Verlauf und Therapie des idiopathischen Parkinson-Syndroms bei Patienten der Klinik und Poliklinik für Neurologie des Universitätsklinikums Köln

Ziel der Studie war es, mit Hilfe einer großen Kohorte Trends und etablierte Methoden der Therapie des Morbus Parkinson zu analysieren und mit Ergebnissen der internationalen Literatur zu vergleichen. Dafür wurden Daten von 365 Parkinson-Patienten der Universitätsklinik Köln retrospektiv erfasst und ausgewertet. Die Daten umfassten demographische Angaben wie Alter, Geschlecht und Erkrankungsdauer sowie Parameter zu Medikation, motorischem Zustand und neuropsychologischen Tests. Der Verlauf der Krankheitsparameter wurde dann in Bezug auf den Einsatz der Tiefen Hirnstimulation überprüft und dargestellt. Die Ergebnisse unserer Studie waren in vielen Bereichen im Einklang mit der aktuellen Datenlage international veröffentlichter Studien, wobei unsere Studie jedoch im Vergleich zu vielen anderen der angeführten Studien eine globale Sicht auf verschiedene Parameter der Parkinson-Krankheit ermöglichte. Die Tiefe Hirnstimulation führte bei unseren Patienten zu einer signifikanten Verminderung der Parkinson-Medikation, sowie zu einer Verbesserung der Motorik in den ersten Jahren nach deren Einsatz und einer fraglich positiven Modifikation des Krankheitsverlaufs. Weiterhin konnten Aussagen zum Alter der Patienten, Krankheitsdauer, Geschlechtsunterschieden, Stimulationszielgebieten und Krankheitssubtypen bezogen auf die Tiefe Hirnstimulation gemacht werden. Aufbauend auf unserer Studie sind weitere longitudinale prospektive Studien sinnvoll und interessant, um die gefundenen Ergebnisse zu überprüfen und ein tieferes Verständnis für eine verbesserte Therapie des Morbus Parkinson zu schaffen

Liver transplantation reverses hypergammaglobulinemia in patients with chronic hepatic failure

Introduction: Sparse data are available about the effect of therapy methods on antibody levels in patients with liver failure. The aim of this study was to determine serum immunoglobulin concentrations in patients with chronic hepatic failure (CHF), acute- (ALF), or acute-on-chronic liver failure (ACLF) and to evaluate the impact of MARS treatment or liver transplantation (LT) on antibody levels. Materials and methods: We followed ten patients with ALF, twelve with ACLF and 18 with CHF. Eight patients with ALF and seven with ACLF underwent MARS therapy, whereas the rest received LT. 13 healthy volunteers served as controls. Serum antibody concentrations were measured using ELISA-technique. Results: Median serum levels of IgA, IgG and IgM were significantly increased in patients with CHF compared to ALF or controls (P < 0.02, P < 0.01, and P < 0.01). IgM and IgG concentrations were also significantly elevated in patients with CHF compared to ACLF (IgM, 3.7 vs. 1 g/L, P < 0.001; IgG, 8.7 vs. 3.1 g/L, P = 0.004). Immediately after LT a significant decrease of IgA (6.9 vs. 3.1 g/L, P = 0.004), IgG (8.7 vs. 5.1 g/L, P = 0.02) and IgM (3.7 vs. 1.8 g/L, P = 0.001) was detected in patients with CHF and antibody levels further decreased the days after LT reaching levels comparable to healthy individuals. MARS treatment had no apparent effect on the immunoglobulin profile in patients with ALF or ACLF. Conclusion: We provide evidence that LT reverses hypergammaglobulinemia in patients suffering from CHF within one day, which could be explained to a reconstituted hepatic antibody clearance, whereas MARS treatment has no immediate effect on immunoglobulin levels

Femtosecond UV-pump mid-IR probe spectroscopy of the ultrafast photodissociation of azide radicals from an azidoiron(III) complex

The ultrafast photolysis of the cation complex [(cyclam-ac)FeN3]+ is studied by femtosecond spectroscopy with ultraviolet excitation and mid-infrared probing. Immediately after UV absorption, the excited complex undergoes internal conversion and azide dissociation within 2 ps. The subsequent vibrational relaxation in the electronic ground state and geminate recombination of the fragments take place on time scales of 13 and 20 ps, respectively

Dose-Response-Relationship between Number of Laser Burns and IOP Reduction in Cyclophotocoagulation: An Animal Study

Purpose. The relationship between number of laser burns of cyclophotocoagulation (CPC) and intraocular pressure (IOP) reduction is unknown. This animal model was established to reveal a possible dose-response-relationship between the number of applied laser burns and the IOP lowering effect. Methods. 30 chinchilla bastard rabbits were divided into 5 groups and treated with either 1, 5, 10, 20, or 30 CPC burns, respectively. IOP was followed up for 1 week. IOP reduction of a single 30-burn treatment was compared with a fractionated treatment (three sessions; one week in between; 10 burns/session). Results. IOP reduction increases nonlinearly with the number of CPC burns (max. -6.1±1.4 mmHg). Fractionated treatment shows similar IOP reduction with less complications and more constant results compared to single session treatment. Conclusions. The study reveals a complex relationship between IOP reduction and the number of CPC burns. Fractionated CPC gives comparable IOP reduction at a higher degree of safety

Photoinduced host-to-guest electron transfer in a self-assembled coordination cage

A [Pd$_2$L$_4$] coordination cage, assembled from electron-rich phenothiazine-based ligands and encapsulating an electron-deficient anthraquinone-based disulfonate guest, is reported. Upon excitation at 400 nm, transient absorption spectroscopy unveils photoinduced electron transfer from the host's chromophores to the guest, as indicated by characteristic spectral features assigned to the oxidized donor and reduced acceptor. The structure of the host–guest complex was characterized by NMR spectroscopy, mass spectrometry and single-crystal X-ray analysis. Spectroelectrochemical experiments and DFT calculations both agree with the proposed light-induced charge separation. A kinetic analysis of the involved charge transfer channels reveals, besides a guest-independent LMCT path, 44% efficiency for the host–guest charge transfer (HGCT)

The Photochemical Route to Octahedral Iron(V). Primary Processes and Quantum Yields from Ultrafast Mid-Infrared Spectroscopy

Recently, the complex cation [(cyclam-ac)­Fe^III(N₃)]⁺ has been used in solid matrices under cryogenic conditions as a photochemical precursor for an octahedral iron nitride containing the metal at the remarkably high oxidation state +5. Here, we study the photochemical primary events of this complex cation in liquid solution at room temperature using femtosecond time-resolved mid-infrared (fs-MIR) spectroscopy as well as step-scan Fourier-transform infrared spectroscopy, both of which were carried out with variable-wavelength excitation. In stark contrast to the cryomatrix experiments, a photooxidized product cannot be detected in liquid solution when the complex is excited through its putative LMCT band in the visible region. Instead, only a redox-neutral dissociation of azide anions is seen under these conditions. However, clear evidence is found for the formation of the highly oxidized iron nitride product when the photolysis is carried out in liquid solution with UV light. Yet, the photooxidation must compete with photoreductive Fe–N bond cleavage leading to azide radicals and an iron­(II) complex. Both, redox-neutral and photoreductive Fe–N bond breakage as well as photooxidative N–N bond breakage occur on a time scale well below a few hundred femtoseconds. The majority of fragments suffer from geminate recombination back to the parent complex on a time scale of 10 ps. Upper limits of the primary quantum yield for photooxidation are derived from the fs-MIR data, which increase with increasing energy of the photolysis photon

Time-Resolved Spectroscopy of Photo-Induced Electron Transfer in Dinuclear and Tetranuclear Fe/Co Prussian Blue Analogues

The dynamics of photo-driven charge transfer-induced spin transition (CTIST) in two Fe/Co Prussian Blue Analogues (PBAs) is revealed by femtosecond IR and UV/vis pump-probe spectroscopy. Depending on temperature the known tetranuclear square-type complex [Co2Fe2(CN)6(tp*)2(4,4’-dtbbpy)4](PF6)2 (1) exists in two electronic states. In acetonitrile solution at <240 K the low temperature (LT) phase is prevalent consisting of low-spin Fe(II) and low-spin Co(III), [FeIILSCoIIILS]2. Temperature rise causes thermally induced CTIST towards the high temperature (HT) phase consisting of low-spin Fe(III) and high-spin Co(II), [FeIIILSCoIIHS]2, being prevalent at >300 K. Photo-excitation into the intervalence charge transfer (IVCT) band of the LT phase at 800 nm induces electron transfer in one Fe-Co edge of PBA 1 and produces a [FeIIILSCoIILS] intermediate which by spin crossover (SCO) is stabilized within 400 fs to a long-lived (>1 ns) [FeIIILSCoIIHS]. In contrast, IVCT excitation of the HT phase at 400 nm generates a [FeIILSCoIIIHS] species with a lifetime of 3.6 ps. Subsequent back-electron transfer populates the vibrationally hot ground state, which thermalizes within 8 ps. The newly synthesized dinuclear PBA, [CoFe(CN)3(tp*)(pz*4Lut)]ClO4 (2), provides a benchmark of the HT phase of 1, i.e. [FeIIILSCoIIHS], as verified by variable temperature magnetic susceptibility measurements and 57Fe Mößbauer spectroscopy. The photo-induced charge transfer dynamics of PBA 2 indeed is almost identical to that of the HT phase of phase of PBA 1 with a lifetime of the excited [FeIILSCoIIIHS] species of 3.8 ps

TREATMENT OF PERSISTENT MACULAR HOLES WITH HEAVY SILICONE OIL

Background/Purpose:To determine anatomical success and best-corrected visual acuity after secondary surgery with heavy silicone oil tamponade in patients with persistent full-thickness macular holes.Methods:In this retrospective study, 63 eyes with persistent full-thickness macular holes after primary pars plana vitrectomy and internal limiting membrane peeling underwent secondary surgery with heavy silicone oil tamponade. Macular spectral domain optical coherence tomography and best-corrected visual acuity measurements were performed during the follow-up.Results:Fifty of 63 eyes (79.4%) achieved anatomical success. In eyes achieving anatomical success, best-corrected visual acuity before primary vitreoretinal surgery was significantly better (0.77 [similar to 20/125 Snellen] +/- 0.24 [1.3-0.3] logarithm of the minimum angle of resolution) compared with eyes not achieving anatomical success (0.88 [similar to 20/160 Snellen] +/- 0.17 [1.1-0.6] logarithm of the minimum angle of resolution, P = 0.044). Minimum linear diameter of full-thickness macular holes was significantly smaller in eyes achieving anatomical success, both before primary (403.4 +/- 128.7 [199.0-707.0] mu m vs. 568.1 +/- 209.1 [307.0-953.0] mu m, P = 0.009) and secondary surgery (464.1 +/- 215.0 [178.0-1,521.0] mu m vs. 663.3 +/- 228.5 [451.0-1,301.0] mu m, P = 0.010). Patients remaining phakic during all three surgeries did not benefit from best-corrected visual acuity improvement, although anatomical success was achieved.Conclusion:Heavy silicone oil tamponade in secondary surgery for persistent full-thickness macular holes is a safe and efficient surgical method. Best-corrected visual acuity and minimum linear diameter before surgery may be indicators for anatomical success