Zwischen Nächstenliebe und Wirtschaftlichkeit

Zusammenfassung  Diakonische Sozialleistungsunternehmen definieren die Nächstenliebe als ihr Proprium, das sie von anderen Anbietern auf den Sozialmärkten unterscheiden sollte. Gleichzeitig sind jedoch auch diakonische Träger Unternehmen, die wirtschaftlich handeln müssen. Die Spannung zwischen Nächstenliebe und Wirtschaftlichkeit wird oftmals als Konflikt empfunden.Der vorliegende Artikel zeigt auf, dass Nächstenliebe und Wirtschaftlichkeit kein Widerspruch sein müssen. Eine verhaltensorientierte Form der Nächstenliebe erfordert vielmehr, dass diese Liebe für den Kunden spürbar ist. Hierzu ist es nötig, dass die Ressourcen wirtschaftlich verwendet werden, so dass eine maximale Ergebnisqualität mit gegebenen Produktionsfaktoren erzeugt wird. Anhand des Beispiels der ambulanten Pflegedienste des Diakonischen Werkes in Bayern wird aufgezeigt, dass effiziente Einheiten besonders diejenigen Outputs betonen, die von den Kunden gemeinhin als Nächstenliebe wahrgenommen werden. Als methodische Grundlage dienen Modelle der Data Envelopment Analysis.

Hepatitis E, Helicobacter pylori, and gastrointestinal symptoms in workers exposed to waste water

Background: Workers exposed to sewage may have an increased risk of infection by Helicobacter pylori and hepatitis E virus (HEV).     

False memories in schizophrenia

In prior studies, it was observed that patients with schizophrenia show abnormally high knowledge corruption (i.e., high-confident errors expressed as a percentage of all high-confident responses were increased for schizophrenic patients relative to controls). The authors examined the conditions under which excessive knowledge corruption occurred using the Deese-Roediger-McDermott paradigm. Whereas knowledge corruption in schizophrenia was significantly greater for false-negative errors relative to controls, no group difference occurred for false-positive errors. The groups showed a comparable high degree of confidence for false-positive recognition of critical lure items. Similar to findings collected in elderly participants, patients, but not controls, showed a strong positive correlation between the number of recognized studied items and false-positive recognition of the critical lure.     

Epithelial hyaluronic acid and CD44v6 are mutually involved in invasion of colorectal adenocarcinomas and linked to patient prognosis

Desmoplastic stroma of colorectal adenocarcinomas contains a variety of extracellular matrix molecules, including hyaluronic acid (HA). Overexpression of the HA receptor CD44 and, in particular, its splicing variant CD44v6 has been described as a prognostic factor for patients with colorectal adenocarcinomas in some studies, but converse reports also exist. Our hypothesis is that these divergent results may be related to the fact that the function of CD44v6 depends on the HA content of cell-surrounding matrix. Therefore, we studied the expression of HA and CD44v6 in tissue samples of 145 patients suffering from colorectal adenocarcinomas using immunohistochemistry. Expression of HA was separately evaluated in tumor epithelium and stroma. We additionally examined the influence of HA on invasion and adhesion of colorectal adenocarcinoma cells in vitro. The results show that epithelial HA expression was not correlated with tumor stage but with lymph-node or distant metastasis. Patients with tumors expressing epithelial HA had a decreased overall survival (P=0.017) as well as tumors with coexpression of epithelial HA and CD44v6 (P=0.011). The latter issue remained an independent prognostic factor in multivariate analysis (relative risk 5.06; 95% confidence interval, 1.18–21.57; P=0.028). HA exclusively stimulated in vitro invasion of CD44v6-expressing cells. This stimulation was partly reversed by an anti-CD44v6 antibody. Our findings suggest that the adverse prognostic effect of CD44v6 in colorectal adenocarcinoma might be restricted to those tumors that have pericellular HA.     

Functional genomics of fibroblasts

PURPOSE OF REVIEW: Successful analysis of the pathophysiology of rheumatoid arthritis requires the functional understanding of interactions between different cell types and the cell matrix, intracellular signaling pathways, as well as between cartilage, bone, and synovium in rheumatoid arthritis. During the review period, molecular biology has provided and used a growing number of tools to screen the genome such as gene and protein chips, haplotype analysis, and single nucleotide polymorphism analysis, resulting in various novel findings with considerable impact on the overall understanding of rheumatoid arthritis. RECENT FINDINGS: Key issues that have been addressed and elucidated by numerous research groups are the regulation and modulation of synovial fibroblast metabolism and activation by proinflammatory cytokines and chemokines. In addition, examination of adhesion processes and neoangiogenesis has revealed new insights into the interaction network between rheumatoid synovial fibroblasts and the surrounding matrix and cells. Finally, a more detailed view of activation of these fibroblasts has been obtained by analysis of the molecular balance between cellular activation and regulation of apoptosis. SUMMARY: Although high throughput molecular analysis methods provided an ample amount of novel data, it needs to be stressed that a one-method approach of gene expression (eg, by array analysis) is not sufficient to validate the gene/gene product as a new therapeutic target. Therefore, the next steps are the so-called functional genomics or functionomics, which intend to reveal relations between the obtained data and to unveil their interactions for a better understanding of the pathogenesis and the mechanisms that are operative in rheumatoid arthritis.     

Transfer of human leukocytes into double-knockout Pfp-/-Rag2-/- mice grafted with human skin: increased accumulation of neutrophils in human dermal microvessels

Severe combined immunodeficient mice reconstituted with human leukocytes have been useful to model parts of the human immune system, including some of its diseases (e.g., AIDS). Because no human polymorphonuclear leukocytes (huPMN) develop in these xenograft models, diseases such as several forms of vasculitis cannot be modeled using this approach. To provide such a model for vasculitis, human skin patches were grafted onto double-knockout Pfp(-/-)Rag2(-/-) mice, which not only lack functional T and B cells but which are also devoid of natural killer cells. After intravenous injection, a high proportion of huPMNs survived within the circulation and accumulated in the human blood vessels. The accumulation increased considerably after the endothelium of the skin patches had been stimulated by tumor necrosis factor-alpha. Alpha mild perivascular neutrophilic infiltration and vascular necrosis was observed in the microvessels of the skin patches. Thus, a xenograft model of vasculitis with predominant huPMNs infiltration has been established for the first time.     

Torsion in patients with superior oblique palsies: dynamic torsion during saccades and changes in Listing’s plane

Background The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. Methods Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10° vertical saccades over a range of ±20°. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing’s plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n = 5), by recession of the inferior rectus muscle on the normal eye (n = 4) or by both procedures (n = 2). Postoperative recordings were obtained at least 1 month after surgery. Results Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0°) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing’s plane (up to 15° for primary position). Conclusion Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing’s plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP. This study was supported by the Deutsche Forschungsgemeinschaft DFG 860/2-1, Bonn Germany, Grant EYO1489, from the National Institute of Health, Bethesda, Maryland, the Abe Pollin scholarship fund, Swiss National Science Foundation Grant 3200B0-105434 and the Betty and David Koetser Foundation for Brain Research, Zurich, Switzerland.     

Expression of the apoptosis inhibitor livin in renal cell carcinomas: correlations with pathology and outcome.

Livin has recently been identified as a member of the inhibitor of apoptosis family expressed in several types of cancer but not in most benign tissues. Expression levels of livin were associated with prognosis in various malignancies, but livin expression and its prognostic relevance have not been evaluated in renal cell carcinomas (RCC). In a cohort of 152 RCC patients, we analyzed the relative expression of livin and its splicing variants by real-time RT-PCR and Western blot in tumor and adjacent normal renal tissue specimens. Livin expression was detected in 59 (38.8%) of 152 RCC specimens but in none of the normal samples. Both splicing variants were present in the livin-positive RCC specimens. Livin expression levels did not correlate with pathological or clinical parameters and were not predictive of patient outcome. Our findings suggest that livin expression in RCC is not of prognostic relevance. Further studies to clarify the role of livin expression in RCC and its potential value as a target for immune-mediated tumor destruction are warranted.