Analyse der Einweisungsdiagnose in einer universitären Schmerzambulanz unter dem besonderen Aspekt des Anteils therapiebedürftiger psychischer Störungen bei Patienten mit Rückenschmerzen, Morbus Sudeck, Phantomschmerzen sowie

Es wurde eine retrograde Analyse von Patientenakten der Schmerzambulanzder Klinik für Anästhesiologie der Universitätsklinik Mainz durchgeführt, indie alle Patienten mit bestimmten Einschlußkriterien derBehandlungsjahrgänge1996 und 1997 aufgenommen wurden.Dies waren die vier Diagnosegruppen multilokuläre Schmerzen,Rückenschmerzen, Phantomschmerz und Morbus Sudeck (SRD). Das Ziel dervorliegenden Arbeit war die Frage nach der Häufigkeit von Psychotherapie alsergänzende Therapieempfehlung seitens der Schmerzambulanz herauszuarbeiten.Psychotherapie (ambulant, stationär, Bestandteil vonRehabilitationsaufenthalten) in vielgestaltiger Weise wurde häufigerempfohlen, 1. je länger die Schmerzerkrankung bestand,2. je jünger die Patienten waren,3. je länger sie arbeitsunfähig waren,4. wenn belastende biographische Ereignisse festgestellt werden konnten5. je höher das Chronifizierungsstadium nach Gerbershagen war. Im Einzelnenspielten die zeitlichen Aspekte der Erkrankung, Lokalisationseinflüsse sowieAspekte vorheriger Behandlungen und schmerzbedingter Krankenhausaufenthalteeine besondere Rolle.6. wenn Patienten nicht berentet waren.

Fluctuation spectroscopy of single plasmonic nanostructures

Plasmonic nanoparticles are great candidates for sensing applications with optical read-out. Plasmon sensing is based on the interaction of the nanoparticle with electromagnetic waves where the particle scatters light at its resonance wavelength. This wavelength depends on several intrinsic factors like material, shape and size of the nanoparticle as well as extrinsic factors like the refractive index of the surrounding medium. The latter allows the nanoparticle to be used as a sensor; changes in the proximate environment can be directly monitored by the wavelength of the emitted light. Due to their minuscule size and high sensitivity this allows individual nanoparticles to report on changes in particle coverage.rnrnTo use this single particle plasmon sensor for future sensing applications it has to meet the demand for detection of incidents on the single molecule level, such as single molecule sensing or even the detection of conformational changes of a single molecule. Therefore, time resolution and sensitivity have to be enhanced as today’s measurement methods for signal read-out are too slow and not sensitive enough to resolve these processes. This thesis presents a new experimental setup, the 'Plasmon Fluctuation Setup', that leads to tremendous improvements in time resolution and sensitivity. This is achieved by implementation of a stronger light source and a more sensitive detector. The new setup has a time resolution in the microsecond regime, an advancement of 4-6 orders of magnitude to previous setups. Its resonance wavelength stability of 0.03 nm, measured with an exposure time of 10 ms, is an improvement of a factor of 20 even though the exposure time is 3000 times shorter than in previous reports. Thus, previously unresolvable wavelength changes of the plasmon sensor induced by minor local environmental alteration can be monitored with extremely high temporal resolution.rnrnUsing the 'Plasmon Fluctuation Setup', I can resolve adsorption events of single unlabeled proteins on an individual nanorod. Additionally, I monitored the dynamic evolution of a single protein binding event on a millisecond time scale. This feasibility is of high interest as the role of certain domains in the protein can be probed by a study of modified analytes without the need for labels possibly introducing conformational or characteristic changes to the target. The technique also resolves equilibrium fluctuations in the coverage, opening a window into observing Brownian dynamics of unlabeled macromolecules. rnrnA further topic addressed in this thesis is the usability of the nanoruler, two nanospheres connected with a spacer molecule, as a stiffness sensor for the interparticle linker under strong illumination. Here, I discover a light induced collapse of the nanoruler. Furthermore, I exploit the sensing volume of a fixed nanorod to study unlabeled analytes diffusing around the nanorod at concentrations that are too high for fluorescence correlation spectroscopy but realistic for biological systems. Additionally, local pH sensing with nanoparticles is achieved.