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Sonstige beteiligte Institutionen
Stimulatory or superagonistic (SA) CD28-specific monoclonal antibodies (mAbs) are potent polyclonal activators of regulatory T cells and have proven highly effective as treatment in a wide range of rodent models for autoimmune and inflammatory diseases. In these models, a preferential activation of regulatory T cells was observed by in vivo administration of CD28SA. In stark contrast, human volunteers receiving TGN1412, a humanized CD28-specific mAb, experienced a life-threatening cytokine release syndrome during the first-in-man trial. Preclinical tests employing human peripheral blood mononuclear cells (PBMC) failed to announce the rapid cytokine release measured in the human volunteers in response to TGN1412. The aim of this thesis project was to find an explanation of why standard PBMC assays failed to predict the unexpected TGN1412-induced "cytokine storm" observed in human volunteers. CD28 superagonists can activate T cells without T cell receptor (TCR) ligation. They do depend, however, on “tonic” TCR signals received by MHC scanning, signals that they amplify. PBMC do not receive these signals in the circulation. Short-term in vitro preculture of human PBMC at a high cell density (HDC) resulted in massive cytokine release during subsequent TGN1412 stimulation. Restoration of reactivity was cell-contact dependent, associated with TCR polarization and tyrosine-phosphorylation, and blocked by HLA-specific mAb. In HDC, both CD4 T cells and monocytes functionally mature in a mutually dependent fashion. However, only CD4 memory T-cells proliferate upon TGN1412 stimulation, and were identified as the main source of pro-inflammatory cytokines. Importantly, responses to other T-cell activating agents were also enhanced if PBMC were first allowed to interact under tissue-like conditions. A new in vitro protocol is provided that returns circulating T-cells to a tissue-like status where they respond to TGN1412 stimulation, and it might represent a more reliable preclinical in vitro test for both activating and inhibitory immunomodulatory drugs. Finally, the surprising observation was made that the IgG1 “sibling” of TGN1412, which is of the poorly Fc receptor-binding IgG4 isotype, has a much lower stimulatory activity. We could exclude steric hindrance as an explanation and provide evidence for removal of TGN1112 from the T-cell surface by trans-endocytosis.
Das Ziel der Studie war es, den vorbeschriebenen Befund des P50-Gating-Defizits bei Schizophrenie, insbesondere die Unterschiede zwischen den verschiedenen Subgruppen nach Leonhard zu replizieren und darüber hinaus diejenigen kortikalen Areale zu detektieren, die während Bedingungen gesteigerten sensorischen Gatings mit signifikanter Aktivierung reagieren. Ferner sollten mögliche Differenzen im Muster kortikaler Aktivierung zwischen gesunden Kontrollen und Patienten aufgedeckt werden, um das kortikale Substrat defizitären sensorischen Gatings zu ermitteln.
Von August 1997 bis Ende 2011 wurden in einem zweistufigen Neugeborenen-Hörscreening-Modell über 16994 Neugeborene mit dem MB 11 BERAphon® (MAICO, Diagnostic GmbH, Berlin) getestet. Anfangs wurde unter Verwendung des Zeitgang-BERA das Screening durchgeführt. Der akustische Reiz wurde im Laufe der Zeit verändert und optimiert. Aktuell wird mit einem breitbandigen akustischen CE-Chirp™ bei einem Screeningpegel von 35 dB-nHL gearbeitet. Von April 2008 bis September 2008 wurden im Rahmen dieser Arbeit Neugeborene mit der genannten Methode gescreent. Im Juli 2008 wurde zusätzlich eine Umfrage unter Eltern durchgeführt, deren Kinder ca. zwei Jahre zuvor in der Univ.-Frauenklinik Würzburg nach Hörstörungen untersucht worden waren. Das Ziel dieser Arbeit ist, die Qualität des Neugeborenen-Hörscreening-Modells zu überprüfen und somit auch die Ermittlung der Sensitivität und Spezifität des MB 11 BERAphons®. In dieser Studie werden Ergebnisse von 583 gescreenten Neugeborenen (1166 Ohren) dargestellt. Die mittlere Messzeit betrug 42,5s (SD = ± 34,24s). Die Messzeiten lagen zwischen 16s und 178s, im Median dauerte eine Messung 28s. Die Pass-Rate nach Stufe I betrug 97,69 % und nach Stufe II, bzw. nach den Kontrollscreenings 98,95 %. Eine pädaudiologische Diagnostik und Therapie fand bei 11 Ohren (8 Kinder) statt. Es wurden somit 0,94% der Ohren richtig-positiv ermittelt. Die falsch-positiv-Rate betrug 2,41 %. 0,69 % der Kinder gelten als Drop-outs. Insgesamt wurden 96,31% als richtig-negativ eingeordnet. Eine Spezifität von 97,57 % wurde erreicht. Im zweiten Teil der Arbeit wurde eine Umfrage unter 500 Elternpaaren durchgeführt. Zur Informationsermittlung wurde ein selbst entworfener Würzburger Fragebogen sowie der LittlEARS-Fragebogen der Firma MED-EL Medical Electronics verwendet. Der Würzburger Fragebogen erwies sich als sehr gut geeignet für die Sensitivitätsstudie. Es wurde eine Rücklaufquote von 71,57 % erreicht. Die durchschnittliche Antwortdauer war 16,3 Tage. Im Median dauerte eine Antwort 6 Tage. Die aus den Umfrageergebnissen ermittelte Sensitivität beträgt 100 %. Die bereits genannten Ziele dieser Arbeit wurden erreicht. Die in Würzburg angewandte Screeningmethode erwies sich als effizient und übertrifft damit die Anforderungen an eine vom G-BA geforderte Screening-Einrichtung.
Superoxidanionen (O2˙‾) sind eine von mehreren sogenannten reaktiven Sauerstoffspezies, die im menschlichen Körper intra-, aber auch extrazellulär vorkommen. Verschiedene Enzyme, z.B. in der mitochondrialen Atmungskette, die NADPH-Oxidase oder endotheliale NO-Synthasen bilden O2˙‾. Da es sich um eine sehr reaktive Substanz handelt, die mit der DNA sowie mit Proteinen und Lipiden interagiert und diese schädigen kann, spielt sie bei kardiovaskulären Erkrankungen wie etwa der chronischen Herzinsuffizienz, Hypertonie oder Arteriosklerose eine große Rolle, ist aber auch an vielen anderen Erkrankungen wie z.B. dem Diabetes mellitus pathophysiologisch beteiligt. Dies macht verständlich, dass es für die Forschung von entscheidender Bedeutung ist, Methoden zu entwickeln, die zur Erkennung und Quantifizierung von O2˙‾ geeignet sind. Bereits heute gibt es verschiedene Methoden, O2˙‾ nachzuweisen. Jede dieser Methoden hat jedoch ihre ganz spezifischen Vor- aber auch Nachteile. Wir haben eine neue, einfache, sehr schnelle und sensitive HPLC-Methode mit einem internen Standard entwickelt, mit der die O2˙‾-Produktion in Endothelzellen und aortalem Gewebe gut zu messen ist. Sie beruht auf der Tatsache, dass Dihydroethidium (DHE) mit O2.- zu 2-Hydroxyethidium (2-OH-E+) reagiert. Nach Trennung mittels HPLC wurde die Menge an entstandenem 2-OH-E+ durch einen elektrochemischen Detektor gemessen. Die Proben wurden durch isokrate Elution aufgetrennt, was bisher bei der Detektion von 2-OH-E+, DHE und O2˙‾ mit vielen Nachteilen verbunden war. Durch eine spezielle mobile Phase, die ein Ionen-Paar-Reagens enthielt, konnte diese Form der Elution nun auch zur Erkennung von O2˙‾ angewandt werden. DHE und seine Reaktionsprodukte konnten nicht nur eindeutig aufgetrennt werden, sondern die Auftrennung erfolgte auch sehr schnell in nur etwa 15min, was gegenüber älteren Methoden einen eindeutigen Zeitvorteil bringt. Anstatt zwei benötigten wir darüber hinaus nur eine Pumpe, was ebenfalls ein Vorteil der isokraten Elution ist. Wir erreichten auch über längere Messreihen stabile Bedingungen, da für die isokrate Elution die mobile Phase nicht verändert werden muss. Des Weiteren haben wir 3,4-Dihydroxyzimtsäure als internen Standard eingeführt, der sich hinsichtlich seiner Retentionszeit als sehr geeignet erwies und mit einem elektrochemischen Detektor klar und eindeutig nachweisbar war. Dies bietet große Vorteile gegenüber Methoden ohne internen Standard. Veränderungen der Konzentrationen von DHE, 2-OH-E+ und Ethidium aufgrund von Verdampfen des Lösungsmittels Methanol können ebenso erkannt werden wie Ungenauigkeiten während der Präparation sowie Schwankungen im HPLC-System, wie sie etwa bei langen Messreihen durch Auswaschungs-Effekte oder Verunreinigungen auftreten können. Da sich die Konzentration des internen Standards 3,4-Dihydroxyzimtsäure stets mitverändert, können die Messwerte normalisiert werden und somit die Verfälschungen aufgehoben werden. Dem zu Folge sind Messungen mit einem internen Standard gegenüber solchen ohne internen Standard deutlich valider. Sowohl die Stimulation von humanen aortalen Endothelzellen (HAEC) mit Glukose bzw. Tumornekrosefaktor α, als auch die Infusion von Angiotensin II bei männlichen Mäusen mit anschließender Untersuchung der Aorta führt bekanntermaßen zu einem Anstieg von O2˙‾. Dieser Effekt konnte nun auch mit unserer neu etablierten HPLC-Methode nachgewiesen werden. Ebenfalls war ein Anstieg des aortalen O2˙‾-Spiegels bei Ratten nach induziertem Myokardinfarkt bereits in mehreren früheren Arbeiten beschrieben worden. Dieser lag auch bei Messung mit unserer neu etablierten HPLC-Methode eindeutig vor. Die Signale waren hierbei für die untersuchten Substanzen 2-OH-E+, DHE sowie für den internen Standard 3,4-Dihydroxyzimtsäure eindeutig und gut voneinander getrennt. Zusammenfassend konnte somit gezeigt werden, dass sich anhand mehrerer etablierter in vitro und in vivo Modelle erhöhter Sauerstoffradikal-Produktion der Anstieg von O2˙‾ auch mit unserer neuen Variante der HPLC mit isokrater Elution, internem Standard und Messung mittels elektrochemischem Detektor nachweisen ließ. Es handelt sich um eine zuverlässige und sensitive Methode, die zusätzliche Vorteile für die Messung von O2˙‾ mit sich bringt.
Background: Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis. Differential diagnosis with cystic echinococcosis (CE) caused by E. granulosus and AE is challenging. We aimed at improving diagnosis of AE on paraffin sections of infected human tissue by immunohistochemical testing of a specific antibody.
Methodology/Principal Findings: We have analysed 96 paraffin archived specimens, including 6 cutting needle biopsies and 3 fine needle aspirates, from patients with suspected AE or CE with the monoclonal antibody (mAb) Em2G11 specific for the Em2 antigen of E. multilocularis metacestodes. In human tissue, staining with mAb Em2G11 is highly specific for E. multilocularis metacestodes while no staining is detected in CE lesions. In addition, the antibody detects small particles of E. multilocularis (spems) of less than 1 mm outside the main lesion in necrotic tissue, liver sinusoids and lymphatic tissue most probably caused by shedding of parasitic material. The conventional histological diagnosis based on haematoxylin and eosin and PAS stainings were in accordance with the immunohistological diagnosis using mAb Em2G11 in 90 of 96 samples. In 6 samples conventional subtype diagnosis of echinococcosis had to be adjusted when revised by immunohistology with mAb Em2G11.
Conclusions/Significance: Immunohistochemistry with the mAb Em2G11 is a new, highly specific and sensitive diagnostic tool for AE. The staining of small particles of E. multilocularis (spems) outside the main lesion including immunocompetent tissue, such as lymph nodes, suggests a systemic effect on the host.
Lymph node metastases associated with prostate cancer (PCa) has been shown to be a poor prognostic factor. The role of pelvic lymph node dissection (PLND) itself in relation to survival remains unclear, however. A Medline search was conducted to address this issue. The following conclusions were drawn. Only recently, improved survival due to completion of radical prostatectomy (RP) (compared to abandoning RP) in known or presumed lymph-node-positive patients has been shown. Lymph node sampling can only be considered representative if an adequate number of nodes is removed. While several authors have suggested that a therapeutic benefit in patients undergoing RP is not provided by PLND, the reliability of these studies is uncertain. Contrary to this, several studies have indicated the possibility of long-term survival even in the presence of limited lymph node metastases. The role and timing of initiation of adjuvant androgen deprivation therapy (ADT) in patients who have node-positive disease after RP is controversial. Recent studies suggest that delaying ADT may not adversely impact survival.
Secondary Prevention after Minor Stroke and TIA - Usual Care and Development of a Support Program
(2012)
Background: Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program.
Methods: Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU). Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed.
Results: 168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP): 155/84 mmHg) and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg) were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01). LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12). Proportions of patients who stopped smoking were 50 versus 79% (p<0.01). 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09).
Conclusions: Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-)vascular recurrence rates are going to be assessed in a multicenter randomized trial.
Measuring and estimating biodiversity patterns is a fundamental task of the scientist working to support conservation and informmanagement decisions.Most biodiversity studies in temperate regions were often carried out over a very short period of time (e.g., a single season) and it is often—at least tacitly—assumed that these short-termfindings are representative of long-termgeneral patterns.However, should the studied biodiversity pattern in fact contain significant temporal dynamics, perhaps leading to contradictory conclusions. Here, we studied the seasonal diversity dynamics of arboreal spider communities dwelling in 216 European beeches (Fagus sylvatica L.) to assess the spider community composition in the following seasons: two cold seasons (I:November 2005–January 2006; II: February–April) and two warm seasons (III: May–July; IV: August–October). We show that the usually measured diversity of the warmseason community (IV: 58 estimated species) alone did not deliver a reliable image of the overall diversity present in these trees, and therefore, we recommend it should not be used for sampling protocols aimed at providing a full picture of a forest’s biodiversity in the temperate zones. In particular, when the additional samplings of other seasons (I, II, III) were included, the estimated species richness nearly doubled (108). Community I possessed the lowest diversity and evenness due to the harsh winter conditions: this community was comprised of one dominant species together with several species low in abundance. Similarity was lowest (38.6%) between seasonal communities I and III, indicating a significant species turnover due to recolonization, so that community III had the highest diversity. Finally, using nonparametric estimators, we found that further sampling in late winter (February–April) is most needed to complete our inventory. Our study clearly demonstrates that seasonal dynamics of communities should be taken into account when studying biodiversity patterns of spiders, and probably forest arthropods in general.
This letter reports the results of a search for top and bottom squarks from gluino pair production in 4.7 fb\(^{−1}\) of pp collisions at √s=7 TeV using the ATLAS detector at the LHC. The search is performed in events with large missing transverse momentum and at least three jets identified as originating from a b-quark. Exclusion limits are presented for a variety of gluino-mediated models with gluino masses up to 1 TeV excluded.
A search for the Standard Model Higgs boson in the H→WW(⋆)→ℓνℓνH→WW(⋆)→ℓνℓν (ℓ=e,μℓ=e,μ) decay mode is presented. The search is performed using proton–proton collision data corresponding to an integrated luminosity of 4.7 fb\(^{−1}\) at a centre-of-mass energy of 7 TeV collected during 2011 with the ATLAS detector at the Large Hadron Collider. No significant excess of events over the expected background is observed. An upper bound is placed on the Higgs boson production cross section as a function of its mass. A Standard Model Higgs boson with mass in the range between 133 GeV and 261 GeV is excluded at 95% confidence level, while the expected exclusion range is from 127 GeV to 233 GeV.
A search for supersymmetry (SUSY) in events with large missing transverse momentum, jets, and at least one hadronically decaying τ lepton, with zero or one additional light lepton (e/μ), has been performed using 4.7 fb\(^{−1}\) of proton-proton collision data at \(\sqrt s\)=7TeV recorded with the ATLAS detector at the Large Hadron Collider. No excess above the Standard Model background expectation is observed and a 95 % confidence level visible cross-section upper limit for new phenomena is set. In the framework of gauge-mediated SUSY-breaking models, lower limits on the mass scale Λ are set at 54 TeV in the regions where the \(\tilde τ_1\) is the next-to-lightest SUSY particle (tanβ>20). These limits provide the most stringent tests to date of GMSB models in a large part of the parameter space considered.
Search for second generation scalar leptoquarks in pp collisions at √s=7 TeV with the ATLAS detector
(2012)
The results of a search for the production of second generation scalar leptoquarks are presented for final states consisting of either two muons and at least two jets or a muon plus missing transverse momentum and at least two jets. A total of 1.03 fb\(^{−1}\) integrated luminosity of proton-proton collision data produced by the Large Hadron Collider at s√=7 TeV and recorded by the ATLAS detector is used for the search. The event yields in the signal regions are found to be consistent with the Standard Model background expectations. The production of second generation leptoquarks is excluded for a leptoquark mass m\(_{LQ}\)<594 (685) GeV at 95 % confidence level, for a branching ratio of 0.5 (1.0) for leptoquark decay to a muon and a quark.
A search is presented for same-sign top-quark production and down-type heavy quarks of charge −1/3 in events with two isolated leptons (e or μ) that have the same electric charge, at least two jets and large missing transverse momentum. The data are selected from pp collisions at √s=7TeV recorded by the ATLAS detector and correspond to an integrated luminosity of 1.04 fb\(^{−1}\). The observed data are consistent with expectations from Standard Model processes. Upper limits are set at 95 % confidence level on the cross section of new sources of same-sign top-quark pair production of 1.4-2.0 pb depending on the assumed mediator mass. Upper limits are also set on the pair-production cross-section for new heavy down-type quarks; a lower limit of 450 GeV is set at 95 % confidence level on the mass of heavy down-type quarks under the assumption that they decay 100 % of the time to W t.
A search for new phenomena in final states with four or more leptons (electrons or muons) is presented. The analysis is based on 4.7 fb\(^{−1}\) of √s=7 TeV proton-proton collisions delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in two signal regions: one that requires moderate values of missing transverse momentum and another that requires large effective mass. The results are interpreted in a simplified model of R-parity-violating supersymmetry in which a 95% CL exclusion region is set for charged wino masses up to 540 GeV. In an R-parity-violating MSUGRA/CMSSM model, values of m 1/2 up to 820 GeV are excluded for 10 < tan β < 40.
A search is conducted for hadronic three-body decays of a new massive coloured particle in √s=7TeV pp collisions at the LHC using an integrated luminosity of 4.6 fb\(^{−1}\) collected by the ATLAS detector. Supersymmetric gluino pair production in the context of a model with R-parity violation is used as a benchmark scenario. The analysis is divided into two search channels, each optimised separately for their sensitivity to high-mass and low-mass gluino production. The first search channel uses a stringent selection on the transverse momentum of the six leading jets and is performed as a counting experiment. The second search channel focuses on low-mass gluinos produced with a large boost. Large-radius jets are selected and the invariant mass of each of the two leading jets is used as a discriminant between the signal and the background. The results are found to be consistent with Standard Model expectations and limits are set on the allowed gluino mass.
A search is presented for the pair production of light scalar top quarks in √s=7 TeV proton–proton collisions recorded with the ATLAS detector at the Large Hadron Collider. This analysis uses the full data sample collected during 2011 running that corresponds to a total integrated luminosity of 4.7 fb\(^{−1}\). Light scalar top quarks are searched for in events with two opposite-sign leptons (e, μ), large missing transverse momentum and at least one jet in the final state. No excess over Standard Model expectations is found, and the results are interpreted under the assumption that the light scalar top decays to a b-quark in addition to an on-shell chargino whose decay occurs through a virtual W boson. If the chargino mass is 106 GeV, light scalar top-quark masses up to 130 GeV are excluded for neutralino masses below 70 GeV.
This paper presents a search for the t-channel exchange of an R-parity violating scalar top quark ( \(\tilde{t}\) ) in the e\(^±\) μ\(^∓\) continuum using 2.1 fb\(^{−1}\) of data collected by the ATLAS detector in √s=7 TeV pp collisions at the Large Hadron Collider. Data are found to be consistent with the expectation from the Standard Model backgrounds. Limits on R-parity-violating couplings at 95 % C.L. are calculated as a function of the scalar top mass (m\(_\tilde{t}\)). The upper limits on the production cross section for pp→eμX, through the t-channel exchange of a scalar top quark, ranges from 170 fb for m\(_\tilde{t}\)=95 GeV to 30 fb for m\(_\tilde{t}\)=1000 GeV.
The ATLAS detector at the Large Hadron Collider is used to search for high-mass resonances decaying to an electron-positron pair or a muon-antimuon pair. The search is sensitive to heavy neutral Z′ gauge bosons, Randall-Sundrum gravitons, Z* bosons, techni-mesons, Kaluza-Klein Z/γ bosons, and bosons predicted by Torsion models. Results are presented based on an analysis of pp collisions at a center-of-mass energy of 7 TeV corresponding to an integrated luminosity of 4.9 fb\(^{−1}\) in the e\(^+\)e\(^−\) channel and 5.0 fb\(^{−1}\) in the μ\(^+\)μ\(^−\)channel. A Z′ boson with Standard Model-like couplings is excluded at 95 % confidence level for masses below 2.22 TeV. A Randall-Sundrum graviton with coupling k/\(\overline M_{Pl}\)=0.1 is excluded at 95 % confidence level for masses below 2.16 TeV. Limits on the other models are also presented, including Technicolor and Minimal Z′ Models.
This letter reports on a search for hypothetical heavy neutrinos, N, and right-handed gauge bosons, W R, in events with high transverse momentum objects which include two reconstructed leptons and at least one hadronic jet. The results were obtained from data corresponding to an integrated luminosity of 2.1 fb\(^{−1}\) collected in proton–proton collisions at √s=7 TeV with the ATLAS detector at the CERN Large Hadron Collider. No excess above the Standard Model background expectation is observed. Excluded mass regions for Majorana and Dirac neutrinos are presented using two approaches for interactions that violate lepton and lepton-flavor numbers. One approach uses an effective operator framework, the other approach is guided by the Left–Right Symmetric Model. The results described in this letter represent the most stringent limits to date on the masses of heavy neutrinos and W\(_R\) bosons obtained in direct searches.
A search for doubly charged Higgs bosons decaying to pairs of electrons and/or muons is presented. The search is performed using a data sample corresponding to an integrated luminosity of 4.7 fb\(^{−1}\) of pp collisions at √s = 7 TeV collected by the ATLAS detector at the LHC. Pairs of prompt, isolated, high-p\(_T\) leptons with the same electric charge (\(e^±e^±, e^±μ^±, μ^±μ^±\)) are selected, and their invariant mass distribution is searched for a narrow resonance. No significant excess over Standard Model background expectations is observed, and limits are placed on the cross section times branching ratio for pair production of doubly charged Higgs bosons. The masses of doubly charged Higgs bosons are constrained depending on the branching ratio into these leptonic final states. Assuming pair production, coupling to left-handed fermions, and a branching ratio of 100 % for each final state, masses below 409 GeV, 375 GeV, and 398 GeV are excluded for \(e^±e^±, e^±μ^±\), and \(μ^±μ^±\), respectively.
The results of a search for charged Higgs bosons are presented. The analysis is based on 4.6fb\(^{−1}\) of proton-proton collision data at √s=7TeV collected by the ATLAS experiment at the Large Hadron Collider, using top quark pair events with a τ lepton in the final state. The data are consistent with the expected background from Standard Model processes. Assuming that the branching ratio of the charged Higgs boson to a τ lepton and a neutrino is 100 %, this leads to upper limits on the branching ratio of top quark decays to a b quark and a charged Higgs boson between 5% and 1% for charged Higgs boson masses ranging from 90 GeV to 160 GeV, respectively. In the context of the m\(^{max}_h\) scenario of the MSSM, tan β above 12-26, as well as between 1 and 2-6, can be excluded for charged Higgs boson masses between 90 GeV and 150 GeV.
In models of anomaly-mediated supersymmetry breaking (AMSB), the lightest chargino is predicted to have a lifetime long enough to be detected in collider experiments. This letter explores AMSB scenarios in pp collisions at √s=7 TeV by attempting to identify decaying charginos which result in tracks that appear to have few associated hits in the outer region of the tracking system. The search was based on data corresponding to an integrated luminosity of 1.02 fb\(^{−1}\) collected with the ATLAS detector in 2011. The p\(_T\) spectrum of candidate tracks is found to be consistent with the expectation from Standard Model background processes and constraints on the lifetime and the production cross section were obtained. In the minimal AMSB framework with m\(_{3/2}\)<32 TeV, m\(_0\)<1.5 TeV, tanβ=5 and μ>0, a chargino having mass below 92 GeV and a lifetime between 0.5 ns and 2 ns is excluded at 95 % confidence level.
Search for anomalous production of prompt like-sign lepton pairs at √s=7TeV with the ATLAS detector
(2012)
An inclusive search for anomalous production of two prompt, isolated leptons with the same electric charge is presented. The search is performed in a data sample corresponding to 4.7 fb\(^{−1}\) of integrated luminosity collected in 2011 at √s=7TeV with the ATLAS detector at the LHC. Pairs of leptons (e\(^{±}\)e\(^{±}\), e\(^{±}\)μ\(^{±}\), and μ\(^{±}\)μ\(^{±}\)) with large transverse momentum are selected, and the dilepton invariant mass distribution is examined for any deviation from the Standard Model expectation. No excess is found, and upper limits on the production cross section of like-sign lepton pairs from physics processes beyond the Standard Model are placed as a function of the dilepton invariant mass within a fiducial region close to the experimental selection criteria. The 95% confidence level upper limits on the cross section of anomalous e\(^{±}\)e\(^{±}\), e\(^{±}\)μ\(^{±}\), or μ\(^{±}\)μ\(^{±}\) production range between 1.7 fb and 64 fb depending on the dilepton mass and flavour combination.
The results of a search for direct pair production of heavy top-quark partners in 4.7 fb\(^{−1}\) of integrated luminosity from pp collisions at √s=7 TeV collected by the ATLAS detector at the LHC are reported. Heavy top-quark partners decaying into a top quark and a neutral non-interacting particle are searched for in events with two leptons in the final state. No excess above the Standard Model expectation is observed. Limits are placed on the mass of a supersymmetric scalar top and of a spin-1/2 top-quark partner. A spin-1/2 top-quark partner with a mass between 300 GeV and 480 GeV, decaying to a top quark and a neutral non-interacting particle lighter than 100 GeV, is excluded at 95% confidence level.
A search for a fermiophobic Higgs boson using diphoton events produced in proton-proton collisions at a centre-of-mass energy of √s=7 TeV is performed using data corresponding to an integrated luminosity of 4.9 fb\(^{−1}\) collected by the ATLAS experiment at the Large Hadron Collider. A specific benchmark model is considered where all the fermion couplings to the Higgs boson are set to zero and the bosonic couplings are kept at the Standard Model values (fermiophobic Higgs model). The largest excess with respect to the background-only hypothesis is found at 125.5 GeV, with a local significance of 2.9 standard deviations, which reduces to 1.6 standard deviations when taking into account the look-elsewhere effect. The data exclude the fermiophobic Higgs model in the ranges 110.0–118.0 GeV and 119.5–121.0 GeV at 95 % confidence level.
The infectious intracellular lifestyle of Salmonella enterica relies on the adaptation to nutritional conditions within the Salmonella-containing vacuole (SCV) in host cells. We summarize latest results on metabolic requirements for Salmonella during infection. This includes intracellular phenotypes of mutant strains based on metabolic modeling and experimental tests, isotopolog profiling using (13)C-compounds in intracellular Salmonella, and complementation of metabolic defects for attenuated mutant strains towards a comprehensive understanding of the metabolic requirements of the intracellular lifestyle of Salmonella. Helpful for this are also genomic comparisons. We outline further recent studies and which analyses of intracellular phenotypes and improved metabolic simulations were done and comment on technical required steps as well as progress involved in the iterative refinement of metabolic flux models, analyses of mutant phenotypes, and isotopolog analyses. Salmonella lifestyle is well-adapted to the SCV and its specific metabolic requirements. Salmonella metabolism adapts rapidly to SCV conditions, the metabolic generalist Salmonella is quite successful in host infection.
The thesis enhances the strategy of non-destructive fluorescence read-out in rylene bisimide-diarylethene containing photochromic systems. The fluorescence of the emitter unit is quenched by a photoinduced electron transfer only to one of the isomeric forms of the photochrome. The driving force of the fuorescence-quenching electron transfer was calculated by the help of the Rehm-Weller equation. The novel photochromic systems satisfy the necessary requirements for non-destructive read-out in write/read/erase fluorescent memory devices.
Rumination has been defined as a mode of responding to distress that involves passively focusing one's attention on symptoms of distress without taking action. This dysfunctional response style intensifies depressed mood, impairs interpersonal problem solving, and leads to more pessimistic future perspectives and less social support. As most of these results were obtained from younger people, it remains unclear how age affects ruminative thinking. Three hundred members of the general public ranging in age from 15 to 87 years were asked about their ruminative styles using the Response Styles Questionnaire (RSQ), depression and satisfaction with life. A Mokken Scale analysis confirmed the two-factor structure of the RSQ with brooding and reflective pondering as subcomponents of rumination. Older participants (63 years and older) reported less ruminative thinking than other age groups. Life satisfaction was associated with brooding and highest for the earlier and latest life stages investigated in this study.
Background. Nitric oxide (NO)-signal transduction plays an important role in renal ischemia/reperfusion (I/R) injury. NO produced by endothelial NO-synthase (eNOS) has protective functions whereas NO from inducible NO-synthase (iNOS) induces impairment. Rosiglitazone (RGZ), a peroxisome proliferator-activated receptor (PPAR)-gamma agonist exerted beneficial effects after renal I/R injury, so we investigated whether this might be causally linked with NOS imbalance. Methods. RGZ (5 mg/kg) was administered i.p. to SD-rats (f) subjected to bilateral renal ischemia (60 min). Following 24 h of reperfusion, inulin-and PAH-clearance as well as PAH-net secretion were determined. Morphological alterations were graded by histopathological scoring. Plasma NOx-production was measured. eNOS and iNOS expression was analyzed by qPCR. Cleaved caspase 3 (CC3) was determined as an apoptosis indicator and ED1 as a marker of macrophage infiltration in renal tissue. Results. RGZ improves renal function after renal I/R injury (PAH-/inulin-clearance, PAH-net secretion) and reduces histomorphological injury. Additionally, RGZ reduces NOx plasma levels, ED-1 positive cell infiltration and CC3 expression. iNOS-mRNA is reduced whereas eNOS-mRNA is increased by RGZ. Conclusion. RGZ has protective properties after severe renal I/R injury. Alterations of the NO pathway regarding eNOS and iNOS could be an explanation of the underlying mechanism of RGZ protection in renal I/R injury.
ATP dependent chromatin remodeling complexes are multifactorial complexes that utilize the energy of ATP to rearrange the chromatin structure. The changes in chromatin structure lead to either increased or decreased DNA accessibility. SWI/SNF is one of such complex. The SWI/SNF complex is involved in both transcription activation and transcription repression. The ATPase subunit of SWI/SNF is called SWI2/SNF2 in yeast and Brahma, Brm, in Drosophila melanogaster. In mammals there are two paralogs of the ATPase subunit, Brm and Brg1. Recent studies have shown that the human Brm is involved in the regulation of alternative splicing. The aim of this study was to investigate the role of Brm in pre-mRNA processing. The model systems used were Chironomus tentans, well suited for in situ studies and D. melanogaster, known for its full genome information. Immunofluorescent staining of the polytene chromosome indicated that Brm protein of C. tentans, ctBrm, is associated with several gene loci including the Balbiani ring (BR) puffs. Mapping the distribution of ctBrm along the BR genes by both immuno-electron microscopy and chromatin immunoprecipitation showed that ctBrm is widely distributed along the BR genes. The results also show that a fraction of ctBrm is associated with the nascent BR pre-mRNP. Biochemical fractionation experiments confirmed the association of Brm with the RNP fractions, not only in C. tentans but also in D. melanogaster and in HeLa cells. Microarray hybridization experiments performed on S2 cells depleted of either dBrm or other SWI/SNF subunits show that Brm affects alternative splicing and 3´ end formation. These results indicated that BRM affects pre-mRNA processing as a component of SWI/SNF complexes. 1
It is of interest to define bacterial toxin biochemical properties to use them as molecular-syringe devices in order to deliver enzymatic activities into host cells. Binary toxins of the AB7/8-type are among the most potent and specialized bacterial protein toxins. The B subunits oligomerize to form a pore that binds with high affinity host cell receptors and the enzymatic A subunit. This allows the endocytosis of the complex and subsequent injection of the A subunit into the cytosol of the host cells. Here we report that the addition of an N-terminal His6-tag to different proteins increased their binding affinity to the protective antigen (PA) PA63-channels, irrespective if they are related (C2I) or unrelated (gpJ, EDIN) to the AB7/8-family of toxins. His6-EDIN exhibited voltage-dependent increase of the stability constant for binding by a factor of about 25 when the trans-side corresponding to the cell interior was set to 270 mV. Surprisingly, the C. botulinum toxin C2II-channel did not share this feature of PA63. Cell-based experiments demonstrated that addition of an N-terminal His6-tag promoted also intoxication of endothelial cells by C2I or EDIN via PA63. Our results revealed that addition of His6-tags to several factors increase their binding properties to PA63 and enhance the property to intoxicate cells.
RNase P processes the 5'-end of tRNAs. An essential catalytic RNA has been demonstrated in Bacteria, Archaea and the nuclei of most eukaryotes; an organism-specific number of proteins complement the holoenzyme. Nuclear RNase P from yeast and humans is well understood and contains an RNA, similar to the sister enzyme RNase MRP. In contrast, no protein subunits have yet been identified in the plant enzymes, and the presence of a nucleic acid in RNase P is still enigmatic. We have thus set out to identify and characterize the subunits of these enzymes in two plant model systems. Expression of the two known Arabidopsis MRP RNA genes in vivo was verified. The first wheat MRP RNA sequences are presented, leading to improved structure models for plant MRP RNAs. A novel mRNA encoding the central RNase P/MRP protein Pop1p was identified in Arabidopsis, suggesting the expression of distinct protein variants from this gene in vivo. Pop1p-specific antibodies precipitate RNase P activity and MRP RNAs from wheat extracts. Our results provide evidence that in plants, Pop1p is associated with MRP RNAs and with the catalytic subunit of RNase P, either separately or in a single large complex.
Background: There are few studies of the effects of nasal snuff and environmental factors on the risk of nasal cancer. This study aimed to investigate the impact of using nasal snuff and of other risk factors on the risk of nasal cancer in German men.
Methods: A population-based case-control study was conducted in the German Federal States of Bavaria and Baden-Wurttemberg. Tumor registries and ear, nose and throat departments provided access to patients born in 1926 or later.
Results: Telephone interviews were conducted with 427 cases (mean age 62.1 years) and 2.401 population-based controls (mean age 60.8 years). Ever-use of nasal snuff was associated with an odds ratio (OR) for nasal cancer of 1.45 (95% confidence interval [CI] 0.88-2.38) in the total study population, whereas OR in smokers was 2.01 (95% CI 1.00-4.02) and in never smokers was 1.10 (95% CI 0.43-2.80). The OR in ever-smokers vs. never-smokers was 1.60 (95% CI 1.24-2.07), with an OR of 1.06 (95% CI 1.05-1.07) per pack-year smoked, and the risk was significantly decreased after quitting smoking. Exposure to hardwood dust for at least 1 year resulted in an OR of 2.33 (95% CI 1.40-3.91) in the total population, which was further increased in never-smokers (OR 4.89, 95% CI 1.92-12.49) in analyses stratified by smoking status. The OR for nasal cancer after exposure to organic solvents for at least 1 year was 1.53 (1.17-2.01). Ever-use of nasal sprays/nasal lavage for at least 1 month rendered an OR of 1.59 (1.04-2.44). The OR after use of insecticides in homes was 1.48 (95% CI 1.04-2.11).
Conclusions: Smoking and exposure to hardwood dust were confirmed as risk factors for nasal carcinoma. There is evidence that exposure to organic solvents, and in-house use of insecticides could represent novel risk factors. Exposure to asbestos and use of nasal snuff were risk factors in smokers only.
Ziel dieser klinisch prospektiven Studie ist es bei über 80 jährigen Patienten mit moderater und hochgradiger AS echokardiographische Parameter zu identifizieren, die die langfristige Prognose für diese Patienten quantifizieren können. Methodik: Es wurde bei 118 Patienten eine konventionelle echokardiographische Standarduntersuchung und eine Gewebedoppleruntersuchung durchgeführt. Zudem wurden die aktuellen klinischen Daten erhoben. Nach durchschnittlich 641 ± 224.2 wurde eine telefonische Follow Up Untersuchung durchgeführt. Ergebnisse: Die Patienten wurden anhand der konventionellen echokardiographischen Parameter in 5 Gruppen eingeteilt. Eine hochgradige Aortenstenose mit reduziertem Gradienten und reduzierter EF ist mittels der Standardechokardiographiedaten von einer moderaten AS signifikant unterscheidbar. Besser gelingt es jedoch eine Niedrig Gradient AS mit der mittels Gewebedoppler ermittelten Strainrate und der Ringmotion von einer mittelgradigen AS zu unterscheiden. Die Patienten aus der Gruppe mit einer hochgradigen AS und einem hohen Gradienten wiesen das höchste Risiko eines kardialen Todes auf. Es stellte sich heraus, dass diese Patienten mittels Ringmotion und Strainrate signifikant von den Patienten mit einem niedrigeren Risiko unterschieden werden können. Zusammenfassung: Die Detektion des Grades der AS mit zusätzlich der Ringmotion und der Strainrate hat signifikante Vorteile gegenüber der Risikoquantifizierung über die EF und den Druckgradienten über der Aortenklappe alleine. Dies liefert wiederum eine bessere Einschätzung bezüglich der Dringlichkeit und Planung des Zeitpunktes für einen operativen Aortenklappenersatz, da alleine mit den Parametern der EF und des Gradienten die eigentlichen Hochrisikopatienten nicht ausreichend erfasst werden.
Many organisms evolved an endogenous clock to adapt to the daily environmental changes caused by the earth’s rotation. Light is the primary time cue (“Zeitgeber”) for entrainment of circadian clocks to the external 24-h day. In Drosophila, several visual pigments are known to mediate synchronization to light: The blue-light photopigment Cryptochrome (CRY) and six well-described rhodopsins (Rh1-Rh6). CRY is present in the majority of clock neurons as well as in the compound eyes, whereas the location of rhodopsins is restricted to the photoreceptive organs – the compound eyes, the ocelli and the HB-eyelets. CRY is thought to represent the key photoreceptor of Drosophila’s circadian clock. Nevertheless, mutant flies lacking CRY (cry01) are able to synchronize their locomotor activity rhythms to light-dark (LD) cycles, but need significantly longer than wild-type flies. In this behavior, cry01 mutants strongly resemble mammalian species that do not possess any internal photoreceptors and perceive light information exclusively through their photoreceptive organs (eyes). Thus, a mammalian-like phase-shifting behavior would be expected in cry01 flies. We investigated this issue by monitoring a phase response curve (PRC) of cry01 and wild-type flies to 1-h light pulses of 1000 lux irradiance. Indeed, cry01 mutants produced a mammalian-similar so called type 1 PRC of comparatively low amplitude (< 25% of wild-type) with phase delays to light pulses during the early subjective night and phase advances to light pulses during the late subjective night (~1 h each). Despite the predominant role of CRY, the visual system contributes to the light sensitivity of the fly’s circadian clock, mainly around dawn and dusk. Furthermore, this phase shifting allows for the slow re-entrainment which we observed in cry01 mutants to 8-h phase delays of the LD 12 h:12 h cycle. However, cry01 also showed surprising differences in their shifting ability: First of all, their PRC was characterized by a second dead zone in the middle of the subjective night (ZT17-ZT19) in addition to the usual unresponsiveness during the subjective day. Second, in contrast to wild-type flies, cry01 mutants did not increase their shift of activity rhythms neither in response to longer stimuli nor to light pulses of higher irradiance. In contrast, both 6-h light pulses of 1000 lux and 1-h light pulses of 10,000 lux light intensity during the early subjective night even resulted in phase advances instead of the expected delays. Thus, CRY seems to be not only responsible for the high light sensitivity of the wild-type circadian clock, but is apparently also involved in integrating and processing light information. Rhodopsin 7 (Rh7) is a yet uncharacterized protein, but became a good photoreceptor candidate due to sequence similarities to the six known Drosophila Rhs. The second part of this thesis investigated the expression pattern of Rh7 and its possible functions, especially in circadian photoreception. Furthermore, we were interested in a potential interaction with CRY and thus, tested cry01 and rh70 cry01 mutants as well. Rh1 is the main visual pigment of the Drosophila compound eye and expressed in six out of eight photoreceptors cells (R1-R6) in each of the ~800 ommatidia. Motion vision depends exclusively on Rh1 function but, moreover, Rh1 plays an important structural role and assures proper photoreceptor cell development and maintenance. In order to investigate its possible photoreceptive function, we expressed Rh7 in place of Rh1. Rh7 was indeed able to overtake the role of Rh1 in both aspects: It prevented retinal degeneration and mediated the optomotor response (OR), a motion vision-dependent behavior. At the transcriptional level, rh7 is expressed at approximately equal amounts in adult fly brains and retinas. Due to a reduced specificity of anti-Rh7 antibodies, we could not verify this result at the protein level. However, analysis of rh7 null mutants (rh70) suggested different Rh7 functions in vivo. Previous experiments strongly indicated an increased sensitivity of the compound eyes in the absence of Rh7 and suggested impaired light adaptation. We aimed to test this hypothesis at the levels of circadian photoreception. Locomotor activity rhythms are a reliable output of the circadian clock. Rh70 mutant flies generally displayed a wild-type similar bimodal activity pattern comprising morning (M) and evening (E) activity bouts. Activity monitoring supported the proposed “shielding” function, since rh70 mutants behaved like wild-type flies experiencing high irradiances. Under all investigated conditions, their activity peaks lay further apart resulting in a prolonged midday break. The behavior of cry01 mutants was mainly characterized by an unexpectedly high flexibility in the timing of M and E activity bouts which allowed tracking of lights-on and lights-off even under extreme photoperiods. Activity profiles of the corresponding rh70 cry01 double mutants reflected neither synergistic nor antagonistic effects of Rh7 and CRY and were dominated by a broad E activity peak. In the future, the different circadian phenotypes will be further investigated on the molecular level by analysis of clock protein cycling in the underlying pacemaker neurons. The work of this thesis confirmed that Rh7 is indeed able to work as a photoreceptor and to initiate the classical phototransduction cascade. On the other hand, it provided further evidence at the levels of circadian photoreception that Rh7 might serve as a shielding pigment for Rh1 in vivo, thereby mediating proper light adaptation.
The development of insecticides requires valid risk assessment procedures to avoid causing harm to beneficial insects and especially to pollinators such as the honeybee Apis mellifera. In addition to testing according to current guidelines designed to detect bee mortality, tests are needed to determine possible sublethal effects interfering with the animal's vitality and behavioral performance. Several methods have been used to detect sublethal effects of different insecticides under laboratory conditions using olfactory conditioning. Furthermore, studies have been conducted on the influence insecticides have on foraging activity and homing ability which require time-consuming visual observation. We tested an experimental design using the radiofrequency identification (RFID) method to monitor the influence of sublethal doses of insecticides on individual honeybee foragers on an automated basis. With electronic readers positioned at the hive entrance and at an artificial food source, we obtained quantifiable data on honeybee foraging behavior. This enabled us to efficiently retrieve detailed information on flight parameters. We compared several groups of bees, fed simultaneously with different dosages of a tested substance. With this experimental approach we monitored the acute effects of sublethal doses of the neonicotinoids imidacloprid (0.15-6 ng/bee) and clothianidin (0.05-2 ng/bee) under field-like circumstances. At field-relevant doses for nectar and pollen no adverse effects were observed for either substance. Both substances led to a significant reduction of foraging activity and to longer foraging flights at doses of >= 0.5 ng/bee (clothianidin) and >= 1.5 ng/bee (imidacloprid) during the first three hours after treatment. This study demonstrates that the RFID-method is an effective way to record short-term alterations in foraging activity after insecticides have been administered once, orally, to individual bees. We contribute further information on the understanding of how honeybees are affected by sublethal doses of insecticides.
Ziel der retrospektiven Studie war es, den Einfluss der prothetischen Restauration, beziehungsweise der Position des Pfeilers im Zahnbogen sowie der Art des restaurierten Zahnes auf das Überleben von mit Stift-Stumpfaufbauten rekonstruierten Zähnen zu untersuchen. Die verschiedenen Parameter, die zu Erfolg oder Misserfolg geführt haben, sollten analysiert werden, um gegebenenfalls deren Einfluss auf die Verweildauer der Stift-Stumpfaufbauten beziehungsweise der damit versorgten Zähne in Form einer Überlebenszeitanalyse zu untersuchen Seit 1999 wurden Patienten, die in der Klinik mit einem Stift-Stumpfaufbau versorgt worden waren, protokollarisch erfasst. Die koronal stark zerstörten Zähne wurden durch ein weitgehend standardisiertes Behandlungsverfahren rekonstruiert und mit diversen prothetischen Restaurationen versehen. Das Patientenkollektiv umfasste 195 Patienten mit 320 Stift-Stumpfaufbauten. Zur Überlebenszeitanalyse kam die Methode nach Kaplan-Meier zum Einsatz. Die gruppenbezogenen Überlebenskurven wurden mittels Log-Rang-Test auf statistische Signifikanz getestet. Die häufigsten Misserfolgsgründe stellten Dezementierungen der Stift-Stumpfauf- bauten und Entzündungszeichen mit apikalen Läsionen dar. Die Ergebnisse dieser Studie zeigten, dass der Erfolg einer postendodontischen Stiftverankerung je nach Zahntyp und Art der prothetischen Versorgung variierte. Festsitzende prothetische Restaurationen auf der Basis eines Stift-Stumpfaufbaus im Frontzahn- und Prämolarenbereich hatten eine relativ hohe Überlebeswahrscheinlichkeit, vor allem wenn sie Brückenpfeiler waren. War der mit einem Stift-Stumpfaufbau rekonstruierte Zahn aber endständig in der Zahnreihe, überdurchschnittlichen Belastungen ausgesezt - wie der Eckzahn - oder diente als endständiger Pfeiler einer herausnehmbaren teleskopierenden Prothese, waren frühzeitige Komplikationen wahrscheinlich. Die Ergebnisse zeigten, dass eine primäre Verblockung die Überlebenswahrscheinlichkeit von Innenteleskopkronen positiv beeinflussen konnte.
Die Auswertung des Patientenkollektivs von 2000 bis 2004 an der Chirurgischen Universitätsklinik Würzburg ergab 63 Patienten (Gruppe 1), die einer Minoramputation und
59 Patienten die einer Minor- mit konsekutiver Majoramputation (Gruppe 2) infolge pAVK unterzogen wurden. Eine Abhängigkeit zwischen Alter und Majornachamputationsrate konnte nicht festgestellt werden, jedoch eine Tendenz beim Einfluss von Comorbiditäten wie Diabetes mellitus und dialysepflichtiger Niereninsuffizienz auf die Wundheilung und Liegedauer.
Die Anzahl an durchgeführten gefäßchirurgischen Eingriffen wie PTA und Bypass-Operation lag in beiden Gruppen mit 65% bzw. 72% im Vergleich zur Literatur im Standardbereich.
Eine hohe Rate an gefäßmedizinischer Diagnostik und Therapie scheint auch bei fortgeschrittener pAVK (Grad IV) erforderlich, um die Notwendigkeit von Amputationen
insbesondere die Anzahl an Majoramputationen zu verringern. Bei hoher und mit Gruppe 1 vergleichbarer Interventionsrate in Gruppe 2 lässt sich allerdings auch erkennen, dass trotz Ausschöpfung dieser Massnahmen die Rate an Majoramputationen und damit des
Beinverlustes hoch ist.
Positiv zu werten ist, dass es bei über 50% der Amputierten ausgereicht hat, eine Amputation im Fussbereich (Minoramputation) durchzuführen. Bei diesen 63 Patienten, war bei 58 Patienten sogar nur ein Eingriff nötig. Ferner handelte es sich bei den Majoramputationen in der Mehrzahl um Unterschenkelamputation, und somit um einen nur partiellen Beinverlust . 76% der durchgeführten ersten Majoramputationen erfolgten in den ersten beiden Monaten nach vorausgegangener Minoramputation, die größte Anzahl innerhalb des ersten Monats. Auch die letzte Amputation, die definitive Versorgung, erfolgte
in den meisten Fällen innerhalb der ersten beiden Monate nach Primäreingriff. Somit ist ein nur unwesentlicher Aufschub bis zur definitiven Versorgung ersichtlich.
Der Versuch einer Konsolidierung der Ischämiefolgen (Gangrän) mittels Minoramputation scheint bei fortgeschrittener pAVK im Stadium IV nach Ausschöpfung der
gefäßmedizinischen Diagnostika und Interventionen somit immer gerechtfertigt, und sollte wenn möglich einer Majoramputation vorgezogen werden.
Die durchschnittliche Krankenhausverweildauer in der Gruppe der Minoramputationen lag bei 28 Tagen, in der Gruppe 2 der Majoramputationen bei 39 Tagen. Die Mortalitätsrate ergibt einen deutlich erhöhten Wert in der Gruppe der Majoramputationen. Die Dreijahresmortalität betrug in der Gruppe der Minoramputationen 20% und der Majoramputationen 58%. Es zeigte sich eine Zunahme der Mortalität mit zunehmender
Amputationshöhe und zunehmender Zahl der Amputationen. Diese Daten lassen sich mit 52 aktuellen Literaturangaben durchaus vergleichen und beweisen die schlechte Prognose für AVK-Patienten, bei denen eine Majoramputation unausweichlich ist.
Insgesamt ist es wichtig, dass ein Team aus Chirurgen, Gefäßchirurgen, Radiologen und Angiologen kooperativ zusammen arbeitet, um dem Patienten, eine für ihn
beste Versorgung anbieten zu können. Hier sollte auch nicht vor einem oft höheren Patientenalter zurückgeschreckt werden, denn häufig konnte gerade bei diesen Patienten durch eine Bypass-Operation eine sonst vermutlich unumgängliche Amputation im Unter- bzw.
Oberschenkelbereich verhindert werden.
Objective: The objective of this study was to investigate the applicability of microanalytical methods with high spatial resolution to the characterization of the composition and corrosion behavior of two bracket systems.
Material and methods: The surfaces of six nickel-free brackets and six nickel-containing brackets were examined for signs of corrosion and qualitative surface analysis using an electron probe microanalyzer (EPMA), prior to bonding to patient's tooth surfaces and four months after clinical use. The surfaces were characterized qualitatively by secondary electron (SE) images and back scattered electron (BSE) images in both compositional and topographical mode. Qualitative and quantitative wavelength-dispersive analyses were performed for different elements, and by utilizing qualitative analysis the relative concentration of selected elements was mapped two-dimensionally. The absolute concentration of the elements was determined in specially prepared brackets by quantitative analysis using pure element standards for calibration and calculating correction-factors (ZAF).
Results: Clear differences were observed between the different bracket types. The nickel-containing stainless steel brackets consist of two separate pieces joined by a brazing alloy. Compositional analysis revealed two different alloy compositions, and reaction zones on both sides of the brazing alloy. The nickel-free bracket was a single piece with only slight variation in element concentration, but had a significantly rougher surface. After clinical use, no corrosive phenomena were detectable with the methods applied. Traces of intraoral wear at the contact areas between the bracket slot and the arch wire were verified. Conclusion: Electron probe microanalysis is a valuable tool for the characterization of element distribution and quantitative analysis for corrosion studies.
Respiratory sinus arrhythmia (RSA) is related to cardiac vagal outflow and the respiratory pattern. Prior infant studies have not systematically examined respiration rate and tidal volume influences on infant RSA or the extent to which infants' breathing is too fast to extract a valid RSA. We therefore monitored cardiac activity, respiration, and physical activity in 23 six-month old infants during a standardized laboratory stressor protocol. On average, 12.6% (range 0-58.2%) of analyzed breaths were too short for RSA extraction. Higher respiration rate was associated with lower RSA amplitude in most infants, and lower tidal volume was associated with lower RSA amplitude in some infants. RSA amplitude corrected for respiration rate and tidal volume influences showed theoretically expected strong reductions during stress, whereas performance of uncorrected RSA was less consistent. We conclude that stress-induced changes of peak-valley RSA and effects of variations in breathing patterns on RSA can be determined for a representative percentage of infant breaths. As expected, breathing substantially affects infant RSA and needs to be considered in studies of infant psychophysiology.
From November 2nd - 4th 2012, the 4th NEUROWIND e.V. meeting was held in Motzen, Brandenburg, Germany. Again more than 60 participants, predominantly at the doctoral student or postdoc level, gathered to share their latest findings in the fields of neurovascular research, neurodegeneration and neuroinflammation. Like in the previous years, the symposium provided an excellent platform for scientific exchange and the presentation of innovative projects in the stimulating surroundings of the Brandenburg outback. This year’s keynote lecture on the pathophysiological relevance of neuronal networks was given by Christian Gerloff, Head of the Department of Neurology at the University Clinic of Hamburg-Eppendorf. Another highlight of the meeting was the awarding of the NEUROWIND e.V. prize for young scientists working in the field of experimental neurology. The award is donated by the Merck Serono GmbH, Darmstadt, Germany and is endowed with 20.000 Euro. This year the jury decided unanimously to adjudge the award to Michael Gliem from the Department of Neurology at the University Clinic of Düsseldorf (group of Sebastian Jander), Germany, for his outstanding work on different macrophage subsets in the pathogenesis of ischemic stroke published in the Annals of Neurology in 2012.
From November 4th- 6th 2011, the 3rd NEUROWIND e.V. meeting was held in Motzen, Brandenburg, Germany. Like in the previous years, the meeting provided an excellent platform for scientific exchange and the presentation of innovative projects for young colleagues in the fields of neurovascular research, neuroinflammation and neurodegeneration. As kick-off to the scientific sessions, Reinhard Hohlfeld, Head of the Institute for Clinical Neuroimmunology in Munich, gave an illustrious overview on the many fascinations of neuroimmunologic research. A particular highlight on the second day of the meeting was the award of the 1’st NEUROWIND e.V. prize for young academics in the field of experimental neurology. This award is posted for young colleagues under the age of 35 with a significant achievement in the field of neurovascular research, neuroinflammation or neurodegeneration and comprises an amount of 20.000 Euro, founded by Merck Serono GmbH, Darmstadt. Germany. The first prize was awarded to Ivana Nikic from Martin Kerschensteiner’s group in Munich for her brilliant work on a reversible form of axon damage in experimental autoimmune encephalomyelitis and multiple sclerosis, published in Nature Medicine in 2011. This first prize award ceremony was a great incentive for the next call for proposals now upcoming in 2012.
A recent genome-wide association study in patients with panic disorder (PD) identified a risk haplotype consisting of two single-nucleotide polymorphisms (SNPs) (rs7309727 and rs11060369) located in intron 3 of TMEM132D to be associated with PD in three independent samples. Now we report a subsequent confirmation study using five additional PD case-control samples (n = 1670 cases and n 2266 controls) assembled as part of the Panic Disorder International Consortium (PanIC) study for a total of 2678 cases and 3262 controls in the analysis. In the new independent samples of European ancestry (EA), the association of rs7309727 and the risk haplotype rs7309727-rs11060369 was, indeed, replicated, with the strongest signal coming from patients with primary PD, that is, patients without major psychiatric comorbidities (n 1038 cases and n 2411 controls). This finding was paralleled by the results of the meta-analysis across all samples, in which the risk haplotype and rs7309727 reached P-levels of P = 1.4e-8 and P = 1.1e-8, respectively, when restricting the samples to individuals of EA with primary PD. In the Japanese sample no associations with PD could be found. The present results support the initial finding that TMEM132D gene contributes to genetic susceptibility for PD in individuals of EA. Our results also indicate that patient ascertainment and genetic background could be important sources of heterogeneity modifying this association signal in different populations.
Reorganisation der Zellkontakte der Endothelbarriere bei der Stabilisierung durch cAMP und Rac1
(2012)
Zwischen Blutkompartiment und umliegenden Interstitium besteht eine Barriere, die durch eine einzelne Schicht aus Endothelzellen gebildet wird. Essentiell für diese Barriere, deren Funktion in der Begrenzung des Austausches von Flüssigkeit und gelösten Stoffen liegt, sind interzelluläre Junktionen, welche die Endothelzellen miteinander verbinden. Durch eine gestörte Funktion und Regulation der Endothelbarriere entstehen beim Menschen verschiedene Pathologien wie zum Beispiel Ödeme, hämorrhagischer Schlaganfall und vaskuläre Malformationen.
Es ist bekannt, dass cAMP die Endothelbarriere zum Teil durch Aktivierung der kleinen GTPase Rac1 stabilisiert. Trotz der großen medizinischen Relevanz dieses Signalweges, sind die damit einhergehenden Effekte auf die interzellulären Kontakte auf ultrastruktureller Ebene weitgehend unbekannt.
In mikrovaskulären Endothelzellkulturen kam es ähnlich wie in intakten Mikrogefäßen zur Stärkung der Barrierefunktion. So resultierte sowohl nach Behandlung mit Forskolin und Rolipram (F/R), welche zur Steigerung der intrazellulären cAMP-Spiegel führen, als auch nach Zugabe von 8-(4-chlorophenylthio)-2´-O-methyladenosin-3´,5´-cyclic monophosphorothioate (O-Me-cAMP), einem selektiven Aktivator des cAMP nachgeschalteten Epac/Rap1-Signalweges, ein Anstieg des TER; außerdem konnte durch beide Substanzen (F/R und O-Me-cAMP) die Aktivierung von Rac1 induziert werden. Desweiteren wurde eine verstärkte Intensität und Linearisierung des Immunfluoreszenzsignals der Zelljunktionsproteine VE-Cadherin und Claudin5 entlang der Zellgrenzen beobachtet.
In der ultrastrukturellen Analyse der interzellulären Kontaktzonen-Architektur zeigte sich unter F/R- oder O-Me-cAMP-Exposition ein signifikanter Anstieg an komplexen Interdigitationen. Diese komplexen Strukturen waren dadurch charakterisiert, dass sich die Membranen benachbarter Zellen, die durch zahlreiche endotheliale Junktionen stabilisiert wurden, über vergleichsweise lange Distanzen eng aneinanderlegten, so dass ein deutlich verlängerter Interzellularspalt resultierte. Die Inhibition der Rac1-Aktivierung durch NSC-23766 verminderte die Barrierefunktion und blockierte effektiv die O-Me-cAMP-vermittelte Barrierestabilisierung und Reorganisation der Kontaktzone einschließlich der Junktionsproteine.
Demgegenüber konnte die F/R-vermittelte Barrierestabilisierung durch NSC-23766 nicht beeinträchtigt werden.
Parallel dazu durchgeführte Experimente mit makrovaskulären Endothelien zeigten, dass es in diesem Zelltyp unter Bedingungen erhöhter cAMP-Konzentrationen weder zur Rac1-Aktivierung noch zur Barrierestärkung oder Kontaktzonen-Reorganisation kam.
Diese Ergebnisse deuten darauf hin, dass in mikrovaskulären Endothelien Rac1-vermittelte Änderungen der Kontaktzonen-Morphologie zur cAMP-induzierten Barrierestabilisierung beitragen.
Renal Perfusion in Scleroderma Patients Assessed by Microbubble-Based Contrast-Enhanced Ultrasound
(2012)
Abstract: Objectives: Renal damage is common in scleroderma. It can occur acutely or chronically. Renal reserve might already be impaired before it can be detected by laboratory findings. Microbubble-based contrast-enhanced ultrasound has been demonstrated to improve blood perfusion imaging in organs. Therefore, we conducted a study to assess renal perfusion in scleroderma patients utilizing this novel technique. Materials and Methodology: Microbubble-based contrast agent was infused and destroyed by using high mechanical index by Siemens Sequoia (curved array, 4.5 MHz). Replenishment was recorded for 8 seconds. Regions of interests (ROI) were analyzed in renal parenchyma, interlobular artery and renal pyramid with quantitative contrast software (CUSQ 1.4, Siemens Acuson, Mountain View, California). Time to maximal Enhancement (TmE), maximal enhancement (mE) and maximal enhancement relative to maximal enhancement of the interlobular artery (mE%A) were calculated for different ROIs. Results: There was a linear correlation between the time to maximal enhancement in the parenchyma and the glomerular filtration rate. However, the other parameters did not reveal significant differences between scleroderma patients and healthy controls. Conclusion: Renal perfusion of scleroderma patients including the glomerular filtration rate can be assessed using microbubble-based contrast media.
Background. The purpose of this study was to identify determinants of renal disease progression in adults with Fabry disease during treatment with agalsidase beta.
Methods. Renal function was evaluated in 151 men and 62 women from the Fabry Registry who received agalsidase beta at an average dose of 1 mg/kg/2 weeks for at least 2 years. Patients were categorized into quartiles based on slopes of estimated glomerular filtration rate (eGFR) during treatment. Multivariate logistic regression analyses were used to identify factors associated with renal disease progression.
Results. Men within the first quartile had a mean eGFR slope of –0.1 mL/min/1.73m2/year, whereas men with the most rapid renal disease progression (Quartile 4) had a mean eGFR slope of –6.7 mL/min/1.73m2/year. The risk factor most strongly associated with renal disease progression was averaged urinary protein:creatinine ratio (UP/Cr) ≥1 g/g (odds ratio 112, 95% confidence interval (95% CI) 4–3109, P = 0.0054). Longer time from symptom onset to treatment was also associated with renal disease progression (odds ratio 19, 95% CI 2–184, P = 0.0098). Women in Quartile 4 had the highest averaged UP/Cr (mean 1.8 g/g) and the most rapid renal disease progression: (mean slope –4.4 mL/min/1.73m2/year).
Conclusions. Adults with Fabry disease are at risk for progressive loss of eGFR despite enzyme replacement therapy, particularly if proteinuria is ≥1 g/g. Men with little urinary protein excretion and those who began receiving agalsidase beta sooner after the onset of symptoms had stable renal function. These findings suggest that early intervention may lead to optimal renal outcomes.
Background: Remote ischemic conditioning is gaining interest as potential method to induce resistance against ischemia reperfusion injury in a variety of clinical settings. We performed a systematic review and meta-analysis to investigate whether remote ischemic conditioning reduces mortality, major adverse cardiovascular events, length of stay in hospital and in the intensive care unit and biomarker release in patients who suffer from or are at risk for ischemia reperfusion injury.
Methods and Results: Medline, EMBASE and Cochrane databases were searched for randomized clinical trials comparing remote ischemic conditioning, regardless of timing, with no conditioning. Two investigators independently selected suitable trials, assessed trial quality and extracted data. 23 studies in patients undergoing cardiac surgery (15 studies), percutaneous coronary intervention (four studies) and vascular surgery (four studies), comprising in total 1878 patients, were included in this review. Compared to no conditioning, remote ischemic conditioning did not reduce mortality (odds ratio 1.22 [95% confidence interval 0.48, 3.07]) or major adverse cardiovascular events (0.65 [0.38, 1.14]). However, the incidence of myocardial infarction was reduced with remote ischemic conditioning (0.50 [0.31, 0.82]), as was peak troponin release (standardized mean difference -0.28 [-0.47, -0.09]).
Conclusion: There is no evidence that remote ischemic conditioning reduces mortality associated with ischemic events; nor does it reduce major adverse cardiovascular events. However, remote ischemic conditioning did reduce the incidence of peri-procedural myocardial infarctions, as well as the release of troponin.
Das Ziel dieser Promotion ist der Aufbau eines dreMR Setups für einen klinischen 1,5T Scanner, das die Relaxations-Dispersions-Bildgebung ermöglicht, und die anschließende Ergründung von möglichst vielen Anwendungsfeldern von dreMR. Zu der Aufgabe gehört die Bereitstellung der zugrunde liegenden Theorie, der Bau des experimentellen Setups (Offset-Spule und Stromversorgung) sowie die Programmierung der nötigen Software. Mit dem gebauten Setup konnten zwei große Anwendungsfelder — dreMR Messungen mit und ohne Kontrastmitteln — untersucht werden.
Introduction: Sleep disturbances are common in adolescents and adversely affect performance, social contact, and susceptibility to stress. We investigated the hypothesis of a relationship between sleep and health-related quality of life (HRQoL), and applied self- and proxy ratings. Materials and Methods: The sample comprised 92 adolescents aged 11–17 years. All participants and their parents completed a HRQoL measure and the Sleep Disturbance Scale for Children (SDSC ). Children with SDSC T -scores above the normal range (above 60) were classified as poor sleepers. Results: According to self- and proxy ratings, good sleepers reported significantly higher HRQoL than poor sleep- ers. Sleep disturbances were significantly higher and HRQoL significantly lower in self- as compared to parental ratings. Parent-child agreement was higher for subscales measuring observable aspects. Girls experienced significantly stronger sleep disturbances and lower self-rated HRQoL than boys. Discussion: Our findings support the positive relationship of sleep and HRQoL. Furthermore, parents significantly underestimate sleep disturbances and overestimate HRQoL in their children.