Objektivierung von funktionellen und strukturellen Beeinträchtigungen sensorischer Afferenzen bei neuroimmunologischen Krankheitsbildern

In dieser kumulativen Habilitationsschrift werden eigene Arbeiten zusammengefasst, die sich thematisch mit der Objektivierung sensorischer Afferenzstörungen bei neuroimmunologischen Krankheitsbildern befassen. B-mode Ultraschall, eine in der klinischen Routine weit verbreitete Methode, wurde als objektives Untersuchungsverfahren zur Beurteilung der Pupillenfunktion etabliert, Normwerte von Pupillendurchmessern und Pupillenkonstriktionszeiten wurden für verschiedene Altersgruppen publiziert. Das frühzeitige Erkennen und Behandeln einer ON ist entscheidend, um irreversible Schäden des N. opticus zu verhindern. Eine Funktionsstörung des afferenten visuellen Systems bei Patienten mit ON ließ sich gut mittels B-mode Ultraschall objektivieren und quantifizieren. B-mode Ultraschall könnte als bildgebender Biomarker für ein RAPD und als Surrogat-Parameter für eine Läsion des N. opticus in klinischen Studien und in der Routinediagnostik Anwendung finden. In einer weiteren Studie wurde die visuelle Lebensqualität bei NMOSD und MS Patienten mit Zustand nach ON untersucht. Die Einschränkung an visueller Lebensqualität korrelierte mit dem Ausmaß an funktioneller und struktureller Schädigung des afferenten visuellen Systems, gemessen mittels OCT und Visus. Die Integrität des afferenten olfaktorischen Systems wurde bei der NMOSD, PPMS und AE in eigenen Arbeiten erstmals untersucht. Zusammenfassend erwies sich das Riechvermögen bei diesen seltenen neuroimmunoloigschen Krankheitsbildern als deutlich eingeschränkt, wobei wir dabei von unterschiedlichen Pathomechanismen ausgehen. Riechstörungen sind möglicherweise ein weiteres Symptom dieser phänotypisch sehr heterogenen Krankheitsbilder. Eine niederschwellige Riechtestung im Rahmen der differentialdiagnostischen Zuordnung sollte bei den untersuchten Krankheitsbildern in Erwägung gezogen werden

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieve

Longitudinal Testing of Olfactory and Gustatory Function in Patients with Multiple Sclerosis

Background The aim of the study was to investigate changes of the olfactory and gustatory capacity in patients with multiple sclerosis (MS). Methodology 20 MS patients were tested longitudinally for 3 years after initial testing. The Threshold Discrimination Identification test (TDI) was used for subjective olfactometry. Objective olfactometry was performed by registering olfactory evoked potentials (OEP) by EEG. The Taste Strip Test (TST) was used for gustatory testing. Results 45% of the patients showed olfactory dysfunction in the follow-up TDI test and 50% showed delayed OEP´s. 20% of the patients showed gustatory dysfunction on follow-up visit. The patients showed mild disease activity with 0,3 ± 0,5 relapses over the testing period and no significant change of their olfactory and gustatory capacity. The olfactory capacity for the discrimination of odors correlated inversely with the number of relapses (r = -0.5, p ≤ 0.05). The patients were aware of their olfactory deficit. Conclusions Olfactory and gustatory dysfunction is a symptom in MS patients and may be a useful parameter to estimate disease progression in MS patients. As the discrimination of odors is processed in higher central regions of the central nervous system (CNS), the results suggest that olfactory dysfunction could be due to CNS damage

Ethynyl-Bridged Bis-quinolinium Dyes : Studies of the Dependence of Different Types of Conjugation on Spectroscopic Properties

Dicationic bis-quinolinium salts possessing different types of conjugation are presented in which the hetareniums are separated by acetylenic or 1,4-diethynylbenzene spacers. Cross-conjugation is induced by interconnections via the 3-positions of the heteroareniums, and conjugation is realized by 2,2/2,4/4,4-interconnections. We also synthesized mixed cross-conjugated/conjugated 2,3/4,3-interconnected species. The different types of conjugation determine the charge distribution according to the rules of resonance which translate into characteristic C-13 NMR as well as UV-Vis-spectroscopic properties, LUMO geometries, and chemical properties. We found that the triple bond's resonance frequencies are sensitive C-13 NMR spectroscopic indicators for the type of conjugation. Combining cross-conjugated and conjugated structure elements of dicationic bis-quinolinium dyes via triple bonds without additional benzene spacer results in considerable bathochromic shifts of the UV-Vis absorption maxima [Delta lambda(max)approximate to 100 nm]. A charge transfer was calculated from the HOMO of the conjugated into the LUMO of the cross-conjugated partial structure.Peer reviewe

Pain in AQP4-IgG-positive and MOG-IgG-positive neuromyelitis optica spectrum disorders

Background: Pain is a frequent symptom in aquaporin-4-immunoglobulin-G-positive neuromyelitis optica spectrum disorders (AQP4-IgG-pos. NMOSD). Data on pain in myelin-oligodendrocyteglycoprotein- immunoglobulin-G autoimmunity with a clinical NMOSD phenotype (MOG-IgG-pos. NMOSD) are scarce. Objective: The objective of this paper is to investigate pain in MOG-IgG-pos. NMOSD, AQP4-IgG-pos. NMOSD and NMOSD without AQP4/MOG-IgG detection (AQP4/MOG-IgG-neg. NMOSD). Methods: Forty-nine MOG-IgG-pos. (n=14), AQP4-IgG-pos. (n=29) and AQP4/MOG-IgG-neg. (n=6) NMOSD patients were included in this cross-sectional baseline analysis from an ongoing observational study. We identified spinal cord lesions on magnetic resonance imaging, assessed pain by the painDETECT and McGill Pain questionnaires, quality of life by Short Form Health Survey, and depression by Beck Depression Inventory. Results: Twelve MOG-IgG-pos. NMOSD patients (86%), 24 AQP4-IgG-pos. NMOSD patients (83%), and all AQP4/MOG-IgG-neg. NMOSD patients (100%) suffered from pain. MOG-IgG-pos. NMOSD patients had mostly neuropathic pain and headache; AQP4-IgG-pos. and AQP4/MOG-IgG-neg. NMOSD patients had mostly neuropathic pain. A history of myelitis was less frequent in MOG-IgGpos. NMOSD than in AQP4-IgG-pos. NMOSD patients. Pain influenced quality of life in all patients. Thirty-six percent of patients with pain received pain medication; none of them were free of pain. Conclusions: Pain is a frequent symptom of patients with MOG-IgG-pos. NMOSD and is as important as in AQP4-IgG-pos. and AQP4/MOG-IgG-neg. NMOSD. Despite its impact on quality of life, pain is insufficiently alleviated by medication

The new Felsenkeller 5 MV underground accelerator

The field of nuclear astrophysics is devoted to the study of the creation of the chemical elements. By nature, it is deeply intertwined with the physics of the Sun. The nuclear reactions of the proton-proton cycle of hydrogen burning, including the 3He({\alpha},{\gamma})7Be reaction, provide the necessary nuclear energy to prevent the gravitational collapse of the Sun and give rise to the by now well-studied pp, 7Be, and 8B solar neutrinos. The not yet measured flux of 13N, 15O, and 17F neutrinos from the carbon-nitrogen-oxygen cycle is affected in rate by the 14N(p,{\gamma})15O reaction and in emission profile by the 12C(p,{\gamma})13N reaction. The nucleosynthetic output of the subsequent phase in stellar evolution, helium burning, is controlled by the 12C({\alpha},{\gamma})16O reaction. In order to properly interpret the existing and upcoming solar neutrino data, precise nuclear physics information is needed. For nuclear reactions between light, stable nuclei, the best available technique are experiments with small ion accelerators in underground, low-background settings. The pioneering work in this regard has been done by the LUNA collaboration at Gran Sasso/Italy, using a 0.4 MV accelerator. The present contribution reports on a higher-energy, 5.0 MV, underground accelerator in the Felsenkeller underground site in Dresden/Germany. Results from {\gamma}-ray, neutron, and muon background measurements in the Felsenkeller underground site in Dresden, Germany, show that the background conditions are satisfactory for nuclear astrophysics purposes. The accelerator is in the commissioning phase and will provide intense, up to 50{\mu}A, beams of 1H+, 4He+ , and 12C+ ions, enabling research on astrophysically relevant nuclear reactions with unprecedented sensitivity.Comment: Submitted to the Proceedings of the 5th International Solar Neutrino Conference, Dresden/Germany, 11-14 June 2018, to appear on World Scientific -- updated version (Figure 2 and relevant discussion updated, co-author A. Domula added

Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

Aims: To explore differences in advanced brain magnetic resonance imaging (MRI) characteristics between myelin oligodendrocyte (MOG) immunoglobulin (IgG) and aquaporin-4 (AQP4) IgG seropositive (+) neuromyelitis optica spectrum disorders (NMOSD). Methods: 33 AQP4-IgG and 18 MOG-IgG seropositive NMOSD patients and 61 healthy control (HC) subjects were included. All 112 participants were scanned with the same standardized MRI-protocol on a 3-Tesla MRI-scanner. Brain volume and diffusion tensor imaging (DTI) parameters were assessed. Results: MOG-IgG+ patients showed reduced parallel diffusivity within white matter tracts compared to HC whereas AQP4-IgG+ showed no significant brain parenchymal damage in DTI analysis. AQP4-IgG+ patients showed reduced whole brain volumes and reduced volumes of several deep gray matter structures compared to HC whereas MOG-IgG+ patients did not show reduced brain or deep gray matter volumes compared to HC. Conclusions: Microstructural brain parenchymal damage in MOG-IgG+ patients was more pronounced than in AQP4-IgG+ patients, compared with HC, whereas normalized brain volume reduction was more severe in AQP4-IgG+ patients. Longitudinal imaging studies are warranted to further investigate this trend in NMOSD. Our results suggest that MOG-IgG+ and AQP4-IgG+ NMOSD patients differ in cerebral MRI characteristics. Advanced MRI analysis did not help to differentiate between MOG-IgG+ and AQP4-IgG+ patients in our study

Milky Way Disk-Halo Transition in HI: Properties of the Cloud Population

Using 21cm HI observations from the Parkes Radio Telescope's Galactic All-Sky Survey, we measure 255 HI clouds in the lower Galactic halo that are located near the tangent points at 16.9 < l < 35.3 degrees and |b| < 20 degrees. The clouds have a median mass of 700 Msun and a median distance from the Galactic plane of 660 pc. This first Galactic quadrant (QI) region is symmetric to a region of the fourth quadrant (QIV) studied previously using the same data set and measurement criteria. The properties of the individual clouds in the two quadrants are quite similar suggesting that they belong to the same population, and both populations have a line of sight cloud-cloud velocity dispersion of sigma_cc ~ 16 km/s. However, there are three times as many disk-halo clouds at the QI tangent points and their scale height, at h=800 pc, is twice as large as in QIV. Thus the observed line of sight random cloud motions are not connected to the cloud scale height or its variation around the Galaxy. The surface density of clouds is nearly constant over the QI tangent point region but is peaked near R~4 kpc in QIV. We ascribe all of these differences to the coincidental location of the QI region at the tip of the Milky Way's bar, where it merges with a major spiral arm. The QIV tangent point region, in contrast, covers only a segment of a minor spiral arm. The disk-halo HI cloud population is thus likely tied to and driven by large-scale star formation processes, possibly through the mechanism of supershells and feedback.Comment: 14 pages, 20 figures, to be published in ApJ (accepted August 3 2010

Pharmacological Modulation of the Psychiatric Risk Factor FKBP51 Alters Efficiency of Common Antidepressant Drugs

Despite a growing body of research over the last few decades, mental disorders, including anxiety disorders or depression, are still one of the most prevalent and hardest to treat health burdens worldwide. Since pharmacological treatment with a single drug is often rather ineffective, approaches such as co-medication with functionally diverse antidepressants (ADs) have been discussed and tried more recently. Besides classical ADs, there is a growing number of candidate targets identified as potential starting points for new treatment methods. One of these candidates, the FK506 binding protein 51 (FKBP51) is linked to a number of psychiatric disorders in humans. In this study, we used SAFit2-a newly developed modulator of FKBP51, which has shown promising results in rodent models for stress-related disorders delivered in a depot formulation. We combined SAFit2 with the commonly prescribed selective serotonin reuptake inhibitor (SSRI) escitalopram and performed basic behavioral characterization in a mouse model. Remarkably, co-application of SAFit2 lowered the efficacy of escitalopram in anxiety-related tests but improved stress coping behavior. Given the fact that mental diseases such as anxiety disorders or depression can be divided into different sub-categories, some of which more or less prone to stress, SAFit2 could indeed be a highly beneficial co-medication in very specific cases. This study could be a first, promising step towards the use of FKBP51 modulators as potent and specific enhancers of AD efficiency for subclasses of patients in the future

Development of a GEM-TPC prototype

The use of GEM foils for the amplification stage of a TPC instead of a con- ventional MWPC allows one to bypass the necessity of gating, as the backdrift is suppressed thanks to the asymmetric field configuration. This way, a novel continuously running TPC, which represents one option for the PANDA central tracker, can be realized. A medium sized prototype with a diameter of 300 mm and a length of 600 mm will be tested inside the FOPI spectrometer at GSI using a carbon or lithium beam at intermediate energies (E = 1-3AGeV). This detector test under realistic experimental conditions should allow us to verify the spatial resolution for single tracks and the reconstruction capability for displaced vertexes. A series of physics measurement implying pion beams is scheduled with the FOPI spectrometer together with the GEM-TPC as well.Comment: 5 pages, 4 figures, Proceedings for 11th ICATTP conference in como (italy