Academic Ceremonies January 2010

“The nucleus accumbens: stimulate your impulse”

“Onset, course and comorbidity of bipolar symptoms and treatment setting”

Manic, depressive and psychotic symptoms can be part of the bipolar disorder, also called manic depression. The seriousness, the tempo of improvement and the impact of these symptoms turn out to be influenced by various factors, such as the use of cannabis or other drugs, or the simultaneous occurrence of the symptoms. Also an unfavourable social context, such as not having a relationship or being in a dependent living situation, appears to have a negative effect on the seriousness and impact of these symptoms. Furthermore, the research provides indirect indications of a general deviation in dopamine activity in the brain of patients with a bipolar disorder.

Key words:

bipolar disorder, cannabis, dopamine activity

“Fetal asphyxia: Friend or foe?”

Asphyxia before, during or shortly after birth is worldwide one of the most common problems in obstetrics. It is the most common cause of death of newly born children. The cause is mostly defective oxygen supply, for example because of a detaching placenta or pinched umbilical cord. Depending on the seriousness of the lack of oxygen this can lead to brain damage. Little or nothing is known about the long-term effects of asphyxia. It could possibly be an important factor that contributes to neurodegenerative diseases (for example Parkinson). This dissertation shows that serious fetal asphyxia leads to disorders in the motor activity and anxiety behaviour, along with the loss of the accompanying brain cells. Also the number of connections between brain cells changes. The second part of this dissertation shows that asphyxia, when it is sufficiently mild, can also offer protection, because it makes the tissue more resistant against the damaging effects of long-term asphyxia (asphyctic preconditioning).

Key words:

asphyxia, brain damage, newly born children

“Sexual risk behavior and mental health of young gay men”

Men who have sex with men continue to run a risk of getting a HIV infection as a result of unprotected anal sex. Research shows that sexual risk behaviour occurs among young men. This dissertation describes among others longitudinal studies into the sexual risk behaviour of gay young men during their coming out. The results show that a substantial part of the gay young men uses no condoms during their first anal sex experience and during consecutive episodes of anal sex. This requires HIV preventive interventions so that this target group is urged to always use condoms during anal sex. 
(This dissertation was realized with the support of the Aids Fund)

Key words:

HIV infection, young gay men, sexual risk behaviour

“Quantitative contrast-enhanced MRI of the microvasculature”

The growth of new, microscopically small blood vessels plays an important role in a series of very common diseases, such as cancer and heart attacks. Currently, for example, new therapies are being developed that can inhibit vessel growth in malignant tumours, or that can in fact stimulate vessel growth in the heart after an infarct. However, to be able to evaluate and direct these therapies at an early stage non-invasive techniques are required. This dissertation describes the application of new MRI techniques that allow the selective imaging of vessel growth in tumours and in the heart muscle.  This is an important step towards early diagnostics of vessel growth and therapy-monitoring of these patients.

Key words:

blood vessel growth, MRI, diagnostics

“Prognosis in complex regional pain syndrome 1”

Complex Regional Pain Syndrome 1 (CPRS-1) is een chronische aandoening, gekarakteriseerd door pijn, pathologische veranderingen in bot en huid, overdadig zweten, zwellingen en extreme gevoeligheid voor aanraken. Symptomen treden meestal op in een van de ledematen, na verwonding of chirurgische ingrepen. Hoewel CPRS-1 in de klinische praktijk betrekkelijk vaak voorkomt, is er nog weinig bekend over deze aandoening. De diagnose wordt meestal laat gesteld, omdat de symptomen overeenkomen met normale posttraumatische verschijnselen. Het proefschrift bestaat uit een serie onderzoeksprojecten, waaronder het ontwerp van een prospectieve cohortstudie om een prognostisch risicoprofiel voor deze patiënten te ontwikkelen. De bedoeling is om een klinische database aan te leggen van patiënten die twee jaar lang worden gevolgd.

Key words:

Complex Regional Pain Syndrome 1, post-traumatic phenomena

“Multinational Subsidiary Evolution: corporate change in new EU member states”

“Technology transfer and learning under the Kyoto regime: Exploring the technological impact of  CDM projects in developing countries”

“Genetic determinants of emotional processing in anxiety and depression – some implications for treatment response”

“Efficacy of macronutrients on targeting Obesity and beyond”

This dissertation shows that weight loss is efficiently achieved with a daily protein intake of 0.8-1.2g/kg bodyweight, while the fat and carbohydrate intake is drastically lowered. Loss of weight is followed by maintaining the obtained weight: that requires a daily protein intake of 1.2g/kg bodyweight, again with a low fat and carbohydrate intake. This results in a lasting lower bodyweight, with a lower fat content and favourable metabolic profile, without negative consequences for the kidney function. So, 0.8g/kg is sufficient, but 1.2g/kg bodyweight is more efficient in the long term. These findings can be implemented in professionally supervised diet programmes.

Key words:

obesity, overweight, diets, body composition, macronutrients, protein intake

“Financial Risk Management”

With newly discovered data this dissertation provides insight in the dynamics of the bubble and crash in the year 1720. Although for many years this bubble was regarded a classic example of speculative mania and irrational behaviour, we show that innovation in the Atlantic trade and the birth of a new business organization for insurance companies played an important role in the investors’ enthusiasm. For example, in 1720 the insurance company Stad Rotterdam was established and it still exists as a division of Fortis. The dissertation shows also that the cost levels of pension funds are considerably lower than those of investment funds and that there are important scale economies in costs of pension funds. We also show that the risk adjusted returns of pension funds on average and after deduction of costs are higher than those of investment funds.

Key words:

speculative mania, pension funds, investment funds

“Molecular Imaging of Atherosclerosis and Thrombus Formation”

Cardiovascular diseases are an important cause of death in the Netherlands. The underlying cause of these diseases is often atherosclerosis. When atherosclerotic plaques tear, this can lead to thrombi that can lead to a heart or brain infarct.  This dissertation describes various contrast agents for molecular imaging, a new research area which allow the visualization of specific molecules or processes for certain diseases by means of, for example, Magnetic Resonance Imaging (MRI). It turned out possible, among others, to detect fresh thrombi. In the future, molecular imaging can possibly play a role in the clinical assessment of atherosclerosis and thrombus formation. 
(This research was partly financed by the Nederlandse Hartstichting.)

Key words:

atherosclerosis, thrombus formation, molecular imaging

“Cell-type specific CD40-CD40L interactions in atherosclerosis”

Atherosclerosis is a chronic inflammatory disease of the large arteries, characterized by the build-up of fat, inflammatory cells and connective tissue (plaques). Earlier research showed that inhibition of the molecule CD40 leads to smaller and more stable plaques. However, the specific function of the CD40(L) per cell type in atherosclerosis is not yet known. Therefore in this dissertation the underlying mechanism was unravelled. Binding two types of proteins (TRAFs) to CD40 turns out to play an important role there. Blocking the binding place for TRAF-6 to CD40 appears an effective way of inhibiting plaque formation. This research provides important new insights in the role of the immune system, and of CD40-CD40L interactions in particular, in the pathogenesis of atherosclerosis. This newly acquired knowledge can contribute to the development of more purposeful treatment. 
(This dissertation was also realized with financial support of the Nederlandse Hartstichting.)

Key words:

atherosclerosis, plaques, CD40, TRAF-6

“Economic evaluation in fertility research”

About 10-15% of the people who want to become pregnant face fertility problems. It is important to determine the cause of the fertility problem as fast as possible, so that the right treatment can be quickly applied. This dissertation describes the efficiency of various techniques for the treatment of lower fertility. For this purpose, the study particularly investigated which embryo transferral strategy in IVF is the most cost effective. The transferral of two embryos has in all cases the best chance of being successful, but it is the most expensive. With regard to cost effectiveness the preferred strategy depends on what the society is prepared to pay for one extra successful pregnancy.

Key words:

fertility problems, cost effectiveness, IVF

“Intermittent Claudication”