968 resultados para Etica griega s.I-II
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La tesi riguarda la concessione di spazi di proprietà pubblica a privati, intesi come singole persone o enti, quali ad esempio i collegi, da parte delle autorità cittadine. Le fonti a disposizione per indagare tale pratica burocratica sono quasi totalmente di natura epigrafica, per lo più attestanti l’espressione locus datus decreto decurionum, variamente abbreviata, o formule similari. Questo aspetto della vita civica è stata cursoriamente oggetto di studio in diversi contributi, ma si tratta di articoli che circoscrivono il tema, analizzandolo in relazione a ristrette aree geografiche, oppure considerandone determinati aspetti (ad esempio l’ambito sacro o quello funerario). Si è perciò ritenuto utile proseguire questa linea di ricerca affrontando uno studio di più ampio raggio, che comprenda la documentazione epigrafica dell’intero territorio italico (costituito dalle undici regioni augustee ad esclusione di Roma), per tutte le tipologie testuali (iscrizioni sacre, funerarie, onorarie, su opera pubblica, exempla decreti), allo scopo di formulare osservazioni più precise e puntuali sulla procedura burocratica in esame, pur con tutti i limiti noti a chi affronti questo genere di indagine. Tra le conclusioni raggiunte, è emerso come durante il I-II sec. d.C. vi fosse la tendenza a concedere, sporadicamente, dei loca sepulturae extraurbani a membri delle famiglie delle élites cittadine, anche donne e fanciulli, mentre il foro e le altre aree pubbliche interne alla città erano soprattutto utilizzate direttamente dai decurioni per l’elevazione di dediche e statue. Nel corso del II sec. d.C., con massima diffusione nell’età antonina e poi in quella severiana, prese invece piede l’uso privato a scopo onorario degli spazi pubblici siti all’interno delle città, ovvero in aree prima pressoché precluse all’intervento di singoli cittadini: familiari e liberti, collegi e altri organismi commissionavano statue dedicate prevalentemente agli amministratori locali, magistrati cittadini spesso divenuti anche cavalieri.
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Im Immunsystem spielen regulatorische T-Zellen (Treg) eine essentielle Rolle bei der Unterdrückung und Eindämmung von überschüssigen oder schädlichen Immunreaktionen. Ihre suppressiven Eigenschaften wirken aber auch bei Immune Escape Mechanismen von Tumoren mit und können den Erfolg von Tumorimmuntherapien deutlich mindern.rnIn dieser Arbeit konnte zum ersten Mal die Frequenz verschiedener Treg Subpopulationen im peripheren Blut von gesunden Spendern und Melanompatienten in verschiedenen Stadien der Erkrankung verglichen werden. Dabei wurden Treg-Subpopulationen mit den Markerkombinationen CD4+CD25++, CD4+CD25+CD127low, CD4+CD25+HLA DR+, CD4+Foxp3+, CD4+Foxp3+CD25+, CD4+Foxp3+CD127low und CD4+Foxp3+HLA DR+ untersucht. Insbesondere bei den Subpopulationen, die durch die Expression von Foxp3 charakterisiert sind, konnten in Patienten im Spätstadium IV der Melanomerkrankung, verglichen mit Patienten im Stadium I-II oder gesunden Spendern, erhöhte Treg Frequenzen im peripheren Blut festgestellt werden. Diese Funde korrelierten mit der Beobachtung einer verminderten antigenspezifischen T Zellreaktivität in solchen Melanompatienten. Des Weiteren zeigte sich, dass eine DC basierte Tumorantigen-spezifische Immuntherapie bei einem Teil der behandelten Stadium IV Melanompatienten eine Abnahme der Treg Frequenzen im peripheren Blut zur Folge hatte. Dies korrelierte mit Beobachtungen aus vorangegangenen Studien unserer Arbeitsgruppe, bei denen sich zeigte, dass eine solche Immuntherapie die zuvor supprimierten T Zellantworten zumindest vorübergehend wiederherstellen kann. Bei Untersuchungen zur Expression des IL 1-Rezeptors-1 konnte dieser auf Proteinebene als verstärkt exprimierter Aktivierungsmarker auf Treg bestätigt werden. In Anwesenheit von IL-1 wird die Suppressorfunktion der Treg inhibiert. Eine Konversion von humanen Treg zu nicht suppressorischen TH-17-Zellen durch die Kostimulation mit IL 1 konnte dabei nicht nachgewiesen werden. Vielmehr scheint die Induktion von IL 2 die entscheidende Wirkung von IL 1 auf humane Treg und Teff darzustellen.rn
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A field of computational neuroscience develops mathematical models to describe neuronal systems. The aim is to better understand the nervous system. Historically, the integrate-and-fire model, developed by Lapique in 1907, was the first model describing a neuron. In 1952 Hodgkin and Huxley [8] described the so called Hodgkin-Huxley model in the article “A Quantitative Description of Membrane Current and Its Application to Conduction and Excitation in Nerve”. The Hodgkin-Huxley model is one of the most successful and widely-used biological neuron models. Based on experimental data from the squid giant axon, Hodgkin and Huxley developed their mathematical model as a four-dimensional system of first-order ordinary differential equations. One of these equations characterizes the membrane potential as a process in time, whereas the other three equations depict the opening and closing state of sodium and potassium ion channels. The membrane potential is proportional to the sum of ionic current flowing across the membrane and an externally applied current. For various types of external input the membrane potential behaves differently. This thesis considers the following three types of input: (i) Rinzel and Miller [15] calculated an interval of amplitudes for a constant applied current, where the membrane potential is repetitively spiking; (ii) Aihara, Matsumoto and Ikegaya [1] said that dependent on the amplitude and the frequency of a periodic applied current the membrane potential responds periodically; (iii) Izhikevich [12] stated that brief pulses of positive and negative current with different amplitudes and frequencies can lead to a periodic response of the membrane potential. In chapter 1 the Hodgkin-Huxley model is introduced according to Izhikevich [12]. Besides the definition of the model, several biological and physiological notes are made, and further concepts are described by examples. Moreover, the numerical methods to solve the equations of the Hodgkin-Huxley model are presented which were used for the computer simulations in chapter 2 and chapter 3. In chapter 2 the statements for the three different inputs (i), (ii) and (iii) will be verified, and periodic behavior for the inputs (ii) and (iii) will be investigated. In chapter 3 the inputs are embedded in an Ornstein-Uhlenbeck process to see the influence of noise on the results of chapter 2.
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First both life stages of Leishmania major (L. major) FEBNI parasites, promastigotes as well as amastigotes, were characterized. We found that the virulence marker GP63 and cysteine peptidase b (Cpb) were higher expressed by axenic amastigotes as compared to promastigotes. In addition to the L. major FEBNI strain, we applied and successfully modified our novel in vitro method to generate axenic amastigotes of the L. major Friedlin and 5ASKH strains. Interestingly, these L. major strains needed another temperature to be transferred into amastigotes in the axenic culture system. Investigating apoptosis mechanisms in both parasite life stages of L. major FEBNI we found both ROS dependent and independent cell death mechanisms. Focusing on promastigote and amastigote interaction with pro-inflammatory (MF I) and anti-inflammatory (MF II) macrophages we found amastigotes to be more infective as compared to promastigotes. Moreover, we could demonstrate that pro-inflammatory MF I were less susceptible to infection than anti-inflammatory MF II. Finally we investigated parasite stage-specific responses of MF I + II and their defense mechanisms against L. major. Using knockdown techniques for primary human macrophages we identified a new mechanism enabling intracellular killing of promastigotes inside MF I. This mechanism depends on the antimicrobial molecule cathelicidin (LL-37).
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Il cancro colorettale (CRC) rimane la prima causa di morte nei paesi occidentali.Dal 15% al 25% dei pazienti affetti da CRC presenta metastasi epatiche sincrone (CRLM) al momento della diagnosi.La resezione epatica radicale rimane l’unica terapia potenzialmente curativa in presenza di CRLM con una sopravvivenza a 5 anni compresa tra il 17% ed il 35% ed a 10 anni tra il 16% e il 23% rispettivamente. La tempistica ottimale per la resezione chirurgica in caso di presentazione sincrona di CRC è controversa.Questo studio intende dimostrare che le resezioni epatiche ecoguidate radicali ma conservative simultanee ad una resezione colorettale rappresentano una tecnica sicura ed efficace nei pazienti con CRC avanzato. 48 pazienti sono stati sottoposti ad una resezione simultanea colorettale ed epatica. L’età media +SD (range) era di 64,2+9,7 (38-84).Un solo paziente è deceduto entro 30 giorni. La mortalità post operatoria è stata complessivamente del 2,1%. Nove pazienti (18,8%) hanno sviluppato una o più complicanza ,4 (8,3%) di grado III-IV sec. Clavien-Dindo e 5 (10,4%) di grado I-II. La durata complessiva dell’intervento chirurgico simultaneo è stata di 486,6+144,0 (153-804) minuti.Questo studio conferma che le resezioni colorettali ed epatiche simultanee possono essere eseguite senza un significativo aumento della morbilità e mortalità perioperatorie, anche in pazienti sottoposti ad una resezione anteriore ultrabassa ed in quelli in cui sia indicato il clampaggio intermittente dell’ilo epatico. L’IOUS è efficace nel ridurre l’estensione della resezione epatica in pazienti sia con CRLM anche multiple e bilobari .Poichè le complicanze maggiori sono frequenti dopo resezioni epatiche maggiori simultanee, riducendo l’estensione della resezione del parenchima epatico si può avere un impatto favorevole sul decorso post operatorio.Le resezioni epatiche ecoguidate radicali ma conservative simultanee ad una resezione colorettale sono una tecnica sicura ed efficace in pazienti con carcinoma colorettale avanzato e andrebbero considerate l’opzione primaria in casi selezionati
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The Pulmonary Embolism Severity Index (PESI) is a validated clinical prognostic model for patients with acute pulmonary embolism (PE). Our goal was to assess the PESI's inter-rater reliability in patients diagnosed with PE. We prospectively identified consecutive patients diagnosed with PE in the emergency department of a Swiss teaching hospital. For all patients, resident and attending physician raters independently collected the 11 PESI variables. The raters then calculated the PESI total point score and classified patients into one of five PESI risk classes (I-V) and as low (risk classes I/II) versus higher-risk (risk classes III-V). We examined the inter-rater reliability for each of the 11 PESI variables, the PESI total point score, assignment to each of the five PESI risk classes, and classification of patients as low versus higher-risk using kappa ( ) and intra-class correlation coefficients (ICC). Among 48 consecutive patients with an objective diagnosis of PE, reliability coefficients between resident and attending physician raters were > 0.60 for 10 of the 11 variables comprising the PESI. The inter-rater reliability for the PESI total point score (ICC: 0.89, 95% CI: 0.81-0.94), PESI risk class assignment ( : 0.81, 95% CI: 0.66-0.94), and the classification of patients as low versus higher-risk ( : 0.92, 95% CI: 0.72-0.98) was near perfect. Our results demonstrate the high reproducibility of the PESI, supporting the use of the PESI for risk stratification of patients with PE.
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Meprin-α is a metalloprotease overexpressed in cancer cells, leading to the accumulation of this protease in a subset of colorectal tumors. The impact of increased meprin-α levels on tumor progression is not known. We investigated the effect of this protease on cell migration and angiogenesis in vitro and studied the expression of meprin-α mRNA, protein and proteolytic activity in primary tumors at progressive stages and in liver metastases of patients with colorectal cancer, as well as inhibitory activity towards meprin-α in sera of cancer patient as compared to healthy controls. We found that the hepatocyte growth factor (HGF)-induced migratory response of meprin-transfected epithelial cells was increased compared to wild-type cells in the presence of plasminogen, and that the angiogenic response in organ-cultured rat aortic explants was enhanced in the presence of exogenous human meprin-α. In patients, meprin-α mRNA was expressed in colonic adenomas, primary tumors UICC (International Union Against Cancer) stage I, II, III and IV, as well as in liver metastases. In contrast, the corresponding protein accumulated only in primary tumors and liver metastases, but not in adenomas. However, liver metastases lacked meprin-α activity despite increased expression of the corresponding protein, which correlated with inefficient zymogen activation. Sera from cancer patients exhibited reduced meprin-α inhibition compared to healthy controls. In conclusion, meprin-α activity is regulated differently in primary tumors and metastases, leading to high proteolytic activity in primary tumors and low activity in liver metastases. By virtue of its pro-migratory and pro-angiogenic activity, meprin-α may promote tumor progression in colorectal cancer.
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Traumatische Epiphysenfugenlösungen [Einteilung von Salter u. Harris (SH) I/II] der unteren Extremität sind selten. Mit Komplikationen behaftete Verläufe werden in 2,2–39,6% der Fälle berichtet. Die vorliegende Arbeit soll aktuelle Daten zur Epidemiologie und zu den Behandlungsgrundlagen von Wachstumsfugenlösungen der distalen Tibia liefern. In einem Zeitraum von 36 Monaten wurden in einer multizentrischen Studie alle Patienten aufgenommen, die eine Wachstumsfugenlösung der distalen Tibia erlitten hatten. Daten zu Alter, Geschlecht, Unfall, Klassifikation, Therapieentscheidung und Frühkomplikationen wurden erhoben und online archiviert. 150 Fälle (64,6% Jungen, 35,4% Mädchen, Altersdurchschnitt 11,8 Jahre) wurden eingeschlossen. Häufigste Unfallursache war der Sport (42%). 76% der Fälle wurden einer Reposition zugeführt. Die Toleranzgrenze für eine Antekurvationsfehlstellung lag bei 10° (p=0,0021), für den Valgus bei 7° (p=0,0155). Toleranzen von maximal 5° für Retrokurvation und Varus waren statistisch nicht signifikant. Die Untersuchung bestätigt die Verletzungsepidemiologie anderer Studien. Erstmals wurden Daten zur Behandlungswirklichkeit bei Wachstumsfugenlösungen der distalen Tibia erhoben. Diese orientiert sich konsequent an den Empfehlungen der einschlägigen Literatur.
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Objectives The aim of this study was to assess the role of transcatheter aortic valve implantation (TAVI) compared with medical treatment (MT) and surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) at increased surgical risk. Background Elderly patients with comorbidities are at considerable risk for SAVR. Methods Since July 2007, 442 patients with severe AS (age: 81.7 ± 6.0 years, mean logistic European System for Cardiac Operative Risk Evaluation: 22.3 ± 14.6%) underwent treatment allocation to MT (n = 78), SAVR (n = 107), or TAVI (n = 257) on the basis of a comprehensive evaluation protocol as part of a prospective registry. Results Baseline clinical characteristics were similar among patients allocated to MT and TAVI, whereas patients allocated to SAVR were younger (p < 0.001) and had a lower predicted peri-operative risk (p < 0.001). Unadjusted rates of all-cause mortality at 30 months were lower for SAVR (22.4%) and TAVI (22.6%) compared with MT (61.5%, p < 0.001). Adjusted hazard ratios for death were 0.51 (95% confidence interval: 0.30 to 0.87) for SAVR compared with MT and 0.38 (95% confidence interval: 0.25 to 0.58) for TAVI compared with MT. Medical treatment (<0.001), older age (>80 years, p = 0.01), peripheral vascular disease (<0.001), and atrial fibrillation (p = 0.04) were significantly associated with all-cause mortality at 30 months in the multivariate analysis. At 1 year, more patients undergoing SAVR (92.3%) or TAVI (93.2%) had New York Heart Association functional class I/II as compared with patients with MT (70.8%, p = 0.003). Conclusions Among patients with severe AS with increased surgical risk, SAVR and TAVI improve survival and symptoms compared with MT. Clinical outcomes of TAVI and SAVR seem similar among carefully selected patients with severe symptomatic AS at increased risk.
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Background Serologic testing algorithms for recent HIV seroconversion (STARHS) provide important information for HIV surveillance. We have shown that a patient's antibody reaction in a confirmatory line immunoassay (INNO-LIATM HIV I/II Score, Innogenetics) provides information on the duration of infection. Here, we sought to further investigate the diagnostic specificity of various Inno-Lia algorithms and to identify factors affecting it. Methods Plasma samples of 714 selected patients of the Swiss HIV Cohort Study infected for longer than 12 months and representing all viral clades and stages of chronic HIV-1 infection were tested blindly by Inno-Lia and classified as either incident (up to 12 m) or older infection by 24 different algorithms. Of the total, 524 patients received HAART, 308 had HIV-1 RNA below 50 copies/mL, and 620 were infected by a HIV-1 non-B clade. Using logistic regression analysis we evaluated factors that might affect the specificity of these algorithms. Results HIV-1 RNA <50 copies/mL was associated with significantly lower reactivity to all five HIV-1 antigens of the Inno-Lia and impaired specificity of most algorithms. Among 412 patients either untreated or with HIV-1 RNA ≥50 copies/mL despite HAART, the median specificity of the algorithms was 96.5% (range 92.0-100%). The only factor that significantly promoted false-incident results in this group was age, with false-incident results increasing by a few percent per additional year. HIV-1 clade, HIV-1 RNA, CD4 percentage, sex, disease stage, and testing modalities exhibited no significance. Results were similar among 190 untreated patients. Conclusions The specificity of most Inno-Lia algorithms was high and not affected by HIV-1 variability, advanced disease and other factors promoting false-recent results in other STARHS. Specificity should be good in any group of untreated HIV-1 patients.
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Background: The Geneva Prognostic Score (GPS), the Pulmonary Embolism Severity Index (PESI), and its simplified version (sPESI) are well known clinical prognostic scores for pulmonary embolism (PE).Objectives: To compare the prognostic performance of these scores in elderly patients with PE. Patients/Methods: In a multicenter Swiss cohort of elderly patients with venous thromboembolism, we prospectively studied 449 patients aged ≥65 years with symptomatic PE. The outcome was 30-day overall mortality. We dichotomized patients as low- vs. higher-risk in all three scores using the following thresholds: GPS scores ≤2 vs. >2, PESI risk classes I-II vs. III-V, and sPESI scores 0 vs. ≥1. We compared 30-day mortality in low- vs. higher-risk patients and the areas under the receiver operating characteristic curve (ROC). Results: Overall, 3.8% of patients (17/449) died within 30 days. The GPS classified a greater proportion of patients as low risk (92% [413/449]) than the PESI (36.3% [163/449]) and the sPESI (39.6% [178/449]) (P<0.001 for each comparison). Low-risk patients based on the sPESI had a mortality of 0% (95% confidence interval [CI] 0-2.1%) compared to 0.6% (95% CI 0-3.4%) for low-risk patients based on the PESI and 3.4% (95% CI 1.9-5.6%) for low-risk patients based on the GPS. The areas under the ROC curves were 0.77 (95%CI 0.72-0.81), 0.76 (95% CI 0.72-0.80), and 0.71 (95% CI 0.66-0.75), respectively (P=0.47). Conclusions: In this cohort of elderly patients with PE, the GPS identified a higher proportion of patients as low-risk but the PESI and sPESI were more accurate in predicting mortality.
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Predictable coverage of multiple adjacent gingival recessions (MAGRs) is a major challenge for clinicians. Although several surgical techniques have been proposed to treat MAGR, it is still unclear as to what extent the proposed approaches may lead to predictable root coverage. The aim of this article is to identify the predictability of the available surgical techniques used to achieve complete root coverage (CRC) of Miller Class I, II, and III MAGRs.
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The pathology associated with Streptococcus pneumoniae meningitis results largely from activation of immune-associated pathways. We systematically investigated the production of IFN subtypes, as well as their influence on pathology, in a mouse model of S. pneumoniae meningitis. Despite the occurrence of a mixed IFN type I/II gene signature, no evidence for production or involvement of type I IFNs in disease progression was found. In contrast, type II IFN (IFN-γ) was strongly induced, and IFN-γ(-/-) mice were significantly protected from severe disease. Using intracellular cytokine staining and targeted cell-depletion approaches, NK cells were found to be the dominant source of IFN-γ. Furthermore, production of IFN-γ was found to be dependent upon ASC and IL-18, indicating that an ASC-dependent inflammasome pathway was responsible for mediating IFN-γ induction. The influence of IFN-γ gene deletion on a range of processes known to be involved in bacterial meningitis pathogenesis was examined. Although neutrophil numbers in the brain were similar in infected wild-type and IFN-γ(-/-) mice, both monocyte recruitment and CCL2 production were less in infected IFN-γ(-/-) mice compared with infected wild-type controls. Additionally, gene expression of NO synthase was strongly diminished in infected IFN-γ(-/-) mice compared with infected controls. Finally, bacterial clearance was enhanced in IFN-γ(-/-) mice, although the underlying mechanism remains unclear. Together, these data suggest that inflammasome-dependent IFN-γ contributes via multiple pathways to pathology during S. pneumoniae meningitis.
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Background Serologic testing algorithms for recent HIV seroconversion (STARHS) provide important information for HIV surveillance. We have previously demonstrated that a patient's antibody reaction pattern in a confirmatory line immunoassay (INNO-LIA™ HIV I/II Score) provides information on the duration of infection, which is unaffected by clinical, immunological and viral variables. In this report we have set out to determine the diagnostic performance of Inno-Lia algorithms for identifying incident infections in patients with known duration of infection and evaluated the algorithms in annual cohorts of HIV notifications. Methods Diagnostic sensitivity was determined in 527 treatment-naive patients infected for up to 12 months. Specificity was determined in 740 patients infected for longer than 12 months. Plasma was tested by Inno-Lia and classified as either incident (< = 12 m) or older infection by 26 different algorithms. Incident infection rates (IIR) were calculated based on diagnostic sensitivity and specificity of each algorithm and the rule that the total of incident results is the sum of true-incident and false-incident results, which can be calculated by means of the pre-determined sensitivity and specificity. Results The 10 best algorithms had a mean raw sensitivity of 59.4% and a mean specificity of 95.1%. Adjustment for overrepresentation of patients in the first quarter year of infection further reduced the sensitivity. In the preferred model, the mean adjusted sensitivity was 37.4%. Application of the 10 best algorithms to four annual cohorts of HIV-1 notifications totalling 2'595 patients yielded a mean IIR of 0.35 in 2005/6 (baseline) and of 0.45, 0.42 and 0.35 in 2008, 2009 and 2010, respectively. The increase between baseline and 2008 and the ensuing decreases were highly significant. Other adjustment models yielded different absolute IIR, although the relative changes between the cohorts were identical for all models. Conclusions The method can be used for comparing IIR in annual cohorts of HIV notifications. The use of several different algorithms in combination, each with its own sensitivity and specificity to detect incident infection, is advisable as this reduces the impact of individual imperfections stemming primarily from relatively low sensitivities and sampling bias.
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Endocrine resistance in breast cancer remains a major clinical problem and is caused by crosstalk mechanisms of growth factor receptor cascades, such as the erbB and PI3K/AKT pathways. The possibilities a single breast cancer cell has to achieve resistance are manifold. We developed a model of 4-hydroxy-tamoxifen (OHT)‑resistant human breast cancer cell lines and compared their different expression patterns, activation of growth factor receptor pathways and compared cells by genomic hybridization (CGH). We also tested a panel of selective inhibitors of the erbB and AKT/mTOR pathways to overcome OHT resistance. OHT‑resistant MCF-7-TR and T47D-TR cells showed increased expression of HER2 and activation of AKT. T47D-TR cells showed EGFR expression and activated MAPK (ERK-1/2), whereas in resistant MCF-7-TR cells activated AKT was due to loss of CTMP expression. CGH analyses revealed remarkable aberrations in resistant sublines, which were predominantly depletions. Gefitinib inhibited erbB signalling and restored OHT sensitivity in T47D-TR cells. The AKT inhibitor perifosine restored OHT sensitivity in MCF-7-TR cells. All cell lines showed expression of receptors for gonadotropin-releasing hormone (GnRH) I and II, and analogs of GnRH-I/II restored OHT sensitivity in both resistant cell lines by inhibition of erbB and AKT signalling. In conclusion, mechanisms to escape endocrine treatment in breast cancer share similarities in expression profiling but are based on substantially different genetic aberrations. Evaluation of activated mediators of growth factor receptor cascades is helpful to predict response to specific inhibitors. Expression of GnRH-I/II receptors provides multi-targeting treatment strategies.