Gesamtverzeichnis der Hamburger Universitätsreden

Nach der kampflosen Besetzung Hamburgs durch britische Truppen am 3. Mai 1945 wurde die Hamburger Universität geschlossen, aber bereits am 6. November 1945 – ein halbes Jahr nach Ende des „Dritten Reichs“ und des Zweiten Weltkriegs – mit einem Festakt in der Musikhalle wiedereröffnet. Den 70. Jahrestag dieser Wiedereröffnung am 6. November 2015 nahm die Universität Hamburg zum Anlass, sich erneut öffentlich mit dem schwierigen Übergang der eigenen Institution von der NS-Diktatur in die demokratische Nachkriegszeit auseinanderzusetzen. Dieser Band der „Hamburger Universitätsreden“ dokumentiert die vier am 6. November 2015 im Magdalene-Schoch-Hörsaal im Hauptgebäude der Universität gehaltenen Reden.After the occupation of Hamburg by British troops on May 3rd, 1945, the Hamburg University was closed, but reopened on November 6th, 1945 - half a year after the end of the "Third Reich" and the Second World War. On the occasion of the 70th anniversary of this reopening on 6 November 2015, the University of Hamburg took the opportunity to publicly discuss the difficult transition of its own institution from the Nazi dictatorship into the democratic post-war period. This volume of "Hamburger Universitätsreden" documents the four speeches held on on this occation

Effects of a cerebral inflammatory reaction to the systemic immune response and the risk of pneumonia in a rat model

GesamtdissertationInfektionen sind Haupttodesursache bei Patienten mit akuten Hirnläsionen, sowohl bei ischämischen, hämorrhagischen, traumatisch oder infektiös bedingten Hirnschädigungen. Die Pneumonie ist eine der Hauptkomplikationen nach Schlaganfall und Schädel-Hirn-Trauma. In den meisten Fällen finden sich Staphylococcus aureus, Streptococcus pneumoniae und Haemophilus influenzae als verursachende Keime dieser Pneumonie der frühen Phase. Die bekannten Risikofaktoren einer Aspiration durch verminderte Schutzreflexe oder die endotracheale Intubation können die Häufung von Pneumonien nur bedingt erklären. Bei diesen Patienten findet sich eine zentral induzierte Immunsuppression mit einer eingeschränkten zellulären Abwehr bei verminderten Leukozytenzahlen, einer Deaktivierung von Monozyten und Makrophagen, einer verminderten Aktivität von T-Zellen und Natural-Killer-Zellen sowie eine beeinträchtigte Produktion pro-inflammatorischer Zytokine. Ausgangspunkt ist die intrazerebrale Freisetzung pro-inflammatorischer Zytokine bei Gewebsschädigung, die als Neurotransmitter über eine Aktivierung der Hypothalamus-Hypophysen-Achse, des Sympathischen und Parasympathischen Nervensystems eine Beeinträchtigung der systemischen Immunabwehr hervorrufen. In Tierstudien konnte intrazerebrales IL-1β als starker Aktivator der Immunreaktion identifiziert werden. Nach intrazerebraler Infusion von IL-1β fand sich eine verminderte Konzentration pro-inflammatorischer Zytokine, eine verminderte T-Zell-Proliferation, eine vermehrte Ausschüttung von anti- inflammatorischem IL-10, sowie eine vermehrte Zellinvasion in den Liquor. Ziel der vorliegenden Studie im Rattenmodell war der Nachweis einer erhöhten Pneumonierate bei Tieren, die intrazerebral IL-1β erhielten im Vergleich zu Kontrolltieren mit Vehikelinfusion. Alle Tiere wurden der Implantation einer ALZET-Pumpe unterzogen, die gleichmäßig die gewünschte Menge an Zytokin/Vehikellösung produzierte. Nach 18 Stunden nach Beginn der intrazerebralen Infusion erfolgte die intratracheale Bakteriengabe von Streptococcus pneumoniae. Die Lungen wurden mikrobiologisch aufgearbeitet und Bakterienkolonien und Zytokinkonzentrationen untersucht. Der Zeitpunkt der maximalen systemischen Immunsuppression wurde anhand der IL-10-Konzentration im Blut mittels Durchflusszytometrie auf 18 Stunden nach Beginn der intrazerebralen Infusion bestimmt. Die Auszählung der Bakterienkolonien ergab keinen signifikanten Unterschied zwischen Kontroll- und IL-1β-Tieren, jedoch zeigte sich in der Bronchiallavage eine signifikante Minderung der pro- inflammatorischen Zytokine IL-6, IL-1β, TNF-α und CINC. Obwohl sich keine Unterschiede in der Zellzählung der Alveolarmakrophagen zeigten, bestand im Differentialblutbild bei den IL-1β-Tieren ein granulozytäres Zellbild während bei den Kontrolltieren ein lymphozytäres Zellbild vorlag. Insgesamt konnte bei den IL-1β-Tieren keine erhöhte Pneumonierate festgestellt werden. Jedoch lässt die signifikante Verminderung der pro-inflammatorischen Zytokine in der Bronchiallavage auf eine Funktionsstörung der Alveolarmakrophagen nach intrazerebraler IL-1β-Infusion schließen. Diese ist jedoch nicht ausreichend, um eine Pneumonie hervorzurufen.Infections are a leading cause of death in patients with acute brain injury, such as trauma, stroke or cerebral infection. It is well known that neurosurgical patients often develop early onset pneumonia after brain surgery or trauma. Infections after acute brain injury increase morbidity and mortality. Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influencae are found in most cases. Risk factors like dysphagia, aspiration and mechanical ventilation are not sufficient to induce pneumonia. Patients after brain injury show impaired T- and natural killer-cell activity, a deactivation of macrophages and monocytes and reduced phagocytotic activity of granulocytes. Brain injury leads to a local release of pro-inflammatory cytokines activating three mechanisms modulating the CNS injury-induced immunodepression: the sympathetic nervous system, the parasympathetic nervous system and the hypothalamic-pituitary-adrenal axis. In previous experiments we demonstrated the immunosuppressive effect of intracerebral infusion of IL-1β. This cytokine is produced in the brain after different types of brain injury. It can act as neurotransmitters and develop direct effects on the central nervous system. Moreover, IL-1β is a key cytokine in cerebral damage as well as brain repair processes. We hypothize, that cerebral release of pro- inflammatory cytokines induces the systemic production of anti-inflammatory cytokines, especially IL-10. This may lead to systemic immunodepression and influence pulmonary bacterial clearance and neutrophil recruitment. In order to prove our hypothesis a special animal model was developed. Rats received a continuous intracerebral infusion of IL-1β using ALZET-mini-pumps. After 18 hours they were infected with Streptococcus pneumoniae by intratracheal injection. Lung tissue was prepared to differentiate bacterial burden, clearance and neutrophile recruitment. Cytokines were measured in bronchoalveolar lavage. With this paradigm we could show decreased pro- inflammatory cytokine levels in the bronchoalveolar lavage in IL-1β\- treated animals. However, blood cell counts were not diminished but an increase of neutrophiles compared to lymphocytes in blood was demonstrated. Intracerebral IL-1β-infusion leads to diminution of cytokines leading to an impairment of neutrophil recruitment and cellular activity of alveolar-macrophages. However, this immunodepression did not lead to pneumonia after bacterial challenge. This suggests that immunodepression induced by intracerebral IL-1β is not powerful enough to induce pneumonia in this model

Kontinuität im Neubeginn. Reden der Zentralen Veranstaltung der Universität Hamburg am 6. November 2015 anlässlich des 70. Jahrestags ihrer Wiedereröffnung 1945

After the occupation of Hamburg by British troops on May 3rd, 1945, the Hamburg University was closed, but reopened on November 6th, 1945 - half a year after the end of the "Third Reich" and the Second World War. On the occasion of the 70th anniversary of this reopening on 6 November 2015, the University of Hamburg took the opportunity to publicly discuss the difficult transition of its own institution from the Nazi dictatorship into the democratic post-war period. This volume of "Hamburger Universitätsreden" documents the four speeches held on on this occation

Kontinuität im Neubeginn. Reden der Zentralen Veranstaltung der Universität Hamburg am 6. November 2015 anlässlich des 70. Jahrestags ihrer Wiedereröffnung 1945

After the occupation of Hamburg by British troops on May 3rd, 1945, the Hamburg University was closed, but reopened on November 6th, 1945 - half a year after the end of the "Third Reich" and the Second World War. On the occasion of the 70th anniversary of this reopening on 6 November 2015, the University of Hamburg took the opportunity to publicly discuss the difficult transition of its own institution from the Nazi dictatorship into the democratic post-war period. This volume of "Hamburger Universitätsreden" documents the four speeches held on on this occation

Endoscopic Biopsy for Intra- and Paraventricular Tumors: Rates of Complications, Mortality, and Tumor Cell Dissemination

Background and Study Aim Intra- and paraventricular tumors are frequently associated with cerebrospinal fluid (CSF) pathway obstruction. Thus the aim of an endoscopic approach is to restore patency of the CSF pathways and to obtain a tumor biopsy. Because endoscopic tumor biopsy may increase tumor cell dissemination, this study sought to evaluate this risk. Patients, Materials, and Methods Forty-four patients who underwent endoscopic biopsies for ventricular or paraventricular tumors between 1993 and 2011 were included in the study. Charts and images were reviewed retrospectively to evaluate rates of adverse events, mortality, and tumor cell dissemination. Adverse events, mortality, and tumor cell dissemination were evaluated. Results Postoperative clinical condition improved in 63.0% of patients, remained stable in 30.4%, and worsened in 6.6%. One patient (2.2%) had a postoperative thalamic stroke leading to hemiparesis and hemineglect. No procedure-related deaths occurred. Postoperative tumor cell dissemination was observed in 14.3% of patients available for follow-up. Conclusions For patients presenting with occlusive hydrocephalus due to tumors in or adjacent to the ventricular system, endoscopic CSF diversion is the procedure of first choice. Tumor biopsy in the current study did not affect safety or efficacy

Antimicrobial resistance of Neisseria gonorrhoeae in Germany: low levels of cephalosporin resistance, but high azithromycin resistance

Abstract Background The widespread antimicrobial resistance of Neisseria gonorrhoeae is a serious problem for the treatment and control of gonorrhoea. Many of the previously effective therapeutic agents are no longer viable. Because N. gonorrhoeae infections are not reportable in Germany, only limited data on disease epidemiology and antimicrobial susceptibility patterns are available. The Gonococcal Resistance Network (GORENET) is a surveillance project to monitor trends in the antimicrobial susceptibility of N. gonorrhoeae in Germany in order to guide treatment algorithms and target future prevention strategies. Methods Between April 2014 and December 2015, data on patient-related information were collected from laboratories nationwide, and susceptibility testing was performed on 537 N. gonorrhoeae isolates forwarded from the network laboratories to the Conciliar Laboratory for gonococci. Susceptibility results for cefixime, ceftriaxone, azithromycin, ciprofloxacin and penicillin were defined according to EUCAST 4.0 standards. Percentages, medians and interquartile ranges (IQR) were calculated. Results Altogether, 90% of isolates were from men. The median age was 32 (IQR 25–44) years for men and 25 (IQR 22–40) years for women (p-value < 0.001). The most frequently tested materials among men were urethral (96.1%) and rectal swabs (1.7%), and among women, it was mainly endocervical and vaginal swabs (84.3%). None of the isolates were resistant to ceftriaxone. Furthermore, 1.9% (in 2014) and 1.4% (in 2015) of the isolates were resistant to cefixime, 11.9% and 9.8% showed resistance against azithromycin, 72.0% and 58.3% were resistant to ciprofloxacin, and 29.1% and 18.8% were resistant to penicillin. Conclusions Resistance to ceftriaxone was not detected, and the percentage of isolates with resistance to cefixime was low, whereas azithromycin resistance showed high levels during the observation period. The rates of ciprofloxacin resistance and penicillin resistance were very high across Germany. Continued surveillance of antimicrobial drug susceptibilities for N. gonorrhoeae remains highly important to ensure efficient disease management

Gonorrhö mit einem high-level-Azithromycin-resistenten Erreger in Deutschland

Das Epidemiologische Bulletin 32/33 2019 berichtet über eine urogenitale Gonorrhö bei einem 42-jährigen Patienten mit einem high-level-Azithromycin-resistenten N. gonorrhoeae-Stamm. Die Erkrankung wurde Ende Juni 2019 in Deutschland diagnostiziert. Eine Reiseanamnese beim Patienten bestand nicht, ebenso keine Vorerkrankungen und keine relevanten vorherigen Antibiotikatherapien. Die Partnerin des Patienten war ebenfalls erkrankt. Bei ihr wurde eine Gonorrhö sowohl endozervikal als auch pharyngeal nachgewiesen.Peer Reviewe

Quantifying unruptured giant intracranial aneurysms by measuring diameter and volume--a comparative analysis of 69 cases

Intracranial aneurysms (IA) are usually quantified according to their largest diameter. However, volumetry has recently been increasingly conducted as well, especially in giant intracranial aneurysms (GIAs). Since so far the true value of GIA volumetry is unknown, we designed a trial to examine correlations between GIA diameter and volume with special focus on clinical implications