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Die roboterassistierte abdominothorakale Ösophagusresektion ist ein etabliertes Verfahren und wird am Universitätsklinikum Heidelberg circa 60 Mal im Jahr durchgeführt. Das Operationsprinzip besteht in der transthorakalen und abdominellen Entfernung des Ösophagus sowie einer onkologischen Lymphadenektomie und stellt somit einen Zwei-Höhlen-Eingriff dar. Die Rekonstruktion erfolgt mittels Magenschlauchbildung und anschließendem Magenhochzug.

There are three types of known “telehealth players” and only two will prevail in the future. The first type are credible known entities like Cleveland Clinic, UnitedHealth Group, CVS Health, or Amazon Care, which would be their online arm. The second type will be telehealth solutions that broker availability of different services between brands. The third type – and the one that won’t work – is the standalone solution. From a patient standpoint, more credibility is needed to use these services. Smart market players in the telehealth industry anticipate future trends and make sure business focuses on several consumer problems, not one. Further, there are concerns about equitable access to telehealth services, particularly for video telehealth – something HCPs and telehealth companies should think about as telehealth becomes a long-term/permanent solution. Basic technological barriers like lack of broadband access, digital literacy, social isolation, disparities in technology/device ownership prevent patients from engaging with their providers via telehealth. These barriers have disproportionate impacts across different populations. Additionally, social data gaps – low technology for certain sub-populations indicates minimal data availability.

Large B-cell lymphomas include several subtypes. Recently, anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma has been delineated as a distinct entity involving mostly lymph nodes and rarely affecting extranodal sites. We describe the first case of a primary cutaneous ALK-positive large B-cell lymphoma in a 48-year-old man with a solitary nodule on the back, and describe the histologic and phenotypic features. Accurate staging confirmed the absence of other lesions, and so surgical excision and postoperative local radiation therapy were initiated and resulted in complete remission. Two years later, extracutaneous spread with involvement of axillary lymph nodes occurred. Complete remission was achieved again by multiagent chemotherapy. Our case demonstrates that a primary cutaneous form of ALK-positive large B-cell lymphoma exists. The immunophenotypic analysis of cutaneous large B-cell lymphomas affecting the skin primarily or secondarily should include the assessment of ALK expression.

Apart from rehabilitation research, there have been no studies regarding the expectations of patients with chronic back pain in terms of inpatient multimodal pain therapy. The aim of this naturalistic longitudinal study is to explore treatment expectations, their fulfilment, and influence on the treatment success of inpatient multimodal pain therapy.This study included 118 patients with chronic back pain who were physically examined and assessed for their psychological comorbidity. They were interviewed pre and post pain therapy. Treatment expectations were recorded via the questionnaire for assessing rehabilitational expectations and motivations (FREM-17), and further variables via the Pain Disability Index (PDI, german version) and the german Hospital Anxiety and Depression Scale (HADS-D).The results show that treatment expectations have an impact on therapy success or failure. In particular, patients' expectations of coping with illness and recovery could be met by inpatient multimodal pain therapy, whereas health and pension-related expectations remained unfulfilled. In addition to the treatment expectations, the therapy result was primarily determined by the patient's ability to perform before the therapy.From the clinical side, treatment expectations should be explored and checked for feasibility to avoid patient disappointment.HINTERGRUND: Bislang gibt es außer in der Rehabilitationsforschung keine Untersuchungen hinsichtlich der Erwartungen von Patienten mit chronischen Rückenschmerzen an eine stationäre multimodale Schmerztherapie. Ziel dieser naturalistischen Längsschnittstudie ist es, Behandlungserwartungen, deren Erfüllung sowie Einfluss auf den Behandlungserfolg einer stationären multimodalen Schmerztherapie zu explorieren.In die Studie wurden 118 Patienten mit chronischen Rückenschmerzen eingeschlossen, die körperlich untersucht und hinsichtlich ihrer psychischen Komorbidität beurteilt wurden. Sie wurden prästationär und poststationär nach Abschluss der Schmerztherapie befragt. Die Behandlungserwartung wurde über den FREM-17 (Fragebogen zur Erfassung von rehabilitationsbezogenen Erwartungen und Motivationen) erfasst, außerdem wurden der Deutsche Schmerzfragebogen, PDI (Pain Disability Index, deutsche Version) und HADS‑D (Hospital Anxiety and Depression Scale, deutsche Version) eingesetzt.Insgesamt zeigen die Ergebnisse der Studie, dass die Behandlungserwartungen einen Einfluss auf den Therapieerfolg oder -misserfolg haben. Insbesondere die Erwartungen der Patienten an Krankheitsbewältigung und Erholung konnten durch die stationäre multimodale Schmerztherapie erfüllt werden, wohingegen die gesundheits- und rentenbezogenen Erwartungen unerfüllt geblieben sind. Neben den Behandlungserwartungen wurde das Therapieergebnis vor allem durch das vor der Therapie bestehende Leistungsvermögen der Patienten determiniert.Von klinischer Seite sollten die Behandlungserwartungen vor Beginn einer multimodalen Schmerztherapie exploriert und auf Realisierbarkeit geprüft werden, um Enttäuschungen auf Patientenseite zu vermeiden.

Nonvolatile memories especially the ferroelectric (FE)-based ones such as ferroelectric tunnel junctions (FTJs) and ferroelectric field-effect transistors (FeFETs) have recently attracted a lot of attention. FTJs have been intensively researched for the last decade and found to be very promising memory devices due to their significant nondestructive readout advantage as compared to conventional ferroelectric random access memory (FRAM). However, more research is needed on FTJ devices to obtain reliable endurance and retention behavior. In this article, we demonstrate the characteristics and performance of zirconium-doped hafnium oxide-based FTJ devices in terms of FE switching and reliability. This is investigated for FTJ stack structure tuning as well as for the FE switching process in FTJ devices. The FTJ memory switching characteristics, the effects of polarization switching on the write conditions, and the impact of pulse width and pulse amplitude on switching are investigated. The impact of FE layer thickness and interface layer type/thickness are reported to obtain a maximum FTJ ION/IOFF ratio (memory window) and reliable performance. The maximum ION/IOFF ratio changes depending on the FE layer (zirconium-doped HfO 2 layer) thickness (12, 8, 6, and 4 nm), the interface layer type (SiO 2 , Al 2 O 3 ), and thickness (1 and 2 nm), indicating the maximum value of ION/IOFF ratio for a 1 nm SiO 2 interface layer stack. Moreover, a stable endurance of 10 4 cycles is reported and extrapolated measurements suggest stable retention for more than ten years. Time-dependent breakdown analysis was performed to investigate the reliability of devices indicating a lifetime of ten years.

Ventricular tachycardia (VT) is the most common and potentially lethal complication following myocardial infarction (MI). Biological correction of the conduction inhomogeneity that underlies re-entry could be a major advance in infarction therapy. As minimal increases in conduction of infarcted tissue markedly influence VT susceptibility, we reasoned that enhanced propagation of the electrical signal between non-excitable cells within a resolving infarct might comprise a simple means to decrease post-infarction arrhythmia risk. We therefore tested lentivirus-mediated delivery of the gap-junction protein Connexin 43 (Cx43) into acute myocardial lesions. Cx43 was expressed in (myo)fibroblasts and CD45+ cells within the scar and provided prominent and long lasting arrhythmia protection in vivo. Optical mapping of Cx43 injected hearts revealed enhanced conduction velocity within the scar, indicating Cx43-mediated electrical coupling between myocytes and (myo)fibroblasts. Thus, Cx43 gene therapy, by direct in vivo transduction of non-cardiomyocytes, comprises a simple and clinically applicable biological therapy that markedly reduces post-infarction VT.

Gap junctional intercellular communication (GJIC) has been suggested to be involved in early embryonic development but the actual functional role remained elusive. Connexin (Cx) 43 and Cx45 are co-expressed in embryonic stem (ES) cells, form gap junctions and are considered to exhibit adhesive function and/or to contribute to the establishment of defined communication compartments. Here, we describe the generation of Cx43/Cx45-double deficient mouse ES cells to achieve almost complete breakdown of GJIC. Cre-loxP induced deletion of both, Cx43 and Cx45, results in a block of differentiation in embryoid bodies (EBs) without affecting pluripotency marker expression and proliferation in ES cells. We demonstrate that GJIC-incompetent ES cells fail to form primitive endoderm in EB cultures, representing the inductive key step of further differentiation events. Lentiviral overexpression of either Cx43 or Cx45 in Cx43/45 mutants rescued the observed phenotype, confirming the specificity and indicating a partially redundant function of both connexins. Upon differentiation GJIC-incompetent ES cells exhibit a strikingly altered subcellular localization pattern of the transcription factor NFATc3. Control EBs exhibit significantly more activated NFATc3 in cellular nuclei than mutant EBs suggesting that Cx-mediated communication is needed for synchronized NFAT activation to induce orchestrated primitive endoderm formation. Moreover, pharmacological inhibition of NFATc3 activation by Cyclosporin A, a well-described inhibitor of calcineurin, phenocopies the loss of GJIC in control cells.

Primary cutaneous lymphomas (CL) are the second most common form of extranodal lymphomas. Cutaneous T-cell lymphomas represent the majority. They are classified according to the WHO classification 2017 and the updated WHO-EORTC 2018 published in the fourth edition of the WHO classification for Skin Tumors monograph. Primary cutaneous acral CD8+ T-cell lymphoma and EBV-positive mucocutaneous ulcer have been listed as new provisional entities. Moreover, the histological and genetic spectrum of lymphomatoid papulosis has been expanded. Recently, prognostic subtypes were delineated for some entities and subtypes of CL such as folliculotropic mycosis fungoides and marginal zone lymphoma. Since CL show overlapping histological features, clinico-pathological correlation is of outmost importance for the diagnosis. Recent studies revealed new biomarkers and genetic alterations underlying the pathogenesis of CL. Moreover, targeted therapies have widened the treatment options particularly for aggressive lymphomas.

Obwohl Praktiken des Lektorats und des Mentorats zum alltäglichen Bestandteil schriftstellerischer Tätigkeiten gehören, wurden sie von den Literaturwissenschaften bislang kaum untersucht. Der bilinguale Band versammelt Akteure aus dem literarischen Feld sowie der Autorschafts- und Schreibprozesstheorie, welche die Öffnung des Schreibprozesses grundlegend reflektieren. Ihre Beiträge umfassen nicht nur Erfahrungsberichte von Autor_innen, Lektor_innen und Mentor_innen sowie Einblicke in Lehrmethoden des literarischen Schreibens an Hochschulen in verschiedenen Ländern Europas, sondern auch theoretische Ansätze zu einer intersubjektiven literarischen Praxis sowie Entwürfe für dialogische Literaturbegriffe im Zeitalter des Publizierens im Internet. Although practices of editing and mentoring are part of an author's daily activities, they have previously been largely neglected by the literary studies. The bilingual volume therefore assembles players from the fields of literary production and theories of authorship and the writing process, who discuss the development towards an opening up of the creative writing process. Their contributions encompass not only reports of experiences made by authors, editors, and mentors and insights into teaching methods applied in creative writing classes at higher education institutions in different European countries. They also explore theoretical approaches to an intersubjective literary practice as well as suggestions for the definition of a dialogic notion of literature in the age of online publishing.

Cardiovascular disease is often caused by endothelial cell (EC) dysfunction and atherosclerotic plaque formation at predilection sites. Also surgical procedures of plaque removal cause irreversible damage to the EC layer, inducing impairment of vascular function and restenosis. In the current study we have examined a potentially curative approach by radially symmetric re-endothelialization of vessels after their mechanical denudation. For this purpose a combination of nanotechnology with gene and cell therapy was applied to site-specifically re-endothelialize and restore vascular function. We have used complexes of lentiviral vectors and magnetic nanoparticles (MNPs) to overexpress the vasoprotective gene endothelial nitric oxide synthase (eNOS) in ECs. The MNP-loaded and eNOS-overexpressing cells were magnetic, and by magnetic fields they could be positioned at the vascular wall in a radially symmetric fashion even under flow conditions. We demonstrate that the treated vessels displayed enhanced eNOS expression and activity. Moreover, isometric force measurements revealed that EC replacement with eNOS-overexpressing cells restored endothelial function after vascular injury in eNOS(-/-) mice ex and in vivo. Thus, the combination of MNP-based gene and cell therapy with custom-made magnetic fields enables circumferential re-endothelialization of vessels and improvement of vascular function.

In the heart, secretory renin promotes hypertrophy, apoptosis, necrosis, fibrosis, and cardiac failure through angiotensin generation from angiotensinogen. Thus, inhibitors of the renin-angiotensin system are among the most potent drugs in the treatment of cardiac failure. Renin transcripts have been identified encoding a renin isoform with unknown targets and unknown functions that are localized to the cytosol and mitochondria. We hypothesize that this isoform, in contrast to secretory renin, exerts cardioprotective effects in an angiotensin-independent manner. Cells overexpressing cytosolic renin were generated by transfection or obtained from CX(exon2-9)renin transgenic rats. Overexpression of cytosolic renin reduced the rate of necrosis in H9c2 cardiomyoblasts and in primary cardiomyocytes after glucose depletion. These effects were not mediated by angiotensin generation since an inhibitor of renin activity did not influence the in vitro effects. siRNA-mediated knockdown of endogenous cytosolic renin increased the rate of necrosis and aggravated the pro-necrotic effects of glucose depletion. Isolated perfused hearts obtained from transgenic rats overexpressing cytosolic renin exhibited a 50% reduction of infarct size after ischemia-reperfusion injury. Cytosolic renin is essential for survival, both under basal conditions and during glucose starvation. The protective effects are angiotensin-independent and contrary to the known actions of secretory renin.A cytosolic isoform of renin with unknown functions is expressed in the heart. Cytosolic renin diminishes ischemia induced damage to the heart. The protective effects of cytosolic renin contradict the known function of secretory renin. The effects of cytosolic renin are not mediated via angiotensin generation. Renin-binding protein is a potential target for cytosolic renin.

Gut ischemia and reperfusion (IR), e.g. in small bowel transplantation or during resuscitation, may result in severe impairment of the intestinal microcirculation. Potential sequelae are mucosal damage, loss of intestinal barrier function, bacterial translocation, systemic inflammation, multiple organ failure and death. We hypothesized a protective role for extracellular adenosine signalling in intestinal IR injury. Using intravital microscopy we investigated the effects of the adenosine receptor (AR) agonist NECA (5'-N-ethyl carboxamide adenosine) on leukocyte-endothelial interactions and capillary perfusion in the intestinal microcirculation following intestinal IR. Six groups of Lewis rats (n = 44) were studied: control, NECA (5'-N-ethyl carboxamide adenosine), IR (30 minutes of intestinal ischemia, 2 hours of reperfusion), IR + NECA, IR + NECA + MRS1754 (A(2B)AR antagonist), IR + NECA + DPCPX (A(1)AR antagonist). All substances were administered i.v. immediately after declamping of the superior mesenteric artery. Intravital microscopy was performed after 2 hours of reperfusion. Following IR we observed a significant increase of leukocyte adhesion in the intestinal submucosal venules and a reduced capillary perfusion within the muscular layers. NECA reduced leukocyte activation and improved capillary perfusion significantly. Administration of A(2B)AR antagonist completely reversed the NECA effect, whereas A(1)AR inhibition only partially abolished the action of NECA. The data support the hypothesis that adenosine signalling is involved in intestinal IR injury. A(2B)AR may be more important than A(1)AR because A(2B)AR inhibition by MRS1754 completely reversed the effect of the adenosine receptor agonist NECA.

Cell replacement in the heart is considered a promising strategy for the treatment of post-infarct heart failure. Direct intramyocardial injection of cells proved to be the most effective application route, however, engraftment rates are very low (

In this study, we identified a polymorphism in the 5'-flanking region of the chicken serotonin transporter (5-HTT) gene. Sequencing analysis revealed that in comparison with the wild-type variant (W), a deleted variant (D) is generated by deletion of four nucleotides (5'-AATT-3') and a single nucleotide change (A→T). Using a polyacrylamide gel electrophoresis system, we found that the 360-bp DNA fragment containing the W variant with the wild-type sequence 5'-AATTAATT-3' shows intrinsic DNA curvature while the 356-bp fragment containing the D variant lacking the four base pairs AATT is not curved. Quantitative real-time RT-PCR and ELISA demonstrated that the expression of 5-HTT in D/D chickens was higher than that in W/W and W/D chickens. In addition, transient transfection experiments with chloramphenicol acetyltransferase reporter gene constructs revealed increased 5-HTT promoter activity mediated by the D variant and a silencer activity of the W variant. Interestingly, females and males with D/D genotype showed significant greater increase in body weight from 6 weeks and 16 weeks of age, respectively, and higher body mass index. Moreover, we found that D/D chickens of both genders were physically more active than W/W and W/D chickens.

Background Endothelial cell recovery requires replenishment of primary cells from the endothelial lineage. However, recent evidence suggests that cells of the innate immune system enhance endothelial regeneration. Methods and results Focusing on mature CD11b + -monocytes, we analyzed the fate and the effect of transfused CD11b + -monocytes after endothelial injury in vivo. CD11b-diphtheria-toxin-receptor-mice – a mouse model in which administration of diphtheria toxin selectively eliminates endogenous monocytes and macrophages – were treated with WT-derived CD11b + -monocytes from age-matched mice. CD11b + -monocytes improved endothelium-dependent vasoreactivity after 7days while transfusion of WT-derived CD11b − -cells had no beneficial effect on endothelial function. In ApoE −/− -CD11b-DTR-mice with a hypercholesterolemia-induced chronic endothelial injury transfusion of WT-derived CD11b + -monocytes stimulated by interferon-γ (IFNγ) decreased endothelial function, whereas interleukin-4-stimulated (IL4) monocytes had no detectable effect on vascular function. Bioluminescent imaging revealed restriction of transfused CD11b + -monocytes to the endothelial injury site in CD11b-DTR-mice depleted of endogenous monocytes. In vitro co-culture experiments revealed significantly enhanced regeneration properties of human endothelial outgrowth cells (EOCs) when cultured with preconditioned-media (PCM) or monocytes of IL4-stimulated-subsets compared to the effects of IFNγ-stimulated monocytes. Conclusion CD11b + -monocytes play an important role in endothelial cell recovery after endothelial injury by homing to the site of vascular injury, enhancing reendothelialization and improving endothelial function. In vitro experiments suggest that IL4-stimulated monocytes enhance EOC regeneration properties most likely by paracrine induction of proliferation and cellular promotion of differentiation. These results underline novel insights in the biology of endothelial regeneration and provide additional information for the treatment of vascular dysfunction.

Aims Epithelial ovarian cancer (EOC) can be classified into four major types (serous, endometrioid, clear cell, mucinous). The prevalence of driver gene mutations in the different subtypes is controversial. High-grade serous carcinomas show frequent TP53 mutations, whereas KRAS and BRAF mutations are less common. In non-serous EOC, the relevance of these gene mutations remains to be elucidated. Methods We investigated 142 formalin-fixed, paraffin-embedded EOC, including serous (n = 63), endometrioid (n = 29), clear cell (n = 25), mucinous (n = 14), and others (n = 11) for mutations in TP53 exons 5–8, KRAS exons 2 and 3, and BRAF exon 15 by pyro-sequencing using the GS Junior 454 platform. The mutational status was correlated with clinicopathological features and patient overall survival. Results We identified mutations in the coding region of TP53 in 51.4% (73/142), and of KRAS in 9.9% (14/142) but not of BRAF . TP53 mutations occurred frequently not only in high-grade serous carcinomas (58.7%), but also in mucinous (57%) and clear cell EOC (52%). TP53 mutations were associated with high-grade carcinomas (p = 0.014), advanced FIGO stage (p = 0.001), intraoperative residual disease > 1 cm (p = 0.004), as well as poor overall survival (p = 0.002). KRAS mutations were mainly identified in mucinous EOC (57%) and were concomitantly with TP53 mutations in five mucinous carcinomas (36%). Conclusions TP53 gene driver mutations are a common feature of all advanced ovarian cancer subtypes, whereas BRAF mutations seem to be a rare event in EOC. KRAS mutations with synchronous TP53 mutations occur predominantly in low-grade mucinous carcinomas, suggesting a specific molecular background of this ovarian cancer type.

BACKGROUND Fine-needle aspiration biopsy (FNAB) is important in the diagnostic establishment of suspicious thyroid nodules. In thyroid neoplasms, mutation of the BRAF gene occurs rather exclusively in papillary thyroid carcinoma (PTC) and results in > 98% of the cases in V600E amino acid substitution. In the current study, the authors investigated the diagnostic value of a recently described monoclonal antibody that detects this specific mutation on FNAB specimens from patients with PTC. METHODS BRAFV600E status of FNAB cell blocks from 55 patients with PTC was analyzed by immunohistochemistry (IHC) with the new BRAFV600E antibody (clone VE1) and by Sanger sequencing (SaS). In discrepant cases, ultra-deep sequencing was also performed. Available corresponding histological specimens were investigated by IHC and, in selected cases, with SaS as well. RESULTS All cases yielded evaluable IHC staining results of the cell block sections with good interobserver agreement (kappa value, 0.650). Ten tumors (18.2%) demonstrated no staining, 10 tumors (18.2%) demonstrated equivocal staining, 25 tumors (45.4%) demonstrated moderate staining, and 10 tumors (18.2%) demonstrated strong staining. SaS was able to be performed in 48 cases. Nineteen cases demonstrated wild-type BRAF and 29 cases were found to have the BRAFV600E mutation. After performing ultra-deep sequencing 1 false-positive and 2 false-negative VE1 IHC cases remained, resulting in a sensitivity of 93.8% and a specificity of 93.8%. CONCLUSIONS BRAFV600E mutations in FNAB specimens from patients with PTC can be reliably detected in most cases by IHC with a new mutation-specific antibody. Interpretation of VE1 IHC staining results on cell block slides of PTC can be difficult in some cases. Cancer (Cancer Cytopathol) 2014;122:48–58. © 2013 American Cancer Society.

Gene therapy is a promising approach for chronic disorders that require continuous treatment such as cardiovascular disease. Overexpression of vasoprotective genes has generated encouraging results in animal models, but not in clinical trials. One major problem in humans is the delivery of sufficient amounts of genetic vectors to the endothelium which is impeded by blood flow, whereas prolonged stop-flow conditions impose the risk of ischemia. In the current study we have therefore developed a strategy for the efficient circumferential lentiviral gene transfer in the native endothelium under constant flow conditions. For that purpose we perfused vessels that were exposed to specially designed magnetic fields with complexes of lentivirus and magnetic nanoparticles thereby enabling overexpression of therapeutic genes such as endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF). This treatment enhanced NO and VEGF production in the transduced endothelium and resulted in a reduction of vascular tone and increased angiogenesis. Thus, the combination of MNPs with magnetic fields is an innovative strategy for site-specific and efficient vascular gene therapy.

Targeting of specific cells and tissues is of great interest for clinical relevant gene- and cell-based therapies. We use magnetic nanoparticles (MNPs) with a ferrimagnetic core (Fe(3)O(4)) with different coatings to optimize MNP-assisted lentiviral gene transfer with focus on different endothelial cell lines.Lentiviral vector (LV)/MNP binding was characterized for various MNPs by different methods (e.g. magnetic responsiveness measurement). Transduced cells were analyzed by flow cytometry, fluorescence microscopy and iron recovery. Cell transduction and cell positioning under physiological flow conditions were performed using different in vitro and ex vivo systems.Analysis of diverse MNPs with different coatings resulted in identification of nanoparticles with improved LV association and enhanced transduction properties of complexes in several endothelial cell lines. The magnetic moments of LV/MNP complexes are high enough to achieve local gene targeting of perfused endothelial cells. Perfusion of a mouse aorta with LV/MNP transduced cells under clinically relevant flow conditions led to local cell attachment at the intima of the vessel.MNP-guided lentiviral transduction of endothelial cells can be significantly enhanced and localized by using optimized MNPs.

The combination of magnetic nanoparticles (MNPs) with a magnetic field is a powerful approach to enable cell positioning and/or local gene therapy. Because physical requirements for MNPs differ between these two applications we have explored whether the use of different MNPs can provide site-specific positioning combined with efficient viral transduction of endothelial cells (ECs).A variety of MNPs was screened for magnetic cell labeling and lentivirus binding. Then two different MNPs were chosen and their combined application was evaluated regarding EC magnetization and transduction efficiency.The combined use of PEI-Mag2 and NDT-Mag1 particles provided both efficient lentiviral transduction and high magnetic responsiveness of ECs that could be even retained within the vascular wall under flow conditions. The use of these MNPs did not affect biological characteristics of ECs like surface marker expression and vascular network formation. Importantly, with this method we could achieve an efficient functional overexpression of endothelial nitric oxide synthase in ECs.The application of two different MNPs provides optimal results for magnetic labeling of ECs in combination with viral transduction. This novel approach could be very useful for targeted gene therapy ex vivo and site-specific cell replacement in the vascular system.

Im Zusammenhang mit der Frage der Bildungsforderung von Kindern stellt das Feld der Ubergange zwischen Institutionen einen Kristallisationspunkt dar. Ein differenzierter Blick darauf, welche Fragen sich stellen und wo Herausforderungen fur die Kinder- und Jugendhilfe als bedeutsamen Akteur im Feld der Bildungsbegleitung von Kindern und Familien liegen, ist notwendig.

Objective Type-D personality—negative affectivity and social inhibition—are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery. Methods One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12). Results Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery. Conclusion Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cut-off scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.

This study examined whether a short-term psychosomatic intervention during pregnancy had effects on characteristics of labour and delivery as well as on the long-term course of anxiety, depression and physical complaints in pregnant in-patient women.All gynaecological and obstetric inpatients of a university hospital, who had either exhibited complications during their pregnancy or were considered high-risk pregnancies, were examined. Symptoms of anxiety and depression (HADS) and physical symptoms (GBB) were assessed by standardised questionnaires. Women with elevated scores on either the HADS or the GBB were randomly assigned to either a treatment group, which had received a psychosomatic intervention or an untreated control group. Of the n = 238 women who were assessed during their stay in our hospital, n = 135 were included in the follow-up 1-year later.More than one-third of the participants (38.7%) had elevated scores of anxiety, depression and/or physical symptoms. The psychosomatic intervention had a significant effect on anxiety scores (p = 0.006), but not on depression scores, physical complaints and characteristics of labour and delivery.Findings suggest that a short-term psychosomatic intervention can have a positive long-term effect on anxiety symptoms. Future studies are needed to show whether the reduction of anxiety symptoms in turn can lead to a reduction of postnatal complications and lower rates of disturbed mother-child interactions.

OBJECTIVES: The aim of this cross-sectional study was to explore the psychological and physical well-being of patients with chest pain depending on availability cardiological disease (coronary heart disease, different cardiological disease, no cardiological disease, unclear diagnose). METHODS: In a total of 383 cardiological outpatients, anxiety and depression (HADS) as well as physical complaints (B-L) were assessed. RESULTS: For half of the outpatients, no cardiological diagnose was found that explained the symptoms of chest pain. In comparison to the general population, outpatients with various cardiological symptoms exhibited a lower psychological and physical well-being independent of availability cardiological disease. 50.9% of the outpatients showed elevated anxiety scores, 35.2% showed elevated depression scores and 71.7% felt impaired by physical complaints. In comparison to males, females were more anxious and exhibited a lower physical well-being. In general, physical impairment increased with age, while anxiety decreased. CONCLUSIONS: The present study discovered a very high psychological comorbidity in cardiological outpatients with chest pain that underlines the necessity of an integrated psychosomatic care regardless of clinical finding. In order to understand the symptom of chest pain it is not indicated to differentiate between cardiologically vs. psychologically ill patients.

In this work load–penetration curves obtained by nanoindentation were analyzed, using a spherical tip approximation and applying the stress/strain concept by Tabor. Nanoindentation experiments were done on sapphire, pure TiC, and a mixed ceramic with in situ formed TiCx layer, using a sharp cube-corner indenter at very low loads and penetration depths. With the implemented method it is possible to display the elastic to elastic–plastic transition of each investigated phase, and much more information can be extracted than by conventional analysis. Regarding the mixed ceramic, it was found that the present TiC phases exhibit slightly lower hardness than the alumina phase, but they can sustain much higher stresses during the transition from the elastic to the elastic–plastic regime. This is considered to be beneficial for the application as cutting material. No correlation was found between the nanomechanical behavior of the model materials sapphire and TiC and the corresponding phases of the mixed ceramic.

Targeting of viral vectors is a major challenge for in vivo gene delivery, especially after intravascular application. In addition, targeting of the endothelium itself would be of importance for gene-based therapies of vascular disease. Here, we used magnetic nanoparticles (MNPs) to combine cell transduction and positioning in the vascular system under clinically relevant, nonpermissive conditions, including hydrodynamic forces and hypothermia. The use of MNPs enhanced transduction efficiency of endothelial cells and enabled direct endothelial targeting of lentiviral vectors (LVs) by magnetic force, even in perfused vessels. In addition, application of external magnetic fields to mice significantly changed LV/MNP biodistribution in vivo. LV/MNP-transduced cells exhibited superparamagnetic behavior as measured by magnetorelaxometry, and they were efficiently retained by magnetic fields. The magnetic interactions were strong enough to position MNP-containing endothelial cells at the intima of vessels under physiological flow conditions. Importantly, magnetic positioning of MNP-labeled cells was also achieved in vivo in an injury model of the mouse carotid artery. Intravascular gene targeting can be combined with positioning of the transduced cells via nanomagnetic particles, thereby combining gene- and cell-based therapies.

Al2O3–TiC mixed ceramics are popular for dry cutting of hardened steel. In this work, the cutting performance of surface-modified mixed ceramic cutting tools has been studied. A 1-μm-thick modified surface has been obtained by CO2 posttreatment of the Al2O3–TiOC mixed ceramics. The cutting performance of the modified tools has been found to be much better than the precursor-mixed ceramics. The density of the modified layer also has an influence on the cutting performance. Modified ceramics with a dense surface layer show considerably improved wear resistance compared with that of ceramics with a porous layer. While plastic deformation of the TiC layer in the flank surface, followed by abrasive wear of the exposed substrate is responsible for flank wear, crater wear is caused mainly by diffusion reaction as well as by abrasion. In our system, it is mainly the flank wear that controls the cutting performance of the inserts.

The aim of this study is to explore the wish of gynecological and obstetric inpatients to attend psychosomatic services. Predictors influencing this wish are evaluated.Three groups of patients participated in the study. The groups consisted of patients diagnosed with malignant gynecological diseases (n = 175), benign gynecological diseases (n = 302), and obstetric diseases (n = 238). The following domains were assessed in a cross-sectional design: symptoms of anxiety and depression (HADS), physical complaints (GBB-24), health-related quality of life (SF-12), and the wish to attend psychosomatic services.34% of the participants indicated that they wanted to attend psychosomatic services during their stay in the hospital. The group of patients diagnosed with malignant gynecological diseases had the highest proportion of women who stated that wish (43%). Multiple logistic regression models showed that former psychotherapeutic experiences as well as low psychological quality of life predicted the wish to attend psychosomatic services in patients diagnosed with malignant gynecological or obstetric diseases.It was shown that a considerable proportion of patients wanted to attend psychosomatic care during their hospitalization. Contrary to physical and sociodemographic variables, psychological factors were significant predictors of the inpatient's wish to attend psychosomatic services. This suggests that the subjective estimation of impairments is a major predictor of the wish to attend psychosomatic care.