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  • 1
    Publication Date: 2018-01-03
    Description: Elevation of the end-tidal partial pressure of CO 2 (P ET co 2 ) increases cerebral and myocardial blood flow (MBF), suggesting that it may be a suitable alternative to pharmacologic stress or exercise for myocardial perfusion imaging. The purpose of this study was to document the pharmacodynamics of CO 2 for MBF using prospective end-tidal targeting to precisely control arterial P co 2 and PET to measure the outcome variable, MBF. Methods: Ten healthy men underwent serial 82 Rb PET/CT imaging. Imaging was performed at rest and during 6-min hypercapnic plateaus (baseline; P ET co 2 at 50, 55, and 60 mm Hg; repeat of P ET co 2 at 60 mm Hg; and repeat of baseline). MBF was measured using 82 Rb injected 3 min after the beginning of hypercapnia and a 1-tissue-compartment model with flow-dependent extraction correction. Results were compared with those obtained during an adenosine stress test (140 μg/kg/min). Results: Baseline P ET co 2 was 38.9 ± 0.8 (mean ± SD) mm Hg (range, 35–43 mm Hg). All P ET co 2 targets were sustained, with SDs of less than 1.5 mm Hg. Heart rate, systolic blood pressure, rate x pressure product, and respiratory frequency increased with progressive hypercapnia. MBF increased significantly at each level of hypercapnia to 1.92-fold over baseline (0.86 ± 0.24 vs. 0.45 ± 0.08 mL/min/g; P = 0.002) at a P ET co 2 of 60 mm Hg. MBF after the administration of adenosine was significantly greater than that with the maximal hypercapnic stimulus (2.00 vs. 0.86 mL/min/g; P 〈 0.0001). Conclusion: To our knowledge, this study is the first to assess the response of MBF to different levels of hypercapnia in healthy humans with PET. MBF increased with increasing levels of hypercapnia; MBF at a P ET co 2 of 60 mm Hg was double that at baseline.
    Print ISSN: 0022-3123
    Topics: Medicine
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH); 20110507-20110511; Hamburg; DOCMI.04.05 /20110428/
    Publication Date: 2011-04-28
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20031111-20031116; Berlin; DOC03dguF3-1 /20031111/
    Publication Date: 2003-11-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; VOL: 6; DOC16 /20171205/
    Publication Date: 2017-12-05
    Description: Objective: To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli).Design: We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding).Setting: The students were recuited at the BG Trauma Center Ludwigshafen (Germany), a large 528-bed trauma center and one of 13 ATLS course sites in Germany.Participants: 449 ATLS course students taking part in ATLS courses at the above-mentioned course site from February 2009 to May 2010 were sent a questionnaire asking for their background. All 449 course students were eligible to participate. 376 (83.7%) questionnaires were returned, pre- and post-test results of all students aquired and included into our calculations. 312 (83%) were male and 64 (17%) female. The majority (59.3%) of recruited students came from trauma surgery, 21.8% from anesthesiology, 8% from general surgery, 4% from abdominal surgery, 0.5% from vascular or thoracic surgery each and 5.9% from other specialties.Results: Neither age, sex, subspecialty, hospital level of care, hospital operator, or hospital participation in trauma network played a role with respect to motivation or test results. The high degree of intrinsic motivation of consultants (92.3%) had no impact on their test results. Anesthesiologists were higher motivated (75.6% intrinsically motivated) in contrast to all surgical colleagues (63.6%), which showed significant differences in the pre- (89.8% vs. 85.3%, p=0.03) but not the post-test. Of all 13.6% students who were self-payers, 94.1% were intrinsically motivated; the 86.2% whose course fee was accounted for were less likely to be intrinsically motivated (63.9%). Sponsoring however did not have a negative impact on test results. Conditional funding (sponsored only on passing both tests) was detrimental to motivation: 0% of these individuals were intrinsically motivated and they scored significantly lower (82.5%) than all other students in the post-test (86.9%, p=0.002). Overall, intrinsically motivated students overtopped extrinsically motivated students in the post-test (88.0% vs. 83.4%, p〈0.001).Conclusions: ATLS course participation is not compulsory for medical doctors in Germany. Intrinsic motivation to take part in these courses is a key prerequisite to increase performance, irrespective of the background of the students. Intrinsically motivated students are ready to invest into their education and vice versa. Conditional funding (course fee only sponsored on passing the course) evokes no intrinsic motivation at all and causes worse results.
    Description: Ziele: Korrelation der Testergebnisse von Teilnehmern an Advanced Trauma Life Support (ATLS)-Kursen mit deren fachlichen Hintergrund und Motivation. Die Auswertung basiert auf der Selbstbestimmungstheorie, die zwischen intrinsischer (Eigenantrieb) und extrinsischer Motivation (externe Anreize) unterscheidet.Material und Methoden: Wir stellen eine unverblindete, monozentrische, nicht-randomisierte, deskriptive Studie mit 376 Teilnehmern vor. Die Teilnehmer wurden an der Berufsgenossenschaftlichen Unfallklinik in Ludwigshafen, einem großen Trauma-Zentrum mit 528 Betten und einem von 13 ATLS-Kursorten in Deutschland, rekrutiert.Teil eines jeden Zweitages-ATLS-Kurses sind zwei schriftliche Tests (Eingangs- und Abschlusstest). Wir korrelierten die hier erzielten Testergebnisse mit Hintergrundinformationen eines Fragebogens mit 13 Items (Alter, Geschlecht, Adresse, Facharztstatus, Facharztdisziplin, Zusatzbezeichnung, Position, Versorgungsstufe des Krankenhauses, Krankenhausträger, Partizipationsstatus im Trauma-Netzwerk, Motivation, Geldquelle, Erfolgsabhängkeit der Fremdfinanzierung).Insgesamt 449 Kursteilnehmer zwischen Februar 2009 und Mai 2010 erhielten den o.g. Fragebogen mit der Einladung zum Kurs per Post. Alle 449 Kursteilnehmer waren in unserer Studie teilnahmeberechtigt. 376 (83,7%) der Fragebögen wurden retourniert, die Ergebnisse von Eingangs- und Abschlusstest aller Studienteilnehmer erfasst und in unsere Berechnungen einbezogen. 312 (83%) waren Männer und 64 (17%) Frauen. Die Mehrzahl (59,3%) der rekrutierten Studienteilnehmer waren Unfallchirurgen, 21,8% Anästhesisten, 8% Allgemeinchirurgen, 4% Viszeralchirurgen, 0,5% jeweils Gefäß- und Thoraxchirurgen und 5,9% Ärzte aus anderen Disziplinen.Ergebnisse: Weder Alter, Geschlecht, Zusatzbezeichnung(en), Versorgungsstufe, Krankenhausträger noch Partizipationsstatus in Bezug auf das Trauma Netzwerk spielten eine Rolle in Bezug auf Motivation oder Testergebnisse. Den größten Anteil intrinsisch motivierter Teilnehmer verzeichneten Chefärzte (92,3%), jedoch ohne Implikationen auf deren Testergebnisse. Der Anteil intrinsisch motivierter Anästhesisten war höher (75,6%) im Vergleich zu allen Chirurgen (63,6%); dies schlug sich in signifikant besseren Ergebnissen im Eingangs- (89,8% vs. 85,3%, p=0,03), jedoch nicht im Abschlusstest nieder. Von den 13,6% aller Selbstzahler waren 94,1% intrinsisch motiviert. Nur 63,9% der 86,2% Fremdfinanzierten waren intrinsisch motiviert. Der Aspekt der Finanzierung der Kursgebühr hatte keine Auswirkungen auf die Testergebnisse. Die erfolgsabhängige Finanzierung der Kursgebühr hatte dabei jedoch einen deutlich negativen Effekt in Bezug auf die Motivation der betroffenen Teilnehmer: niemand aus dieser Gruppe war intrinsisch motiviert und sie erzielte schlechtere Ergebnisse (82,5%) im Abschlusstest im Vergleich zu allen anderen Teilnehmern (86,9%, p=0,002). Generell erreichten alle intrinsisch motivierten Teilnehmer im Abschlusstest bessere Ergebnisse als extrinsisch motivierte (88,0% vs. 83,4%, p〈0,001).Schlussfolgerungen: Die Teilnahme an ATLS-Kursen ist bislang für Ärzte in Deutschland nicht verpflichtend. Intrinsische Motivation zur Teilnahme an diesen Kursen ist ein Schlüsselfaktor in Bezug auf die Testergebnisse, unabhängig vom fachlichen Hintergrund. Intrinsisch motivierte Teilnehmer sind zu Investitionen in Ihre Ausbildung bereit und vice versa. Erfolgsabhängige Finanzierung der Kursgebühr macht jegliche intrinsische Motivation zunichte und hat schlechtere Testergebnisse zur Folge.
    Keywords: Advanced Trauma Life Support ; ATLS ; motivation ; incentives ; test performance ; Advanced Trauma Life Support ; ATLS ; Motivation ; Anreize ; Testergebnisse ; ddc: 610
    Language: English
    Type: article
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA); 20100923-20100925; Bochum; DOC10gma141 /20100805/
    Publication Date: 2010-08-06
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010); 20100623-20100626; Köln; DOCP46 /20100602/
    Publication Date: 2010-06-02
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 7
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien; 20090524-20090527; Münster; DOCP08-04 /20090520/
    Publication Date: 2009-06-30
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 8
    Keywords: BLOOD ; Germany ; LUNG ; DNA adducts ; EXPOSURE ; liver ; TISSUE ; HEART ; DNA ; kidney ; 3-nitrobenzanthrone ; DIESEL EXHAUST ; DNA ADDUCT FORMATION ; POSTLABELING ANALYSIS ; RAT ; BIOMARKERS ; CONTAMINANT 3-NITROBENZANTHRONE ; ENRICHMENT ; HPLC ; RATS ; METABOLITES ; HUMANS ; URINARY-BLADDER ; HUMAN ACETYLTRANSFERASES ; METABOLIC-ACTIVATION ; NUCLEOTIDES ; POLLUTANT 3-NITROBENZANTHRONE ; ADDUCTS ; PERFORMANCE LIQUID-CHROMATOGRAPHY ; DNA-ADDUCTS ; SURFACE SOIL ; V79 CELLS ; SINGLE ; RE ; EMISSIONS ; CARCINOGEN ; ADDUCT ; biomarker ; MUTAGEN 3-NITROBENZANTHRONE ; DNA ADDUCT ; intratracheal instillation ; P-32-postlabeling
    Abstract: 3-Nitrobenzanthrone (3-NBA) is an environmental pollutant and suspected human carcinogen found in emissions from diesel and gasoline engines and on the surface of ambient air particulate matter; human exposure to 3-NBA is likely to occur primarily via the respiratory tract. In our study female Sprague Dawley rats were treated by intratracheal instillation with a single dose of 0.2 or 2 mg/kg body weight of 3-NBA. Using the butanol enrichment version of the P-32-postlabeling method, DNA adduct formation by 3-NBA 48 hr after intratracheal administration in different organs (lung, pancreas, kidney, urinary bladder, heart, small intestine and liver) and in blood was investigated. The same adduct pattern consisting of up to 5 DNA adduct spots was detected by thin layer chromatography in all tissues and blood and at both doses. Highest total adduct levels were found in lung and pancreas (350 +/- 139 and 620 +/- 370 adducts per 10(8) nucleotides for the high dose and 39 +/- 18 and 55 +/- 34 adducts per 10(8) nucleotides for the low dose, respectively) followed by kidney, urinary bladder, heart, small intestine and liver. Adduct levels were dose-dependent in all organs (approximately 10-fold difference between doses). It was demonstrated by high performance liquid chromatography (HPLC) that all 5 3-NBA-derived DNA adducts formed in rats after intratracheal instillation are identical to those formed by other routes of application and are, as previously shown, formed from reductive metabolites bound to purine bases. Although total adduct levels in the blood were much lower (41 +/- 27 and 9.5 +/- 1.9 adducts per 10(8) nucleotides for the high and low dose, respectively) than those found in the lung, they were related to dose and to the levels found in lung. These results show that uptake of 3-NBA by the lung induces high levels of specific DNA adducts in several organs of the rat and an identical adduct pattern in DNA from blood. Therefore, 3-NBA-DNA adducts present in the blood are useful biomarkers for exposure to 3-NBA and may help to assess the effective biological dose in humans exposed to it. (C) 2005 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 15856450
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  • 9
    Keywords: CELLS ; EXPRESSION ; CELL ; MODEL ; MODELS ; DEATH ; DISEASE ; liver ; GENE ; MICE ; COMPLEX ; COMPLEXES ; CEREBELLUM ; MIGRATION ; MOUSE MODEL ; ABNORMALITIES ; DEFECTS ; development ; MOUSE MODELS ; BIOGENESIS ; peroxisome ; DYSFUNCTION ; CORTICAL NEURONAL MIGRATION ; GRANULE CELLS ; neocortex ; NMDA RECEPTORS ; ZELLWEGER-SYNDROME
    Abstract: Defects in the formation of the cerebral cortex and the cerebellum are a prominent feature of the peroxisome biogenesis disorder Zellweger syndrome and in mouse models for this disease. The aim of the present study was to investigate the impact of liver and brain peroxisomes on neurodevelopment by analyzing mice with tissue-selective elimination of peroxisomes. To this end, Pex5-IoxP mice were bred with albumin/alpha-fetoprotein (Alfp)-Cre and nestin (Nes)-Cre mice. Local elimination of peroxisomes from the brain in Nes-Pex5 knockout mice caused a delay of cortical neuronal migration and of the formation of cerebellar folia and fissures. Migration of granule cells from the external granular layer was retarded, as was the polarization and branching of Purkinje cells, resulting in a less complex branching pattern and a smaller dendritic tree at P21. The Alfp-Pex5 knockout mice were affected differently, displaying a partial arrest of neuronal migration in the cerebral neopallium in the postnatal period despite of the incomplete elimination of peroxisomes from liver during embryonic development. Major abnormalities were seen in the formation of the cerebellum of these liver knockout mice, including hypotrophy, impaired foliation, a delay of granule cell migration, increased cell death, and stunted Purkinje cell arborization. In conclusion, these data demonstrate that absence of peroxisomal function both from liver and brain impairs cortical neuronal migration and maturation of the cerebellum, but different pathogenic mechanisms might be involved. (c) 2006 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 17075904
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  • 10
    Keywords: brain ; EXPRESSION ; transcription ; TRANSGENIC MICE ; BEHAVIOR ; secretion ; CORTICOTROPIN-RELEASING-FACTOR ; IMPAIRED STRESS-RESPONSE ; ELEVATED PLUS-MAZE ; ADRENOCORTICAL REGULATION
    Abstract: The glucocorticoid receptor (Gr, encoded by the gene Grl1) controls transcription of target genes both directly by interaction with DNA regulatory elements and indirectly by cross-talk with other transcription factors. In response to various stimuli, including stress, glucocorticoids coordinate metabolic, endocrine, immune and nervous system responses and ensure an adequate profile of transcription. In the brain, Gr has been proposed to modulate emotional behaviour, cognitive functions and addictive states. Previously, these aspects were not studied in the absence of functional Gr because inactivation of Grl1 in mice causes lethality at birth (F.T., C.K. and G.S., unpublished data). Therefore, we generated tissue-specific mutations of this gene using the Cre/loxP -recombination system. This allowed us to generate viable adult mice with loss of Gr function in selected tissues. Loss of Gr function in the nervous system impairs hypothalamus-pituitary-adrenal (HPA)-axis regulation, resulting in increased glucocorticoid (GC) levels that lead to symptoms reminiscent of those observed in Cushing syndrome. Conditional mutagenesis of Gr in the nervous system provides genetic evidence for the importance of Gr signalling in emotional behaviour because mutant animals show an impaired behavioural response to stress and display reduced anxiety.
    Type of Publication: Journal article published
    PubMed ID: 10471508
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