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Institute
- Theodor-Boveri-Institut für Biowissenschaften (86)
- Medizinische Klinik und Poliklinik I (46)
- Physikalisches Institut (44)
- Universität Würzburg (41)
- Graduate School of Life Sciences (39)
- Institut für Psychologie (35)
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie (34)
- Julius-von-Sachs-Institut für Biowissenschaften (32)
- Institut für Pharmazie und Lebensmittelchemie (24)
- Institut für Molekulare Infektionsbiologie (22)
- Medizinische Klinik und Poliklinik II (21)
- Rudolf-Virchow-Zentrum (21)
- Pathologisches Institut (20)
- Neurologische Klinik und Poliklinik (19)
- Medizinische Fakultät (18)
- Lehrstuhl für Orthopädie (17)
- Kinderklinik und Poliklinik (16)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (16)
- Institut für Physikalische und Theoretische Chemie (15)
- Institut für Theoretische Physik und Astrophysik (15)
- Institut für Virologie und Immunbiologie (15)
- Institut für Geographie und Geologie (14)
- Institut für Anorganische Chemie (13)
- Universität - Fakultätsübergreifend (13)
- Institut für Humangenetik (11)
- Institut für Hygiene und Mikrobiologie (11)
- Institut für Mathematik (11)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (11)
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie (11)
- Frauenklinik und Poliklinik (10)
- Institut für Organische Chemie (10)
- Institut für Pharmakologie und Toxikologie (10)
- Klinik und Poliklinik für Strahlentherapie (10)
- Physiologisches Institut (10)
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (9)
- Lehrstuhl für Biochemie (9)
- Augenklinik und Poliklinik (8)
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen (8)
- Institut für Informatik (7)
- Philosophische Fakultät (Histor., philolog., Kultur- und geograph. Wissensch.) (7)
- Abteilung für Molekulare Innere Medizin (in der Medizinischen Klinik und Poliklinik II) (6)
- Institut für Anatomie und Zellbiologie (6)
- Institut für Klinische Epidemiologie und Biometrie (6)
- Institut für Klinische Neurobiologie (6)
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (6)
- Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie (6)
- Medizinische Klinik (bis 2004) (6)
- Neuphilologisches Institut - Moderne Fremdsprachen (6)
- Neurochirurgische Klinik und Poliklinik (6)
- Betriebswirtschaftliches Institut (5)
- Institut für Funktionsmaterialien und Biofabrikation (5)
- Institut für Medizinische Strahlenkunde und Zellforschung (5)
- Institut für deutsche Philologie (5)
- Klinik und Polikliniken für Zahn-, Mund- und Kieferkrankheiten (5)
- Fakultät für Biologie (4)
- Fakultät für Chemie und Pharmazie (4)
- Klinik und Poliklinik für Nuklearmedizin (4)
- Lehrstuhl für Tissue Engineering und Regenerative Medizin (4)
- Missionsärztliche Klinik (4)
- Poliklinik für Kieferorthopädie (4)
- Poliklinik für Zahnerhaltung und Parodontologie (4)
- Urologische Klinik und Poliklinik (4)
- Deutsches Zentrum für Herzinsuffizienz (DZHI) (3)
- Fakultät für Physik und Astronomie (3)
- Institut für Biblische Theologie (3)
- Institut für Geschichte (3)
- Institut für Klinische Biochemie und Pathobiochemie (3)
- Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II) (3)
- Fakultät für Humanwissenschaften (Philos., Psycho., Erziehungs- u. Gesell.-Wissensch.) (2)
- Institut Mensch - Computer - Medien (2)
- Institut für Historische Theologie (2)
- Institut für Musikforschung (2)
- Institut für Praktische Theologie (2)
- Institut für Psychologie (bis Sept. 2007) (2)
- Institut für Psychotherapie und Medizinische Psychologie (2)
- Institut für Pädagogik (2)
- Lehrstuhl für Molekulare Psychiatrie (2)
- Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde (1)
- Comprehensive Cancer Center Mainfranken (1)
- Institut für Altertumswissenschaften (1)
- Institut für Bürgerliches Recht und Zivilprozessrecht (1)
- Institut für Experimentelle Biomedizin (1)
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- Institut für Internationales Recht, Europarecht und Europäisches Privatrecht (1)
- Institut für Kulturwissenschaften Ost- und Südasiens (1)
- Institut für Politikwissenschaft und Soziologie (1)
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- Klinik und Poliklinik für Thorax-, Herz- u. Thorakale Gefäßchirurgie (1)
- Rechenzentrum (1)
- Volkswirtschaftliches Institut (1)
- Wirtschaftswissenschaftliche Fakultät (1)
Schriftenreihe
Sonstige beteiligte Institutionen
- Center for Interdisciplinary Clinical Research, Würzburg University, Würzburg, Germany (2)
- Orthopädische Klinik und Poliklinik der Universität Würzburg (2)
- Bavarian Center for Applied Energy Research (ZAE Bayern), 97074 Würzburg, Germany (1)
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut fuer biophysikalische Chemie (1)
- Blindeninstitut, Ohmstr. 7, 97076, Wuerzburg, Germany (1)
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany (1)
- DNA Analytics Core Facility, Biocenter, University of Wuerzburg, Wuerzburg, Germany (1)
- Deakin University, Australia (1)
- Department of Pediatrics, Pediatrics I, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria (1)
- EMBL, Structural and Computational Biology Unit, Heidelberg, Germany (1)
ResearcherID
- D-1250-2010 (1)
- N-7500-2014 (1)
Trisomy 22 is a common trisomy in spontaneous abortions. In contrast, live-born trisomy 22 is rarely seen due to severe organ malformations associated with this condition. Here, we report on a male infant with complete, non-mosaic trisomy 22 born at 35 + 5 weeks via caesarean section. Peripheral blood lymphocytes and fibroblasts showed an additional chromosome 22 in all metaphases analyzed (47,XY,+22). In addition, array CGH confirmed complete trisomy 22. The patient’s clinical features included dolichocephalus, hypertelorism, flattened nasal bridge, dysplastic ears with preauricular sinuses and tags, medial cleft palate, anal atresia, and coronary hypospadias with scrotum bipartitum. Essential treatment was implemented in close coordination with the parents. The child died 29 days after birth due to respiratory insufficiency and deterioration of renal function. Our patient’s history complements other reports illustrating that children with complete trisomy 22 may survive until birth and beyond.
Objectives: The purpose of this study was to investigate the development of lateralization skills in children who received bilateral cochlear implants (CIs) in sequential operations. Methods: The lateralization skills of 9 children with a mean age of 4.1 years at the first surgery and 5.5 years at the second surgery were assessed at 3 time intervals. Children were assessed with a 3-loudspeaker setup (front, left and right) at 0.9 years (interval I) and 1.6 years (interval II) after the second implantation, and after 5.3 years of bilateral implant use (interval III) with a 9-loudspeaker setup in the frontal horizontal plane between -90° and 90° azimuth. Results: With bilateral implants, a significant decrease in lateralization error was noted between test interval I (45.0°) and II (23.3°), with a subsequent significant decrease at test interval III (4.7°). Unilateral performance with the CI did not improve significantly between the first 2 intervals; however, there was a bias of responses towards the unilateral side by test interval III. Conclusions: The lateralization abilities of children with bilateral CIs develop in a relatively short period of time (1-2 years) after the second implant. Children appear to be able to acquire binaural skills after bilateral cochlear implantation.
Auditory Brainstem Implantation Improves Speech Recognition in Neurofibromatosis Type II Patients
(2013)
This prospective study aimed to determine speech understanding in neurofibromatosis type II (NF2) patients following implantation of a MED-EL COMBI 40+ auditory brainstem implant (ABI). Patients (n = 32) were enrolled postsurgically. Nonauditory side effects were evaluated at fitting and audiological performance was determined using the Sound Effects Recognition Test (SERT), Monosyllable-Trochee-Polysyllable (MTP) test and open-set sentence tests. Subjective benefits were determined by questionnaire. ABI activation was documented in 27 patients, 2 patients were too ill for testing and 3 patients were without any auditory perception. SERT and MTP outcomes under auditory-only conditions improved significantly between first fitting and 12-month follow-up. Open-set sentence recognition improved from 5% at first fitting to 37% after 12 months. The number of active electrodes had no significant effect on performance. All questionnaire respondents were ‘satisfied' to ‘very satisfied' with their ABI. An ABI is an effective treatment option in NF2 patients with the potential to provide open-set speech recognition and subjective benefits. To our knowledge, the data presented herein is exceptional in terms of the open-set speech perception achieved in NF2 patients.
Background: Chronic kidney disease (CKD) associated with type 2 diabetes mellitus constitutes a global epidemic complicated by considerable renal and cardiovascular morbidity and mortality, despite the provision of inhibitors of the renin-angiotensin-aldosterone system (RAAS). Bardoxolone methyl, a synthetic triterpenoid that reduces oxidative stress and inflammation through Nrf2 activation and inhibition of NF-κB was previously shown to increase estimated glomerular filtration rate (eGFR) in patients with CKD associated with type 2 diabetes mellitus. To date, no antioxidant or anti-inflammatory therapy has proved successful at slowing the progression of CKD. Methods: Herein, we describe the design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes: the Occurrence of Renal Events (BEACON) trial, a multinational, multicenter, double-blind, randomized, placebo-controlled Phase 3 trial designed to determine whether long-term administration of bardoxolone methyl (on a background of standard therapy, including RAAS inhibitors) safely reduces renal and cardiac morbidity and mortality. Results: The primary composite endpoint is time-to-first occurrence of either end-stage renal disease or cardiovascular death. Secondary endpoints include the change in eGFR and time to occurrence of cardiovascular events. Conclusion: BEACON will be the first event-driven trial to evaluate the effect of an oral antioxidant and anti-inflammatory drug in advanced CKD.
The psychology of eating
(2013)
Two studies are reported that investigate how readily accessible and applicable ten force-dynamic categories are to novices in describing short episodes of human-technology interaction (Study 1) and that establish a measure of inter-coder reliability when re-classifying these episodes into force-dynamic categories (Study 2). The results of the first study show that people can easily and confidently relate their experiences with technology to the definitions of force-dynamic events (e.g. “The driver released the handbrake” as an example of restraint removal). The results of the second study show moderate agreement between four expert coders across all ten force-dynamic categories (Cohen’s kappa = .59) when re-classifying these episodes. Agreement values for single force-dynamic categories ranged between ‘fair’ and ‘almost perfect’, i.e. between kappa = .30 and .95. Agreement with the originally intended classifications of study 1 was higher than the pure inter-coder reliabilities. Single coders achieved an average kappa of .71, indicating substantial agreement. Using more than one coder increased kappas to almost perfect: up to .87 for four coders. A qualitative analysis of the predicted versus the observed number of category confusions revealed that about half of the category disagreement could be predicted from strong overlaps in the definitions of force-dynamic categories. From the quantitative and qualitative results, guidelines are derived to aid the better training of coders in order to increase inter-coder reliability.
Kein Abstract verfügbar.
AbstractUne tradition grammaticale largement répandue distingue trois types de relations entre propositions, donc trois types de phrases complexes: les propositions juxtaposées, les propositions coordonnées et les phrases hypotaxiques. Riegel et al. (2009) ajoutent en outre les phrases avec incise ou incidente comme quatrième type. Les grammaires et traités décrivent les différentes sortes de coordination (copulative, disjonctive, adversative, causale et consécutive) et de subordination (complétive, relative et circonstancielle). Pourtant, jusqu’à présent il n’existe pas, à ce qu’il semble, de description plus détaillée, ni des divers degrés de l’hypotaxe et de la parataxe d’une part, ni des différentes combinaisons de structures hypotaxiques et parataxiques d’autre part. Le but de cet article est donc de proposer une typologie plus complète des phrases complexes sur la base d’un petit corpus de référence. Cette typologie distinguera, d’un côté, divers degrés de phrases parataxiques homogènes et de phrases parataxiques hétérogènes et, de l’autre côté, des phrases hypotaxiques simples et des phrases hypotaxiques multiples.
Interplanetary shocks are believed to play an important role in the acceleration of charged particles in the heliosphere. While the acceleration to high energies proceeds via the diffusive mechanism at the scales exceeding by far the shock width, the initial stage (injection) should occur at the shock itself. Numerical tracing of ions is done in a model quasi-perpendicular shock front with a typical interplanetary shock parameters (Mach number, upstream ion temperature). The analysis of the distribution of the transmitted solar wind is used to adjust the cross-shock potential which is not directly measured. It is found that, for typical upstream ion temperatures, acceleration of the ions from the tail of the solar wind distribution is unlikely. Pickup ions with a shell distribution are found to be effectively energized and may be injected into further diffusive acceleration regime. Pre-accelerated ions are efficiently upscaled in energies. A part of these ions is returned to the upstream region where they can further be diffusively accelerated.
Lieferketten im Einzelhandel
(2013)
Lieferketten im Einzelhandel haben sich in den letzten Jahren stark gewandelt. Die wachsenden Marktanteile von Einzelhandelsunternehmen oder -genossenschaften, die größer werdenden Einzelhandelsformate und die Erweiterung der Produktbreite und -tiefe führten zu früher kaum vorstellbaren Quantitäten. Gleichzeitig haben die Einführung von Informationstechnologie, die intensive Kooperation zwischen Händlern und Lieferanten durch Informationsaustausch oder vertikale Integration von Teilen der Lieferketten sowie die globale Ausbreitung von Lieferbeziehungen Prozesse des Supply-Chain-Managements auch qualitativ erheblich verändert. Parallel dazu wurden Ansätze entwickelt, wie diese Entwicklungen analysiert und konzeptionalisiert werden können. Dabei haben Analyserahmen wie die Ansätze der Globalen Warenketten oder der Globalen Produktionsnetzwerke die komplexe Aufgabe, Prozesse zu erfassen, die einerseits immer globaler werden, andererseits lokal und regional stark eingebettet sind. Vor diesem Hintergrund stellt der vorliegende Band aktuelle Forschungsergebnisse aus einer geographischen Perspektive vor. Insgesamt acht Beiträge beleuchten Lieferketten im Einzelhandel aus unterschiedlichen theoretischen Perspektiven und analysieren Fallstudien aus Australien, Deutschland, Indien, Südafrika und den USA. Dabei bezieht sich ein Großteil der Beiträge auf den Handel mit Lebensmitteln.
Mit Projektentwicklung, Vermarktung und Management von Handelsimmobilien beschäftigt sich eine wachsende Zahl von Berufsgeographen, jedoch nur ein überschaubarer Kreis von Forschern. Zwar ist unbestritten, dass der stationäre Handel als Betriebsmittel eine Verkaufsfläche braucht und klar definierte Ansprüche an ihre Gestaltung, ihren Zuschnitt und ihren Standort stellt. Jedoch überdeckt die Tatsache, dass der Handel diese Fläche nackt mietet und die für den Konsumenten sichtbare Kaufumgebung selbst stellt, gestaltet und laufend renoviert, ihren immobilien¬wirtschaft-lichen Charakter. Zudem trägt dazu bei, mit der Nennung der Betriebsform auch die zugehörige Immobilie zu bezeichnen.
Da aber gerade die Projektentwicklung einer Handelsimmobilie und ihr späteres Management über den Erfolg des Hauptnutzers entscheiden, verfolgt der vorliegende Band zwei Ziele: Einerseits führt er in diese Teildisziplin der Immobilienökonomie ein, andererseits vermittelt er einen Ausschnitt des bereits vorliegenden Praxiswissens. So wird im Grundlagenabschnitt für den Teilbereich der Discount- und Fachmarktimmobilien der Nachweis einer eigenständigen Forschungsdisziplin erbracht. Mit der phasenorientierten Betrachtung der Handelsimmobilien wird deren ökonomischer Lebenszyklus nachgezeichnet. Hierbei kommen die verschiedensten Akteure zu Wort, darunter die Öffentliche Planung, der Investor und auch der Eigentümer. Gerade letzteres Beispiel zeigt den entstehenden Interessenkonflikt zwischen den Ansprüchen einer sich dynamisch entwickelnden Handelsnutzung und den nachträglich veränderten Rahmenbedingungen der Bauleitplanung und darauf basierender Einzelhandelsentwicklungs¬konzepte. Funktionsspezifische Aspekte hinterfragen, in wieweit eine innenstädtische Bausubstanz den Anforderungen moderner Handelsunternehmen entspricht. Und unter strategiebezogenen Aspekten sind Beiträge unterschiedlicher Maßstäblichkeit zur Zukunftsperspektive von Handelsimmobilien zusammengefasst. Dabei werden BIDs als eine Initiative von Immobilieneigentümern zur Umfeldverbesserung der Handelsnutzung begriffen und die Investitionen in den Handelsimmobilienbestand von Hauptgeschäftsstraßen als nachhaltiger Beitrag zur Erhaltung der Urbanität aufgezeigt. Der Blick in die zukünftige Gestaltung der Managementimmobilie Shopping-Center gibt die Wechselwirkung mit der gesellschaftlichen Entwicklung und dem Stellenwert von Konsum wieder. Letztlich wird der Einfluss des Online-Handels auf die weitere Handelsimmobilienentwicklung abzuschätzen versucht.
Die Lage(qualität) stellt den wichtigsten Faktor für den Erfolg eines Standorts dar! Dies gilt spätestens seit der Entstehung der ersten Fußgängerzonen in den 1950er Jahren und der Herausbildung der 1A-Lagen als begehrte innerstädtische Unternehmensstandorte.
Verwunderlich ist jedoch, dass trotz einer weitläufigen Bekanntheit des Begriffs der Lage(qualität), bzw. der 1A-, B- und C-Lage, zum aktuellen Zeitpunkt in Theorie und Praxis nicht nur vielfältige Bezeichnungen zur Beschreibung und Klassifizierung innerstädtischer Handelsstandorte, sondern auch eine große Bandbreite an Kriterien und Methodiken bestehen, die zur Qualitätsermittlung herangezogen werden.
Im Hinblick auf die aktuell knappen kommunalen Haushaltsmittel, den steigenden Wettbewerbsdruck im Handel und die zunehmende Krisenanfälligkeit des Wirtschafts-, Finanz- und Immobiliensektors und dem daraus resultierenden Bedeutungszuwachs fundierter Standort- bzw. Lageanalysen, stellt sich die Frage, welche Kriterien aus wissenschaftlicher Sicht zur Ermittlung von Lagequalitäten geeignet sind und wie ein aus diesen bestehendes Instrumentarium auszugestalten ist.
Darüber hinaus ist vor dem Hintergrund der in den letzten Jahren wachsenden Aktivitäten zur Zentrenrevitalisierung zudem zu überprüfen, ob ein solches Lagequalitäteninstrumentarium zur Schaffung einer soliden Datenbasis eingesetzt werden könnte, welche als wesentliche Grundlage zur Evaluierung verschiedener innerstädtischer Wiederbelebungsmaßnahmen fungiert.
Diesen und weiteren im Kontext der aktuellen Innenstadt- und Einzelhandelsentwicklung auftretenden Fragestellungen geht die vorliegende Arbeit nach.
Eine attraktive Innenstadt ist das Aushängeschild jeder Stadt, an deren Entwicklung eine Vielzahl von Akteuren beteiligt ist. Neben den Einzelhändlern und der Verwaltung wurden in den letzten Jahren auch die Immobilieneigentümer als wichtige Akteure in der Stadtentwicklung erkannt. Sie bieten mit ihren Immobilien Standorte, an denen eine Ansiedlung von Einzelhändlern erfolgen kann und beeinflussen durch die Gestaltung ihrer Immobilien sowie durch die Wahl der Mieter und Nutzungen die Attraktivität der Innenstädte. Die Untersuchungen dieser Arbeit konzentrieren sich auf die Bedeutung der Immobilieneigentümer für die Einzelhandelsentwicklung und damit für die Attraktivität der Innenstadt.
Ziel dieser Arbeit ist es, den Einfluss des Eigentümers auf die Handelsimmobilie und damit auf die Attraktivität der Innenstadt am Beispiel der Stadt Würzburg genauer zu untersuchen. Der Fokus liegt auf dem Zusammenhang von Eigenschaften, Zielen und Motiven des Immobilieneigentümers einerseits und dem Zustand der Immobilie andererseits.
Die methodische Vorgehensweise gliedert sich dementsprechend in zwei Untersuchungsansätze. Auf der einen Seite werden Informationen zu den Immobilieneigentümern durch Grundbuchauswertungen und Befragungen erhoben, um eine Typisierung vornehmen zu können. Auf der anderen Seite werden die Anforderungen von Einzelhändlern an innerstädtische Handelsimmobilien herausgearbeitet und in ein Bewertungsmodell überführt. Mit diesem werden die Immobilien im Untersuchungsgebiet hinsichtlich ihrer Eignung für den Einzelhandel bewertet. Aus der Verschneidung dieser beiden Ansätze können dann Aussagen über den Einfluss der Eigentümer auf die Handelsimmobilien und damit auch auf die Attraktivität der Innenstadt abgeleitet werden.
Die vorliegende Untersuchung gilt der Mikro- und Makrotypografie der seit 125 Jahren erscheinenden katholischen Verbandszeitschrift "Academia". Für die graphologischen und paläographischen Besonderheiten wird eine Hermeneutik vorgeschlagen. Das hier erforschte Druckbild repräsentiert mit einer Auflage von 30.000 Exemplaren im achtwöchigen Erscheinungsrhythmus den Cartellverband der Katholischen Deutschen Studentenverbindungen (CV). So illustriert und visualisiert dieses Druckbild mit seiner typografischen Performance zugleich den mitgliederstärksten Akademikerverband Europas.
A proangiogenic micromilieu is associated with a worse prognosis in systemic lymphoma. Hence, targeting the tumour microenvironment and its vasculature has evolved as a promising novel treatment strategy. The role of tumour neoangiogenesis in cutaneous B-cell lymphoma, however, has not yet been elucidated. Therefore, we examined the expression of vascular endothelial growth factor (VEGF) and its receptors VEGFR-1 and VEGFR-2, as well as microvessel density by immunohistochemistry in paraffin-embedded specimens of different subtypes of primary cutaneous B-cell lymphomas, systemic diffuse large B-cell lymphoma, and cutaneous B-cell pseudolymphoma. Primary cutaneous large B-cell lymphoma (PCLBCL) were characterized by significantly higher intratumoral expression levels of VEGF and its receptors in comparison with the indolent lymphoma subtypes. Moreover, PCLBCL exhibited significantly higher intratumoral microvessel counts. Our study provides evidence that the most aggressive subtype of cutaneous B-cell lymphoma, PCLBCL, is characterized by a proangiogenic micromilieu.
Paradigm Shift
(2013)
Neuro-immune alterations in the peripheral and central nervous system play a role in the pathophysiology of chronic pain, and non-coding RNAs – and microRNAs (miRNAs) in particular – regulate both immune and neuronal processes. Specifically, miRNAs control macromolecular complexes in neurons, glia and immune cells and regulate signals used for neuro-immune communication in the pain pathway. Therefore, miRNAs may be hypothesized as critically important master switches modulating chronic pain. In particular, understanding the concerted function of miRNA in the regulation of nociception and endogenous analgesia and defining the importance of miRNAs in the circuitries and cognitive, emotional and behavioral components involved in pain is expected to shed new light on the enigmatic pathophysiology of neuropathic pain, migraine and complex regional pain syndrome. Specific miRNAs may evolve as new druggable molecular targets for pain prevention and relief. Furthermore, predisposing miRNA expression patterns and inter-individual variations and polymorphisms in miRNAs and/or their binding sites may serve as biomarkers for pain and help to predict individual risks for certain types of pain and responsiveness to analgesic drugs. miRNA-based diagnostics are expected to develop into hands-on tools that allow better patient stratification, improved mechanism-based treatment, and targeted prevention strategies for high risk individuals.
Singapore has a unique and proactive approach towards managing the national transport system. This article explores the integrative approach of carsharing into the overall transport system from an individual sustainable mobility perspective. The authors argue that for Singapore, taxi services are the strongest competitor for the establishment of free-floating carsharing systems. Low taxi fares and a high distribution rate provide easy access for consumers and show great advantages in correspondence with the prevalent transport measures. Furthermore, the Singaporean government considers taxi services as part of public transport that helps bridging public transportation gaps in door-to-door travel. The article draws on literature review and expert interviews to evaluate the current market conditions and analyse the pros and cons of carsharing systems and taxi services as integrated part of the public transport system. The authors conclude by stating that from a sustainable perspective, the goal is to replace private car ownership. Provision of multi modal choices and therefore co-existence of different individual transport opportunities is indispensable.
Systemic treatment of metastatic uveal melanoma: review of literature and future perspectives
(2013)
Up to 50% of patients with uveal melanoma develop metastatic disease with poor prognosis. Regional, mainly liver-directed, therapies may induce limited tumor responses but do not improve overall survival. Response rates of metastatic uveal melanoma (MUM) to systemic chemotherapy are poor. Insights into the molecular biology of MUM recently led to investigation of new drugs. In this study, to compare response rates of systemic treatment for MUM we searched Pubmed/Web of Knowledge databases and ASCO website (1980–2013) for “metastatic/uveal/melanoma” and “melanoma/eye.” Forty studies (one case series, three phase I, five pilot, 22 nonrandomized, and two randomized phase II, one randomized phase III study, data of three expanded access programs, three retrospective studies) with 841 evaluable patients were included in the numeric outcome analysis. Complete or partial remissions were observed in 39/841 patients (overall response rate [ORR] 4.6%; 95% confidence intervals [CI] 3.3–6.3%), no responses were observed in 22/40 studies. Progression-free survival ranged from 1.8 to 7.2, median overall survival from 5.2 to 19.0 months as reported in 21/40 and 26/40 studies, respectively. Best responses were seen for chemoimmunotherapy (ORR 10.3%; 95% CI 4.8–18.7%) though mainly in first-line patients. Immunotherapy with ipilimumab, antiangiogenetic approaches, and kinase inhibitors have not yet proven to be superior to chemotherapy. MEK inhibitors are currently investigated in a phase II trial with promising preliminary data. Despite new insights into genetic and molecular background of MUM, satisfying systemic treatment approaches are currently lacking. Study results of innovative treatment strategies are urgently awaited.
Role of Hypoxia-Inducible Factor (HIF) 1α in Dendritic Cells in Immune Regulation of Atherosclerosis
(2013)
Atherosclerosis is the underlying cause of cardiovascular diseases and a major threat to human health worldwide. It involves not only accumulation of lipids in the vessel wall but a chronic inflammatory response mediated by highly specific cellular and molecular responses. Macrophages and dendritic cells (DCs) play an essential role in taking up modified lipids and presenting them to T and B lymphocytes, which promote the immune response. Enhanced activation, migration and accumulation of inflammatory cells at the local site leads to formation of atherosclerotic plaques.
Atherosclerotic plaques become hypoxic due to reduced oxygen diffusion and high metabolic demand of accumulated cells. The various immune cells experience hypoxic conditions locally and inflammatory stimuli systemically, thus up-regulating Hypoxia-inducible factor 1α. Though the role of HIF1α in macrophages and lymphocytes has been elucidated, its role in DCs still remains controversial, especially with respect to atherosclerosis. In this project work, the role of HIF1α in DCs was investigated by using a cell specific knockout mouse model where HIF1α was deleted in CD11c+ cells.
Aortic root sections from atherosclerotic mice showed presence of hypoxia and up-regulation of HIF1α which co-localized with CD11c+ cells. Atherosclerotic splenic DCs also displayed enhanced expression of HIF1α, proving non-hypoxic stimulation of HIF1α due to systemic inflammation. Conditional knockout (CKO) mice lacking HIF1α in CD11c+ cells, under baseline conditions did not show changes in immune responses suggesting effects of HIF1α only under inflammatory conditions. When these mice were crossed to the Ldlr-/- line and placed on 8 weeks of high fat diet, they developed enhanced plaques with higher T-cell infiltration as compared to the wild-type (WT) controls. The plaques were of a complex phenotype, defined by increased percent of smooth muscle cells (SMCs) and necrotic core area and reduced percent of macrophages and DCs. The mice also displayed enhanced T-cell activation and a Th1 bias in the periphery.
The CKO DCs themselves exhibited increased expression of IL 12 and a higher capacity to proliferate and polarize naive T cells to the Th1 phenotype in vitro. The DCs also showed decreased expression of STAT3, in line with the inhibitory effects of STAT3 on DC activation seen in previous studies. When STAT3 was overexpressed in DCs in vitro, IL 12 was down-regulated, but its expression increased significantly on STAT3 inhibition using a mutant vector. In addition, when STAT3 was overexpressed in DCs in vivo using a Cre regulated lentiviral system, the mice showed decreased plaque formation compared to controls. Interestingly, the effects of STAT3 modulation were similar in WT and CKO mice, intending that STAT3 lies downstream of HIF1α. Finally, using a chromatin immunoprecipitation assay (ChIP), it was confirmed that HIF1α binds to hypoxia responsive elements (HREs) in the Stat3 gene promoter thus regulating its expression. When DCs lack HIF1α, STAT3 expression is not stimulated and hence IL 12 production by DCs is uninhibited. This excessive IL 12 can activate naive T cells and polarize them to the Th1 phenotype, thereby enhancing atherosclerotic plaque progression.
This project thus concludes that HIF1α restrains DC activation via STAT3 generation and prevents excessive production of IL 12 that helps to keep inflammation and atherosclerosis under check.
P-glycoprotein (P-gp)-mediated efflux system plays an important role to maintain chemical balance in mammalian cells for endogenous and exogenous chemical compounds. However, despite the extensive characterisation of P-gp potential interaction with drug-like molecules, the interaction of carbon nanoparticles with this type of protein molecule is poorly understood. Thus, carbon nanoparticles were analysed, such as buckminsterfullerenes (C20, C60, C70), capped armchair single-walled carbon nanotube (SWCNT or C168), and P-gp interactions using different molecular docking techniques, such as gradient optimisation algorithm (ADVina), Lamarckian genetic algorithm (FastDock), and shape-based approach (PatchDock) to estimate the binding affinities between these structures. The theoretical results represented in this work show that fullerenes might be P-gp binders because of low levels of Gibbs free energy of binding (ΔG) and potential of mean force (PMF) values. Furthermore, the SWCNT binding is energetically unfavourable, leading to a total decrease in binding affinity by elevation of the residual area (Ares), which also affects the π-π stacking mechanisms. Further, the obtained data could potentially call experimental studies using carbon nanostructures, such as SWCNT for development of drug delivery vehicles, to administer and assess drug-like chemical compounds to the target cells since organisms probably did not develop molecular sensing elements to detect these types of carbon molecules.
The present work illustrates the structural and biochemical characterization of two diverse proteins, BadI and MenD from Rhodopseudomonas palustris and Staphylococcus aureus, respectively.
BadI or 2-ketocyclohexanecarboxyl-CoA is one of the key enzymes involved in the anaerobic degradation of aromatic compounds. The degradation of aromatic compounds is a vital process for the maintenance of the biogeochemical carbon cycle and bioremediation of xenobiotic compounds, which if present at higher concentrations can cause potential hazards to humans. Due to the relatively inert nature of aromatic compounds, enzymes catalyzing their degradation are of special interest for industrial applications. BadI is one of the key enzymes involved in the anaerobic degradation of aromatic compounds into an aliphatic moiety.
The major focus of this study was to provide mechanistic insights into the reaction catalyzed by BadI. BadI belongs to the crotonase superfamily and shares high sequence homology with the family members of MenB or dihydroxynaphthoate synthase. BadI is known to catalyze the cleavage of the cyclic ring of 2-ketocyclohexane carboxyl-CoA by hydrolyzing the C-C bond leading to the formation of the aliphatic compound pimelyl CoA. On the other hand MenB catalyzes the condensation reaction of o-succinylbenzoyl-CoA to dihydroxylnaphthoyl-CoA. A comprehensive amino acid sequence analysis between BadI and MenB showed that the active site residues of MenB from Mycobacterium tuberculosis (mtMenB) are conserved in BadI from Rhodopseudomonas palustris. MenB is involved in the menaquinone biosynthesis pathway and is a potential drug target against Mycobacterium tuberculosis as it has no known human homologs. Due to the high homology between MenB and BadI and the inability to obtain MenB-inhibitor complex structures we extended our interest to BadI to explore a potential substitute model for mtMenB as a drug target.
In addition, BadI possesses some unique mechanistic characteristics. As mentioned before, it hydrolyzes the substrate via a retro Dieckmann’s reaction contrasting its closest homolog MenB that catalyzes a ring closing reaction through a Dieckmann’s reaction. Nevertheless the active site residues in both enzymes seem to be highly conserved. We therefore decided to pursue the structural characterization of BadI to shed light on the similarities and differences between BadI and MenB and thereby provide some insights how they accomplish the contrasting reactions described above.
We determined the first structures of BadI, in its apo and a substrate mimic bound form. The crystal structures revealed that the overall fold of BadI is similar to other crotonase superfamily members. However, there is no indication of domain swapping in BadI as observed for MenB. The absence of domain swapping is quite remarkable because the domain swapped C-terminal helical domain in MenB provides a tyrosine that is imperative for catalysis and is also conserved in the BadI sequence. Comparison of the active sites revealed that the C-terminus of BadI folds onto its core in such a way that the conserved tyrosine is located in the same position as in MenB and can form interactions with the ligand molecule. The structure of BadI also confirms the role of a serine and an aspartate in ligand interaction, thus validating that the conserved active site triad participates in the enzymatic reaction. The structures also reveal a noteworthy movement of the active site aspartate that adopts two major conformations. Structural studies further illuminated close proximity of the active site serine to a water and chlorine molecule and to the carbon atom at which the carbonyl group of the true substrate would reside. Biochemical characterization of BadI using enzyme kinetics validated that the suggested active site residues are involved in substrate interaction. However, the role of these residues is very distinct, with the serine assuming a major role. Thus, the present work ascertain the participation of putative active site residues and demonstrates that the active site residues of BadI adopt very distinctive roles compared to their closest homolog MenB.
The MenD protein also referred to as SEPHCHC (2-succinyl-5-enolpyruvyl-6- hydroxy-3-cyclohexene-1-carboxylic acid) synthase is one of the enzymes involved in menaquinone biosynthesis in Staphylococcous aureus. Though S. aureus is usually considered as a commensal it can act as a remarkable pathogen when it crosses the epithelium, causing a wide spectrum of disorders ranging from skin infection to life threatening diseases. Small colony variants (SCVs), a slow growing, small sized subpopulation of the bacteria has been associated with persistent, recurrent and antibiotic resistant infections. These variants show autotrophy for thiamine, menaquinone or hemin. Menaquinone is an essential component in the electron transport pathway in gram-positive organisms. Therefore, enzymes partaking in this pathway are attractive drug targets against pathogens such as Mycobacterium tuberculosis and Bacillus subtilis. MenD, an enzyme catalyzing the first irreversible step in the menaquinone biosynthetic pathway has been implicated in the SCV phenotype of S. aureus. In the present work we explored biochemical and structural properties of this important enzyme.
Our structural analysis revealed that despite its low sequence identity of 28%, the overall fold of staphylococcal MenD (saMenD) is similar to Escherichia coli MenD (ecMenD) albeit with some significant disparities. Major structural differences can be observed near the active site region of the protein and are profound in the C-terminal helix and a loop near the active site. The loop contains critical residues for cofactor binding and is well ordered only in the ecMenD-ThDP structure, while in the apo and substrate bound structures of ecMenD the loop is primarily disordered. In our saMenD structure the loop is for the first time completely ordered in the apo form and displays a novel conformation of the cofactor-binding loop. The loop adopts an unusual open conformation and the conserved residues, which are responsible for cofactor binding are located too far away to form a productive complex with the cofactor in this conformation. Additionally, biochemical studies in conjugation with the structural data aided in the identification of the substrate-binding pocket and delineated residues contributing to its binding and catalysis. Thus the present work successfully divulged the unique biochemical and structural characteristics of saMenD.
An essential step in eukaryotic gene expression is splicing, i.e. the excision of non-coding sequences from pre-mRNA and the ligation of coding-sequences. This reaction is carried out by the spliceosome, which is a macromolecular machine composed of small nuclear ribonucleoproteins (snRNPs) and a large number of proteins. Spliceosomal snRNPs are composed of one snRNA (or two in case of U4/6 snRNPs), seven common Sm proteins (SmD1, D2, D3, B, E, F, G) and several particle-specific proteins. The seven Sm proteins form a ring shaped structure on the snRNA, termed Sm core domain that forms a structural framework of all spliceosomal snRNPs. In the toroidal Sm core domain, the individual Sm proteins are arranged in the sequence SmE-SmG-SmD3-SmB- SmD1-SmD2-SmF from the first to the seventh nucleotide of the Sm site, respectively. The individual positions of Sm proteins in the Sm core domain are not interchangeable.
snRNPs are formed in vivo in a step-wise process, which starts with the export of newly transcribed snRNA to the cytoplasm. Within this compartment, Sm proteins are synthesized and subsequently transferred onto the snRNA. Upon formation of the Sm core and further modifications of snRNA, the snRNP is imported into the nucleus to join the spliceosome.
Prior to assembly into snRNPs, Sm proteins exist as specific hetero-oligomers in the cytoplasm. The association of these proteins with snRNA occurs spontaneously in vitro but requires the assistance of two major units, PRMT5- and SMN- complexes, in vivo. The early phase of assembly is critically influenced by the assembly chaperone pICln. This protein pre-organizes Sm proteins to functional building blocks and enables their recruitment onto the PRMT5 complex for methylation. Sm proteins are subsequently released from the PRMT5 complex as pICln bound entities and transferred onto the SMN-complex. The SMN complex then liberates the Sm proteins from the pICln-induced kinetic trap and allows their transfer onto the snRNA. Although the principal roles of SMN- and PRMT5 complexes in the assembly of snRNPs have been established, it is still not clear how newly translated Sm proteins are guided into the assembly line.
In this thesis, I have uncovered a new facet of pICln function in the assembly of snRNPs. I have shown that newly synthesized Sm proteins are retained at the ribosome upon termination of translation. Their release is facilitated by pICln, which interacts with the cognate Sm protein hetero-oligomers at their site of synthesis on the ribosome and recruits them into the assembly pathway. Additionally, I have been able to show that the early engagement of pICln with the Sm proteins ensures the flawless oligomerization of Sm proteins and prevents any non-chaperoned release and diffusion of Sm proteins in the cytoplasm.
In a second project, I have studied the mechanism of U7 snRNP assembly. This particle is a major component of the 3’ end processing machinery of replication dependent histone mRNAs. A biochemical hallmark of U7 is its unique Sm core in which the two canonical Sm proteins D1 and D2 are replaced by so-called “like Sm proteins”. The key question I addressed in my thesis was, how this “alternative” Sm core is assembled onto U7 snRNA. I have provided experimental evidence that the assembly route of U7 snRNPs and spliceosomal snRNPs are remarkably similar: The assembly of both particles depends on the same assembly factors and the mechanistic details are similar. It appears that formation of the U7- or spliceosomal- core specific 6S complex is the decisive step in assembly.
Funktionelle Expression von ChR2 in Pflanzen In der vorliegenden Arbeit konnte erstmalig die funktionelle Expression des licht-aktivierten Channelrhodopsin-2 aus Chlamydomonas reinhardtii in höheren Pflanzen gezeigt werden. Obwohl die erfolgreiche Transformation auf der Basis der Integration einer Expressionskassette für WT-ChR2 in Pflanzen genetisch nachgewiesen werden konnte, war ein funktioneller Nachweis nicht möglich. Demgegenüber war die funktio-nelle Expression aller getesteten ChR2-Mutanten im transienten Expressionsansatz er-folgreich und konnte schließlich auf der Basis der im Rahmen dieser Arbeit generierten Konstrukte auch für stabil transformierte Arabidopsis-Pflanzen bestätigt werden. ChR2 wurde in Arabidopsis-Protoplasten sowie Tabak-Epidermis- und Mesophyllzellen an der Plasmamembran lokalisiert, zeigte jedoch aufgrund der Überexpression eine starke Überladung des Endomembransystems. Elektrophysiologische Messungen mit Hilfe der Einstichtechnik belegten, dass ChR2 sowohl in Arabidopsis-Keimlingen als auch im Tabakmesophyll funktionell ist, wobei sich die erzeugten Blaulicht-vermittelten Depolarisationen weitaus erfolgreicher im Ta-baksystem darstellten. Alle eingesetzten ChR2-Mutanten waren funktionell und zeigten in Einstichmessungen mit Oozytendaten korrelierende Kinetiken. Die Mutante C128A wurde hinsichtlich der erzielten lichtinduzierten Membranpotentialdepolarisationen als effektivste ChR2-Variante identifiziert. Calcium-Messungen mit dem Reporterprotein Aequorin lieferten keinen Beweis für einen direkt durch ChR2-C128A vermittelten Calcium-Einstrom in Arabidopsis-Protoplasten. Jedoch konnte ein cytosolischer Calcium-Anstieg ca. 3min nach Blau-lichtapplikation beobachtet werden. Dies deutet darauf hin, dass die durch ChR2 vermittelten Membranpotentialänderungen zu einer Aktivierung endogener, Calcium-permeabler Ionenkanäle führen könnte. Für die ChR2-L132C Mutante konnte allerdings in ersten Messungen ein direkter Calcium-Anstieg nach Lichtgabe beobachtet werden. Transkriptionelle Änderungen aufgrund ChR2-basierter, elektrischer Signalmuster In RNA-Seq-Analysen mit transient transformierten Tabakblättern konnte die Bedeu-tung der Signalsignatur elektrischer bzw. Calcium-basierter Signale verifiziert werden: Die Applikation zweier in ihrer Form gänzlich unterschiedlicher elektrischer Signal-muster lieferte ein signifikant unterschiedlich reguliertes Set an Genen, wobei einige wenige durch beide Behandlungen induziert werden konnten. Langanhaltende Depolari-sationen regulierten deutlich mehr Gene und waren daher in ihrer Wirkung weitaus ef-fektiver als kurze, repetitive Depolarisationen. Die bioinformatische Analyse dieser Daten zeigte, dass die Nachahmung eines im Zuge der Pathogenantwort bekannten, langen Depolarisationspulses Gene der Flagellin-induzierten Signaltransduktion adressierte, während kurze, wiederkehrende Pulse mit gleichem Informationsgehalt diese nicht regulierten.
In einigen Punkten konnte diese Arbeit die Ergebnisse früherer Studien bestätigen.
Einstellungs- und Nadelmodi (wenn auch mit unterschiedlicher Ausprägung)
haben einen Einfluss auf die verbesserte Sichtbarkeit der Regionalanästhesienadeln
im Ultraschall. Damit diese sonographisch besser erkannt werden, sollten sie
in einem flacheren Winkel (30-45°) eingestochen werden. Größere Nadellumina
haben einen Vorteil in der Sichtbarkeit im Ultraschall. Auch konnte gezeigt werden,
dass der Nadelschliff einen Einfluss darauf hat, wie gut die Anästhesiekanülenspitze
sonographisch gesehen wird. Allein die (in der Arbeit untersuchten) Nadelbeschichtungs-
Arten brachten keinen wesentlichen Effekt für die verbesserte
Erkennbarkeit.
Es war jedoch auffallend, dass die subjektiven und objektiven Resultate in einem
relativ hohen Maße nicht übereinstimmten. Gründe dafür sehe ich v.a. im gewählten
Verfahren der objektiven Untersuchung (mit der Bildbearbeitungssoftware
muss die region of interest zielgenauer erfasst werden, um störende Umgebungseinflüsse
auszuschließen).
Echogene Nadeloberflächen (auch wenn diese nicht Gegenstand der vorliegenden
Untersuchung waren), weisen eine verbesserte Ultraschall-Reflexion auf. Sie
werden dazu beitragen, dass die sichere Anwendung der USRA weiter zunimmt.
Verbesserte Sonographiegeräte, zusätzliche Hilfsmittel (GPS-Unterstützung) und
neueste Nadelentwicklungen versprechen einen wichtigen Fortschritt auf dem
Gebiet der ultraschallunterstützten Regionalanästhesie (USRA). Diese Weiterentwicklungen
werden der USRA den Stellenwert als Gold-Standard in der
Regionalanästhesie sichern.
Ergebnisse einer retrospektiven Studie an der Universität Würzburg:
Patienten und Methoden:
In einer retrospektiven Studie wurden Einflussfaktoren auf die Lokoregionäre Kontrolle, das Gesamtüberleben und das rezidivfreie Überleben von 106 Patienten, mit histologisch gesicherten Oropharynxkarzinomen (28 T1, 46 T2, 25 T3 und 7 T4 Tumore, mit lymphatischer Beteiligung in 78 Fällen), mit uni- und multivariaten Analysen untersucht.
Das mediane Alter bei Primärdiagnose betrug 55 Jahre. Es wurde eine mediane Nachbeobachtungszeit 36 Monaten erreicht (zwischen 5 bis 126 Monate). In 18 Fällen (17%) konnte der Primärtumor in sano entfernt werden (Sicherheitsabstand > 3mm). In 34 Fällen (32%) bestand ein knapper Sicherheitsabstand (definitionsgemäß < als 3mm) und in 54 Fällen (51%) waren die Resektatränder nicht frei von Tumorzellen (R1 Resektion). Patienten, welche eine Chemotherapie aufgrund des erhöhten Rezidivrisikos erhielten, machten 24% (25 Patienten) des Patientenkollektivs aus.
Behandlungskonzept
Das Tumorbett des Primärtumors und die zervikalen lymphatischen Abflussgebiete erhielten mediane Bestrahlungsdosen von 56 Gy (2 Gy/ Behandlung, 5 Fraktionen pro Woche). Patienten mit R0-Resektion erhielten Bestrahlungsdosen von 56-60Gy. Bei Patienten mit knappen Resektatrand wurde das Tumorbett mit einer höheren Dosis von 60-66Gy bestrahlt, R1 Resektionen wurden mit einer Boost-Aufsättigung bis zu einer Gesamtdosis von 66-70 Gy behandelt. Patienten im UICC-Stadium 4, mit erhöhtem Rezidivrisiko, machten 24% (25 Patienten) des Patientenkollektivs aus. Diese Patienten erhielten je nach Nierenfunktion und Blutbild eine zusätzliche Chemotherapie mit Cisplatin (40mg/m² wöchentlich) in 1-4 Zyklen, sowie eine Boost-Aufsättigung des Tumorbettes bis zu einer Gesamtdosis von 66-70 Gy.
Ergebnisse der univariaten Analysen mittels Kaplan-Maier Plot Verfahren:
lokoregionäre Kontrolle
Mit einer medianen Nachbeobachtungszeit von 36 Monaten wurde eine 5 Jahres Rezidivfreiheit bei 87% der Patienten erzielt. Davon wurden 80% der Rezidive innerhalb der ersten 24 Monate diagnostiziert. Bei Patienten mit R0 Status wurde in 16,7 % ein Rezidiv diagnostiziert, bei Patienten mit R1 Situation in 17% und bei Patienten mit knappen Resektatrand wurde nur in 6 % ein Rezidiv diagnostiziert. Als statistisch signifikanter Einflussfaktor des Rezidiv erwies sich nur das Gesamttumorvolumen.
Gesamtüberlebensrate
Es wurde eine 3- und 5- Jahresüberlebensrate von 75% und 66% erreicht.
Die 5JÜR bezüglich der Radikalität der Resektion erreichte bei R0 Resektion 61%, 71% bei Patienten mit knappen Resektatrand und 65% bei R1 Situation.
Bei Patienten mit einem T1 Tumorstadium ergab sich eine 5JÜR von 82%, bei T2 67%, bei T3 52% und für Patienten im T4 Stadium ergab sich eine 5JÜR von 43 %.
Patienten mit N0-Status verzeichneten eine 5JÜR von 68%, mit N1-Status 82%, N2a,b-Status 68%, N2c-Status 36% und N3-Status ergab 43%.
Patienten ohne adjuvante Chemotherapie erzielten eine 5JÜR von 69% und Patienten, die aufgrund des erhöhten Rezidivrisikos eine Chemotherapie erhielten, erreichten 56%.
Die Einflussgröße der Rezidiventwicklung erbrachte eine 5JÜR von 13%, wogegen sie bei Patienten ohne Rezidiv 75% betrug.
Patienten, welche einen 2. Tumor entwickelten, verzeichneten eine 5JÜR von 45% gegenüber 71% bei Patienten ohne 2.Tumor.
Der Vergleich der Bestrahlungsdosen im Tumorbett ergab, dass Patienten mit einer Gesamtdosis unter/gleich 66Gy eine 5JÜR von 71% erreichten und 62% bei Gesamtdosen über 66Gy.
Die 5JÜR bezüglich des Tumorvolumens des Primärtumors, inklusive der befallenen Lymphknoten, erbrachte in der ersten Gruppe von unter 10ml Tumorvolumen 77%, von 10 bis 20ml 83%, von 20 bis 50ml 52% und in der vierten Gruppe mit über 50ml Tumorvolumen 33%.
Mit einem Grading von 2 wurde 69% und mit einem Grading von 3 wurde bei Patienten eine 5JÜR von 61% berechnet.
In der univariaten Analyse mittels des Kaplan-Maier-Plot-Verfahrens, zeigte sich in der 5-Jahres Überlebenskurve eine Signifikanz der Einflussgrößen Tumorstadium (p-Wert 0,003), Rezidivereignis (p-Wert 0,000), 2.Tumor (p-Wert 0,001) und Tumorvolumen (p-Wert 0,000).
Rezidivfreies Überleben
Das rezidivfreie Überleben betrug nach 3 Jahren 68% und nach 5 Jahren 64%.
Bezüglich der Radikalität der Resektion ermittelte man für Patienten mit R0 Resektion nach 5 Jahren ein rezidivfreies Überleben von 61%, 71% bei knappen Resektatrand und 61% bei R1 Situation.
Patienten mit einem T1 Stadium erreichten ein 5 jähriges rezidivfreies Überleben in 82%, mit T2 Stadium 67%, mit T3 Stadium 48% und Patienten im T4 Tumorstadium erzielten 43 %.
Patienten mit N0-Status verzeichneten ein 5 jähriges rezidivfreies Überleben von 64%, mit N1-Status 82%, N2a,b-Status 68%, N2c-Status 27% und ein N3-Status ergab 43%.
Patienten ohne adjuvante Chemotherapie erreichten in 68% und Patienten, welche eine Chemotherapie erhielten, erreichten ein 5 jähriges rezidivfreies Überleben in 52%.
Patienten, welche einen 2. Tumor entwickelten, verzeichneten eine 5 jähriges rezidivfreies Überleben von 45%, gegenüber 68% bei Patienten ohne 2.Tumor.
Die Gegenüberstellung der Bestrahlungsdosen im Tumorbett ergab, dass Patienten mit einer Gesamtdosis unter/gleich 66Gy ein rezidivfreies 5-jähriges Überleben von 69% erreichten, hingegen Patienten mit mehr als 66Gy Bestrahlungsdosis 60% erzielten.
Das 5 jährige rezidivfreie Überleben in Bezug auf das Tumorvolumen des Primärtumors, inklusive der befallenen Lymphknoten, erbrachte in der ersten Gruppe von unter 10ml Tumorvolumen 77%, von 10 bis 20ml 79%, in der dritten Gruppe von 20 bis 50ml 48% und in der vierten Gruppe mit über 50ml Tumorvolumen wurde nach 5 Jahren ein rezidivfreies Überleben von 33% verzeichnet.
Mit einem Grading von 2, wurde 66% und mit einem Grading von 3 ergaben sich für die Patienten ein 5 jähriges rezidivfreies Überleben von 61%.
In der univariaten Analyse mittels des Kaplan-Maier-Plot-Verfahren, zeigte sich in der Kurve für das 5-jährige rezidivfreie Überleben, eine Signifikanz der Einflussgrößen Tumorstadium (p-Wert 0,003), Lymphknotenstatus (p-Wert 0,048), Chemotherapie (p-Wert 0,047), 2.Tumor (p-Wert 0,003) und Tumorvolumen (p-Wert 0,000).
Ergebnisse der multivarianten Analysen
In einer multivariaten Cox-Regressions Analyse erwiesen sich die Einflussgrößen des Tumorstadiums und die Entwicklung eines 2. Tumors, bezüglich des Gesamt- und des rezidivfreien Überlebens, als statistisch signifikant.
Das Tumorstadium konnte, in Bezug auf das Gesamtüberleben, eine Signifikanz von 0,015 ermittelt werden. Im Hinblick auf das rezidivfreie Überleben konnte ihm eine Signifikanz von 0,03 zugeschreiben werden. Die Einflussgröße des 2.Tumors ergab für das Gesamtüberleben eine Signifikanz von ebenfalls 0,015 und eine Signifikanz von 0,025 bezüglich des rezidivfreien Überlebens.
Schlussfolgerung:
Mit dem Therapiekonzept konnte eine Verbesserung der 5JÜR und des 5-jährigen rezidivfreien Überlebens erzielt werden. Die Patienten mit knappen Resektatrand wiesen durchweg bessere Ergebnisse auf als Patienten mit R0-Resektion. Als Konsequenz dieser Ergebnisse müsste man eine Angleichung des bisherigen Therapiekonzeptes der R0 Patienten an das der knapp resezierten Patienten vornehmen.
Bei Patienten mit einem primär erhöhtem Rezidivrisiko, welche eine simultane Radiochemotherapie erhielten, erzielte man mit diesem Therapiekonzept eine Angleichung der 5JÜR an Patienten ohne dieses. Es zeigte sich hierbei in der multivariaten Analyse, sowohl beim Gesamtüberleben, als auch beim rezidivfreien Überleben kein statistisch signifikanter Unterschied (Gesamtüberleben p-Wert 0,064, rezidivfreies Überleben p-Wert 0,085).
Cu- and Mn-bearing tourmalines from Brazil and Mozambique were characterised chemically (EMPA and LA-ICP-MS) and by X-ray single-crystal structure refinement. All these samples are rich in Al, Li and F (fluor-elbaite) and contain significant amounts of CuO (up to ~1.8 wt%) and MnO (up to ~3.5 wt%). Structurally investigated samples show a pronounced positive correlation between the <Y-O> distances and the (Li + Mn\(^{2+}\) + Cu + Fe\(^{2+}\)) content (apfu) at this site with R\(^2\) = 0.90. An excellent negative correlation exists between the <Y-O> distances and the Al\(_2\)O\(_3\) content (R\(^2\) = 0.94). The samples at each locality generally show a strong negative correlation between the X-site vacancies and the (MnO + FeO) content. The Mn content in these tourmalines depends on the availability of Mn, on the formation temperature, as well as on stereochemical constraints. Because of a very weak correlation between MnO and CuO we believe that the Cu content in tourmaline is essentially dependent on the availability of Cu and on stereochemical constraints.
The subject of this work was to develop, implement, optimize and apply methods for quantitative MR imaging of tumors. In the context of functional and physiological characterization, this implied transferring techniques established in tumor model research to human subjects and assessing their feasibility for use in patients. In the context of the morphologic assessment and parameter imaging of tumors, novel concepts and techniques were developed, which facilitated the simultaneous quantification of multiple MR parameters, the generation of “synthetic” MR images with various contrasts, and the fast single-shot acquisition of purely T2-weighted images.
Plant communities in the European Alps are assumed to be highly affected by climate change, as the temperature rise in this region is above the global average. It is predicted that higher temperatures will lead to advanced snowmelt dates and that the number of extreme weather events will increase. The aims of this study were to determine the impacts of extreme climatic events on flower phenology and to assess whether those impacts differed between lower and higher altitudes. In 2010, an experiment simulating advanced and delayed snowmelt as well as a drought event was conducted along an altitudinal transect approximately every 250 m (600–2000 m above sea level) in the Berchtesgaden National Park, Germany. The study showed that flower phenology was strongly affected by altitude; however, there were few effects of the manipulative treatments on flowering. The effects of advanced snowmelt were significantly greater at higher than at lower sites, but no significant difference was found between both altitudinal bands for the other treatments. The response of flower phenology to temperature declined through the season and the length of flowering duration was not significantly influenced by treatments. The stronger effect of advanced snowmelt at higher altitudes may be a response to differences in treatment intensity across the gradient. Consequently, shifts in the date of snowmelt due to global warming may affect species more at higher than at lower altitudes, as changes may be more pronounced at higher altitudes. These data indicate a rather low risk of drought events on flowering phenology in the Bavarian Alps.
Although agricultural habitats can provide enormous amounts of food resources for pollinator species, links between agricultural and (semi-)natural habitats through dispersal and foraging movements have hardly been studied. In 67 study sites, we assessed the interactions between mass-flowering oilseed rape fields and semi-natural grasslands at different spatial scales, and their effects on the number of brood cells of a solitary cavity-nesting bee. The probability that the bee Osmia bicornis colonized trap nests in oilseed rape fields increased from 12 to 59 % when grassland was nearby, compared to fields isolated from grassland. In grasslands, the number of brood cells of O. bicornis in trap nests was 55 % higher when adjacent to oilseed rape compared to isolated grasslands. The percentage of oilseed rape pollen in the larval food was higher in oilseed rape fields and grasslands adjacent to oilseed rape than in isolated grasslands. In both oilseed rape fields and grasslands, the number of brood cells was positively correlated with the percentage of oilseed rape pollen in the larval food. We show that mass-flowering agricultural habitats—even when they are intensively managed—can strongly enhance the abundance of a solitary bee species nesting in nearby semi-natural habitats. Our results suggest that positive effects of agricultural habitats have been underestimated and might be very common (at least) for generalist species in landscapes consisting of a mixture of agricultural and semi-natural habitats. These effects might also have—so far overlooked—implications for interspecific competition and mutualistic interactions in semi-natural habitats.
As a consequence of obstetric complications, neonatal hypoxia has been discussed as an environmental factor in the pathophysiology of schizophrenia. However, the biological consequences of hypoxia are unclear. The neurodevelopmental hypothesis of schizophrenia suggests that the onset of abnormal brain development and neuropathology occurs perinatally, whereas symptoms of the disease appear in early adulthood. In our animal model of chronic neonatal hypoxia, we have detected behavioral alterations resembling those known from schizophrenia. Disturbances in cell proliferation possibly contribute to the pathophysiology of this disease. In the present study, we used postnatal rats to investigate cell proliferation in several brain areas following neonatal hypoxia. Rats were repeatedly exposed to hypoxia (89 % N2, 11 % O2) from postnatal day (PD) 4–8. We then evaluated cell proliferation on PD 13 and 39, respectively. These investigations were performed in the anterior cingulate cortex (ACC), caudate-putamen (CPU), dentate gyrus, and subventricular zone. Rats exposed to hypoxia exhibited increased cell proliferation in the ACC at PD 13, normalizing at PD 39. In other brain regions, no alterations have been detected. Additionally, hypoxia-treated rats showed decreased CPU volume at PD 13. The results of the present study on the one hand support the assumption of chronic hypoxia influencing transient cell proliferation in the ACC, and on the other hand reveal normalization during ageing.
Objective: The situation of patients with multiple myeloma, whose treatment often implies high-dose chemotherapy and stem cell transplantation that can be associated with severe symptoms and psychological distress, has gained attention in recent psychooncological research. This study followed an idiographic approach in order to identify the areas of life most relevant for the interviewed myeloma patients’ quality of life (QoL) as well as their current satisfaction with these.
Methods: 64 patients took part in semi-structured interviews according to the SEIQoL-DW Manual (Schedule for the Evaluation of Individual Quality of Life – Direct Weighting). Visual analogue scales (VAS) were used to gain additional information about a general assessment of the present QoL. Qualitative data evaluation preceded quantitative processing. Groups were compared according to the time elapsed since diagnosis regarding specified areas of life, satisfaction with these and their relative weighting. SEIQoL-DW-indices were correlated to the VAS to reflect on an interindividually comparable parameter.
Results: Personal social relationships were mentioned significantly more often as important for QoL than healthrelated aspects, and in direct comparison were weighted significantly stronger. Regarding the change of areas relevant for QoL over the time elapsed since diagnosis, there was a significant difference between groups concerning the area of spirituality. Satisfaction differed significantly between groups for the field of leisure.
Conclusion: The results for the interviewed patients with multiple myeloma point out the need to take into account the importance of social and individual aspects when reflecting on QoL. Similar findings have been reported for different samples. The relevance of an individualized approach is illustrated by the fact that individually named areas of life were rated comparatively strongly in their importance for the patients’ QoL. An overall assessment for the current QoL by means of VAS is regarded as an adequate supplement to the SEIQoL-Profile and an alternative to the SEIQoL-DW-Index.
The dispersion routes of cyclodextrin complexes with nicardipine (NC), such as hydrophilic hydroxypropyl-\(\beta\)-cyclodextrin (NC/HP\(\beta\)CD) and hydrophobic triacetyl-\(\beta\)-cyclodextrin (NC/TA\(\beta\)CD), through the body for controlled drug delivery and sustained release have been examined. The two-compartment pharmacokinetic model described the mechanisms of how the human body handles with ingestion of NC-cyclodextrin complexes in gastrointestinal tract (GI), distribution in plasma, and their metabolism in the liver. The model showed that drug bioavailability was significantly improved after oral administration of cyclodextrin complexes. The mathematical significance of this study to predict nicardipine delivery using pharmacokinetic two-compartment mathematical model with linear ordinary differential equations (ODE) approach represents a valuable tool to emphasize its effectiveness and metabolizing rate and diminish the side effects.
There is an urgent need for rapid and highly sensitive detection of pathogen-derivedDNAin a point-of-care (POC) device for diagnostics in hospitals and clinics. This device needs to work in a ‘sample-in-result-out’ mode with minimum number of steps so that it can be completely integrated into a cheap and simple instrument. We have developed a method that directly detects unamplified DNA, and demonstrate its sensitivity on realistically sized 5 kbp targetDNA fragments of Micrococcus luteus in small sample volumes of 20 mL. The assay consists of capturing and accumulating of target DNA on magnetic beads with specific capture oligonucleotides, hybridization of complementary fluorescently labeled detection oligonucleotides, and fluorescence imaging on a miniaturized wide-field fluorescence microscope. Our simple method delivers results in less than 20 minutes with a limit of detection (LOD) of,5 pMand a linear detection range spanning three orders of magnitude.
The natural environment and livelihoods in the Lower Mekong Basin (LMB) are significantly affected by the annual hydrological cycle. Monitoring of soil moisture as a key variable in the hydrological cycle is of great interest in a number of Hydrological and agricultural applications. In this study we evaluated the quality and spatiotemporal variability of the soil moisture product retrieved from C-band scatterometers data across the LMB sub-catchments. The soil moisture retrieval algorithm showed reasonable performance in most areas of the LMB with the exception of a few sub-catchments in the eastern parts of Laos, where the land cover is characterized by dense vegetation. The best performance of the retrieval algorithm was obtained in agricultural regions. Comparison of the available in situ evaporation data in the LMB and the Basin Water Index (BWI), an indicator of the basin soil moisture condition, showed significant negative correlations up to R = −0.85. The inter-annual variation of the calculated BWI was also found corresponding to the reported extreme hydro-meteorological events in the Mekong region. The retrieved soil moisture data show high correlation (up to R = 0.92) with monthly anomalies of precipitation in non-irrigated regions. In general, the seasonal variability of soil moisture in the LMB was well captured by the retrieval method. The results of analysis also showed significant correlation between El Niño events and the monthly BWI anomaly measurements particularly for the month May with the maximum correlation of R = 0.88.
Mobile laser scanning puts high requirements on the accuracy of the positioning systems and the calibration of the measurement system. We present a novel algorithmic approach for calibration with the goal of improving the measurement accuracy of mobile laser scanners. We describe a general framework for calibrating mobile sensor platforms that estimates all configuration parameters for any arrangement of positioning sensors, including odometry. In addition, we present a novel semi-rigid Simultaneous Localization and Mapping (SLAM) algorithm that corrects the vehicle position at every point in time along its trajectory, while simultaneously improving the quality and precision of the entire acquired point cloud. Using this algorithm, the temporary failure of accurate external positioning systems or the lack thereof can be compensated for. We demonstrate the capabilities of the two newly proposed algorithms on a wide variety of datasets.
Abstract
Streptococcus pneumoniae (pneumococcal) meningitis is a common bacterial infection of the brain. The cholesterol-dependent cytolysin pneumolysin represents a key factor, determining the neuropathogenic potential of the pneumococci. Here, we demonstrate selective synaptic loss within the superficial layers of the frontal neocortex of post-mortem brain samples from individuals with pneumococcal meningitis. A similar effect was observed in mice with pneumococcal meningitis only when the bacteria expressed the pore-forming cholesterol-dependent cytolysin pneumolysin. Exposure of acute mouse brain slices to only pore-competent pneumolysin at disease-relevant, non-lytic concentrations caused permanent dendritic swelling, dendritic spine elimination and synaptic loss. The NMDA glutamate receptor antagonists MK801 and D-AP5 reduced this pathology. Pneumolysin increased glutamate levels within the mouse brain slices. In mouse astrocytes, pneumolysin initiated the release of glutamate in a calcium-dependent manner. We propose that pneumolysin plays a significant synapto- and dendritotoxic role in pneumococcal meningitis by initiating glutamate release from astrocytes, leading to subsequent glutamate-dependent synaptic damage. We outline for the first time the occurrence of synaptic pathology in pneumococcal meningitis and demonstrate that a bacterial cytolysin can dysregulate the control of glutamate in the brain, inducing excitotoxic damage.
Author Summary
Bacterial meningitis is one of the most devastating brain diseases. Among the bacteria that cause meningitis, Streptococcus pneumoniae is the most common. Meningitis predominantly affects children, especially in the Third World, and most of them do not survive. Those that do survive often suffer permanent brain damage and hearing problems. The exact morphological substrates of brain damage in Streptococcus pneumoniae meningitis remain largely unknown. In our experiments, we found that the brain cortex of patients with meningitis demonstrated a loss of synapses (the contact points among neurons, responsible for the processes of learning and memory), and we identified the major pneumococcal neurotoxin pneumolysin as a sufficient cause of this loss. The effect was not direct but was mediated by the brain neurotransmitter glutamate, which was released upon toxin binding by one of the non-neuronal cell types of the brain – the astrocytes. Pneumolysin initiated calcium influx in astrocytes and subsequent glutamate release. Glutamate damaged the synapses via NMDA-receptors – a mechanism similar to the damage occurring in brain ischemia. Thus, we show that synaptic loss is present in pneumococcal meningitis, and we identify the toxic bacterial protein pneumolysin as the major factor in this process. These findings alter our understanding of bacterial meningitis and establish new therapeutic strategies for this fatal disease.
Abstract
In the murine model of Leishmania major infection, resistance or susceptibility to the parasite has been associated with the development of a Th1 or Th2 type of immune response. Recently, however, the immunosuppressive effects of IL-10 have been ascribed a crucial role in the development of the different clinical correlates of Leishmania infection in humans. Since T cells and professional APC are important cellular sources of IL-10, we compared leishmaniasis disease progression in T cell-specific, macrophage/neutrophil-specific and complete IL-10-deficient C57BL/6 as well as T cell-specific and complete IL-10-deficient BALB/c mice. As early as two weeks after infection of these mice with L. major, T cell-specific and complete IL-10-deficient animals showed significantly increased lesion development accompanied by a markedly elevated secretion of IFN-γ or IFN-γ and IL-4 in the lymph nodes draining the lesions of the C57BL/6 or BALB/c mutants, respectively. In contrast, macrophage/neutrophil-specific IL-10-deficient C57BL/6 mice did not show any altered phenotype. During the further course of disease, the T cell-specific as well as the complete IL-10-deficient BALB/c mice were able to control the infection. Furthermore, a dendritic cell-based vaccination against leishmaniasis efficiently suppresses the early secretion of IL-10, thus contributing to the control of parasite spread. Taken together, IL-10 secretion by T cells has an influence on immune activation early after infection and is sufficient to render BALB/c mice susceptible to an uncontrolled Leishmania major infection.
Author Summary
The clinical symptoms caused by infections with Leishmania parasites range from self-healing cutaneous to uncontrolled visceral disease and depend not only on the parasite species but also on the type of the host's immune response. It is estimated that 350 million people worldwide are at risk, with a global incidence of 1–1.5 million cases of cutaneous and 500,000 cases of visceral leishmaniasis. Murine leishmaniasis is the best-characterized model to elucidate the mechanisms underlying resistance or susceptibility to Leishmania major parasites in vivo. Using T cell-specific and macrophage-specific mutant mice, we demonstrate that abrogating the secretion of the immunosuppressive cytokine IL-10 by T cells is sufficient to render otherwise susceptible mice resistant to an infection with the pathogen. The healing phenotype is accompanied by an elevated specific inflammatory immune response very early after infection. We further show that dendritic cell-based vaccination against leishmaniasis suppresses the early secretion of IL-10 following challenge infection. Thus, our study unravels a molecular mechanism critical for host immune defense, aiding in the development of an effective vaccine against leishmaniasis.