TY - JOUR A1 - Chen, Yong A1 - Boettger, Michael K. A1 - Reif, Andreas A1 - Schmitt, Angelika A1 - Ueceyler, Nurcan A1 - Sommer, Claudia T1 - Nitric oxide synthase modulates CFA-induced thermal hyperalgesia through cytokine regulation in mice N2 - Background: Although it has been largely demonstrated that nitric oxide synthase (NOS), a key enzyme for nitric oxide (NO) production, modulates inflammatory pain, the molecular mechanisms underlying these effects remain to be clarified. Here we asked whether cytokines, which have well-described roles in inflammatory pain, are downstream targets of NO in inflammatory pain and which of the isoforms of NOS are involved in this process. Results: Intraperitoneal (i.p.) pretreatment with 7-nitroindazole sodium salt (7-NINA, a selective neuronal NOS inhibitor), aminoguanidine hydrochloride (AG, a selective inducible NOS inhibitor), L-N(G)-nitroarginine methyl ester (L-NAME, a non-selective NOS inhibitor), but not L-N(5)-(1-iminoethyl)-ornithine (L-NIO, a selective endothelial NOS inhibitor), significantly attenuated thermal hyperalgesia induced by intraplantar (i.pl.) injection of complete Freund’s adjuvant (CFA). Real-time reverse transcription-polymerase chain reaction (RT-PCR) revealed a significant increase of nNOS, iNOS, and eNOS gene expression, as well as tumor necrosis factor-alpha (TNF), interleukin-1 beta (IL-1b), and interleukin-10 (IL-10) gene expression in plantar skin, following CFA. Pretreatment with the NOS inhibitors prevented the CFA-induced increase of the pro-inflammatory cytokines TNF and IL-1b. The increase of the antiinflammatory cytokine IL-10 was augmented in mice pretreated with 7-NINA or L-NAME, but reduced in mice receiving AG or L-NIO. NNOS-, iNOS- or eNOS-knockout (KO) mice had lower gene expression of TNF, IL-1b, and IL-10 following CFA, overall corroborating the inhibitor data. Conclusion: These findings lead us to propose that inhibition of NOS modulates inflammatory thermal hyperalgesia by regulating cytokine expression. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68349 ER - TY - JOUR A1 - Meierjohann, Svenja A1 - Hufnagel, Anita A1 - Wende, Elisabeth A1 - Kleinschmidt, Markus A. A1 - Wolf, Katarina A1 - Friedl, Peter A1 - Gaubatz, Stefan A1 - Schartl, Manfred T1 - MMP13 mediates cell cycle progression in melanocytes and melanoma cells: in vitro studies of migration and proliferation N2 - Background: Melanoma cells are usually characterized by a strong proliferative potential and efficient invasive migration. Among the multiple molecular changes that are recorded during progression of this disease, aberrant activation of receptor tyrosine kinases (RTK) is often observed. Activation of matrix metalloproteases goes along with RTK activation and usually enhances RTK-driven migration. The purpose of this study was to examine RTKdriven three-dimensional migration of melanocytes and the pro-tumorigenic role of matrix metalloproteases for melanocytes and melanoma cells. Results: Using experimental melanocyte dedifferentiation as a model for early melanomagenesis we show that an activated EGF receptor variant potentiates migration through three-dimensional fibrillar collagen. EGFR stimulation also resulted in a strong induction of matrix metalloproteases in a MAPK-dependent manner. However, neither MAPK nor MMP activity were required for migration, as the cells migrated in an entirely amoeboid mode. Instead, MMPs fulfilled a function in cell cycle regulation, as their inhibition resulted in strong growth inhibition of melanocytes. The same effect was observed in the human melanoma cell line A375 after stimulation with FCS. Using sh- and siRNA techniques, we could show that MMP13 is the protease responsible for this effect. Along with decreased proliferation, knockdown of MMP13 strongly enhanced pigmentation of melanocytes. Conclusions: Our data show for the first time that growth stimuli are mediated via MMP13 in melanocytes and melanoma, suggesting an autocrine MMP13-driven loop. Given that MMP13-specific inhibitors are already developed, these results support the evaluation of these inhibitors in the treatment of melanoma. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68335 ER - TY - JOUR A1 - Puetz, Stephanie M. A1 - Vogiatzi, Fotini A1 - Stiewe, Thorsten A1 - Sickmann, Albert T1 - Malignant transformation in a defined genetic background: proteome changes displayed by 2D-PAGE N2 - Background: Cancer arises from normal cells through the stepwise accumulation of genetic alterations. Cancer development can be studied by direct genetic manipulation within experimental models of tumorigenesis. Thereby, confusion by the genetic heterogeneity of patients can be circumvented. Moreover, identification of the critical changes that convert a pre-malignant cell into a metastatic, therapy resistant tumor cell, however, is one necessary step to develop effective and selective anti-cancer drugs. Thus, for the current study a cell culture model for malignant transformation was used: Primary human fibroblasts of the BJ strain were sequentially transduced with retroviral vectors encoding the genes for hTERT (cell line BJ-T), simian virus 40 early region (SV40 ER, cell line BJ-TE) and H-Ras V12 (cell line BJ-TER). Results: The stepwise malignant transformation of human fibroblasts was analyzed on the protein level by differential proteome analysis. We observed 39 regulated protein spots and therein identified 67 different proteins. The strongest change of spot patterns was detected due to integration of SV40 ER. Among the proteins being significantly regulated during the malignant transformation process well known proliferating cell nuclear antigen (PCNA) as well as the chaperones mitochondrial heat shock protein 75 kDa (TRAP-1) and heat shock protein HSP90 were identified. Moreover, we find out, that TRAP-1 is already up-regulated by means of SV40 ER expression instead of H-Ras V12. Furthermore Peroxiredoxin-6 (PRDX6), Annexin A2 (p36), Plasminogen activator inhibitor 2 (PAI-2) and Keratin type II cytoskeletal 7 (CK-7) were identified to be regulated. For some protein candidates we confirmed our 2D-PAGE results by Western Blot. Conclusion: These findings give further hints for intriguing interactions between the p16-RB pathway, the mitochondrial chaperone network and the cytoskeleton. In summary, using a cell culture model for malignant transformation analyzed with 2D-PAGE, proteome and cellular changes can be related to defined steps of tumorigenesis. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68321 ER - TY - JOUR A1 - Grimm, Martin A1 - Lazariotou, Maria A1 - Kircher, Stefan A1 - Stuermer, Luisa A1 - Reiber, Christoph A1 - Hoefelmayr, Andreas A1 - Gattenloehner, Stefan A1 - Otto, Christoph A1 - Germer, Christoph T. A1 - von Rahden, Burkhard H. A. T1 - MMP-1 is a (pre-)invasive factor in Barrett-associated esophageal adenocarcinomas and is associated with positive lymph node status N2 - Background: Esophageal adenocarcinomas (EACs) arise due to gastroesophageal reflux, with Barrett’s esophagus (BE) regarded as precancerous lesion. Matrix metalloproteinases (MMPs) might play a role during the multistep carcinogenetic process. Methods: Expression of MMP-1 and -13 was analyzed in esophageal cancer (n = 41 EAC with BE, n = 19 EAC without BE, and n = 10 esophageal squamous-cell carcinomas, ESCC), furthermore in BE without intraepithelial neoplasia (IN) (n = 18), and the cell line OE-33. MMP-1 was co-labelled with Ki-67 (proliferation), Cdx-2 (marker for intestinal metaplasia, BE) and analyzed on mRNA level. MMP-1 staining results were correlated with clinicopatholocical parameters. Results: On protein level, MMP-1 expression was found in 39 of 41 (95%) EAC with BE, in 19 of 19 (100%) EAC without BE, in 6 of 10 (60%) ESCC, and in 10 of 18 (56%) BE without IN. No expression of MMP-13 was found in these specimens. Quantification showed 48% MMP-1 positive cells in EAC with BE, compared to 35% in adjacent BE (p < 0.05), 44% in EAC without BE, 32% in ESCC, and 4% in BE without IN. Immunofluorescence double staining experiments revealed increased MMP-1 expressing in proliferating cells (MMP-1+/Ki-67+) (r = 0.943 for BE and r = 0.811 for EAC). On mRNA-level, expression of MMP-1 was significantly higher in EAC compared to BE (p = 0.01) and confirmed immunohistochemical staining results. High MMP-1 levels were associated with lymph node metastases but not with poorer survival (p = 0.307). Conclusions: Our findings suggest that MMP-1 plays a role as preinvasive factor in BE-associated EAC. Expression of MMP-1 in proliferating BE and EAC cells suggest malignant proliferation following the clonal expansion model. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68293 ER - TY - JOUR A1 - Frey, Li­dia M. A1 - Houben, Roland A1 - Bröcker, Eva-B. T1 - Pigmentation, Melanocyte Colonization, and p53 Status in Basal Cell Carcinoma N2 - Basal cell carcinoma (BCC) is the most common neoplasm in the Caucasian population. Only a fraction of BCC exhibits pigmentation. Lack of melanocyte colonization has been suggested to be due to p53-inactivating mutations in the BCC cells interfering with the p53-proopiomelanocortin pathway and the production of alpha melanocyte-stimulating hormone in the tumor. To evaluate this, we determined tumor pigmentation as well as expression of melan-A and of p53 in 49 BCC tissues bymeans of immunohistochemistry. As expected, we observed a positive relation between tumor pigmentation and melan-A positive intratumoral melanocytes.Melanocyte colonization and, to a lesser extent, p53 overexpression showed intraindividual heterogeneity in larger tumors. p53 overexpression, which is indicative of p53 mutations, was not correlated to melanocyte colonization of BCC. Sequencing of exon 5–8 of the p53 gene in selected BCC cases revealed that colonization by melanocytes and BCC pigmentation is neither ablated by p53 mutations nor generally present in BCCs with wild-type p53. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68283 ER - TY - JOUR A1 - Winter, Julia A1 - Kneitz, Hermann A1 - Bröcker, Eva-B. T1 - Blood Vessel Density in Basal Cell Carcinomas and Benign Trichogenic Tumors as a Marker for Differential Diagnosis in Dermatopathology N2 - In order to get insight into the density of blood vessels in the stroma of benign and malignant trichogenic neoplasms, immunohistological quantification of CD 31 positive vessels was performed in 112 tumors, comprised of 50 BCCs of nodular (35) or morphoeic (15) growth patterns, 17 Pinkus’ tumors, as well as 17 trichoepitheliomas of which 6 were desmoplastic, 8 trichofolliculomas, and 20 trichoblastomas. Methods. Vessel density was counted within the tumors, in the tumor-surrounding stroma, and, as a control, in the normal skin of the operation specimen. The results were compared using statistical methods. Results. Whereas, irrespective of the patients’ age and location of tumors, the vessel density in normal skin showed no significant differences (8.8 ± 2.7), the counts in the peritumoral stroma revealed significant differences between the different tumors investigated. The highest counts were obtained in BCC (24.7 ± 6.7) and the lowest in benign trichogenic neoplasms (around 14) Pinkus’ tumors revealed intermediate counts (19.7 ± 6.6). The vessel densities within the tumors were generally low, and no correlation to the dignity was found. Conclusion. Determination of blood vessel density in the peritumoral stroma may be an additional parameter for differential diagnosis of trichogenic tumors of uncertain dignity. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68275 ER - TY - JOUR A1 - Parczyk, Marco A1 - Herold, Volker A1 - Klug, Gert A1 - Bauer, Wolfgang R. A1 - Rommel, Eberhard A1 - Jakob, Peter M. T1 - Regional in vivo transit time measurements of aortic pulse wave velocity in mice with high-field CMR at 17.6 Tesla N2 - Background: Transgenic mouse models are increasingly used to study the pathophysiology of human cardiovascular diseases. The aortic pulse wave velocity (PWV) is an indirect measure for vascular stiffness and a marker for cardiovascular risk. Results: This study presents a cardiovascular magnetic resonance (CMR) transit time (TT) method that allows the determination of the PWV in the descending murine aorta by analyzing blood flow waveforms. Systolic flow pulses were recorded with a temporal resolution of 1 ms applying phase velocity encoding. In a first step, the CMR method was validated by pressure waveform measurements on a pulsatile elastic vessel phantom. In a second step, the CMR method was applied to measure PWVs in a group of five eight-month-old apolipoprotein E deficient (ApoE(-/-)) mice and an age matched group of four C57Bl/6J mice. The ApoE(-/-) group had a higher mean PWV (PWV = 3.0 ± 0.6 m/s) than the C57Bl/6J group (PWV = 2.4 ± 0.4 m/s). The difference was statistically significant (p = 0.014). Conclusions: The findings of this study demonstrate that high field CMR is applicable to non-invasively determine and distinguish PWVs in the arterial system of healthy and diseased groups of mice. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68219 ER - TY - JOUR A1 - Gattenloehner, Stefan A1 - Joerissen, H. A1 - Huhn, M. A1 - Vincent, A. A1 - Beeson, D. A1 - Tzartos, S. A1 - Mamalaki, A. A1 - Etschmann, B. A1 - Muller-Hermelink, H. K. A1 - Koscielniak, E. A1 - Barth, S. A1 - Marx, A. T1 - A Human Recombinant Autoantibody-Based Immunotoxin Specific for the Fetal Acetylcholine Receptor Inhibits Rhabdomyosarcoma Growth In Vitro and in a Murine Transplantation Model [Research Article] N2 - Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumor in children and is highly resistant to all forms of treatment currently available once metastasis or relapse has commenced. As it has recently been determined that the acetylcholine receptor (AChR) γ-subunit, which defines the fetal AChR (fAChR) isoform, is almost exclusively expressed in RMS post partum, we recombinantly fused a single chain variable fragment (scFv) derived from a fully human anti-fAChR Fab-fragment to Pseudomonas exotoxin A to generate an anti-fAChR immunotoxin (scFv35-ETA).While scFv35-ETA had no damaging effect on fAChR-negative control cell lines, it killed human embryonic and alveolar RMS cell lines in vitro and delayed RMS development in a murine transplantation model. These results indicate that scFv35-ETA may be a valuable new therapeutic tool as well as a relevant step towards the development of a fully human immunotoxin directed against RMS. Moreover, as approximately 20% of metastatic malignant melanomas (MMs) display rhabdoid features including the expression of fAChR, the immunotoxin we developed may also prove to be of significant use in the treatment of these more common and most often fatal neoplasms. KW - Medizin Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68200 ER - TY - JOUR A1 - Geissinger, Eva A1 - Sadler, Petra A1 - Roth, Sabine A1 - Grieb, Tina A1 - Puppe, Bernhard A1 - Mueller, Nora A1 - Reimer, Peter A1 - Vetter-Kauczok, Claudia S. A1 - Wenzel, Joerg A1 - Bonzheim, Irina A1 - Ruediger, Thomas A1 - Mueller-Hermelink, Hans Konrad A1 - Rosenwald, Andreas T1 - Disturbed expression of the T-cell receptor/CD3 complex and associated signaling molecules in CD30(+) T-cell lymphoproliferations N2 - Background CD30+ T-cell lymphoproliferations comprise a spectrum of clinically heterogeneous entities, including systemic anaplastic large cell lymphomas (ALK- and ALK+) and primary cutaneous CD30+ T-cell lymphoproliferative disorders. While all these entities are characterized by proliferation of highly atypical, anaplastic CD30+ T cells, the expression of T-cell specific antigens in the tumor cells is not consistently detectable. Design and Methods We evaluated biopsies from 19 patients with primary cutaneous CD30+ lymphoproliferative disorders, 38 with ALK- and 33 with ALK+ systemic anaplastic large cell lymphoma. The biopsies were examined for the expression of T-cell receptoraβ/CD3 complex (CD3γ, δ, ε, ζ), transcription factors regulating T-cell receptor expression (ATF1, ATF2, TCF-1, TCF-1a/LEF-1, Ets1), and molecules of T-cell receptor-associated signaling cascades (Lck, ZAP-70, LAT, bcl-10, Carma1, NFATc1, c-Jun, c-Fos, Syk) using immunohistochemistry. Results In comparison to the pattern in 20 peripheral T-cell lymphomas, not otherwise specified, we detected a highly disturbed expression of the T-cell receptor/CD3 complex, TCF-1, TCF- 1a/LEF-1, Lck, ZAP-70, LAT, NFATc1, c-Jun, c-Fos and Syk in most of the systemic anaplastic large cell lymphomas. In addition, primary cutaneous CD30+ lymphoproliferative disorders showed such a similar expression pattern to that of systemic anaplastic large cell lymphomas, that none of the markers we investigated can reliably distinguish between these CD30+ T-cell lymphoproliferations. Conclusions Severely altered expression of the T-cell receptor/CD3 complex, T-cell receptor-associated transcription factors and signal transduction molecules is a common characteristic of systemic and cutaneous CD30+ lymphoproliferations, although the clinical behavior of these entities is very different. Since peripheral T-cell lymphomas, not otherwise specified retain the full expression program required for functioning T-cell receptor signaling, the differential expression of a subset of these markers might be of diagnostic utility in distinguishing peripheral T-cell lymphomas, not otherwise specified from the entire group of CD30+ lymphoproliferations. KW - Medizin KW - systemic and cutaneous CD30+ lymphoproliferations KW - anaplastic large cell lymphoma KW - lymphomatoid papulosis KW - ALCL KW - LyP KW - TCR Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68179 ER - TY - JOUR A1 - Herbert, M. K. A1 - Holzer, P. T1 - Nitric oxide mediates the amplification by interleukin-1β of neurogenic vasodilatation in the rat skin N2 - No abstract available. KW - Medizin KW - Afferent nerve stimulation KW - Capsaicin KW - Cutaneous hyperemia KW - lnterleukin-lβ KW - Neurogenie inflammation KW - Nitric oxide (NO) Y1 - 1994 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59969 ER - TY - JOUR A1 - Herbert, M. K. A1 - Schmidt, R. F. T1 - Activation of normal and inflamed fine articular afferent units by serotonin N2 - In cats anesthetized with alpha-chloralose, extracellular recordings were made from fine afferent units belonging to the medial articular nerve (MAN) of the knee joint. The excitatory and sensitizing effects on articular afferents of serotonin (5-HT) applied intra-arterially close to the joint were examined. The joints were either normal or an experimental arthritis had been induced some hours before the recording session. Bolus injections of 1.35-135 p,g 5-HT excited about 43% of group 111 (CV: 2.5-20 m/sec) and 73% of group IV units (CV: < 2.5 mjsec) from normal joints. The latency was usually between 10 and 30 sec, and the duration and size of the responses were dose-dependent. Fast group 111 units (CV: > 16 mjsec) and group li units (CV: > 20 m/sec) were never excited by 5-HT. Repetitiveadministration led to pronounced tachyphylaxis of the 5-HT response. Inflammation induced an enhanced sensitivity of group III articular afferent units to close intra-arterial application of 5-HT. In particular the total duration of each response was considerably prolonged (4-10 min against 1-2 min under normal conditions). At the same time the tachyphylaxis seen under normal conditions was gteatly reduced. In contrast, group IV articular afferent units did not become sensitized to 5-HT in the course of inflammation. In normal joints 5-HT did not sensitize fineafferent units for movement-induced responses. However, after inflammation, a distinct sensitization to such movements by 5-HT application could be observed bothin group 111 and group IV fiber ranges. The sensitization had a short time course not exceeding 7 min. The tonic component of the movement-induced response was more enhanced than the phasic one. The bolus application of 5-HT led to temporary vasoconstriction of the knee joint vessels. This vasoconstriction was especially pronounced in inflamed joints and impeded the access of subsequently applied substances to the terminal regions of the afferent units under observation. lt is concluded that the present results support the notion that 5-HT may participate in the mediation of pain from inflamed tissue such as an arthritic joint by exciting and sensitizing fine afferent units. During inflammation group 111 units are particularly sensitive to 5-HT and, thus, may carry the bulk of the 5-HT-induced nociceptive messages. KW - Medizin KW - Serotonin (5-HT) KW - Articular afferent KW - Joint pain KW - Inflammation Y1 - 1992 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59952 ER - TY - JOUR A1 - Heinsen, Helmut A1 - Henn, R. A1 - Eisenmenger, W. A1 - Götz, M. A1 - Bohl, J. A1 - Bethke, B. A1 - Lockermann, U. A1 - Püschel, K. T1 - Quantitative investigations on the human entorhinal area: left - right asymmetry and age-related changes N2 - The total nerve cell numbers in the right and in the left human entorhinal areas have been calculated by volume estimations with the Cavalieri principle and by cell density determinations with the optical disector. Thick gallocyanin-stained serial frozen sections through the parahippocampal gyrus of 22 human subjects (10 female, 12 male) ranging from 18 to 86 years were analysed. The laminar composition of gallocyanin (Nissl)-stained sections could easily be compared with Braak's (1972, 1980) pigmentoarchitectonic study, and Braak's nomenclature of the entorhinal laminas was adopted. Cellsparse laminae dissecantes can more clearly be distinguished in Nissl than in aldehydefuchsin preparations. These cell-poor dissecantes, lamina dissecans extema (dis-ext), lamina dissecans 1 (dis-1) and lamina dissecans 2 (dis-2), were excluded from nerve cell nurober determinations. An exact delineation of the entorhinal area is indispensable for any kind of quantitative investigation. We have defined the entorhinal area by the presence of pre-alpha ceil clusters and the deeper layers of lamina principalis externa (pre-beta and gamma) separated from lamina principalis interna (pri) by lamina dissecans 1 (dis-1). The human entorhinal area is quantitatively characterized by a left-sided (asymmetric) higher pre-alpha cell number and an age-related nerve cell loss in pre as well as pri layers. At variance with other CNS cortical and subcortical structures, the neuronal number of the entorhinal area appears to decrease continuously from the earliest stages analysed, although a secular trend has to be considered. The asymmetry in pre-alpha cell number is discussed in the context of higher human mental capabilities, especially language. KW - Medizin KW - Human entorhinal area KW - Ageing KW - Lateralitity Y1 - 1994 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59946 ER - TY - JOUR A1 - Heinsen, Helmut A1 - Heinsen, Y. L. A1 - Beckmann, H. A1 - Gallyas, F. A1 - Haas, S. A1 - Scharff, G. T1 - Laminar neuropathology in Alzheimer's disease by a modified Gallyas impregnation N2 - No abstract available KW - Medizin KW - Alzheimer-Krankheit Y1 - 1989 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59933 ER - TY - JOUR A1 - Heinsen, Helmut A1 - Heinsen, Y. L. T1 - Cerebellar capillaries: qualitative and quantitative observations in young and senile rats N2 - Ultrastructural changes including reduced electron density, reduction in polysemes and cisternae of rough endoplasmic reticulum occur in the cytoplasrn of endothelial cells and pericytes in the cerebellar cortex of senile virgin female Han: WIST-rats in cornparison to 3-month old virgin rats. Processes of pericytes cover less of the capillary surface in the cerebellar cortex of senile rats; moreover, arithmetic and harmonic mean thickness of the endothelium and relative volume of mitochondria in endothelial cells and pericytes are reduced, w hereas the luminal diameter of the capillaries, harmonic and arithmetic mean thickness of pericytes and their processes and of the basal laminae between endothelial cells and astrocytes (abbreviated BAL 1), pericytes and astrocytes (BAL 2) and endothelial cells and pericytes (BAL 3) increase. The increase in harmonic mean thickness of the basal laminae is statistically significant (α<=0.05) and compensates for a decrease in thickness of capillary endothelium. Consequently, the total barrier mass and thickness of cerebellar cortical capillaries in senile animals is higher than in young individuals. KW - Medizin KW - Capillaries KW - Blood-brain barrier KW - Quantitative anatomy KW - Cerebellar cortex KW - Senile rats Y1 - 1983 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59924 ER - TY - JOUR A1 - Heinsen, Helmut A1 - Heinsen, Y. L. T1 - Quantitative studies on regional differences in Purkinje cell dendritic spines and parallel fiber synaptic density N2 - No abstact available KW - Medizin KW - Cerebellar cortex KW - Albino rats KW - Quantitative anatomy KW - Purkinje cells KW - Spines KW - Parallel fiber synapses KW - Regional differences Y1 - 1983 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59917 ER - TY - JOUR A1 - Heinsen, Helmut T1 - Regional differences in the distribution of lipofuscin in Purkinje cell perikarya : a quantitative Pigmentarchitectonic study of the Cerebellar Cortexof Senile Albino Rats N2 - The distribution of lipofuscin in the perikarya of Purkin je cells of vermal and hemispheric lobules has been determined quantitatively in 7 rats, 30-38 months old, by the point-counting method. On the basis of morphologically and statistically significant differences a pigmentarchitectonics of the cerebellar cortex is established. The Purkinje cells of lobule VIa (Larsell 1952) are extremely lipofuscin-rich. The Purkinje cells of the hemispheres, lobules V, Vlb + c and VII contain considerable amounts of a finely granular lipofuscin, the Purkinje cells of lobules I-III and VIII- IXa a globular type of lipofuscin. The Purkinje cells of sublobule XI d c and X are lipofuscin-poor cells. Three types of lipofuscin ha ve been identified in the light microscope. KW - Medizin KW - Lipofuscin KW - Purkinje cells KW - Pigmentarchitectonics KW - Senile rat Y1 - 1981 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59904 ER - TY - JOUR A1 - Heinsen, Helmut T1 - Lipofuscin in the cerebellar cortex of albino rats: an electron microscopic study N2 - The ultrastructure of autofluorescent, PAS-positive lipofuscin in Purkinje, granule, Golgi epithelial, basket and stellate, microglial and perivascular cells in the cerebellar cortex of senescent rats is described. The membrane- bounded pigment is composed ofthree elements: 1) electron-lucent homogeneaus droplets, 2) a granular matrix and 3) intensely osmiophilic patches. The proportians ofthese three components vary between cell types and one can grossly differentiate a neuronal and a gliallipofuscin. The lipofuscin granules of stellate and perivscular cells are different from lipofuscin of other cerebellar neurons and glia. lt can be concluded from these morphological observations that each cerebellar cell type has its distinct lipofuscin. KW - Medizin KW - Lipofuscin KW - Cerebellar cortex KW - Ultrastructure KW - Senescent rat Y1 - 1979 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59891 ER - TY - JOUR A1 - Heinsen, Helmut T1 - Quantitative anatomical studies on the postnatal development of the cerebellum of the albino rat N2 - The quantitative postnatal changes of the cerebella of 65 Wistar rats aged 2-120 days have been examined. The cerebellar volume increases in two phases: The first phase lasts from birth to the seventh postnatal week. The second phase begins ten weeks post parturn and lasts for a Ionger period than the first phase. The cerebellar surface increases continuously from birth to the end of the seventh week. The volume of the external granular layer is maximal when the organ grows rapidly. The external granular layer has nearly disappeared 24 days after birth; the volume of the interaal granular layer is maximal at this time. Later on, the volume and the width of the interaal granular layer decrease. Myelinization of the cerebellar fibers and growth of the molecular layer run parallel to this decrease. The second late, but protracted growth of the cerebellum, ten weeks after birth, is due to an increase of the molecular and medullary layer. These findings are in good accord with histological, histochemical, and ultrastructural observations of other authors. KW - Medizin KW - Cerebellum KW - Albino rat KW - Ontogeny KW - Quantitative anatomy Y1 - 1977 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-59881 ER - TY - JOUR A1 - Schmähl, D. A1 - Frank, HK A1 - Lutz, WK A1 - Stransky, M. A1 - Ritzel, G. A1 - Beaufort, F. A1 - Vutuc, C. T1 - Ernährung und Krebs N2 - No abstract available KW - Medizin Y1 - 1985 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-55224 ER - TY - JOUR A1 - Heinsen, Helmut A1 - Strik, M. A1 - Luther, K. A1 - Ulmar, G. A1 - Gangnus, D. A1 - Jungkunz, G. A1 - Eisenmenger, W. A1 - Götz, M. A1 - Bauer, M. T1 - Cortical and striatal neurone number in Huntington's disease N2 - The total cortical and striatal neurone and glial numbers were estimated in five cases of Huntington's disease (three males, two females) and five ageand sex-matched control cases. Serial 500-l-lm-thick gallocyanin-stained frontal sections through the left hemisphere were analysed using Cavalieri's principle for volume and the optical disector for cell density estimations. The average cortical neurone number of five controls (mean age 53±13 years, range 36-72 years) was 5.97x 109±320x 106 , the average number of small striatal neurones was 82 X 106± 15.8 X 106• The left striatum (caudatum, putamen, and accumbens) contained a mean of 273 X 106±53 X 106 glial cells (oligodendrocytes, astrocytes and unc1assifiable glial profiles). The mean cortical neurone number in Huntington's disease patients (mean age 49±14 years, range 36-75 years) was diminished by about 33 % to 3.99x109±218x106 nerve cells (P ::;:::: 0.012, MannWhitney V-test). The mean number of small striatal neurones decreased tremendously to 9.72 X 106 ± 3.64 X 106 (-88 % ). The decrease in total glial cells was less pronounced (193 X 106±26 X 106) but the mean glial index, the numerical ratio of glial cells per neurone, increased from 3.35 to 22.59 in Huntington's disease. Qualitatively, neuronal loss was most pronounced in supragranular layers of primary sensory areas (Brodmann's areae 3,1,2; area 17, area 41). Layer HIc pyramidal cells were preferentially lost in association areas of the temporal, frontal, and parietal lobes, whereas spared layer IV granule cells formed a conspicuous band between layer IH and V in these fields. Methodological issues are discussed in context with previous investigations and similarities and differences of laminar and lobar nerve cellloss in Huntington's disease are compared with nerve cell degent-ration in other neuropsychiatric diseases. KW - Medizin KW - Huntington's disease . Human cerebral cortex KW - Striatum KW - Neurone number KW - Stereology Y1 - 1994 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-55217 ER - TY - JOUR A1 - Sirén, Anna-Leena T1 - Central cardiovascular and thermal effects of prostaglandin D2 in rats N2 - Prostaglandin D2 (PGD2) is the most common prostaglandin type of tile rat brain. Recently a neurornodulator role for PGD2 has been suggested. In the present work the central cardiovascular and thermal effects of PGDz were studied in urethane-anaesthetised rats. Mlen adrndnistered at the doses of 0.001-10 ~g/rat into the lateral cerebral ventricle(i.c.v.), PGD2 slightly increased the blood pressure, heart rate and body ternpera~ ure. The highest dose caused also an initial hypotensive effect. Upon lntravenous injections PGD2 (0.1-10 ~g/rat) initially decreased and then weakly increased the blood pressure but had only negligible effects on heart rate and body temperature. Central pretreatment with sodium meclofenamate or indomethacin (1 mg/rat i.c.v.) antagonised effectively all the recorded central effects of PGD2. The central cardiovascular and thermal effects of PGD2 were much weaker than those obtained earlier with other prostaglandins, such as PGF2alpha and PGE2.. Therefore, in spite of its abundance in the brain PGD2 may not be very important for the central cardiovascular and thermal regulation in the rat. KW - Medizin Y1 - 1982 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-48658 ER - TY - JOUR A1 - Sirén, Anna-Leena A1 - Paakkari, I. T1 - Cardiovascular effects of TRH i.c.v. in conscious rats N2 - In addition to the endocrine effects, the thyrotropin releasing hormone (TRH) is known to induce dose-dependent increases in blood pressure and heart rate after intracerebroventricular (i.c.v.) administration in urethane-anaesthetised rats (1, 2). The a~ of the present study was to investigate whether TRH has similar effects in conscious rats of various strains i.e. spontaneously hypertensive rats (SHR), normotensive Wistar-Kyoto (WKY) and Wistar (NR) rats. KW - Medizin Y1 - 1984 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-49071 ER - TY - JOUR A1 - Sirén, Anna-Leena A1 - Svarström-Fraser, M. A1 - Paakkari, I. T1 - Central cardiovascular effects of the endoperoxide analogue U-46619 i.c.v. in rats N2 - Thromboxanes are abundantly present in the rat brain but their possible physiological functions in the brain are not known. The prostaglandin endoperoxide analogue U-46619 is a selective agonist of TxA2 receptors in many peripheral tissues. In the present study the ·central cardiovascular and ventilatory effects of U-46619 were investigated in rats. In conscious spontaneously hypertensive rats (SHR) U-46619 (1-100 nmol/kg i.c.v.) induced a strong dose-related increase in blood pressure but had no significant effect on heart rate. In conscious normotensive rats (NR) neither blood pressure nor heart rate was significantly affected. Furthermore, U-46619 (0.1-100 nmol/kg i.c.v.) had no significant effect on blood pressure, heart rate or ventilation in urethane-anaesthetised NR . The results demonstrate an increased sensitivity of SHR to TxA2. KW - Medizin Y1 - 1985 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-49064 ER - TY - JOUR A1 - Feuerstein, G. A1 - Sirén, Anna-Leena T1 - Effect of naloxone and morphine on survival of conscious rats after hemorrhage N2 - The endogenous opioid system has been reported to depress the cardiovascular system during shock states, since naloxone, a potent opiate antagonist, enhances recovery of hemodynamic variables in various shock states. However, the effect of naloxone on long-term survival of experimental animals exposed to hypovolemic hypotension is not clear. The present studies tested the capacity of various doses of naloxone to protect conscious rats from mortality following various bleeding paradigms. In addition, the effect of morphine on survival of rats exposed to hemorrhage was also examined. In the six different experimental protocols tested, naloxone treatments failed to improve short- or long-term survival; in fact, naloxone treatment reduced short-term survival in two of the experimental protocols. Morphine injection, however, enhanced the mortality of rats exposed to hemorrhage in a dose-dependent manner. It is concluded that while opiates administered exogenously decrease survival after acute bleeding, naloxone has no protective action in such states and, like morphine, it may decrease survival in some situations. KW - Medizin KW - shock KW - opioid peptides KW - hypovolemic hypotension Y1 - 1986 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-48669 ER - TY - JOUR A1 - Sirén, Anna-Leena A1 - Feuerstein, Giera T1 - Central autonomic pharmacology of thyrotropin releasing hormone N2 - Thyrotropin releasing hormone (TRH, I-pyroglutamyl-l-histidyl-l-prolinamide) was the fIrst hypothalamic releasing SUbstance to be isolated, chemically characterized and synthetized /1/. The studies to date have revealed that the thyrotropin release from the pituitary gland is only one of the numerous actions of TRH. In addition to its endocrine actions (TSH and prolactin release) this tripeptide has central nervous system actions totally unrelated to its effects on the hypothalamo-pituitary axis. This review aims to summarize the studies on the central nervous system' actions of TRH with special emphasis on the autonomic pharmacology of this peptide. KW - Medizin Y1 - 1987 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-49051 ER - TY - JOUR A1 - Feuerstein, G. A1 - Sirén, Anna-Leena T1 - Cardiovascular effects of enkephalins N2 - Enkephalins and their receptors are found in neurons and nerve terminals known to be involved in central cardiovascular control as well as the peripheral sympathetic and parasympathetic systems. Enkephalins and opioid receptors were also iden tified in the heart, kidneys, and blood vessels. The enkephalins interact with several specific receptors, of which p, 0, and K have been best characterized. Enkephalins administered to humans or animals produce cardiovascular effects which depend on the spedes, route of administration, anesthesia, and the selectivity for receptor subtype. While little information exists on the role of enkephalins in normal cardiovascular control, current data suggest that enkephalins might have a role in cardiovascular stress responses such os in shock and trauma. KW - Medizin Y1 - 1987 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-49048 ER - TY - JOUR A1 - Feuerstein, Giora A1 - Sirén, Anna-Leena T1 - The Opioid System in cardiac and vascular regulation of normal and hypertensive states N2 - The endogenous opioid system includes three major families of peptides: dynorphins (derived from pre-proenkephalin B), endorphins (derived from pre-proopiomelanocortin), and enkephalins (derived from pre-proenkephalin A). Multiple species of opioid peptides are derived from these major precursors and many of them possess potent cardiovascular properties. Opioid peptides and opioid receptors, of which multiple forms have been defined, are present in the central nervous system and peripheral neural elements. In the central nervous system, opioid peptides and receptors are found in forebrain and hindbrain nuclei involved in baroregulation, sympathoadrenal activation, and several other vital autonomic functions. In the periphery, opioid peptides are found in autonomic ganglia, adrenal gland, heart, and other organs; multiple opioid receptors are also found in vascular tissue, heart, and kidneys. Although little is known to date on the regulatory mechanisms of the opioid system in normal cardiovascular states, it became clear that cardiovascular stress situations substantially modify the activity of the endogenous opioid system. The purpose of this review is to clarify the sites of interaction of the opioid system with all major components of the cardiovascular system and indicate the potential role of this system in the ontogenesis of cardiac malfunction, vascular diseases, and hypertension. KW - Medizin Y1 - 1987 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-47418 ER - TY - JOUR A1 - Feuerstein, G. A1 - Sirén, Anna-Leena A1 - Goldstein, DS A1 - Johnson, AK A1 - Zerbe, RL T1 - The effect of morphine on the hemodynamic and neuroendocrine responses to hemorrhagic shock in conscious rats N2 - We have previously reported that analgesic doses of morphine accelerate mortality of rats exposed to hemorrhage (Feuerstein and Siren: Circ Shock 19:293-300, 1986). To study the potential mechanisms involved in this phenomenon, rats were chronically implanted with catheters in the femoral vessels and morphine (1.5 or 5 mg/kg) was administered 30 min or 24 hr after bleeding (8.5 mll300 g over 5 min) while arterial blood pressure and heart rate were continuously monitored. Furthermore, the effect of morphine (5 mg/kg) on cardiac output (CO) response to hemorrhage was studied in rats chronically equipped with a mini thermistor for CO monitoring by a thermodilution technique. In addition, plasma catecholamines (HPLC), plasma renin activity (PRA, RIA), vasopressin (RIA), pH, and blood gases were also determined. Morphine administration 30 min after hemorrhage produced a pressor response and tachycardia which were in marked contrast to its depressor effect in intact rats. Morphine elevated PRA and epinephrine but not vasopressin, while blood pH and gases showed no consistent change as compared to salinetreated hemorrhaged rats. Morphine given after the bleeding resulted in enhanced cardiac depression in response to a second bleed of 2 m1l300 g. Our data suggest that activation of pressor mechanisms by morphine during hypovolemic hypotension might enhance vasoconstriction in essential organs, depress cardiac function, and further reduce effective tissue perfusion. KW - Medizin KW - hemorrhagic shock KW - opiates KW - catecholamlnes KW - renin KW - vasopressin Y1 - 1989 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-49033 ER - TY - THES A1 - Ehrmann, Christian T1 - Outsourcing von medizinischen Daten - strafrechtlich betrachtet - T1 - Outsourcing of medical data - from a criminal law perspective - N2 - Nach der vorliegenden Untersuchung zum Outsourcing medizinischer Daten aus strafrechtlicher Sicht kann folgendes Gesamtergebnis festgehalten werden. Beim Outsourcing medizinischer Daten sind regelmäßig personenbezogene Informationen betroffen. Personenbezogene Information umfasst als Oberbegriff „Geheimnisse“ i.S.v. § 203 StGB sowie personenbezogene Daten im Sinne des Datenschutzrechts. Bei der Bestimmung des Personenbezuges ist es trotz der grundsätzlichen Parallelgeltung von Datenschutzrecht und § 203 StGB zulässig, auf Grundsätze aus dem Datenschutzrecht zurückzugreifen. Für den Outsourcer medizinischer Daten droht eine Strafbarkeit nach § 203 StGB, wenn private IT-Dienstleistungsunternehmen vom schweigepflichtigen Outsourcer zur Erledigung von Aufgaben herangezogen werden und in Kontakt mit den Geheimnissen geraten. Daneben kann sich eine Strafbarkeit im Wege der Teilnahme an einer nach § 203 StGB strafbaren Geheimnisverletzung ergeben. Bei Sachverhalten mit Auslandsbezug kann es dabei zu einer Anwendung deutschen Strafrechts kommen, wenn die Teilnahmehandlung im Inland sich auf ein im Ausland erfolgendes Outsourcing bezieht oder die Teilnahmehandlung im Ausland sich auf ein im Inland erfolgendes Outsourcing bezieht. Bei § 85a SGB X und § 44 BDSG können sich ausländische Outsourcingpartner auch als Mittäter strafbar machen, da es sich bei diesen Delikten nicht um Sonderdelikte handelt. Allerdings lässt sich durch eine entsprechende Gestaltung des Outsourcingvorhabens im Einzelfall, unabhängig davon, ob ein Schweigepflichtiger nach § 203 Abs. 1 oder Abs. 2 StGB betroffen ist, eine Strafbarkeit vermeiden. Ansatz ist dabei die Tatbestandsebene des § 203 StGB, nämlich das Merkmal „Geheimnis“ sowie das Merkmal „Offenbaren“. So kann einerseits durch eine wirksame Verschlüsselung ein „Geheimnis“ i.S.v. § 203 StGB entfallen. Andererseits besteht die Möglichkeit, Mitarbeiter des privaten externen Dienstleistungsunternehmens als Gehilfen in den Kreis der zum Wissen Berufenen zu integrieren. Hierzu muss der Dritte an die Funktion des Schweigepflichtigen so angebunden werden, dass aus objektiv-normativer Sicht von einer tatbestandlichen Verantwortungseinheit gesprochen werden kann. Auf der Ebene der Rechtswidrigkeit lässt sich der Gefahr einer Strafbarkeit nach § 203 StGB durch eine Einwilligung begegnen. Außerhalb des Rechtfertigungsgrundes der Einwilligung bestehen für das Outsourcing von medizinischen Daten regelmäßig keine strafrechtlichen Erlaubnissätze. Allenfalls in unvorhergesehenen Ausnahmesituationen ist eine Rechtfertigung nach § 34 StGB denkbar. Für den Regelfall des Outsourcings ist § 34 StGB nicht als Rechtfertigungsgrund tauglich. Neben einer Strafbarkeit nach § 203 StGB kommt beim Outsourcing medizinischer Daten eine Strafbarkeit nach § 44 BDSG bzw. nach entsprechenden Vorschriften der Landesdatenschutzgesetze sowie eine Strafbarkeit nach § 85a SGB X in Betracht. Die Gefahr einer Strafbarkeit kann ausgeschlossen werden, wenn das Outsourcing datenschutzrechtlich bzw. sozialrechtlich zulässig ist. Neben der Möglichkeit einer Einwilligung, die nur ausdrücklich erfolgen kann, ist die Zulässigkeit eines Outsourcings medizinischer Daten über eine Ausgestaltung als Auftragsdatenverarbeitung erreichbar. Vorschriften zur Auftragsdatenverarbeitung existieren sowohl im Datenschutzrecht als auch im Sozialrecht. Diese Vorschriften ermöglichen, sofern nicht spezielle Vorschriften des sektorspezifischen Datenschutzrechts wie beispielsweise Art. 27 Bayerisches Krankenhausgesetz entgegenstehen, in bestimmten Grenzen ein Outsourcing medizinischer Daten unter Beteiligung privater IT-Dienstleistungsunternehmen. Die Normen der Auftragsdatenverarbeitung ermöglichen nicht eine selbständige und eigenverantwortliche Aufgabenerfüllung durch den Outsourcingnehmer im Sinne einer Funktionsübertragung. Vielmehr muss der Outsourcer nach einer Gesamtbetrachtung das Gesamtgeschehen erkennbar beherrschen und steuern. Die Aufgabe darf nicht durch den Auftraggeber insgesamt aus den Händen gegeben werden. Andere Vorschriften, die eine Funktionsübertragung beim Outsourcing medizinischer Daten ermöglichen würden, bestehen nicht. Die straflose Möglichkeit des Outsourcings medizinischer Daten hängt von der Gestaltung im Einzelfall ab. Dies kann unter dem Aspekt der Rechtssicherheit und Rechtsklarheit beklagt werden. Wünschenswert ist eine bundeseinheitliche Regelung, die das Outsourcing strafrechtlich regelt. Unter den verschiedenen gesetzgeberischen Möglichkeiten ist eine Neuregelung des § 203 StGB zu favorisieren. N2 - Following the present analysis, from a criminal law perspective, on outsourcing medical data, the following overall result can be recorded. When outsourcing medical data, personal information is routinely affected. Under the umbrella term "secrets”, personal data includes personal information in terms of § 203 of the Criminal Code (StGB) as well as personal data in terms of the data protection act. When defining personal reference it is permitted, in spite of the basic parallel validity of the data protection act and § 203 StGB, to refer to principles from the data protection act. For the outsourcer of medical data, there is a risk of culpability pursuant to § 203 StGB if private IT service companies are enlisted by the outsourcer, who is sworn to secrecy, to fulfil tasks and come in contact with secrets. In addition, culpability can result from participating in a breach of secrecy that is punishable pursuant to § 203 StGB. For facts and circumstances involving a foreign element, this can result in German criminal law being applied if the domestic participation deed refers to outsourcing that is taking place abroad, or if the participation deed abroad refers to outsourcing that is taking place inland. For § 85a Social Act X (SGB X) and § 44 Federal Data Protection Act (BDSG), foreign outsourcing partners can also be liable to prosecution as co-perpetrators, as these delicts are not special delicts. However, culpability can be avoided by means of a corresponding configuration of the outsourcing proposal in a given case, regardless of whether a person sworn to secrecy pursuant to § 203 para. 1 or para. 2 StGB is affected. The objective here is the basis of the facts of the case of § 203 StGB, in particular the characteristic "secret" as well as the characteristic "disclosure". Thus, on the one hand, a "secret" in terms of § 203 StGB can be cancelled by effective encryption. On the other hand, there is the option of integrating employees working for the private external service companies into the circle of authorized persons as assistants. For this purpose, the third party must be tied to the function of the person sworn to secrecy such that, from an objective-normative point of view, it can be referred to as a factual responsibility unit. On the level of unlawfulness, the risk of culpability can be met pursuant to § 203 StGB by consent. Outside of the grounds of justification of consent, there are consistently no criminal consent principles for outsourcing medical data. In unforeseen exceptional situations, justification pursuant to § 34 StGB is conceivable, at best. § 34 StGB is not a suitable ground of justification for the typical outsourcing case. Apart from culpability pursuant to § 203 StGB, culpability pursuant to § 44 BDSG resp. pursuant to relevant provisions of the Federal Data Protection Act, as well as culpability pursuant to § 85a SGB X, comes into consideration for outsourcing of medical data. The risk of culpability can be ruled out if outsourcing is permitted by data protection or social legislation. Apart from the possibility of consent which can only be obtained expressly, the admissibility of outsourcing medical data can be achieved by commissioning the data processing. There are regulations on commissioning data processing both in data protection as well as in social legislation. These regulations allow for the outsourcing of medical data up to a certain point, unless they are opposed by specific regulations of the branch-specific data protection law, such as for example Art. 27 of the Bavarian Hospital Law, with the participation of private IT service companies. The norms of commissioned data processing do not allow the outsourcee to independently and autonomously fulfil tasks, in terms of a transfer of functions. Instead, the outsourcer must discernibly be in control of and direct the overall events following an overall inspection. The employer must not let the task slip away completely. There are no other regulations that would facilitate transfer of functions for outsourcing medical data. Outsourcing medical data with impunity depends on the configuration in a given case. This can be criticised in terms of legal security and legal clarity. A uniform federal criminal law regulation that controls outsourcing is desirable. Out of the various legislative options, reorganisation of § 203 StGB should be favoured. KW - Schweigepflicht KW - Strafbarkeit KW - Strafrecht KW - Daten KW - Gehilfe KW - Medizin KW - Outsourcing KW - Outsourcing KW - Data KW - Culpability KW - Protection KW - Assistant Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-28917 ER - TY - THES A1 - Betz, Christian T1 - Scalable authoring of diagnostic case based training systems T1 - Skalierbare Erstellung diagnostischer fallbasierter Trainingssysteme N2 - Diagnostic Case Based Training Systems (D-CBT) provide learners with a means to learn and exercise knowledge in a realistic context. In medical education, D-CBT Systems present virtual patients to the learners who are asked to examine, diagnose and state therapies for these patients. Due a number of conflicting and changing requirements, e.g. time for learning, authoring effort, several systems were developed so far. These systems range from simple, easy-to-use presentation systems to highly complex knowledge based systems supporting explorative learning. This thesis presents an approach and tools to create D-CBT systems from existing sources (documents, e.g. dismissal records) using existing tools (word processors): Authors annotate and extend the documents to model the knowledge. A scalable knowledge representation is able to capture the content on multiple levels, from simple to highly structured knowledge. Thus, authoring of D-CBT systems requires less prerequisites and pre-knowledge and is faster than approaches using specialized authoring environments. Also, authors can iteratively add and structure more knowledge to adapt training cases to their learners needs. The theses also discusses the application of the same approach to other domains, especially to knowledge acquisition for the Semantic Web. N2 - Fallbasierte diagnostische Trainingssysteme (FDT) ermöglichen es Lernern, Wissen durch Anwendung in einem realistischen Kontext zu erwerben und zu festigen. In der medizinischen Ausbildung präsentieren FDT Systeme virtuelle Patienten, an denen der Lerner die Auswahl und Interpretation der richtigen Untersuchungen, die Diagnostik und die Bestimmung geeigneter Therapien erlernen und üben kann. Eine Vielzahl von Anforderungen durch die Lerner und die Autoren solcher Systeme hat zur Entwicklung unterschiedlicher Trainingsumgebungen geführt. Darunter gibt es einfache, präsentationsorientierte Systeme ebenso wie komplexe wissensbasierte Systeme, die exploratives Lernern erlauben. Diese Dissertation untersucht einen Ansatz und Werkzeuge, um FDT Systeme aus vorhandenen Daten (d.h. Dokumenten, beispielsweise Entlassschreiben) und mit Hilfe bekannter Werkzeuge (d.h. Textverarbeitung) zu entwickeln: Die Autoren annotieren dazu die Dokumente, um die Fälle zu modellieren. Eine skalierbare Wissensrepräsentation kann das so extrahierte Wissen auf verschiedenen Ebenen erfassen, angefangen mit unstrukturierten Elementen bis zu Wissensmodellen mit kausalen Beziehungen. Autoren können mit Hilfe des vorgestellten Ansatzes fallbasierte diagnostische Trainingssysteme mit geringerem Vorwissen und schneller erstellen als mit Hilfe spezialisierter Autorensysteme. Dabei können die Autoren insbesondere die Fälle sukzessive mit weiterem Wissen anreichern und so auf die Anforderungen ihrer Lerner anpassen. In der Dissertation wird darüber hinaus die Anwendung des Ansatzes und der entstandenen Werkzeuge auf andere Domänen untersucht. Besonders interessant ist dabei die Anwendung in der Wissensakquisition für das Semantic Web. KW - Computerunterstütztes Lernen KW - Medizin KW - Wissensrepräsentation KW - Trainingssystem KW - agile Prozesse KW - Semantic Web KW - d3web.Train KW - knowledge representation KW - training systems KW - agile processes KW - semantic web KW - d3web.Train Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-17885 ER - TY - THES A1 - Leidig, Dorothée T1 - Frauenheilkunde in volkssprachigen Arznei- und Kräuterbüchern des 12. bis 15. Jahrhunderts : eine empirische Untersuchung T1 - Gynaecology in 12th to 15th century pharmacopoeiae and herbaria in the vernacular. An empirical study. N2 - Die Arznei- und Kräuterbücher des Mittelalters enthalten eine große Zahl frauenheilkundlicher Rezepte. Da die Rezepte jedoch unsystematisch und weit verstreut vorliegen, konnten bislang nur bedingt qualifizierte Schlußfolgerungen - etwa über die Häufigkeit bestimmter Indikationen - gezogen werden. Die Verfasserin hat aus einem repräsentativen Querschnitt von 27 als Edition vorliegenden Arznei- und Kräuterbüchern rund 900 Rezepte quantitativ und qualitativ ausgewertet. Dabei wurde u.a. nach der Häufigkeit der einzelnen Indikationen, Anwendungen und Heilmitteln, nach der Wirksamkeit der empfohlenen Behandlungen, nach der Rolle der Patientin sowie nach überlieferungsgeschichtlichen Entwicklungen gefragt. Einige der interessantesten Ergebnisse: Die blutungsfördernden (emmenagogen) Rezepte stellen mit Abstand die größte Indikationsgruppe dar, wobei oft klar zwischen solchen Rezepten unterschieden wird, die eine Blutung zum Zwecke der Gebärmutterreinigung auslösen und solchen, die eine Menstruationsblutung herbeiführen wollen. Aus pharmakologischer Sicht ist die Grenze zwischen menstruationsfördernden und abortiven Rezepten fließend. Die Auswertung ihrer Wirksamkeit und ihres Kontextes zeigt, daß bei mehr als 10% der untersuchten Rezepte Kenntnisse über Abortivmittel und ihrer Anwendungen sicher vorausgesetzt werden können. Unter den treibenden Rezepten fand sich der größte Anteil an Verordnungen, die aus heutiger Sicht medizinisch wirksam sind. Bei den Gebärmutter- und Brusterkrankungen dagegen zeigt sich große Ratlosigkeit in Diagnose und Behandlung. Ein wichtiges Ergebnis ist die im Rahmen der Untersuchung aufgebaute Datenbank. Sie ist in Form zweier Tabellen abgebildet. Außerdem ist jedes Rezept im Wortlaut abgedruckt und mit einem Kommentar zu Indikation, Inhaltsstoffen, Anwendung, Parallelüberlieferungen und Besonderheiten versehen. Man kann nun frauenheilkundliche Rezepte nicht edierter Handschriften oder noch nicht ausgewerteter Editionen mit dem umfangreichen Datenbestand vergleichen, ohne sich durch Hunderte von Textseiten arbeiten zu müssen. Die Datenbank soll weiter ausgebaut und - sofern sich die nötige Unterstützung dazu findet - auch elektronisch zugänglich gemacht werden. N2 - Mediæval pharmacopœiae and herbaria contain a large number of recipes and remedies for gynaecological disorders. However, since these recipes were scattered over a wide area and only available in unsystematic order, it has merely been possible to draw vague conclusions from them, for example on the frequency of certain indications. The author of this study has conducted quantitative and qualitative evaluations of some 900 recipes and remedies culled from a representative cross-section of 27 pharmacopœiae and herbaria extant in book form. In so doing, questions were raised, amongst others, on the frequency of the various indications, applications and remedies, the efficacy of the treatments recommended, the rôle of the patient and the historical developments handed down. Some of the most interesting results are given here: The emmenagogic recipes and remedies (i.e. to promote and expedite menstruation) are by far the largest group of indications. Here, clear differentiation is often made between such remedies and recipes which trigger haemorrhaging with the object of purging the womb and those with the object of inducing menstruation. From the pharmacological point of view, the boundary between remedies and recipes promoting menstruation and those ecbolic in nature is blurred. Evaluation of their efficacy and their context shows that, in more than 10% of the recipes and remedies examined, it can be readily assumed that these were based on knowledge of abortifacients and ecbolics and their applications. The largest percentage of prescribed remedies, which are medically efficient from today’s point of view, can be found amongst the emmenagogues and abortifacient remedies and recipes. On the other hand, there is some evidence of much perplexity in the diagnosis and treatment of womb and breast disorders. One significant result of this study has been the databank compiled within the scope of the study itself. The database is shown in the form of two tables. In addition, each remedy/recipe is copied in the original wording with the provision of a commentary on indications, composition, applications, parallel traditions, and peculiar features. It is now possible to compare gynaecological recipes and remedies contained in unpublished manuscripts or in publications not yet evaluated with the extensive information contained in the database without having to wade through hundreds of pages of text. It is intended to continue to expand the database and – in as far as the necessary support can be found – made accessible electronically. KW - Gynäkologie KW - Arzneibuch KW - Geschichte 1100-1500 KW - Mittelalter KW - Medizin KW - Frau KW - Abtreibung KW - Arzneibuch KW - Volksheilkunde KW - Middle Ages KW - Medicine KW - Woman KW - Abortion KW - Popular Medicine Y1 - 2004 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-15347 ER -