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In aged humans, stroke is a major cause of disability for which no neuroprotective measures are available. In animal studies of focal ischemia, short-term hypothermia often reduces infarct size. Nevertheless, efficient neuroprotection requires long-term, regulated lowering of whole-body temperature. Previously, it is reported that post-stroke exposure to hydrogen sulfide (H2S) effectively lowers whole-body temperature and confers neuroprotection in aged animals. Here we report for the first time that the animals exposed to H2S the normal sleep–wake oscillations are replaced by a low-amplitude EEG dominated by a 4-Hz rhythmicactivity, reminiscent of EEG recordings in hibernating animals. In the present study using magnetic resonance imaging, reverse transcriptase polymerase chain reaction, western blotting and immunofluorescence, we characterized the central nervous system response to H2S -induced hypothermia and report, that annexin A1, a major constituent of peripheral leukocytes that is upregulated after stroke, was consistently downregulated in polymorphonuclear cells in the peri-lesional cortex of post-ischemic, aged rat brain after 48 hours of hypothermia induced by exposure to H2S. This might be due to the reduced kinetics of recruitment, adherence and infiltration of PMN cells by H2S -induced hypothermia. Our findings further suggest that, in contrast to monotherapies that have thus far uniformly failed in clinical practice, prolonged hypothermia has pleiotropic effects on brain physiology that may be necessary for effective protection of the brain after stroke.
The goal of this doctoral thesis is to create and to implement methods for fully automatic segmentation applications in magnetic resonance images and datasets. The work introduces into technical and physical backgrounds of magnetic resonance imaging (MRI) and summarizes essential segmentation challenges in MRI data including technical malfunctions and ill-posedness of inverse segmentation problems. Theoretical background knowledge of all the used methods that are adapted and extended to combine them for problem-specific segmentation applications are explained in more detail. The first application for the implemented solutions in this work deals with two-dimensional tissue segmentation of atherosclerotic plaques in cardiological MRI data. The main part of segmentation solutions is designed for fully automatic liver and kidney parenchyma segmentation in three-dimensional MRI datasets to ensure computer-assisted organ volumetry in epidemiological studies. The results for every application are listed, described and discussed before important conclusions are drawn. Among several applied methods, the level set method is the main focus of this work and is used as central segmentation concept in the most applications. Thus, its possibilities and limitations for MRI data segmentation are analyzed. The level set method is extended by several new ideas to overcome possible limitations and it is combined as important part of modularized frameworks. Additionally, a new approach for probability map generation is presented in this thesis, which reduces data dimensionality of multiple MR-weightings and incorporates organ position probabilities in a probabilistic framework. It is shown, that essential organ features (i.e. MR-intensity distributions, locations) can be well represented in the calculated probability maps. Since MRI data are produced by using multiple MR- weightings, the used dimensionality reduction technique is very helpful to generate a single probability map, which can be used for further segmentation steps in a modularized framework.
The main objective of this research was to enhance the understanding of the inte¬ractions of bentonite with iron in the near field of a HLW-repository. One target was to investigate natural Fe-rich bentonites as a possible analogue. Another topic was to recognize the mineralogical interaction of bentonite with iron powder simulating the contact of bentonite with steel containers (thermodynamic approach). An additional objective was to explore the idea that bentonites have a specific dissolution potential (kinetic approach). In order to take the thermodynamic approach, compacted MX80 bentonite and Friedland clay were used as starting materials for clay/iron interaction experiments in per¬colation systems (Clay/Iron-ratio = 0.1). The natural processes were studied by examining a tropical wea¬thering profile of serpentiniz¬ed diabase from the Thanh Hoa province of Vietnam. The kinetic approach was taken by investigating a series of well characterized bentonites, 9 from API-standard series, 12 from the BGR-collection and 4 others, all of them saturated with deionized water (liquid/solid-ratio = 10/1) and NaCl 1N solution (liquid/solid-ratio = 4/1) for 30 days, followed by exposing the soft gels to mechanical agitation by overhead shaking corresponding to two energy levels (20 rpm and 60 rpm). XRD and TEM – EDX measurement were the major analytical techniques applied in this research, with FT-IR and XRF analyses as additional tools to characterizing the structure and composition of the smectites. Thermodynamic Approach MX80 bentonite and Friedland Clay clearly show that chemical and mineralogical changes have occured in the reaction products. They are exemplified by the neoformation of serpentine and chlorite in certain mixed layer phases. The smectite in the reaction products had also undergone changes especially in the constitution of the octahedral and tetrahedral sheets as well as in the interlayer space. These alterations were evident by the difference in key peak positions and ratios of XRD-patterns, and by TEM-investigations, as well as by different positions and intensities of FT-IR-bands of octahedral and tetrahedral features. The alteration was also seen in the bulk chemical composition data (XRF). MX80 bentonite and Friedland clay show various types and stages of alteration under different experimental conditions. The alteration can be described as “illitization” in open reaction systems and “smectitization” in closed reaction systems. The degree of alteration was controlled by the degree of chemical activities (ion strength, Fe- & Si-activity, con-centration). Higher reactivities give higher degrees of dissolution and release of Si from clay minerals. The oxidation of native iron (Fe0 → Fe2+) was recognized as the main driving force for dissolution, but also the oxidation of Fe2+ (Fe2+ → Fe3+) appeared to reverse an open to a closed reaction system by increased Si-pre¬cipitation. The thermodynamic modelling of C/I-experiments by Mingliang Xie (GRS mbH) verified identified mineralogical alterations in the reaction products. Generally, the contact with metallic iron caused a strong increase in dissolution potential. The reason for this is the reducing potential of oxidation of iron which raised pH to become alkaline and increase dissolution of Si from clay particles. The mineralogical transformations recognized in the experiments, such as the neoformation of serpentine and chlorite phases, were also observed in the tropical weathering profile of serpentinized diabase. The wellknown fast development of Fe-rich montmorillonite in alteration of ultramafic rocks (e.g., Schnellmann, 1964) was also identified by mineralogical investigation of the weather¬ing profile. This confirms that smectitization is linked with higher Fe-activities also in nature. Fe2+ was present in this system and during oxidation acted as driving force for alteration. The reduction potential of Fe-oxidation caused an increase of pH into alkaline conditions. Kinetic Approach The hypothesis that smectite clays have a specific dissolution potential emanated from the study. This would mean that high amounts of Fe and Mg in the octahedral sheet can accelerate alteration in agreement to what was early proposed by Cicel & Novak (1976). The larger ion diameter of Fe and Mg in comparison with Al may well be responsible for a higher sheet stress, which would facilitate dissolution of smectites. The idea proposed Kaufhold & Dohrmann (2008) concerning a mechanism that makes Ca- and Mg-cations in the interlayer space stabilize quasicrystals is also supported by the present study. The performed investigation indicate which mechanisms that serve to protect smectites from undergoing alteration and which promote alteration. Stable smectites, i.e. those with a low specific dissolution potential, were called here “Sleepers”, while fast reacting bentonites, which have a high specific dissolution potential, were termed “Sprinters”. Smectites react with different rates of reaction in laboratory experiments. As said, each smectite sample has its specific potential for dissolution and this potential is controlled by the composition of both the octahedral sheets and the interlayer space. Increasing amounts of octahedral Fe and Mg compared to octahedral Al increase the specific dissolution potential. This potential is also affected by the ion radius, implying that the larger ion radius of Fe and Mg compared to Al increases the mechanical sheet stresses in the octahedral sheet. In summary, this means that, the investigations have confirmed the initial hypothesis concerning the impact of the composition of the octahedral sheet. It results primarily from the pH during the formation of the smectite clay and therefore serves as a geological fingerprint. The Al-Fe ratio in the octahedral sheet influences the stability of the interlayer: A) Aloct > 1.4 and Feoct > 0.2 (per (OH)2 O10) favour delamination of quasicrystals. The swelling pressure increases by a co-volume process between the delaminated layers wiht higher numbers of quasicrystals for Na-dominant population of the interlayer space (Laird, 2006). The microstructural components including both small and large particles and parts of them have a very small ability to move and undergo free rotation. Such Na-montmorillonites are consider as stable phases and have only a low specific dissolution potential. They are „Sleepers“. B) Aloct > 1.4 and Feoct < 0.2 or Aloct < 1.4 and Feoct > 0.2 (per (OH)2 O10) promote demixing of monovalent and divalent interlayer cations (Laird, 2006). In the case of Ca and Mg-dominant interlayers, quasicrystal can break Na-bearing interlayers and help to maintain the quasicrystal structure. Such Ca and Mg-mont¬morillonites can be also be taken as „Sleepers“ because of their low specific dissolution potential. Depending on the octahedral composition, certain cations in the inter¬layer can stabilize bentonites against mineralogical changes. Montmorillonites stabilized by high concentration of Na-cations were classified as belonging to category A, while montmorillonites stabilized by high Ca, Mg-cations in the interlayer sheet were grouped in category B. The classification of a smec¬tite into the categories A or B defined above can be best achieved by IR analyses that yield useful chemical information concerning the composition of the octahedral sheets. Smectites with Na as stabilizing interlayer cation (group A) have shown δAlAlOH-bands with increasing wavenumbers for increasing octahedral Al in FT-IR spectra. The other reaction type of smectite, with Ca, Mg-cations in the interlayers (group B), is characterized by a decreasing octahedral Al-amount for increasing wavenumbers of δAlAlOH-bands in such spectra. Also the FT-IR δAlFeOH-bands are different in the two reaction types of smectite. Increasing octahedral Fe-amounts were mirrored by decreasing wavenumbers of δAlFeOH-bands. However, smectites of group B do contain higher Fe-amounts for the same wavenumber than smectites of group A. Expected alteration of bentonite close and far from a steel canister In the early interaction of smectite-rich clay – the “buffer” - and steel, the system behaves as being chemically closed. Within the clay barrier, Si will be dissolved from clay mineral particles in accordance with its specific dis¬solution potential. The dissolved Si can stay by contributing neoformation of mont¬morillonite layers in mixed layer phases. The interlayer charge decreases by substitution of Mg by Al, which leads to an increase in the swelling pressure. Also minor Si-precipitation may occur if not all the dissolved Si is used up by the neoformed montmorillonite layers. Such precipitation of Si will cause cementation of some quasicrystals and lead to a reduction in porosity. Enhanced temperature and additional Fe-activity, representing an increased reduction potential, increases notably the amount of dissolved Si at the interface between bentonite and steel canister, and as a consequence there will be significant precipitation of Si. The resulting cementation of quasicrystals is ac¬com¬panied also by their collapse which induces broadening of pores. This caused the channel-like migration of infiltrating solutions and switches the system into an open one. Thermodynamic predictions indicate that “illite” will be generated close to the steel canister (via “illitization”) and kaolinite or pyrophyllite to be formed farther away (via smectitization). The “illitization” process results in higher interlayer charges and lower swelling pressures. In contrast, the formation of smectite reduces interlayer charges and promotes higher swelling pressures. At the end of the thermodynamic evolution, the swelling pressure will drop also far from the canister because kaolinite and pyrophyllite are non-swelling minerals. In both cases, the applications of so-called “Sleeper”-bentonites are required to slow the reaction progress. For designers of the engineered barriers in a repository, i.e. the canister and the “buffer” clay, some basic rules are recommend on the basis of the present study. Thus, the presence of native Fe or Fe2+-cations in the clay or in accessory minerals in it, or emanating from the canisters, will speed up the reaction process and make it extensive. Likewise, use of Fe-poor “buffer” clay, representing “Sleepers”-type are suitable for slowing down the reaction. Copper as canister material, and very dense Na-rich montmorillonite of group A as “buffer” seem to be ideal rather than steel/iron and less dense Ca-saturated clay.
This thesis will discuss the different fields of application of the two soft ionization techniques ESI and MALDI in microbial proteomics and their importance for a better understanding of bacteria physiology. The general development in the past 25 years coming from 2D-gel analysis and protein identification by peptide mass fingerprint analysis via MALDI-TOF to genome wide quantitative LC-ESI-MS experiments with fast and sensitive ESI instruments is exemplary shown for the Gram-positive bacterium Bacillus subtilis in article I. Even though 2D-PAGE in conjunction with MALDI-MS is still an important tool in proteomic research, the more recently established global quantitative LC-ESI-MS workflows gain more and more relevance as they overcome 2D-PAGE based protein restrictions and enable the acquisition of higher accurate protein quantities. In article II such a workflow was used to analyze the physiological adaptation of Staphylococcus aureus to vancomycin treatment on a global-scale. Also post-translational modifications of proteins, that are important for regulation of their activity and allow rapid adaption to changed environmental conditions, could be analyzed by LC-ESI-MS workflows using special enrichment strategies (article III and IV). Despite the mentioned discrimination and less accurate quantification of proteins, 2D-PAGE analyses are still advantageous when analyzing large-scale time series experiments. To gain highly time resolved data but also very accurate relative quantities on a global-scale, 2D-PAGE-MALDI-MS and LC-ESI-MS techniques have been combined to investigate dynamic proteome adaptations of B. subtilis during nutrition shift as part of a global systems biology approach (article V). Also absolute quantities of proteins are of high interest for systems biology, but are still challenging to obtain on large-scale as well as with sufficient accuracy. In article VI a method that again combined 2D-PAGE-MALDI-MS and LC-ESI-MS was introduced to gain absolute protein quantities on global-scale. Utilizing the complementarity of 2D-PAGE and LC-ESI-MS this new workflow enabled fast and cost efficient data acquisition on absolute scale. In article VII we described for the first time a global quantitative LC-MALDI-MS workflow. Cross validation with an LTQ Orbitrap proofed that LC-MALDI-MS is able to process complex samples and obtain highly reliable quantities. The comparative analysis of data gained with both instrument types revealed biases for certain biochemical properties of MALDI as well as ESI instruments, resulting in a general complementarity of both ionization techniques. Article I Becher, D., Büttner, K., Moche, M., Hessling, B., Hecker, M., 2011. From the genome sequence to the protein inventory of Bacillus subtilis. Proteomics 11, 2971–2980. Article II Hessling,B., Bonn,F., Herbst,F.-A., Rappen,G.-M., Bernhardt,J., Hecker,M. and Becher,D. Global proteome analysis of vancomycin stress in Staphylococcus aureus. Submitted to Mol. Cell Proteomics. Article III Elsholz, A.K.W., Turgay, K., Michalik, S., Hessling, B., Gronau, K., Oertel, D., Mäder, U., Bernhardt, J., Becher, D., Hecker, M., Gerth, U., 2012. Global impact of protein arginine phosphorylation on the physiology of Bacillus subtilis. Proc. Natl. Acad. Sci. U.S.A. 109, 7451–7456. Article IV Chi, B.K., Gronau, K., Mäder, U., Hessling, B., Becher, D., Antelmann, H., 2011. S-bacillithiolation protects against hypochlorite stress in Bacillus subtilis as revealed by transcriptomics and redox proteomics. Mol. Cell Proteomics 10, M111.009506. Article V Buescher,J.M., Liebermeister,W., Jules,M., Uhr,M., Muntel,J., Botella,E., Hessling,B., Kleijn,R.J., Le Chat,L., Lecointe,F., et al. (2012) Global network reorganization during dynamic adaptations of Bacillus subtilis metabolism. Science, 335, 1099–1103. Article VI Maass, S., Sievers, S., Zühlke, D., Kuzinski, J., Sappa, P.K., Muntel, J., Hessling, B., Bernhardt, J., Sietmann, R., Völker, U., Hecker, M., Becher, D., 2011. Efficient, global-scale quantification of absolute protein amounts by integration of targeted mass spectrometry and two-dimensional gel-based proteomics. Anal. Chem. 83, 2677–2684. Article VII Hessling,B., Büttner,K., Hecker,M. and Becher,D. Global relative quantification with LC-MALDI – cross-validation with LTQ-Orbitrap proves reliability and reveals complementary ionization preferences. Submitted to Mol. Cell Proteomics.
I have investigated the role played by reactive oxygen species (ROS) generated by the phagocyte NADPH oxidase system in the innate immune response. I first looked at effector functions by asking whether ROS released from phagocytes might be effective in the killing of extracellular bacteria. Since bacteria can be killed in many other ways – for example by proteases or by cationic peptides – I made use of the recently demonstrated capacity of ROS to remove discontinuities from the surface of gold as the basis of an in vivo assay for extracellular ROS. Unlike bacterial killing, this readout system is not affected by enzymes, cationic peptides or other biological anti-bacterial agents. By this means I was able to use wild type mice and a congenic strain which lacks the gene coding for the gp91 subunit of the phagocyte NADPH oxidase to demonstrate that ROS generated by the NADPH oxidase system are indeed found outside the cells during an inflammation in vivo and that their principle source is neutrophil granulocytes rather than tissue macrophages. Since ROS released by these cells will be non-specific in its action it is to be expected that the releasing cell will itself suffer considerable damage. This fits well to the known short life of activated neutrophils and may explain the established fact that their death is dependent on the NADPH oxidase system. The long lived macrophages, in contrast, restrict their production of extracellular ROS. ROS are increasingly being found to be involved in both intra and intercellular signalling processes I looked for an involvement of NADPH oxidase derived ROS in the recruitment of neutrophils to sites of inflammation in vivo. Since the gene coding for the gp91 subunit of the NADPH oxidase is on the X chromosome I made use of a mosaic expression strategy based on X chromosomal inactivation. The results show that indeed ROS serves as a component of the neutrophil recruitment process in the critical early stages of an infection. Possible mechanisms are explored.
Beams of ions and electrons are a source of free energy which can be transferred to waves via an instability. Beams exist in almost all plasma environments, but their instabilities are particularly important for the dynamics of space plasmas. In the absence of collisions, the instability drives waves to large amplitudes and forms nonlinear structures such as solitary waves. The electric fields in these waves can scatter particles in the background plasma, or disrupt currents. Both of these effects are important for the overall dynamics of the plasma. In this thesis, both electron and ion beam plasma instabilities have been investigated in the linear plasma device VINETA and using a Particle-in-Cell simulation. The electron beam instability has been demonstrated by previous authors to be a useful diagnostic for the plasma density. The spatial resolution of previous results was confirmed at a few millimetres, and a temporal resolution of 1ms was shown for the first time. An ion beam was generated with a double plasma discharge. Compared to space, this environment and indeed most laboratory plasmas have considerably higher collisionality and a limited spatial extent which introduces gradients in the plasma. Gradients perpendicular to the beam propagation direction are linked to a decrease of both the wavelength and amplitude of the instability. It was observed in both experiment and simulation that gradients in sheaths at the boundaries of the plasma not only affect the time averaged plasma parameters, but also excite instabilities. Fluctuations within the sheath spread the beam in velocity space, effectively increasing its temperature. Warmer beams require a higher drift velocity to excite an instability. This was also confirmed by experimental and numerical results. Collisions are shown to be the dominant damping force for the electron beam instability. For ions, collisions play an important role in the simulation, but appear to be overshadowed by Landau damping from impurities in the experiment. When boundary conditions are removed from the simulation, wave amplitudes increase and nonlinear effects become important. Saturation by particle trapping and coalescence of phase space holes is observed, which could eventually lead to the solitary waves as they are observed in space plasmas.
The general stress response comprises approximately 200 genes and is driven by the alternative sigma factor SigB. Besides the process of sporulation with approximately 500 involved gene products under initial control of Spo0A are the two most significant and extensive cellular responses that can be observed in B. subtilis. The general stress response provides vegetative growing as well as non-growing and non-sporulating cells with a comprehensive cross-protective and preventive multiple stress resistance to various hostile environmental conditions. In contrast, the endospore is the most resistant but also dormant cell type produced by B. subtilis. The scope of this study was the identification of regulatory cascades driven by the general stress response sigma factor SigB to further elucidate the structure and function of the general stress regulon itself and to uncover potential intersections between the SigB response and other major developmental programs in the regulatory network of B. subtilis. It could be shown that the general stress regulon member yqgZ encodes a functional paralogue of Spx, the global regulator of the diamide stress regulon in B. subtilis. Global transcriptome and proteome studies led to the characterization of an YqgZ sub-regulon consisting of 53 positively and 18 negatively regulated genes. Due to its stringent SigB-dependent expression as well as its concerted action with SigB in regulation of its target genes YqgZ was renamed to MgsR which stands for “modulator of the general stress response”. Activity control of MgsR is stringently controlled at multiple levels. In addition to induction by SigB these mechanisms include (i) a positive autoregulatory loop of MgsR on the transcription level of its own structural gene, (ii) a post-translational redox-sensitive activation step by the formation of an intramolecular disulfide-bond within a conserved -CXXC-motif and (iii) rapid proteolytic degradation of MgsR by the ClpCP and ClpXP proteases, resul ting in extremely short in vivo half-lifes below 6 minutes. It was demonstrated that the activation of SigB is a prerequisite but not sufficient for a full expression of all general stress genes and that the SigB-dependent expression of MgsR provides the opportunity for additional redox-sensitive signal-reception, -processing and -integration beyond the primary decision of SigB activation. Our results describe a regulatory cascade integrating secondary oxidative stress signals into a SigB mediated regulatory cascade that is aimed at a precise fine tuning of target gene expression whose products are necessary for proper management of oxidative stress. Although primary oxidative stress stimuli do not typically induce SigB, our observation of redox-sensitive control by MgsR and several other reports that pointed at the implication of the general stress proteins in oxidative stress management led to the proposal that secondary oxidative stress may be a common component of multip le severe physical stress stimuli. This assumption could be supported by the results of a comprehensive phenotype screening of 94 mutants in single general stress genes upon treatment with hydrogen peroxide and the superoxide generating agent paraquat. A substantial amount of 62 mutants (66%) displayed significantly decreased survival rates in response to oxidative stress. The information gained by this phenotypic screening analysis provides a valuable basis for more directed assays to elucidate the biochemical functions of many so far uncharacterized general stress proteins and demonstrates that the SigB response and the regulatory fine tuning by MgsR plays a pivotal role in protection from secondary oxidative stress. Furthermore, it has been intensively discussed throughout the literature of the last years that the general stress response and the process of sporulation may represent mutually exclusive survival strategies of a non-growing B. subtilis cell, but the molecular basis for this assumption was missing until recently. By the identification of a functional SigB-type promoter (PsigB) adjacent to the spo0E, this gene was newly assigned to the general stress regulon. The spo0E gene encodes a phosphatase that specifically inactivates the master regulator of sporulation Spo0A~P by dephosphorylation. The SigB dependent induction of spo0E causes a block of sporulation specific transcription and produces a sporulation deficient phenotype. This effect was overcome by a deletion of the spo0E-SigB promoter, thus clearly addresses SigB activity. This regulatory mechanism is the first example for an integration of SigB inducing stimuli into the decision making process of sporulation initiation that provides a link to interconnect these two dominant and very likely mutually exclusive responses in the regulatory network of B. subtilis. The data presented here provide deeper insights into the structure and function of the general stress regulon in stress management.
The learning theory of panic disorder differs between panic attacks and anxious apprehension as distinct emotional states. Acute panic is accompanied by extreme fear, experience of strong body symptoms reflecting autonomic surge and flight tendencies. In contrast, anxious apprehension is associated with hypervigilance towards bodily sensations and increased distress when subtle somatic symptoms are identified. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues with lowest distance to threat during panic attacks. We tested this model by investigating the dynamics of defensive reactivity in a large group of patients suffering from panic disorder and agoraphobia (PD/AG) prior to a multicenter controlled clinical trial. Three hundred forty-five patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defensive reactivity was assessed measuring avoidance and escape behavior, self reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during the exposure period of the behavioral avoidance test. While 125 patients showed strong anxious apprehension during the task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 72 patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses were observed during 34 reported panic attacks as well. We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. Importantly, the patients differed quite substantially according defensive reactivity during the behavioral avoidance test despite all patients received the same principal diagnosis. These differences can be explained in part by differences in the disposition according to two genetic variants previously associated with panic disorder. Patients carrying the risk variant of a polymorphism in the neuropeptide S receptor gene showed an overall increased heart rate during the whole behavioral avoidance test reflecting an enhanced sympathomimetic activation and consequently arousal level. During the entrapment situation in which heart rate further increased over an already elevated baseline level, risk variant carriers were prone to experience more panic symptoms. This is in line with the learning perspective of panic disorder, postulating that internal cues of elevated arousal increase the chance of experiencing another panic attack once they have been associated with aversive responses. Furthermore, the risk variant of a polymorphism in the monoamine oxidase A gene was observed to augment the occurrence of panic attacks and escape behavior preparation. In addition, we find evidence that suggest an enhanced resistance to corrective learning experiences as indicated by a lack of a reduction of avoiding and escaping behavior during repeated test chamber exposures in wait-list control patients carrying the risk gene variant. Both effects may strengthen the learning mechanism hypothesized to be involved in the pathogenesis of panic disorder. Exteroceptive and interoceptive cues previously associated with the initial panic attack might trigger subsequent attacks in risk allele carriers more rapidly while simultaneously the opportunity to dissolve once established associations due to contradictory experiences is limited. Now, differential dispositions regarding defensive reactivity in PD/AG patients has to be linked to mechanisms supposed to be involved in exposure based therapy. First outcome evaluations of the clinical trial indicated that a behavioral therapy variant suggested to be linked with higher fear activation during exposure exercises is more effective than another. Further analyses have to proof whether those patients showing a clear specific fear response during the behavioral avoidance test benefit more than others from exposure based therapy.
Primary Pan-CT is associated with improved clinical course and outcome in polytrauma patients
(2012)
The early clinical management of patients with polytrauma remains challenging. Clinical examination is unreliable in identifying the presence and severity of injuries, and diagnostic imaging plays a central role in the evaluation of the injury pattern. In the last decade, whole body multi slice computed tomography (Pan-CT) performed immediately after admission gained recognition in Europe and United States. Its utility and value, given the lack of accuracy data and concerns about unnecessary exposure to radiation, is undefined. The primary objective of this retrospective cohort study was to compare survival of multiple trauma (polytrauma) patients (Injury Severity Score [ISS] ≥ 16) prior to (1999 - 2002) and after (2002 - 2004) the introduction of a Pan-CT-based trauma resuscitation algorithm at a maximum care university medical centre. Secondary objectives were to compare the complication rates and duration of intensive care treatment. The study included 123 patients (mean age 34.6 years [SD 16.8], mean ISS 26.7 [SD 8.7]) in the control and 104 (mean age 39.8 years [SD 20.0], mean ISS 28.6 [SD 10.5]) patients in the intervention period. Die Baseline criteria were well balanced amongst both cohorts except for age (34.6 versus 39.8 years, p = 0.034). Both cohorts had a similar predicted probability of survival using the TRISS method (77.5 versus 77.6%, p = 0.979). Raw mortality decreased markedly but not statistically significantly in Pan-CT cohort (17.9 versus 11.5%, risk ratio (RR) 0.65, 95% confidence interval (CI) 0.34 - 1.24). However, after adjustment for injury severity, by mortality odds ratio of 0.40 (95% CI 0.17 – 0.95, p = 0.038) Pan-CT patients were 2.5 times more likely to survive. The mean difference in the duration of ICU treatment (5.1, 95% CI 1.2 – 9.0 days), days on respirator (5.3, 95% CI 2.0 - 8.6), and number of complications (0.4, 95% CI 0.2 – 0.8) was statistically significant and in favour of the Pan-CT-period.
This thesis describes investigations of metal clusters stored in an ion-cyclotron resonance (ICR) trap, as well as corresponding trap research and development. Charged clusters are produced and investigated in the experimental setup Cluster-Trap, comprising a cluster-ion source, an ICR trap and a time-of-flight (ToF) mass spectrometer. In the framework of its move to the new building of the Institute of Physics, new components have been added to the ClusterTrap setup. A radio-frequency ion trap is now used for cluster ion preparation prior to the performance of cluster experiments in the ICR trap. A quadrupole ion deflector allows an optimized usage of the ICR trap, as well as simultaneous use of several ion sources and detectors. The implementation of a potential lift at the ToF mass spectrometer enables a more flexible operation of the setup with ion energies up to several hundreds of electron volts. The new components have been tested and characterized, and the experimental procedures have been adapted. An important aspect of cluster investigations is the manipulation of trapped ions by application of appropriate excitation fields. For the ICR trap, a vector representation model has been developed for quick analysis of radial excitation fields, applied to the quarter-segmented ring electrode of an ICR trap. Its application has been demonstrated for asymmetric radial quadrupolar excitation of stored cluster ions, confirming the observation of unintended ion ejection from the trap. Investigation of multiply negatively charged metal clusters at ClusterTrap has been continued. By the "electron-bath" technique, i.e. simultaneous storage of cluster mono-anions and electrons in the ICR trap, high charge states are produced up to a limit which arises from restrictions for ion trapping. A modification of the electron bath, which bypasses this limit, has been introduced and demonstrated by the first-time production and detection of aluminum cluster anions carrying five excess electrons (penta-anions). Results of the penta-anion production as a function of the trapping voltage relate to the Coulomb potentials of the cluster anions involved, in agreement with previous findings. The observed poly-anionic clusters are meta-stable and their abundance as a function of the cluster size is determined by their lifetimes. Observed poly-anion abundances are described by a thermionic-emission approach, by means of the Richardson-Dushman formula. The height of the Coulomb potential in the formula is decreased to match experimental data, thus accounting for electron tunneling. Poly-anions are observed only above a minimum cluster size, the appearance size. To determine this limit from experimental results, a new data evaluation method has been introduced, which considers the poly-anion lifetimes and respective abundances of a range of cluster sizes. As a result, the experimental appearance size is larger than the smallest poly-anionic cluster observed, in contrast to previous approaches.