic accuracy. KW - travelers KW - Mansoni infection KW - Katayama fever KW - DNA fragments KW - immunodiagnosis KW - tool KW - urine samples KW - haematobium Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121952 SN - 1471-2334 VL - 13 IS - 55 ER - TY - JOUR A1 - Ngwa, Che Julius A1 - Scheuermayer, Matthias A1 - Mair, Gunnar Rudolf A1 - Kern, Selina A1 - Brügl, Thomas A1 - Wirth, Christine Clara A1 - Aminake, Makoah Nigel A1 - Wiesner, Jochen A1 - Fischer, Rainer A1 - Vilcinskas, Andreas A1 - Pradel, Gabriele T1 - Changes in the transcriptome of the malaria parasite Plasmodium falciparum during the initial phase of transmission from the human to the mosquito JF - BMC Genomics N2 - Background: The transmission of the malaria parasite Plasmodium falciparum from the human to the mosquito is mediated by dormant sexual precursor cells, the gametocytes, which become activated in the mosquito midgut. Because gametocytes are the only parasite stages able to establish an infection in the mosquito, they play a crucial role in spreading the tropical disease. The human-to-mosquito transmission triggers important molecular changes in the gametocytes, which initiate gametogenesis and prepare the parasite for life-cycle progression in the insect vector. Results: To better understand gene regulations during the initial phase of malaria parasite transmission, we focused on the transcriptome changes that occur within the first half hour of parasite development in the mosquito. Comparison of mRNA levels of P. falciparum gametocytes before and 30 min following activation using suppression subtractive hybridization (SSH) identified 126 genes, which changed in expression during gametogenesis. Among these, 17.5% had putative functions in signaling, 14.3% were assigned to cell cycle and gene expression, 8.7% were linked to the cytoskeleton or inner membrane complex, 7.9% were involved in proteostasis and 6.4% in metabolism, 12.7% were cell surface-associated proteins, 11.9% were assigned to other functions, and 20.6% represented genes of unknown function. For 40% of the identified genes there has as yet not been any protein evidence. For a subset of 27 genes, transcript changes during gametogenesis were studied in detail by real-time RT-PCR. Of these, 22 genes were expressed in gametocytes, and for 15 genes transcript expression in gametocytes was increased compared to asexual blood stage parasites. Transcript levels of seven genes were particularly high in activated gametocytes, pointing at functions downstream of gametocyte transmission to the mosquito. For selected genes, a regulated expression during gametogenesis was confirmed on the protein level, using quantitative confocal microscopy. Conclusions: The obtained transcriptome data demonstrate the regulations of gene expression immediately following malaria parasite transmission to the mosquito. Our findings support the identification of proteins important for sexual reproduction and further development of the mosquito midgut stages and provide insights into the genetic basis of the rapid adaption of Plasmodium to the insect vector. KW - parasitophorous vacuole KW - sexual development KW - gametocyte KW - transcriptome KW - signal peptide peptidase KW - host cell interface KW - alpha-tubulin-II KW - life-cycle KW - protein kinases KW - in-vitro KW - erythroyte invation KW - blocking antibodies KW - malaria KW - plasmodium falciparum KW - gametogenesis KW - mosquito KW - transmission Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121905 SN - 1471-2164 VL - 14 IS - 256 ER - TY - JOUR A1 - Geyer, Kathrin K. A1 - Chalmers, Iain W. A1 - MacKintosh, Neil A1 - Hirst, Julie E. A1 - Geoghegan, Rory A1 - Badets, Mathieu A1 - Brophy, Peter M. A1 - Brehm, Klaus A1 - Hoffmann, Karl F. T1 - Cytosine methylation is a conserved epigenetic feature found throughout the phylum Platyhelminthes JF - BMC Genomics N2 - Background: The phylum Platyhelminthes (flatworms) contains an important group of bilaterian organisms responsible for many debilitating and chronic infectious diseases of human and animal populations inhabiting the planet today. In addition to their biomedical and veterinary relevance, some platyhelminths are also frequently used models for understanding tissue regeneration and stem cell biology. Therefore, the molecular (genetic and epigenetic) characteristics that underlie trophic specialism, pathogenicity or developmental maturation are likely to be pivotal in our continued studies of this important metazoan group. Indeed, in contrast to earlier studies that failed to detect evidence of cytosine or adenine methylation in parasitic flatworm taxa, our laboratory has recently defined a critical role for cytosine methylation in Schistosoma mansoni oviposition, egg maturation and ovarian development. Thus, in order to identify whether this epigenetic modification features in other platyhelminth species or is a novelty of S. mansoni, we conducted a study simultaneously surveying for DNA methylation machinery components and DNA methylation marks throughout the phylum using both parasitic and non-parasitic representatives. Results: Firstly, using both S. mansoni DNA methyltransferase 2 (SmDNMT2) and methyl-CpG binding domain protein (SmMBD) as query sequences, we illustrate that essential DNA methylation machinery components are well conserved throughout the phylum. Secondly, using both molecular (methylation specific amplification polymorphism, MSAP) and immunological (enzyme-linked immunoabsorbent assay, ELISA) methodologies, we demonstrate that representative species (Echinococcus multilocularis, Protopolystoma xenopodis, Schistosoma haematobium, Schistosoma japonicum, Fasciola hepatica and Polycelis nigra) within all four platyhelminth classes (Cestoda, Monogenea, Trematoda and 'Turbellaria') contain methylated cytosines within their genome compartments. Conclusions: Collectively, these findings provide the first direct evidence for a functionally conserved and enzymatically active DNA methylation system throughout the Platyhelminthes. Defining how this epigenetic feature shapes phenotypic diversity and development within the phylum represents an exciting new area of metazoan biology. KW - methyltransferase homolog KW - echinococcus multilocularis KW - platyhelminthes KW - 5-methyl cytosine KW - gene KW - proteins KW - stem cells KW - maximum liklihood KW - schistoma mansoni KW - flatworm KW - CPG binding domain KW - DNA methylation KW - epgenetics KW - complex Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121892 SN - 1471-2164 VL - 14 IS - 462 ER - TY - JOUR A1 - Eisele, Marion A1 - Blozik, Eva A1 - Störk, Stefan A1 - Träder, Jens-Martin A1 - Herrmann-Lingen, Christoph A1 - Scherer, Martin T1 - Recognition of depression and anxiety and their association with quality of life, hospitalization and mortality in primary care patients with heart failure - study protocol of a longitudinal observation study JF - BMC Family Practice N2 - Background: International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the association between the recognition of current depression/anxiety by the general practitioner (GP) and the quality of life and the patients' prognosis. Methods/Design: In this multicenter, prospective, observational study 3,950 patients with HF are recruited by general practices in Germany. The patients fill out questionnaires at baseline and 12-month follow-up. At baseline the GPs are interviewed regarding the somatic and psychological comorbidities of their patients. During the follow-up assessment, data on hospitalization and mortality are provided by the general practice. Based on baseline data, the patients are allocated into three observation groups: HF patients with depression and/or anxiety recognized by their GP (P+/+), those with depression and/or anxiety not recognized (P+/-) and patients without depression and/or anxiety (P-/-). We will perform multivariate regression models to investigate the influence of the recognition of depression and/or anxiety on quality of life at 12 month follow-up, as well as its influences on the prognosis (hospital admission, mortality). Discussion: We will display the frequency of GP-acknowledged depression and anxiety and the frequency of installed therapeutic strategies. We will also describe the frequency of depression and anxiety missed by the GP and the resulting treatment gap. Effects of correctly acknowledged and missed depression/anxiety on outcome, also in comparison to the outcome of subjects without depression/anxiety will be addressed. In case results suggest a treatment gap of depression/anxiety in patients with HF, the results of this study will provide methodological advice for the efficient planning of further interventional research. KW - anxiety KW - depression KW - health care research KW - heart failure KW - prevalence KW - observational study KW - prognosis KW - quality of life KW - hospitalization KW - treatment KW - mortality KW - task force KW - health questionnaire KW - cardiovascular care KW - validity KW - scale KW - validation KW - outcomes KW - standardization KW - population Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121881 SN - 1471-2296 VL - 14 IS - 180 ER - TY - JOUR A1 - Kang, Ji Hyoun A1 - Schartl, Manfred A1 - Walter, Ronald B. A1 - Meyer, Axel T1 - Comprehensive phylogenetic analysis of all species of swordtails and platies (Pisces: Genus Xiphophorus) uncovers a hybrid origin of a swordtail fish, Xiphophorus monticolus, and demonstrates that the sexually selected sword originated in the ancestral lineage of the genus, but was lost again secondarily JF - BMC Evolutionary Biology N2 - Background: Males in some species of the genus Xiphophorus, small freshwater fishes from Meso-America, have an extended caudal fin, or sword - hence their common name "swordtails". Longer swords are preferred by females from both sworded and - surprisingly also, non-sworded (platyfish) species that belong to the same genus. Swordtails have been studied widely as models in research on sexual selection. Specifically, the pre-existing bias hypothesis was interpreted to best explain the observed bias of females in presumed ancestral lineages of swordless species that show a preference for assumed derived males with swords over their conspecific swordless males. However, many of the phylogenetic relationships within this genus still remained unresolved. Here we construct a comprehensive molecular phylogeny of all 26 known Xiphophorus species, including the four recently described species (X. kallmani, X. mayae, X. mixei and X. monticolus). We use two mitochondrial and six new nuclear markers in an effort to increase the understanding of the evolutionary relationships among the species in this genus. Based on the phylogeny, the evolutionary history and character state evolution of the sword was reconstructed and found to have originated in the common ancestral lineage of the genus Xiphophorus and that it was lost again secondarily. Results: We estimated the evolutionary relationships among all known species of the genus Xiphophorus based on the largest set of DNA markers so far. The phylogeny indicates that one of the newly described swordtail species, Xiphophorus monticolus, is likely to have arisen through hybridization since it is placed with the southern platyfish in the mitochondrial phylogeny, but with the southern swordtails in the nuclear phylogeny. Such discordance between these two types of markers is a strong indication for a hybrid origin. Additionally, by using a maximum likelihood approach the possession of the sexually selected sword trait is shown to be the most likely ancestral state for the genus Xiphophorus. Further, we provide a well supported estimation of the phylogenetic relationships between the previously unresolved northern swordtail groups. Conclusions: This comprehensive molecular phylogeny of the entire genus Xiphophorus provides evidence that a second swordtail species, X. monticolus, arose through hybridization. Previously, we demonstrated that X. clemenciae, another southern swordtail species, arose via hybridization. These findings highlight the potential key role of hybridization in the evolution of this genus and suggest the need for further investigations into how hybridization contributes to speciation more generally. KW - parten-offspring conflict KW - introgressive hybridization KW - mitochondrial DNA KW - molecular phylogeny KW - likelihood approach KW - tree selection KW - preexisting bias KW - adaptive radiation KW - evolution KW - poeciliidae Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121853 SN - 1471-2148 VL - 13 IS - 25 ER - TY - JOUR A1 - Rybalka, Nataliya A1 - Wolf, Matthias A1 - Andersen, Robert A1 - Friedl, Thomas T1 - Congruence of chloroplast- and nuclear-encoded DNA sequence variations used to assess species boundaries in the soil microalga Heterococcus (Stramenopiles, Xanthophyceae) JF - BMC Evolutionary Biology N2 - Background: Heterococcus is a microalgal genus of Xanthophyceae (Stramenopiles) that is common and widespread in soils, especially from cold regions. Species are characterized by extensively branched filaments produced when grown on agarized culture medium. Despite the large number of species described exclusively using light microscopic morphology, the assessment of species diversity is hampered by extensive morphological plasticity. Results: Two independent types of molecular data, the chloroplast-encoded psbA/rbcL spacer complemented by rbcL gene and the internal transcribed spacer 2 of the nuclear rDNA cistron (ITS2), congruently recovered a robust phylogenetic structure. With ITS2 considerable sequence and secondary structure divergence existed among the eight species, but a combined sequence and secondary structure phylogenetic analysis confined to helix II of ITS2 corroborated relationships as inferred from the rbcL gene phylogeny. Intra-genomic divergence of ITS2 sequences was revealed in many strains. The 'monophyletic species concept', appropriate for microalgae without known sexual reproduction, revealed eight different species. Species boundaries established using the molecular-based monophyletic species concept were more conservative than the traditional morphological species concept. Within a species, almost identical chloroplast marker sequences (genotypes) were repeatedly recovered from strains of different origins. At least two species had widespread geographical distributions; however, within a given species, genotypes recovered from Antarctic strains were distinct from those in temperate habitats. Furthermore, the sequence diversity may correspond to adaptation to different types of habitats or climates. Conclusions: We established a method and a reference data base for the unambiguous identification of species of the common soil microalgal genus Heterococcus which uses DNA sequence variation in markers from plastid and nuclear genomes. The molecular data were more reliable and more conservative than morphological data. KW - xanthophyceae KW - psbA/rbcL spacer KW - ITS2 KW - tool KW - RBCL KW - alignment KW - evolution KW - chlorophyta KW - RNA secondary structure KW - terrestrial habitats KW - phylogenetic trees KW - mixed models KW - green algae KW - heterococcus KW - systematics KW - molecular phylogeny KW - species concept Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121848 SN - 1471-2148 VL - 13 IS - 39 ER - TY - JOUR A1 - Dietz, Mariana S. A1 - Hasse, Daniel A1 - Ferraris, Davide M. A1 - Göhler, Antonia A1 - Niemann, Hartmut H. A1 - Heilemann, Mike T1 - Single-molecule photobleaching reveals increased MET receptor dimerization upon ligand binding in intact cells JF - BMC Biophysics N2 - Background: The human receptor tyrosine kinase MET and its ligand hepatocyte growth factor/scatter factor are essential during embryonic development and play an important role during cancer metastasis and tissue regeneration. In addition, it was found that MET is also relevant for infectious diseases and is the target of different bacteria, amongst them Listeria monocytogenes that induces bacterial uptake through the surface protein internalin B. Binding of ligand to the MET receptor is proposed to lead to receptor dimerization. However, it is also discussed whether preformed MET dimers exist on the cell membrane. Results: To address these issues we used single-molecule fluorescence microscopy techniques. Our photobleaching experiments show that MET exists in dimers on the membrane of cells in the absence of ligand and that the proportion of MET dimers increases significantly upon ligand binding. Conclusions: Our results indicate that partially preformed MET dimers may play a role in ligand binding or MET signaling. The addition of the bacterial ligand internalin B leads to an increase of MET dimers which is in agreement with the model of ligand-induced dimerization of receptor tyrosine kinases. KW - single-molecule photobleaching KW - fluorescence correlation spectroscopy KW - fluorescence KW - EGF receptor KW - rat hepatocytes KW - structural insights KW - Scatter factor KW - SEMA domain KW - hepatocyte-growth-factor KW - invasion protein-INLB KW - listeria-monocytogenes KW - tyrosine kinase KW - living cells KW - dimerization KW - MET receptor KW - Signal transduction Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121835 SN - 2046-1682 VL - 6 IS - 6 ER - TY - JOUR A1 - Moffet, R. C. A1 - Rödel, R. C. A1 - Kelly, S. T. A1 - Yu, X. Y. A1 - Carroll, G. T. A1 - Fast, J. A1 - Zaveri, R. A. A1 - Laskin, A. A1 - Gilles, M. K. T1 - Spectro-microscopic measurements of carbonaceous aerosol aging in Central California JF - Atmospheric Chemistry and Physics N2 - Carbonaceous aerosols are responsible for large uncertainties in climate models, degraded visibility, and adverse health effects. The Carbonaceous Aerosols and Radiative Effects Study (CARES) was designed to study carbonaceous aerosols in the natural environment of the Central Valley, California, and learn more about their atmospheric formation and aging. This paper presents results from spectro-microscopic measurements of carbonaceous particles collected during CARES at the time of a pollution accumulation event (27-29 June 2010), when in situ measurements indicated an increase in the organic carbon content of aerosols as the Sacramento urban plume aged. Computer-controlled scanning electron microscopy coupled with an energy dispersive X-ray detector (CCSEM/EDX) and scanning transmission X-ray microscopy coupled with near-edge X-ray absorption spectroscopy (STXM/NEXAFS) were used to probe the chemical composition and morphology of individual particles. It was found that the mass of organic carbon on individual particles increased through condensation of secondary organic aerosol. STXM/NEXAFS indicated that the number fraction of homogenous organic particles lacking inorganic inclusions (greater than similar to 50 nm equivalent circular diameter) increased with plume age, as did the organic mass per particle. Comparison of the CARES spectro-microscopic dataset with a similar dataset obtained in Mexico City during the MILAGRO campaign showed that fresh particles in Mexico City contained three times as much carbon as those sampled during CARES. The number fraction of soot particles at the Mexico City urban site (ranging from 16.6 to 47.3 %) was larger than at the CARES urban site (13.4-15.7%), and the most aged samples from CARES contained fewer carbon-carbon double bonds. Differences between carbonaceous particles in Mexico City and California result from different sources, photochemical conditions, gas phase reactants, and secondary organic aerosol precursors. The detailed results provided by these spectro-microscopic measurements will allow for a comprehensive evaluation of aerosol process models used in climate research. KW - photochemical air-pollution KW - Mexico City KW - black carbon KW - mixing state KW - atmospheric aerosols Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121827 SN - 1680-7324 VL - 13 IS - 20 ER - TY - JOUR A1 - Falge, M. A1 - Engel, V. A1 - Gräfe, S. T1 - Time-resolved photoelectron spectroscopy of coupled nuclear-electronic dynamics JF - EPJ Web of Conferences N2 - We study the effect of nuclear-electron coupling on time-resolved photo-electron spectra, employing a model system which allows to directly comparing spectra resulting from the adiabatic approximation with those obtained within a non-Born-Oppenheimer description. Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121812 SN - 2100-014X VL - 41 ER - TY - JOUR A1 - Bogdan, Sven A1 - Schultz, Jörg A1 - Grosshans, Jörg T1 - Formin’ cellular structures: Physiological roles of Diaphanous (Dia) in actin dynamics JF - Communicative & Integrative Biology N2 - Members of the Diaphanous (Dia) protein family are key regulators of fundamental actin driven cellular processes, which are conserved from yeast to humans. Researchers have uncovered diverse physiological roles in cell morphology, cell motility, cell polarity, and cell division, which are involved in shaping cells into tissues and organs. The identification of numerous binding partners led to substantial progress in our understanding of the differential functions of Dia proteins. Genetic approaches and new microscopy techniques allow important new insights into their localization, activity, and molecular principles of regulation. KW - Drosophila KW - cytoskeleton KW - actin KW - nucleator KW - development KW - formin Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121305 VL - 6 IS - e27634 ER - TY - JOUR A1 - Ginzkey, Christian A1 - Eicker, Sven A1 - Marget, Matthias A1 - Krause, Jörg A1 - Brecht, Stefan A1 - Westphal, Manfred A1 - Hugo, Heinz-Hermann A1 - Mehdorn, Maximilian A1 - Steinmann, Jörg A1 - Hamel, Wolfgang T1 - Incomplete tumour control following DNA vaccination against rat gliomas expressing a model antigen JF - Acta Neurochirurgica N2 - Background Vaccination against tumour-associated antigens is one approach to elicit anti-tumour responses. We investigated the effect of polynucleotide (DNA) vaccination using a model antigen (E. coli lacZ) in a syngeneic gliosarcoma model (9L). Methods Fisher 344 rats were vaccinated thrice by intramuscular injection of a lacZ-encoding or a control plasmid in weekly intervals. One week after the last vaccination, lacZ-expressing 9L cells were implanted into the striatum. Results After 3 weeks, in lacZ-vaccinated animals the tumours were significantly smaller than in control-vaccinated animals. In cytotoxic T cell assays lysis rates of >50 % could only be observed in a few of the lacZ-vaccinated animals. This response was directed against lacZ-expressing and parental 9L cells but not against syngeneic MADB 106 adenocarcinoma cells. In Elispot assays interferon-γ production was observed upon stimulation with 9LlacZ and 9L wild-type but not MADB 106 cells. This response was higher for lacZ-immunized animals. All animals revealed dense infiltrates with CD8+ lymphocytes and, to a lesser extent, with NK cells. CD25-staining indicated cells possibly associated with the maintenance of peripheral tolerance to self-antigens. All tumours were densely infiltrated by microglia consisting mostly of ramified cells. Only focal accumulation of macrophage-like cells expressing ED1, a marker for phagocytic activity, was observed. Conclusion Prophylactic DNA vaccination resulted in effective but incomplete suppression of brain tumour formation. Mechanisms other than cytotoxic T cell responses as measured in the generally used in vitro assays appear to play a role in tumour suppression. KW - lacZ KW - rat glioma KW - immunotherapy KW - DNA vaccination Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-126775 VL - 155 IS - 1 ER - TY - THES A1 - Reicherts, Philipp T1 - Cognitive and Emotional Influences on Placebo Analgesia and Nocebo Hyperalgesia T1 - Kognititve und emotionale Einflussfaktoren auf Placeboanalgesie und Nocebohyperalgesie N2 - The perception of pain can be modulated by a variety of factors such as biological/pharmacological treatments as well as potent cognitive and emotional manipulations. Placebo and nocebo effects are among the most prominent examples for such manipulations. Placebo and nocebo manipulations cause reliable psychological and physiological changes, although the administered agent or treatment is inert. The present dissertation aimed at investigating the role of cognitive and emotional influences in the generation of placebo and nocebo effects on pain perception. In addition, the feasibility of solely psychological placebo manipulations to alter the perception of pain was tested. Two commonly discussed preconditions for the generation of placebo and nocebo effects are prior experiences (i.e., past encounter of drug effects) and expectations (i.e., positive or negative attitudes towards an intervention). So far, research on placebo and nocebo effects relied on the administration of sham interventions, which resembled medical treatments like inert pills, creams or injections. However, such experimental procedures deal with confounds due to earlier experiences and expectations resulting from the individual’s history with medical interventions. Accordingly, the implementation of a placebo manipulation that is completely new to an individual, seems necessary to disentangle the contribution of experience and expectation for the induction of placebo and nocebo effects. To this end, in Experiment 1 the level of experience and expectation regarding a placebo-nocebo treatment was stepwise manipulated across three different experimental groups. To avoid any resemblances to earlier experiences and individual expectations, a mere psychological placebo-nocebo treatment was chosen that was new to all participants. They were instructed that visual black and white stripe patterns had been found to reliably alter the perception of pain. One group of participants received only the placebo-nocebo instruction (expectation), a second group experienced a placebo-nocebo treatment within a conditioning phase (experience) but no instruction, and a third group received the combination of both that is a placebo-nocebo instruction and a placebo-nocebo conditioning (experience + expectation). It was shown that only the experience + expectation group revealed significantly higher pain ratings and physiological responses during nocebo, compared to placebo trials of the succeeding test phase. These findings demonstrate that the induction of a mere psychological placebo-nocebo effect on pain is in principle possible. Most important, results indicate that such effects most likely rely on both, a positive treatment experience, due to the encounter of an effective intervention (placebo conditioning), and a positive expectation about the intervention (placebo instruction).Besides experience and expectation, the current mood state has been shown to modulate pain and to impact the induction of placebo and nocebo effects. In this vein it has been demonstrated that placebo effects come along with positive affect, while nocebo effects often occur together with elevated feelings of anxiety. To clarify the interaction of emotions and placebo-nocebo manipulations on pain perception, in Experiment 2 the paradigm of Experiment 1 was modified. Instead of black and white stripe patterns, positive and negative emotional pictures were presented, which either cued pain increase (nocebo) or pain decrease (placebo). Two experimental groups were compared, which differed with regard to the instructed contingency of positive pictures serving as placebo and negative pictures serving as nocebo cues or vice versa (congruent vs. incongruent). Results indicate that the differentiation of placebo and nocebo trials (behaviorally and physiologically) was more pronounced for the congruent compared to the incongruent group. However, in the incongruent group, affective pain ratings were also significantly higher for nocebo (positive pictures) than placebo (negative pictures) trials, similar to the congruent group. These findings demonstrate that a placebo-nocebo manipulation is capable to dampen and even reverse the originally pain augmenting effect of negative emotions. The results of Experiment 2 were further corroborated in Experiment 3, when the design was adapted to the fMRI scanner, and again a congruent and an incongruent experimental group were compared. Behavioral, physiological and neurophysiological markers of pain processing revealed a differentiation between nocebo and placebo conditions that was present irrespective of the experimental group. In addition, the fMRI analysis revealed an increased engagement of prefrontal areas for the incongruent group only, supposedly reflecting the reinterpretation or appraisal process when positive pictures were cueing negative outcomes. Taken together, the results of the present studies showed (a) that it is possible to induce a placebo-nocebo effect on pain solely by a psychological manipulation, (b) that both, prior experiences and positive expectation, are necessary preconditions for this placebo-nocebo effect, (c) that the impact of negative emotion on pain can be dampened and even reversed by placebo-nocebo manipulations, and (d) that most likely a cognitive top-down process is crucial for the induction of (psychological) placebo-nocebo effects. These results significantly enhance our understanding of psychological mechanisms involved in the induction of placebo-nocebo effects. Further, a fruitful foundation for future studies is provided, which will need to determine the contributions of primarily nocebo or placebo responses mediating the effects as demonstrated in the present studies. In a long-term perspective, the present findings may also help to exploit placebo effects and prevent from nocebo effect in clinical contexts by further elucidating crucial psychological factors that contribute to the placebo and nocebo response. N2 - Die Wahrnehmung von Schmerz kann durch eine Vielzahl von Faktoren beeinflusst werden, darunter biologische und pharmakologische Interventionen sowie potente kognitive und emotionale Manipulationen. Placebo- und Nocebo-effekte gehören mit zu den eindrucksvollsten Beispielen für die Wirksamkeit derartiger Manipulationen. Placebo- und Nocebo-Behandlungen können zu manifesten psychologischen und physiologischen Veränderungen führen, obwohl die verabreichten Substanzen frei von Wirkstoffen bzw. den angewandten Scheinbehandlungen keine Wirkung zugeschrieben wird. In der vorliegenden Dissertation wurden kognitive und emotionale Einflussfaktoren auf die Induktion von Placebo- und Nocebo-Effekten bei der Wahrnehmung von Schmerz untersucht. Darüber hinaus sollte die Möglichkeit zur Verwendung rein psychologischer Placebo-Nocebo Manipulationen für die Modulation von Schmerz getestet werden. Zwei zentrale Voraussetzungen für die Erzeugung von Placebo und Nocebo-Effekten sind vorherige Erfahrung (z.B. auf Grund früherer Erfahrungen mit einem Medikament) und Erwartung (z.B. eine positive oder negative persönliche Einstellung gegenüber einer Therapie). Bisher basierte die Forschung zu Placebo- und Nocebo-Effekten vornehmlich auf Ergebnissen von Untersuchungen die Schein-Behandlungen oder Leerpräparate einsetzten wie z.B. Tabletten, Cremes oder Injektionen, die herkömmlichen medizinischen Interventionen sehr ähnlich sind. Jedoch ergibt sich bei einem derartigen experimentellen Vorgehen stets das Problem einer Konfundierung der Ergebnisse durch den Einfluss früherer Erfahrungen oder der individuellen Erwartungshaltung an die Behandlung, die aus einer Vorgeschichte medizinischer Therapieerlebnissen herrührt. Daraus leitet sich die Notwendigkeit von anderweitigen, dem Probanden völlig unbekannten Placebo-Interventionen ab, um die jeweilige Beteiligung von Erwartungs- und Erfahrungsprozessen für die Induktion von Placebo- und Nocebo-Effekten bestimmen zu können. Zu diesem Zweck wurden in Experiment 1 Erwartung und Erfahrung in drei Experimentalgruppen stufenweise und unabhängig voneinander manipuliert. Um einer Ähnlichkeit zu früheren Behandlungs-Erfahrungen und dadurch abgeleiteten Erwartungen vorzubeugen, wurde ein rein psychologisches Placebo-Nocebo Verfahren herangezogen, das mit Sicherheit allen Teilnehmern unbekannt war. Sie wurden darüber informiert, dass die Betrachtung von schwarz-weißen Streifenmustern eine wissenschaftlich bestätigte Wirkung auf die Schmerzwahrnehmung hätte. Eine Gruppe der Teilnehmer erhielt lediglich eine Placebo-Nocebo Instruktion (Erwartung), eine zweite Gruppe erlebte tatsächlich die Kopplung von zwei verschiedenen Streifenmustern mit unterschiedlich starken Schmerzreizen während einer Konditionierungs-Phase (Erfahrung) bekam aber keine Instruktion und eine dritte Gruppe erhielt sowohl die Placebo-Nocebo Instruktion als auch die Placebo-Nocebo Konditionierung (Erfahrung + Erwartung). Es konnte gezeigt werden, dass während der anschließenden Testphase lediglich die kombinierte Erfahrung + Erwartung Gruppe signifikant unterschiedliche Schmerzratings und physiologische Reaktionen auf die Schmerzreize während der Placebo- im Vergleich zu den Nocebo-Durchgängen aufwies. Diese Ergebnisse belegen, dass die Induktion eines rein psychologischen Placebo-Nocebo Effektes auf die Schmerzwahrnehmung prinzipiell möglich ist. Besonders hervorzuheben ist dabei die Notwendigkeit beider Prozesse, nämlich einer tatsächlichen Erfahrung der Wirksamkeit der Therapie (Placebo-Nocebo Konditionierung) und einer positiven Erwartung hinsichtlich der Intervention (Placebo-Nocebo Instruktion). Neben Erfahrung und Erwartung, hat die momentane Stimmung entscheidenden Einfluss auf die die Induktion von Placebo- und Nocebo-Effekten einerseits, sowie generell auf die Wahrnehmung von Schmerz andererseits. In diesem Zusammenhang konnte gezeigt werden, dass Placebo-Effekte mit einer Verbesserung der Stimmung einhergehen, Nocebo-Effekte hingegen häufig von gesteigerter Angst begleitet sind. Um die Interaktion von Emotionen und Placebo-Nocebo Manipulationen zu eruieren, wurde das in Experiment 1 etablierte Paradigma angewendet und modifiziert. Anstelle von Streifenmustern, wurden positive und negative emotionale Bilder präsentiert, die entweder eine Schmerz-Verstärkung (Nocebo) oder eine Schmerz-Linderung (Placebo) anzeigten. Zwei Experimentalgruppen wurden miteinander verglichen, die sich hinsichtlich der Kontingenz von positiven Bildern als Placebo- und negativen Bildern als Nocebo-Indikator, bzw. umgekehrt, positiven Bildern als Nocebo- und negativen Bildern als Placebo-Indikator, unterschieden (kongruent vs. inkongruent). Es zeigte, dass die Unterscheidung (Schmerzratings und physiologische Reaktionen auf den Schmerzreiz) zwischen Placebo- und Nocebo-Durchgängen in der kongruenten Gruppe stärker ausgeprägt war als in der inkongruenten Gruppe. Allerdings waren die affektiven Schmerzratings der inkongruenten Gruppe ebenfalls in Nocebo-Durchgängen (positive Bilder) signifikant höher als in Placebo-Durchgängen (negative Bilder), ähnlich zur kongruenten Gruppe. Die Daten zeigen damit, dass eine Placebo-Nocebo Manipulation in der Lage ist, die genuin Schmerz verstärkende Wirkung negativer Emotionen abzuschwächen und sogar umzukehren. Die Befunde aus Experiment 2 konnten zusätzlich in Experiment 3 gestützt werden, welches das zuvor getestete Design ins fMRT überführte und gleichermaßen eine kongruente und eine inkongruente Experimentalgruppe miteinander verglich. Verhaltensmaße sowie physiologische und neurophysiologische Korrelate der Schmerzwahrnehmung ergaben eine eindeutige Differenzierung zwischen Placebo- und Nocebo-Durchgängen, unabhängig von der Experimentalgruppe. Darüber hinaus zeigte sich in der inkongruenten Bedingung eine verstärkte präfrontale Aktivierung für den Vergleich von Nocebo- und Placebo-Durchgängen, was potenziell auf einen zusätzlichen Re- Interpretations- oder Appraisal-Prozess zurückzuführen ist, der sich einstellt, wenn ein positives Bild eine negative Konsequenz vorhersagt. Zusammengefasst zeigen die vorliegenden Studien, dass es (a) möglich ist einen Placebo-Nocebo Effekt mit einer rein psychologischen Manipulation hervorzurufen, dass (b) im Fall rein psychologischer Placebo-Nocebo Manipulationen sowohl Erfahrung als auch positive Erwartung notwendig sind, dass (c) der Einfluss negativer Emotionen auf Schmerz mittels einer Placebo-Nocebo Manipulation reduziert und sogar umgekehrt werden kann und (d) höchstwahrscheinlich ein kognitiver (Neu-) Bewertungsprozess für die Induktion (psychologischer) Placebo-Nocebo Effekte essentiell ist. Die Ergebnisse tragen zum Verständnis der beteiligten psychologischen Prozesse bei der Induktion von Placebo-Nocebo Effekten erheblich bei. Darüber hinaus stellen die verwendeten Paradigmen eine vielseitige Ausgangsposition für zukünftige Studien dar, die klären müssen, ob für die gefunden Ergebnisse vornehmlich Placebo- oder Nocebo-Effekte verantwortlich sind. Perspektivisch könnten die vorliegenden Befunden helfen, die psychologischen Grundlagen der Placebo-Nocebo Antwort näher zu beleuchten und damit sogar im klinischen Kontext zum Ausschöpfen von Placebo- sowie zur Vorbeugung von Nocebo-Effekten beizutragen. KW - Placebo KW - Nocebo-Effekt KW - Psychologie KW - Placebo Hypolagesia KW - Nocebo hyperoalgesia KW - Emotional Pain Modulation Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-106455 ER - TY - JOUR A1 - Hirsch, Hans H. A1 - Martino, Rodrigo A1 - Ward, Katherine N. A1 - Boeckh, Michael A1 - Einsele, Hermann A1 - Ljungman, Per T1 - Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for Diagnosis and Treatment of Human Respiratory Syncytial Virus, Parainfluenza Virus, Metapneumovirus, Rhinovirus, and Coronavirus JF - Clinical Infectious Diseases N2 - Community-acquired respiratory virus (CARV) infections have been recognized as a significant cause of morbidity and mortality in patients with leukemia and those undergoing hematopoietic stem cell transplantation (HSCT). Progression to lower respiratory tract infection with clinical and radiological signs of pneumonia and respiratory failure appears to depend on the intrinsic virulence of the specific CARV as well as factors specific to the patient, the underlying disease, and its treatment. To better define the current state of knowledge of CARVs in leukemia and HSCT patients, and to improve CARV diagnosis and management, a working group of the Fourth European Conference on Infections in Leukaemia (ECIL-4) 2011 reviewed the literature on CARVs, graded the available quality of evidence, and made recommendations according to the Infectious Diseases Society of America grading system. Owing to differences in screening, clinical presentation, and therapy for influenza and adenovirus, ECIL-4 recommendations are summarized for CARVs other than influenza and adenovirus. KW - hematopoietic KW - leukemia KW - transplantation KW - respiratory virus KW - bone marrow transplantation Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124758 VL - 56 IS - 2 ER - TY - THES A1 - Glotzbach-Schoon, Evelyn T1 - Contextual fear conditioning in humans: The return of contextual anxiety and the influence of genetic polymorphisms T1 - Kontextuelle Furchtkonditionierung beim Menschen: die Wiederkehr von Kontextangst und der Einfluss von genetischen Polymorphismen N2 - Als Angst bezeichnet man einen nicht auf spezifische Objekte gerichteten länger anhaltenden zukunfts-orientierten Zustand der Besorgnis. Diese ist kennzeichnend für Angststörungen wie Panikstörung, generalisierte Angststörung und Posttraumatische Belastungsstörung (PTBS). Experimentell kann Angst durch kontextuelle Furchtkonditionierung ausgelöst werden. Bei dieser Art der Konditionierung werden aversive Ereignisse als unvorhersehbar erlebt, wodurch der gesamte Kontext mit der Gefahr assoziiert wird. Diese Arbeit hat zum Ziel, Mechanismen der Entstehung und Aufrechterhaltung von Kontextangst zu untersuchen. Dies sind zum einem erleichterte Akquisition von Kontextkonditionierungen und deren fehlerhafte Extinktion. Hier ist vor allem die Fragestellung relevant, wie dies durch genetische Varianten moduliert wird (Studie 1). Zum anderen soll die Wiederkehr der Angst nach der Extinktion mit einem neuen Reinstatement-Paradigma untersucht werden (Studie 2). Zur Untersuchung dieser Forschungsfragen wurden zwei kontextuelle Furchtkonditionierungsstudien in virtueller Realität (VR) durchgeführt. Während der Akquisition wurden leicht schmerzhafte elektrische Reize (unkonditionierter Stimulus, US) unvorhersehbar präsentiert, während die Probanden in einem virtuellen Büroraum waren. Dadurch wurde dieser Raum zum Angstkontext (CXT+). Ein zweiter Büroraum wurde nie mit dem US gepaart, deshalb wurde dieser Raum zum Sicherheitskontext (CXT-). Die Extinktion, in der die Kontexte ohne US präsentiert wurden, fand 24 h später statt, und ein Test zum Abruf der Extinktion bzw. zur Wiederkehr der Angst nochmals 24 h später. In beiden Studien wurde die Angst auf drei verschiedenen Ebenen gemessen: Verhalten (angstpotenzierter Schreckreflex), Physiologie (tonische Hautleitfähigkeit), und verbale Ebene (explizite Ratings). Die Probanden für Studie 1 wurden anhand der 5-HTTLPR (S+ Risikoallel vs. LL nicht-Risikoallel) und NPSR1 rs324981 (T+ Risikoallel vs. AA nicht-Risikoallel) Polymorphismen stratifiziert, sodass vier kombinierte Genotyp Gruppen (S+/T+, S+/LL, LL/T+ und LL/AA) mit je 20 Probanden vorlagen. Es zeigte sich, dass der angstpotenzierte Schreckreflex durch die Interaktion zwischen beiden genetischen Polymorphismen moduliert wurde. Nur Träger beider Risikoallele (S+ Träger des 5-HTTLPR und T+ Träger des NPSR1 Polymorphismus) zeigten einen höheren Schreckreflex im CXT+ als im CXT- während der Akquisition. Der Abruf der Extinktion an Tag 3, gemessen anhand des Schreckreflexes, wurde allerdings nicht durch die Genotypen moduliert. Interessanterweise zeigte sich auf dem expliziten Angstlevel (Valenz- und Angstratings) nur ein Einfluss des NPSR1 Polymorphismus, und zwar bewerteten die nicht-Risikoallel Träger (AA) den CXT+ mit negativerer Valenz und höherer Angst im Vergleich zum CXT-; die Risikoallel Träger (T+) taten dies nicht. In der zweiten Studie wurde fast das gleiche Paradigma benutzt wie in der ersten Studie mit der Ausnahme, dass eine Versuchsgruppe (Reinstatementgruppe) den US noch einmal am Anfang des dritten Untersuchungstages vor der Präsentation von CXT+ und CXT- appliziert bekam. Die zweite Versuchsgruppe (Kontrollgruppe) erhielt keinen US, sondern wurde direkt durch CXT+ und CXT- geführt. Es zeigte sich, dass nur in der Reinstatementgruppe die Angst auf impliziter und expliziter Ebene wiederkehrte, d.h. die Probanden zeigten einen höheren Schreckreflex und höhere Angstratings auf den CXT+ im Vergleich zum CXT-. Wichtig war vor allem, dass die Wiederkehr der Angst in der Reinstatementgruppe mit der Veränderung der Zustandsangst und der Stimmung (von der Extinktion zum Test) korrelierte. D.h. je größer die Angst und je negativer die Stimmung wurden, desto höher war die Wiederkehr der Angst. Zusammengefasst belegt Studie 1, dass erleichterte kontextuelle Furchtkonditionierung auf impliziter Ebene (Schreckreflex) ein Endophänotyp für Angststörungen sein könnte, was zu unserem Verständnis der Ätiologie von Angststörungen beitragen könnte. Die Ergebnisse der zweiten Studie legen nahe, dass eine ängstliche und negative Stimmung nach der Extinktion die Rückkehr von Angst begünstigen könnte. Darüber hinaus scheint das VR-basierte kontextuelle Furchtkonditionierungsparadigma ein geeignetes Mittel zu sein, um Mechanismen der Angstentstehung und Angstwiederkehr experimentell zu erforschen. Weiterführende Studien könnten nun auch Angstpatienten untersuchen und das Paradigma auf evolutionär-relevante Kontexte (z.B. Höhe, Dunkelheit, weite Plätze) ausweiten. N2 - Sustained anxiety is considered as a chronic and future-oriented state of apprehension that does not belong to a specific object. It is discussed as an important characteristic of anxiety disorders including panic disorder, generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). Experimentally, sustained anxiety can be induced by contextual fear conditioning in which aversive events are unpredictably presented and therefore the whole context becomes associated with the threat. This thesis aimed at investigating important mechanisms in the development and maintenance of sustained anxiety: (1) facilitated acquisition and resistant extinction of contextual anxiety due to genetic risk factors (Study 1), and (2) the return of contextual anxiety after successful extinction using a new reinstatement paradigm (Study 2). To this end, two contextual fear conditioning studies were conducted in virtual reality (VR). During acquisition one virtual office was paired with unpredictable mildly painful electric stimuli (unconditioned stimulus, US), thus becoming the anxiety context (CXT+). Another virtual office was never paired with any US, thus becoming the safety context (CXT-). Extinction was conducted 24 h later, i.e. no US was presented, and extinction recall was tested another 24 h later on Day 3. In both studies context-evoked anxiety was measured on three different response levels: behavioral (anxiety-potentiated startle reflex), physiological (skin conductance level), and verbal (explicit ratings). In Study 1, participants were stratified for 5-HTTLPR (S+ risk allele vs. LL no risk allele) and NPSR1 rs324981 (T+ risk allele vs. AA no risk allele) polymorphisms, resulting in four combined genotype groups with 20 participants each: S+/T+, S+/LL, LL/T+, and LL/AA. Results showed that acquisition of anxiety-potentiated startle was influenced by a gene × gene interaction: only carriers of both risk alleles (S+ carriers of the 5-HTTLPR and T+ carriers of the NPSR1 polymorphism) exhibited significantly higher startle magnitudes in CXT+ compared to CXT-. However, extinction recall as measured with anxiety-potentiated startle was not affected by any genotype. Interestingly, the explicit anxiety level, i.e. valence and anxiety ratings, was only influenced by the NPSR1 genotype, in a way that no risk allele carriers (AA) reported higher anxiety and more negative valence in response to CXT+ compared to CXT-, whereas risk allele carriers (T+) did not. Study 2 adopted nearly the same paradigm with the modification that one group (reinstatement group) received one unsignaled US at the beginning of the experimental session on Day 3 before seeing CXT+ and CXT-. The second group served as a control group and received no US, but was immediately exposed to CXT+ and CXT-. Results showed a return of anxiety on the implicit and explicit level (higher startle responses and anxiety ratings in response to CXT+ compared to CXT-) in the reinstatement group only. Most important, the return of contextual anxiety in the reinstatement group was associated with a change of state anxiety and mood from extinction to test, that is the more anxiety and negative mood participants experienced before the reinstatement procedure, the higher their return of anxiety was. In sum, results of Study 1 showed that facilitated contextual fear conditioning on an implicit behavioral level (startle response) could be regarded as an endophenotype for anxiety disorders, which can contribute to our understanding of the etiology of anxiety disorders. Results of Study 2 imply that anxiety and negative mood after extinction could be an important facilitator for the return of anxiety. Furthermore, the present VR-based contextual fear conditioning paradigm seems to be an ideal tool to experimentally study mechanisms underlying the acquisition and the return of anxiety. Future studies could investigate clinical samples and extend the VR paradigm to evolutionary-relevant contexts (e.g., heights, darkness, open spaces). KW - Angst KW - Genetik KW - Kontextkonditionierung KW - context conditioning KW - anxiety KW - genetics KW - virtual reality KW - Virtuelle Realität Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-87955 ER - TY - THES A1 - Busch, Martin T1 - Aortic Dendritic Cell Subsets in Healthy and Atherosclerotic Mice and The Role of the miR-17~92 Cluster in Dendritic Cells T1 - Subsets dendritischer Zellen in der Aorta gesunder und atherosklerotischerMäuse und die Rolle des miR-17~92 Clusters in dendritischen Zellen N2 - Atherosclerosis is accepted to be a chronic inflammatory disease of the arterial vessel wall. Several cellular subsets of the immune system are involved in its initiation and progression, such as monocytes, macrophages, T and B cells. Recent research has demonstrated that dendritic cells (DCs) contribute to atherosclerosis, too. DCs are defined by their ability to sense and phagocyte antigens, to migrate and to prime other immune cells, such as T cells. Although all DCs share these functional characteristics, they are heterogeneous with respect to phenotype and origin. Several markers have been used to describe DCs in different lymphoid and non-lymphoid organs; however, none of them has proven to be unambiguous. The expression of surface molecules is highly variable depending on the state of activation and the surrounding tissue. Furthermore, DCs in the aorta or the atherosclerotic plaque can be derived from designated precursor cells or from monocytes. In addition, DCs share both their marker expression and their functional characteristics with other myeloid cells like monocytes and macrophages. The repertoire of aortic DCs in healthy and atherosclerotic mice has just recently started to be explored, but yet there is no systemic study available, which describes the aortic DC compartment. Because it is conceivable that distinct aortic DC subsets exert dedicated functions, a detailed description of vascular DCs is required. The first part of this thesis characterizes DC subsets in healthy and atherosclerotic mice. It describes a previously unrecognized DC subset and also sheds light on the origin of vascular DCs. In recent years, microRNAs (miRNAs) have been demonstrated to regulate several cellular functions, such as apoptosis, differentiation, development or proliferation. Although several cell types have been characterized extensively with regard to the miRNAs involved in their regulation, only few studies are available that focus on the role of miRNAs in DCs. Because an improved understanding of the regulation of DC functions would allow for new therapeutic options, research on miRNAs in DCs is required. The second part of this thesis focuses on the role of the miRNA cluster miR- 17~92 in DCs by exploring its functions in healthy and atherosclerotic mice. This thesis clearly demonstrates for the first time an anti-inflammatory and atheroprotective role for the miR17-92 cluster. A model for its mechanism is suggested. N2 - Atherosklerose ist eine chronisch-entzündliche Erkrankung der arteriellen Gefäßwand und zahlreiche Zellen des Immunsystems, wie zum Beispiel Monozyten, Makrophagen, T und B Zellen sind an der Entstehung und Entwicklung beteiligt. Aktuelle Forschungsergebnisse haben gezeigt, dass auch dendritische Zellen (DCs) zur Atherosklerose beitragen. DCs sind durch ihre Fähigkeit gekennzeichnet, Antigene zu erkennen, aufzunehmen, zu migrieren und andere Immunzellen, wie zum Beispiel T Zellen, zu aktivieren. Auch wenn alle DCs diese funktionellen Merkmale teilen, so sind sie in Bezug auf ihren Phänotyp oder Ursprung eine eher heterogene Gruppe. Zahlreiche Oberflächenmoleküle wurden in der Vergangenheit genutzt, um DCs in lymphatischen und nicht-lymphatischen Geweben zu beschreiben. Allerdings hat sich keines dieser Moleküle als spezifisch und unverwechselbar erwiesen. Die Expression von Oberflächenmolekülen ist sehr variabel und hängt nicht nur vom Aktivierungszustand der DCs, sondern auch vom umliegenden Gewebe ab. Dazu kommt, dass DCs in der Aorta, beziehungsweise im atherosklerotischen Plaque, von designierten Vorläuferzellen, aber auch von Monozyten abstammen können und DCs das Profil ihrer Oberflächenmoleküle, sowie ihre funktionellen Eigenschaften, mit anderen myeloiden Zellen wie Monozyten und Makrophagen teilen. Neuere Arbeiten haben damit begonnen das Repertoire an DCs in der Aorta von gesunden und atherosklerotischen Mäusen zu untersuchen. Da es naheliegt, dass verschiedene DC Untergruppen ganz bestimmte Funktionen ausüben, wird eine detaillierte Beschreibung vaskulärer DCs in der Forschung benötigt. Weil es hierzu allerdings bislang kaum Studien gibt, untersucht der erste Teil dieser Arbeit zum ersten Mal systematisch die in gesunden und atherosklerotischen Mäusen vorkommenden Gruppen an DCs. Sie beschreibt außerdem eine zuvor nicht beachtete DC-Untergruppe und gibt Aufschluss über den Ursprung vaskulärer DCs. In den letzten Jahren wurde gezeigt, dass microRNAs (mirRNAs) zahlreiche zelluläre Vorgänge wie Apoptose, Differenzierung, Entwicklung und Proliferation regulieren. Obwohl viele Zelltypen in Bezug auf die in ihrer Regulation eingebundenen mirRNAs charakterisiert wurden, gibt es nur wenige Studien, die sich mit der Rolle von mirRNAs in DCs beschäftigen. Der zweite Teil dieser Arbeit konzentriert sich auf die Rolle der miRNA Gruppe miR-17~92 in DCs und untersucht deren Rolle in gesunden und atherosklerotischen Mäusen. Diese Arbeit zeigt erstmals eine deutliche anti-inflammatorische und protektive Rolle dieser miRNA und schlägt ein Modell für die entdeckten Mechanismen vor. KW - Aorta KW - Maus KW - Zelle KW - Cluster KW - miRNS KW - Dendritische Zelle KW - Arteriosklerose KW - miR-17~92 KW - dendritic cells KW - atherosclerosis KW - mice KW - murine Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-71683 ER - TY - THES A1 - Wu, Lingdan T1 - Emotion Regulation in Addicted Smokers T1 - Emotionsregulation bei abhängigen Rauchern N2 - Background: Nicotine addiction is the most prevalent type of drug addiction that has been described as a cycle of spiraling dysregulation of the brain reward systems. Imaging studies have shown that nicotine addiction is associated with abnormal function in prefrontal brain regions that are important for cognitive emotion regulation. It was assumed that addicts may perform less well than healthy nonsmokers in cognitive emotion regulation tasks. The primary aims of this thesis were to investigate emotional responses to natural rewards among smokers and nonsmokers and to determine whether smokers differ from nonsmokers in cognitive regulation of positive and negative emotions. To address these aims, two forms of appraisal paradigms (i.e., appraisal frame and reappraisal) were applied to compare changes in emotional responses of smokers with that of nonsmokers as a function of appraisal strategies. Experiment 1: The aim of the first experiment was to evaluate whether and how appraisal frames preceding positive and negative picture stimuli affect emotional experience and facial expression of individuals. Twenty participants were exposed to 125 pairs of auditory appraisal frames (either neutral or emotional) followed by picture stimuli reflecting five conditions: unpleasant-negative, unpleasant-neutral, pleasant-positive, pleasant-neutral and neutral-neutral. Ratings of valence and arousal as well as facial EMG activity over the corrugator supercilii and the zygomaticus major were measured simultaneously. The results indicated that appraisal frames could alter both subjective emotional experience and facial expressions, irrespective of the valence of the pictorial stimuli. These results suggest and support that appraisal frame is an efficient paradigm in regulation of multi-level emotional responses. 8 Experiment 2: The second experiment applied the appraisal frame paradigm to investigate how smokers differ from nonsmokers on cognitive emotion regulation. Sixty participants (22 nonsmokers, 19 nondeprived smokers and 19 12-h deprived smokers) completed emotion regulation tasks as described in Experiment 1 while emotional responses were concurrently recorded as reflected by self-ratings and psychophysiological measures (i.e., facial EMG and EEG). The results indicated that there was no group difference on emotional responses to natural rewards. Moreover, nondeprived smokers and deprived smokers performed as well as nonsmokers on the emotion regulation task. The lack of group differences in multiple emotional responses (i.e., self-reports, facial EMG activity and brain EEG activity) suggests that nicotine addicts have no deficit in cognitive emotion regulation of natural rewards via appraisal frames. Experiment 3: The third experiment aimed to further evaluate smokers’ emotion regulation ability by comparing performances of smokers and nonsmokers in a more challenging cognitive task (i.e., reappraisal task). Sixty-five participants (23 nonsmokers, 22 nondeprived smokers and 20 12-h deprived smokers) were instructed to regulate emotions by imagining that the depicted negative or positive scenario would become less negative or less positive over time, respectively. The results showed that nondeprived smokers and deprived smokers responded similarly to emotional pictures and performed as well as nonsmokers in down-regulating positive and negative emotions via the reappraisal strategy. These results indicated that nicotine addicts do not have deficit in emotion regulation using cognitive appraisal strategies. In sum, the three studies consistently revealed that addicted smokers were capable to regulate emotions via appraisal strategies. This thesis establishes the groundwork for therapeutic use of appraisal instructions to cope with potential self-regulation failures in nicotine addicts. N2 - Hintergrund: Nikotinsucht ist die am weitesten verbreitete Form von Drogenabhängigkeit und wird beschrieben als eine immer stärker werdende Dysregulation des Belohnungssystems im Gehirn. Bildgebende Studien zeigten, dass Nikotinabhängige eine abnormale Funktion der präfrontalen Gehirnregionen aufweisen, die für die kognitive Emotionsregulation von entscheidender Bedeutung sind. Es wurde angenommen, dass Süchtige bei kognitiven Aufgaben zur Emotionsregulation schlechter abschneiden als gesunde Nichtraucher. Vorrangige Ziele dieser Thesis waren die Untersuchung emotionaler Reaktionen auf natürliche, Raucher-irrelevante Stimuli bei Rauchern und Nichtrauchern. Außerdem sollte herausgefunden werden, ob sich Raucher von Nichtrauchern bezüglich ihrer kognitiven Regulation von positiven und negativen Emotionen unterscheiden. Um diese Veränderungen in der emotionalen Reaktion in Abhängigkeit der Interpretationsstrategie vergleichen zu können, wurden zwei Paradigmen zur Einschätzung emotionaler Stimuli eingesetzt: Eine prospektive Interpretationsstrategie des kommenden Stimulus (appraisal frame) und eine retrospektive Interpretationsstrategie nach der Stimuluspräsentation (reappraisal). Experiment 1: Ziel des ersten Experiments war die Evaluierung ob und wie Interpretationen vor positiven oder negativen Stimulusbildern die emotionale Erfahrung und den Gesichtsausdruck von Personen beeinflussen. 20 Versuchspersonen wurden 125 Paare auditiver Beschreibungen (entweder neutral oder emotional) präsentiert, gefolgt von Stimulusbildern, die zusammen fünf Stimulus-Kategorien bildeten: unangenehm – negativ, unangenehm – neutral, angenehm – positiv, angenehm – neutral und neutral – neutral. Valenz- und Arousal-Ratings wurden abgefragt und die EMG-Aktivität der Gesichtsmuskeln corrugator supercilii und zygomaticus 10 major wurden zeitgleich aufgenommen. Die Ergebnisse zeigten, dass appraisal frames sowohl emotionale Reaktionen einschließlich subjektiver emotionaler Erfahrungen beeinflussen als auch den Gesichtsausdruck verändern können, unabhängig von der Valenz des Bildstimulus. Dies zeigt und beweist die Effizienz des appraisal frame Paradigmas bei der Regulation von emotionalen Reaktionen auf mehreren Verarbeitungsebenen. Experiment 2: Das zweite Experiment bezog sich auf das appraisal frame Paradigma und sollte untersuchen wie sich Raucher von Nichtrauchern in ihrer kognitiven Emotionsregulation unterscheiden. 60 Probanden (22 Nichtraucher, 19 Raucher ohne Entzug und 19 Raucher mit 12 Stunden Zigarettenentzug) führten Emotionsregulationsaufgaben wie in Experiment 1 beschrieben aus, während ihre emotionalen Reaktionen ständig über Selbsteinschätzungen und psychophysiologische Messungen aufgenommen wurden (faziales EMG und EEG). Die Ergebnisse zeigten keine Gruppenunterschieden bei den emotionalen Reaktionen auf natürliche Stimuli, ohne Bezug zum Rauchen; Außerdem schnitten Raucher mit und ohne Zigarettenentzug in der Emotionsregulationsaufgabe genauso gut ab wie Nichtraucher. Die gleichen Ergebnisse in allen Gruppen hinsichtlich emotionaler Reaktionen (Selbsteinschätzung, faziale EMG Aktivität und EEG Aktivität) machten deutlich, dass Nikotinabhängige keine Einschränkungen in der kognitiven Emotionsregulation auf natürliche Stimuli mittels Vorbeurteilungen haben. Experiment 3: Der dritte Versuch wurde durchgeführt, um die Fähigkeiten von Rauchern bei der Emotionsregulation zu untersuchen, indem die Erfolge von Rauchern und Nichtrauchern in einer schwierigeren kognitiven Aufgabe (reappraisal task) verglichen wurden. 65 Versuchspersonen (23 Nichtraucher, 22 Raucher ohne Entzug und 20 Raucher mit 12 Stunden Zigarettenentzug) wurden instruiert ihre Emotionen zu regulieren, indem sie emotionale Bilder 11 mit neutralem Gefühl interpretieren. Die Probanden sollten sich vorstellen, dass die negativen oder positiven Syenarios immer weniger negativ oder weniger positiv werden. Die Ergebnisse stellen heraus, dass Raucher mit und ohne Zigarettenentzug ähnlich auf emotionale Bilder reagierten und ihre positiven und negativen Emotionen mit der reappraisal Strategie genauso gut herunterregulierten wie Nichtraucher. Zusammenfassend machen die drei Studien deutlich, dass Nikotinabhängige mittels Interpretationsstrategien ihre Emotionen regulieren können. Diese Thesis bilden das Fundament für den therapeutischen Nutzen von Interpretationsstrategien, damit Nikotinabhängige mit potenziellen Selbstregulationsstörungen umgehen können. KW - Gefühl KW - Regulation KW - Rauch KW - Elektroencephalogramm KW - Elektromyographie KW - Emotion KW - Regulation KW - Smoke KW - Electroencephalography KW - Electromyography Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-85471 ER -