101
|
Wirz S, Wiese CHR, Zimmermann M, Junker U, Heuser-Grannemann E, Schenk M. [Rapid release fentanyl administration forms. Comments of the Working Group on Tumor Pain of the German Pain Society]. Schmerz 2014; 27:76-80. [PMID: 23377349 DOI: 10.1007/s00482-013-1292-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The spectrum of indications for rapid release fentanyl preparations is controversial. For this reason the Working Group on Tumor Pain will formulate comments on how to deal with these substances. Breakthrough pain should receive individualized therapy; therefore, the use of opioids of various galenic formulations seems to be advisable. New rapid release fentanyl preparations are suitable for alleviating spontaneous breakthrough pain in tumor patients due to a rapid but short-acting effect. However, a prior optimization of the analgesic basis medication is absolutely necessary. Uncontrolled prescription for non-cancer pain must be criticized due to the problem of addiction. The medical profession should be informed about the benefits of rapid release fentanyl preparations but must also be made aware of the risk of a rapid development of addiction and tolerance. A self-commitment of the pharmaceutical industry to waive advertising for the dangerous off-label use would be desirable. In the opinion of the Working Group on Tumor Pain the use of fentanyl should be openly discussed and further scientific investigations are imperative with the aim of formulating clear recommendations.
Collapse
|
102
|
Zepf FD, Sánchez CL, Biskup CS, Kötting WF, Bubenzer S, Helmbold K, Eisert A, Gaber TJ, Landgraf M, Dahmen B, Poustka F, Wöckel L, Stadler C, Grabemann M, Mette C, Heinrich V, Uekermann J, Abdel-Hamid M, Kis B, Zimmermann M, Wiltfang J, Kuhn CM. Acute tryptophan depletion - converging evidence for decreasing central nervous serotonin synthesis in rodents and humans. Acta Psychiatr Scand 2014; 129:157-9. [PMID: 24237607 DOI: 10.1111/acps.12215] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
103
|
Jung CS, Lange B, Zimmermann M, Seifert V. Role of endogenous monomethylated L-arginine (L-NMMA) after subarachnoid hemorrhage. Neurol Res 2013; 35:709-12. [DOI: 10.1179/1743132813y.0000000194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
104
|
Rossig C, Juergens H, Schrappe M, Moericke A, Henze G, von Stackelberg A, Reinhardt D, Burkhardt B, Woessmann W, Zimmermann M, Gadner H, Mann G, Schellong G, Mauz-Koerholz C, Dirksen U, Bielack S, Berthold F, Graf N, Rutkowski S, Calaminus G, Kaatsch P, Creutzig U. Effective childhood cancer treatment: the impact of large scale clinical trials in Germany and Austria. Pediatr Blood Cancer 2013; 60:1574-81. [PMID: 23737479 DOI: 10.1002/pbc.24598] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/22/2013] [Indexed: 01/07/2023]
Abstract
In Germany and Austria, more than 90% of pediatric cancer patients are enrolled into nationwide disease-specific first-line clinical trials or interim registries. Essential components are a pediatric cancer registry and centralized reference laboratories, imaging review, and tumor board assistance. The five-year overall survival rate in countries where such infrastructures are established has improved from <20% before 1950 to >80% since 1995. Today, treatment intensity is tailored to the individual patient's risk to provide the highest chances of survival while minimizing deleterious late effects. Multicenter clinical trials are internationalized and serve as platforms for further improvements by novel drugs and biologicals.
Collapse
|
105
|
Zaliova M, Zimmermannova O, Dörge P, Eckert C, Möricke A, Zimmermann M, Stuchly J, Teigler-Schlegel A, Meissner B, Koehler R, Bartram CR, Karawajew L, Rhein P, Zuna J, Schrappe M, Cario G, Stanulla M. ERG deletion is associated with CD2 and attenuates the negative impact of IKZF1 deletion in childhood acute lymphoblastic leukemia. Leukemia 2013; 28:182-5. [PMID: 24072102 DOI: 10.1038/leu.2013.282] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
106
|
Abdel-Hamid M, Grabemann M, Kownatka M, Zwarg T, Esselmann H, Zimmermann M, Mette C, Wiltfang J, Kis B. “The Star Trek Universe”: The change in perception of mental disease and its treatment during the last five decades. PHARMACOPSYCHIATRY 2013. [DOI: 10.1055/s-0033-1353358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
107
|
Zimmermann M, Mette C, Grabemann M, Abdel-Hamid M, Zepf F, Wiltfang J, Kis B. The impact of 5-HT on neuropsychological trajectories of adult ADHD. PHARMACOPSYCHIATRY 2013. [DOI: 10.1055/s-0033-1353324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
108
|
Noemi P, Zimmermann M, Pils D, Maurer G, Gyongyosi M, Ankersmit HJ. Overexpression of gata-4, tgf3, mef2c and hif-1alpha contributes to improvement of infarct size in porcine model of chronic myocardial infarction, treated with percutaneous intramyocardial delivery of secretome of apoptotic white blood cells (aposec). Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
109
|
Mohr F, Krejci E, Zimmermann M, Klein J. Acetylcholine levels and cholinergic mechanisms in PRiMA deficient mice. Auton Neurosci 2013. [DOI: 10.1016/j.autneu.2013.05.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
110
|
Grabemann M, Mette C, Zimmermann M, Heinrich V, Uekermann J, Wiltfang J, Abdel-Hamid M, Zepf FD, Kis B. No clear effects of acute tryptophan depletion on processing affective prosody in male adults with ADHD. Acta Psychiatr Scand 2013; 128:142-8. [PMID: 23581825 DOI: 10.1111/acps.12130] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Adults with attention deficit hyperactivity disorder (ADHD) have difficulties processing affective prosody, and research evidence demonstrates the importance of brain serotonin (5-HT) in the neurobiology of ADHD. This study aimed to investigate whether diminished brain 5-HT synthesis, as achieved by acute tryptophan depletion (ATD), can impair the processing of affective prosody in adults with ADHD. METHOD Twenty male patients with ADHD and twenty male healthy controls received ATD and a tryptophan-balanced control condition on separate days in a double-blind within-subject repeated measures crossover design. In both conditions, the Tübingen Affect Battery was administered in which subjects had to name the affective prosody of sentences with neutral, congruent, or incongruent semantic content. RESULTS Participants in the group of patients with ADHD perceived affective prosody less accurately than controls. Participants with ADHD showed compromised processing of sentences, committing more errors than healthy controls when identifying affect in instances of incongruent semantic content (P = 0.031). ATD did not contribute to this effect (all P > 0.5). CONCLUSION The difficulties male adults with ADHD have in accurately processing affective prosody may result from impairments in their ability to inhibit unwanted stimuli and impulses. No clear evidence implicates 5-HT as a cause of these impairments.
Collapse
|
111
|
Mette C, Zimmermann M, Grabemann M, Abdel-Hamid M, Uekermann J, Biskup CS, Wiltfang J, Zepf FD, Kis B. The impact of acute tryptophan depletion on attentional performance in adult patients with ADHD. Acta Psychiatr Scand 2013; 128:124-32. [PMID: 23419004 DOI: 10.1111/acps.12090] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To date, the impact of the neurotransmitter serotonin (5-HT) on different neuropsychological functions in adults with attention deficit hyperactivity disorder (ADHD) is underinvestigated. We aimed to examine the effects of acute tryptophan depletion (ATD) and the resulting reduction in central nervous 5-HT synthesis on target/non-target discrimination ability and sustained attention in adults with ADHD using an AX-Continuous Performance Test (AX-CPT). METHOD Twenty male patients with ADHD (age: M = 30.25 SD = 9.37) and twenty male healthy controls (age: M = 27.90 SD = 6.01) received ATD on one day and a tryptophan-balanced control condition (BAL) on another day in a double-blind within-subject crossover design. A continuous performance test (AX-CPT) with three conditions (AX, AY, and BX) was administered on both days under depleted and sham-depleted conditions. RESULTS In patients omissions increased after ATD when compared with BAL. Patient's reaction time decreased after ATD when compared with BAL, which was contrasted by opposite effects in controls. Patients showed fewer correct responses (AX condition) and showed a higher rate of errors (condition AXE ) independent of ATD or BAL intake. CONCLUSION The present preliminary results are indicative of the contribution of serotonergic neurotransmission to attentional processes in adults with ADHD.
Collapse
|
112
|
Nichol DG, Kotwicki S, Zimmermann M. Diel vertical migration of adult Pacific cod Gadus macrocephalus in Alaska. JOURNAL OF FISH BIOLOGY 2013; 83:170-189. [PMID: 23808699 DOI: 10.1111/jfb.12160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 04/26/2013] [Indexed: 06/02/2023]
Abstract
The diel vertical migration (DVM) of Pacific cod Gadus macrocephalus was examined using depth and temperature data from 250 recaptured archival tags deployed on G. macrocephalus in the eastern Bering Sea and in the Gulf of Alaska near Kodiak Island. DVM of two types, deeper during daytime (type I) and deeper during night-time (type II), occurred frequently (15-40% of all days) in G. macrocephalus released at all sites. Most individuals displayed both diel types, with each type of behaviour lasting up to 58 contiguous days, and day and night depth differences averaging c. 8 m. Despite high among-individual variability, the occurrence of DVM varied significantly with the release site, season (i.e. day-of-year) and bottom depth, with the trend in seasonal occurrence nearly opposite for type I compared to type II DVM. No significance could be attributed to G. macrocephalus fork length, sex or ambient (tag) temperature. Trends in the magnitude of G. macrocephalus depth change were observed, with increased movement often occurring during night-time, dawn and dusk, and at release sites where the bathymetry was more complex. Both type I and type II DVMs were attributed to foraging on prey species that also undergo DVM, and increased vertical movements of G. macrocephalus during crepuscular and night-time periods were attributed to more active foraging during dim-light conditions when G. macrocephalus can potentially exploit a sensory advantage over some of their prey.
Collapse
|
113
|
Zimmermann M, Wellnitz T, Laubert T, Hoffmann M, Begum N, Bürk C, Bruch HP, Schlöricke E. [Gastric and duodenal perforations: what is the role of laparoscopic surgery?]. Zentralbl Chir 2013; 139:72-8. [PMID: 23696209 DOI: 10.1055/s-0032-1328344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The gastric and duodenal perforations are a life-threatening complication of peptic ulcer disease with the indication for immediate surgical intervention. To which extent laparoscopy is a suitable method in an acute situation was examined in the present investigation. MATERIALS AND METHODS The data of all patients within a period of 15 years (01/1996-12/2010) who were operated laparoscopically because of a perforated gastric or duodenal ulcer, were collected prospectively in terms of age, gender, localisation of perforation, diagnostics, symptoms, surgical procedures, intraoperative and postoperative complications and postoperative course, and were analysed retrospectively. RESULTS During the observation period 45 patients were operated laparoscopically due to gastric or duodenal perforation. The median age at operation was 58 (18-91) years. An NSAID medication was present in 11 (24.4 %) patients. The perforation was juxtapyloric in 12 (26.7 %) patients, postpyloric in 10 (22.2 %) patients, one (2.2 %) patient in each small and greater curvature, in 18 (40.0 %) at the front and in three (6.7 %) patients on the rear wall. In two cases, previous surgical treatment in the upper abdomen was performed. After primary diagnostic laparoscopy, an indication for conversion was seen in 20 (44.4 %) patients. During laparoscopically completed operations simple suturing was done in 18/25 (72.0 %) patients and excision and suturing was performed in 7/25 (37.8 %) patients. After conversion simple suturing was observed in 7/20 (35.0 %) patients, whereas in 10/20 (50.0 %) patients excision and suturing was performed. 3/20 (15.0 %) patients underwent a resective operation. The median operative time was 105 (40-306) minutes and mean hospitalisation 11 (4-66) days. The ICU stay was in median 2 (0-37) days. Major complications were seen in 11 (24.4 %) patients, namely re-laparotomy (n = 7; 15.6 %) and haemorrhage (n = 4; 8.9 %). Minor complications were observed in 8 (17.8 %) of cases. The mortality rate was 11.1 % (n = 5). CONCLUSION The laparoscopic treatment of gastric and duodenal perforations is a minimally invasive therapeutic option for the definitive treatment of this life-threatening disease. The indication for a laparoscopic approach has to be considered individually and depends to a decisive extent on the experience of the laparoscopic surgeon.
Collapse
|
114
|
Ratei R, Schabath R, Karawajew L, Zimmermann M, Möricke A, Schrappe M, Ludwig WD. Lineage classification of childhood acute lymphoblastic leukemia according to the EGIL recommendations: results of the ALL-BFM 2000 trial. KLINISCHE PADIATRIE 2013; 225 Suppl 1:S34-9. [PMID: 23700065 DOI: 10.1055/s-0033-1337961] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Flow cytometry immunophenotyping (FCM) is an undispensable tool for the diagnosis and for the treatment stratification of childhood acute lymphoblastic leukemia. The correlation of the EGIL-classification with prognostically relevant parameters like age, prednisone response and risk group is analyzed. PATIENTS Between March 2000 and June 2009 12 patients less than 1 year of age, 1 836 patients with 1 to less than 6 years, 620 patients with 6 to less than 10 years, 615 patients with 10 to less than 15 years and 275 patients with 15 to less than 19 years were analyzed with a comprehensive 4-color antibody panel and classified according to the EGIL recommendations. METHODS Bone marrow or peripheral blood mononuclear cells were isolated by ficoll gradient centrifugation, washed and stained with fluorochrome-conjugated antigen-specific monoclonal antibodies. Cell preparations were acquired and analyzed on a flow cytometer. RESULTS Centralized FCM was performed for 2 775 patients (82.6%) with B-cell precursor acute lymphoblastic leukemia, 493 patients (14.7%) with T-cell acute lymphoblastic leukemia and 90 patients (2,7%) with biphenotypic acute leukemia. There was a slight overall predominance of male (56.1%) over female (43.9%) patients. Patients with B-cell precursor ALL had a slightly more favourable outcome with a 10 y pEFS of 78 ± 1.0%, compared to patients with a T-ALL or BAL (biphenotypic acute leukemia) phenotype with a 10 y pEFS of 74 ± 1.8% (n.s.) or 69 ± 9.0% (p<0.009), respectively. CONCLUSIONS FCM according to the EGIL recommendations not only provides diagnostic lineage determination and subclassification but also enables an initial prognostic orientation before MRD (minimal residual disease)-based risk stratification becomes available.
Collapse
|
115
|
Bartram T, Ellinghaus E, Houlston R, Zimmermann M, Möricke A, Cario G, Franke A, Schrappe M, Stanulla M. Identification of germline polymorphisms associated with clinical and toxicity phenotypes in childhood acute lymphoblastic leukemia. KLINISCHE PADIATRIE 2013. [DOI: 10.1055/s-0033-1343635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
116
|
Creutzig U, Zimmermann M, Dworzak MN, Ritter J, Schellong G, Reinhardt D. Development of a curative treatment within the AML-BFM studies. KLINISCHE PADIATRIE 2013; 225 Suppl 1:S79-86. [PMID: 23700063 DOI: 10.1055/s-0033-1337968] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The first multicenter treatment study for AML in childhood in Germany was performed from 1978 onwards. The therapy plan was designed similar to that for the acute lymphoblastic leukaemia (ALL). The drugs with the highest efficacy in AML, cytarabine cutting catara-bine and anthracyclines, were combined during induction and consolidation, followed by preventive cranial irradiation and maintenance therapy similar to that in ALL. The remission rate of the initial study was 80%, and the 5-year survival rate increased from less than 10% before 1970 to 40%. 5 subsequent trials have further increased the 5-year survival to now 70% and even 90% in the subgroup of core-binding factor leukaemias by using an intensified and optimised treatment schedule.The AML-BFM studies were the only prospective study sequence testing the benefit of cranial irradiation. Results from study -87 including the non-randomized patients showed an increased risk of CNS and/or bone marrow relapses in non-irradiated patients. Later on there was evidence that 12 Gy resulted in the same relapse rate as 18 Gy. The AML-BFM studies always used the experience from the previous study to optimize the next study. This approach was essential together with improved supportive treatment and experience of the medical staff for the step-wise and considerable increase of longterm survival within the 6 subsequent AML-BFM studies.
Collapse
|
117
|
Torge A, Zimmermann M, Möricke A, Köhler R, Schrauder A, Bartram CR, Schrappe M, Stanulla M. Prediction of minimal residual disease in pediatric ALL: Evaluation of the predictive potential of the variables from the ALL-BFM 2000 trial. KLINISCHE PADIATRIE 2013. [DOI: 10.1055/s-0033-1343620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
118
|
Möricke A, Lauten M, Beier R, Odenwald E, Stanulla M, Zimmermann M, Attarbaschi A, Niggli F, Schrappe M. Prediction of outcome by early response in childhood acute lymphoblastic leukemia. KLINISCHE PADIATRIE 2013; 225 Suppl 1:S50-6. [PMID: 23700057 DOI: 10.1055/s-0033-1337964] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND In the ALL-BFM studies for treatment of acute lymphoblastic leukemia, reduction of leukemic blasts in peripheral blood after a one-week prednisone pre-phase - the so-called prednisone response - has been used for risk stratification since the 1980s and has been one of the most relevant factors for identification of high-risk patients. In the trial ALL-BFM 95, early cytomorphological marrow response on day 15 of induction therapy was prospectively evaluated and its prognostic value was analyzed in comparison to the prednisone response and other established prognostic factors. RESULTS Compared to prednisone response, day 15 marrow response was superior in outcome prediction - yet with differential effect depending on blast lineage. Outcome was poor in T cell leukemia patients with prednisone poor-response independent of day 15 marrow response, whereas among patients with prednisone good-response different risk groups could be identified by day 15 marrow response. In contrast, prednisone response lost prognostic significance in precursor B cell leukemia when stratified by day 15 marrow response. CONCLUSIONS Selective addition of day 15 marrow response to conventional stratification criteria applied on ALL-BFM 95 may significantly improve risk-adapted treatment delivery. Even though cutting-edge trial risk stratification is meanwhile dominated by minimal residual disease evaluation, an improved conventional risk assessment, as presented here, could be of great importance to countries lacking the technical and/or financial resources associated with the application of minimal residual disease analysis.
Collapse
|
119
|
Schrappe M, Möricke A, Reiter A, Henze G, Welte K, Gadner H, Ludwig WD, Ritter J, Harbott J, Mann G, Klingebiel T, Gruhn B, Niemeyer C, Kremens B, Niggli F, Debatin KM, Ratei R, Stanulla M, Beier R, Cario G, Schrauder A, Zimmermann M. Key treatment questions in childhood acute lymphoblastic leukemia: results in 5 consecutive trials performed by the ALL-BFM study group from 1981 to 2000. KLINISCHE PADIATRIE 2013; 225 Suppl 1:S62-72. [PMID: 23700060 DOI: 10.1055/s-0033-1337966] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Between 1981 and 2000, 6 609 children (<18 years of age) were treated in 5 consecutive trials of the Berlin-Frankfurt-Münster (BFM) study group for childhood acute lymphoblastic leukemia (ALL). Patients were treated in up to 82 centers in Germany, Austria, and Switzerland. Probability of 10-year event-free survival (survival) improved from 65% (77%) in study ALL-BFM 81-78% (85%) in ALL-BFM 95. In parallel to relapse reduction, major efforts focused on reducing acute and late toxicity through advanced risk adaptation of treatment. The major findings derived from these ALL-BFM trials were as follows: 1) preventive cranial radiotherapy could be safely reduced to 12 Gy in T-ALL and high-risk ALL patients and eliminated in non-high-risk non-T-ALL patients, if it was replaced by high-dose and intrathecal methotrexate; 2) omission of delayed reintensification severely impaired outcome of low-risk patients; 3) 6 months less maintenance therapy caused an increase in systemic relapses; 4) slow response to an initial 7-day prednisone window was identified as adverse prognostic factor; 5) condensed induction therapy resulted in a significant improvement of outcome; 6) the daunorubicin dose in induction could be safely reduced in low-risk patients; 7) intensification of consolidation/reintensification treatment led to considerable improvement of outcome in high-risk patients.
Collapse
|
120
|
Hartkopf AD, Bossow S, Lampe J, Zimmermann M, Taran FA, Wallwiener D, Fehm T, Bitzer M, Lauer UM. Enhanced killing of ovarian carcinoma using oncolytic measles vaccine virus armed with a yeast cytosine deaminase and uracil phosphoribosyltransferase. Gynecol Oncol 2013; 130:362-8. [PMID: 23676551 DOI: 10.1016/j.ygyno.2013.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 04/27/2013] [Accepted: 05/05/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To preclinical assess the feasibility of combining oncolytic measles vaccine virus (MeV) with suicide gene therapy for ovarian cancer treatment. METHODS We genetically engineered a recombinant MeV armed with a yeast-derived bifunctional suicide gene that encodes for cytosine deaminase and uracil phosphoribosyltransferase (MeV-SCD). From this suicide gene, a chimeric protein is produced that converts the non-toxic prodrug 5-fluorocytosine (5-FC) into highly cytotoxic 5-fluorouracil (5-FU) and directly into 5-fluorouridine monophosphate (5-FUMP) thereby bypassing an important mechanism of chemoresistance to 5-FU. RESULTS MeV-SCD was demonstrated to infect, replicate in and effectively lyse not only human ovarian cancer cell lines, but also primary tumor cells (albeit at lower efficiencies) that were derived from malignant ascites of ovarian cancer patients. Addition of the prodrug 5-FC significantly enhanced cell killing. Importantly, precision-cut tumor slices of human ovarian cancer patient specimens were efficiently infected with MeV-SCD. The prodrug-converting enzyme SCD was expressed by all infected tumor slices, thereby ensuring provision of the suicide gene arming function in patient-derived materials. CONCLUSIONS With respect to safety and therapeutic impact, arming of oncolytic measles vaccine virus warrants further clinical investigation for ovarian cancer treatment.
Collapse
|
121
|
Zimmermann M, Otto C, Gonzalez JB, Prokop S, Ruprecht K. Cellular origin and diagnostic significance of high-fluorescent cells in cerebrospinal fluid detected by the XE-5000 hematology analyzer. Int J Lab Hematol 2013; 35:580-8. [PMID: 23551597 DOI: 10.1111/ijlh.12090] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 02/27/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The Sysmex XE-5000 is a blood and body fluid analyzer able to differentiate cells into polymorphonuclear, mononuclear, and high-fluorescent cells (HFC). The identity of HFC in cerebrospinal fluid (CSF) has been uncertain; however, compatible with their high nucleic acid content, HFC could represent intrathecal tumor cells. Here, we studied the cellular origin and the diagnostic significance of HFC in CSF. METHODS Results of CSF examinations with the XE-5000 were analyzed in 65 CSF samples with and 126 CSF samples without tumor cells, as defined by manual microscopy of CSF cytospin preparations. RESULTS The XE-5000 detected HFC in 51 of 65 tumor cell-positive and in 33 of 126 tumor cell-negative CSF samples (sensitivity: 78.5%, specificity: 73.8%, positive likelihood ratio: 3.0, negative likelihood ratio: 0.29). The percentages of HFC and tumor cells in CSF samples correlated (r² = 0.41, P < 0.0001). Tumor cells escaped detection by the XE-5000 especially in CSF samples with a low percentage of tumor cells. CONCLUSION While this study identifies tumor cells as the predominant correlate of HFC in CSF, it suggests that measuring HFC is not an appropriate diagnostic test for intrathecal tumor cells. However, if HFC are incidentally detected in CSF, further evaluation by CSF microscopy seems mandatory.
Collapse
|
122
|
Hoetzenecker K, Mitterbauer A, Guenova E, Schweiger T, Altmann P, Zimmermann M, Hofbauer H, Beer L, Klepetko W, Ankersmit HJ. High levels of lung resident CD4+CD28null cells in COPD: implications of autoimmunity. Wien Klin Wochenschr 2013; 125:150-5. [DOI: 10.1007/s00508-013-0340-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 02/22/2013] [Indexed: 12/01/2022]
|
123
|
Begum N, Hubold C, Buchmann I, Thorns C, Bouchard R, Lubienski A, Schlöricke E, Zimmermann M, Lehnert H, Bruch HP, Bürk CG. [Diagnostics and therapy for neuroendocrine neoplasia of an unknown primary - a plea for open exploration]. Zentralbl Chir 2013; 139:284-91. [PMID: 23508839 DOI: 10.1055/s-0032-1327962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Neuroendocrine neoplasia (NEN) are a rare and heterogenous tumour entity. The subgroup with unknown primary tumour (N-CUP) seems to have a worse prognosis as resection of the primary is necessary for cure. The diagnostics and therapeutic algorithms for N-CUP in a German single centre are presented. PATIENTS/METHODS Analysis of the surgical databank showed 35 cases of N-CUP in 261 cases with NEN from gastroenteropancreatic and lung origin over 2 decades (03/1990-03/2011). Three groups were built: K1 - primary detection after operative exploration (n = 10), K2 - unknown primary after operative exploration (n = 10) and K3 - no operative exploration for various reasons (n = 13). RESULTS Initially 13.4 % (35/261) of patients presented as N-CUP, after intensified diagnostics 12.7 % (33/261) and after operative exploration 8.8 % (23/261) remained with unknown primary tumour. The sex ratio was 1 : 1, the median age is significantly higher in N-CUP [63.8 years (y) vs. 55.9 y, p = 0.004), the 5-year-survival is lower (58 vs. 72 %, n. s.). compared to NEN with known primary. Operative exploration was performed in 60.6 % (20/33), 30 % (6/20) of them were found to have inoperable situations, in 20 % (4/20) single site metastases were removed completely and in 50 % (10/20) a primary tumour was detected (8 × midgut, 2 × pancreas) intraoperatively. In these cases 70 % (7/10) got complete tumour resection (R0) and in 30 % (3/10) primary tumour resection with debulking of liver metastasis was done. In K3 (39.4 %, 13/33) most patients [69.2 % (9/13)] were treated with chemotherapy. The median age in K1 was significantly lower than in K3 (54.9 y vs. 68.3 y, p = 0.028), male dominance was seen in K3 (3,3 : 1, n. s.). The average Ki-67 index was 4.3, 23.8 and 53 % in K1, K2 and K3 (p < 0.0001 for K1 and K3 and p = 0.035 for K2 and K3), respectively. The death rate was 20, 30 and 76.9 % in K1, K2 and K3, respectively. CONCLUSION Primary tumours of the midgut and pancreas are often found in the subset of well differentiated neuroendocrine CUP syndrome after open surgical exploration. A high rate of complete tumour resection and cure can be achieved in these cases. After common diagnostic tools (CT, MRI and somatostatin receptor scintigraphy), immunhistochemistry can give important hints (CDX-2 for midgut, TTF-1 for lung and thyroid) for a primary lesion. Also in single site metastasis without primary tumour detection a good clinical outcome is seen after complete resection.
Collapse
|
124
|
Zimmermann M, Urban P. [All men are equal...but there are some more equal than others]. REVUE MEDICALE SUISSE 2013; 9:491. [PMID: 23534107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
125
|
Urban P, Shreshta N, Karki P, Zimmermann M, Cook S, Pilgrim T, Meier B. [Cardiovascular cooperation with the BPKIHS Hospital, in Dharan Bazar, Nepal]. REVUE MEDICALE SUISSE 2013; 9:498-501. [PMID: 23534109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Thanks to a collaboration project that was developed by Swiss cardiologists, the Coeur de la Tour Foundation, and BPKIHS, a teaching hospital in Dharan, it has been possible, within two years and using a "hybrid approach", to set up the first independent invasive and interventional program in East Nepal. 496 patients have been investigated and/or treated since January 2011, during an initial period of 23 months (coronary angiographies, coronary angioplasties, temporary and permanent pacemaker implantations, pericardiocenteses, etc.). In parallel with this, our Foundation, in the same area of the country, has also supported a pre-existing cardiovascular prevention program and has helped start a population-based study of rheumatic heart disease prevalence and treatment outcome among school children.
Collapse
|
126
|
Li G, Klein J, Zimmermann M. Pathophysiological amyloid concentrations induce sustained upregulation of readthrough acetylcholinesterase mediating anti-apoptotic effects. Neuroscience 2013; 240:349-60. [PMID: 23485809 DOI: 10.1016/j.neuroscience.2013.02.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 12/31/2022]
Abstract
Cholinergically differentiated SH-SY5Y neuroblastoma cells were treated with a pathophysiologically relevant, low (300 nM), and a high (3 μM) dose of amyloid beta 1-42 (Abeta) or 42-1 (revAbeta). At early (1 and 4h) and late (24h) time points, the pro- and anti-apoptotic factors--caspase-3 and p53, and B-cell lymphoma 2 protein (Bcl-2), respectively--were assessed together with lactate dehydrogenase (LDH) release as measure of cell viability and ATP levels as marker of mitochondrial activity. The low peptide dose significantly increased Bcl-2 and, time-delayed, caspase-3 and ATP levels, but barely impacted on LDH release, while the high concentration remarkably depressed Bcl-2 levels, depleted ATP and led to increased LDH release. We also monitored acetylcholinesterase (AChE) enzymatic activity and splice variant levels (tailed and readthrough AChE; AChE-T and AChE-R), and assessed choline acetyltransferase (ChAT) and high-affinity choline uptake (HACU). The low Abeta concentration drastically upregulated AChE-R and increased both ChAT and HACU, while the high dose caused cholinergic toxicity. We believe this study offers the first insight into the highly concentration-dependent effects of Abeta on cholinergic dynamics. In particular, it highlights the rescuing role of AChE-R as being, together with mitochondrial activity, involved in cholinergic adaptation to low doses of Abeta.
Collapse
|
127
|
Bader A, Brodarac A, Hetzer R, Kurtz A, Stamm C, Baraki H, Kensah G, Asch S, Rojas S, Martens A, Gruh I, Haverich A, Kutschka I, Cortes-Dericks L, Froment L, Kocher G, Schmid RA, Delyagina E, Schade A, Scharfenberg D, Skorska A, Lux C, Li W, Steinhoff G, Drey F, Lepperhof V, Neef K, Fatima A, Wittwer T, Wahlers T, Saric T, Choi YH, Fehrenbach D, Lehner A, Herrmann F, Hollweck T, Pfeifer S, Wintermantel E, Kozlik-Feldmann R, Hagl C, Akra B, Gyongyosi M, Zimmermann M, Pavo N, Mildner M, Lichtenauer M, Maurer G, Ankersmit J, Hacker S, Mittermayr R, Mildner M, Haider T, Nickl S, Zimmermann M, Beer L, Lebherz-Eichinger D, Schweiger T, Mitterbauer A, Keibl C, Werba G, Frey M, Ankersmit HJ, Herrmann S, Lux CA, Steinhoff G, Holfeld J, Tepekoylu C, Wang FS, Kozaryn R, Schaden W, Grimm M, Wang CJ, Holfeld J, Tepekoylu C, Kozaryn R, Urbschat A, Zacharowski K, Grimm M, Paulus P, Avaca MJ, Kempf H, Malan D, Sasse P, Fleischmann B, Palecek J, Drager G, Kirschning A, Zweigerdt R, Martin U, Katsirntaki K, Haller R, Ulrich S, Sgodda M, Puppe V, Duerr J, Schmiedl A, Ochs M, Cantz T, Mall M, Martin U, Mauritz C, Kensah G, Lara AR, Dahlmann J, Zweigerdt R, Schwanke K, Hegermann J, Skvorc D, Gawol A, Azizian A, Wagner S, Krause A, Drager G, Ochs M, Haverich A, Gruh I, Martin U, Klopsch C, Gaebel R, Kaminski A, Chichkov B, Jockenhoevel S, Steinhoff G, Klose K, Roy R, Brodarac A, Kang KS, Bieback K, Nasseri B, Choi YH, Kurtz A, Stamm C, Lepperhof V, Polchynska O, Kruttwig K, Bruggemann C, Xu G, Drey F, Neef K, Saric T, Lichtenauer M, Werba G, Mildner M, Baumgartner A, Hasun M, Nickl S, Beer L, Mitterbauer A, Zimmermann M, Gyongyosi M, Podesser BK, Ankersmit HJ, Ludwig M, Tolk A, Skorska A, Noack T, Steinhoff G, Margaryan R, Assanta N, Menciassi A, Burchielli S, Matteucci M, Lionetti V, Luchi C, Cariati E, Coceani F, Murzi B, Martens A, Rojas SV, Kensah G, Rotarmel A, Baraki H, Haverich A, Martin U, Gruh I, Kutschka I, Nasseri BA, Klose K, Ebell W, Dandel M, Kukucka M, Gebker R, Choi YH, Hetzer R, Stamm C, Paulus P, Holfeld J, Urbschat A, Mutlak H, Ockelmann P, Tacke S, Zacharowski K, Scheller B, Pereszlenyi A, Rojas SV, Martens A, Baraki H, Schwanke K, Zweigerdt R, Martin U, Haverich A, Kutschka I, Rojas SV, Martens A, Meier M, Baraki H, Schecker N, Rathert C, Zweigerdt R, Martin U, Haverich A, Kutschka I, Roy R, Brodarac A, Kukucka M, Kurtz A, Becher PM, Choi YH, Drori-Carmi N, Bercovich N, Zahavi-Goldstein E, Jack M, Netzer N, Pinzur L, Chajut A, Tschope C, Stamm C, Ruch U, Kaminski A, Strauer BE, Tiedemann G, Steinhoff G, Schade A, Delyagina E, Scharfenberg D, Lux C, Steinhoff G, Schlegel F, Dhein S, Akhavuz O, Mohr FW, Dohmen PM, Schlegel F, Salameh A, Oelmann K, Kiefer P, Dhein S, Mohr FW, Dohmen PM, Schwanke K, Merkert S, Templin C, Jara-Avaca M, Muller S, Haverich A, Martin U, Zweigerdt R, Skorska A, von Haehling S, Ludwig M, Slavic S, Curato C, Altarche-Xifro W, Unger T, Steinhoff G, Li J, Zhang Y, Li WZ, Ou L, Lux CA, Ma N, Steinhoff G, Haase A, Alt R, Schwanke K, Martin U. 3rd EACTS Meeting on Cardiac and Pulmonary Regeneration Berlin-Brandenburgische Akademie, Berlin, Germany, 14-15 December 2012. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivs561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
128
|
Hilker M, Philip A, Arlt M, Amann M, Lunz D, Müller T, Zimmermann M, Graf B, Schmid C. Pre-hospital cardiopulmonary resuscitation supported by ECMO – a case series of 6 patients. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
129
|
Reich S, Vollborn T, Mehl A, Zimmermann M. Intraoral optical impression systems--an overview. INTERNATIONAL JOURNAL OF COMPUTERIZED DENTISTRY 2013; 16:143-162. [PMID: 23930576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
130
|
Zimmermann M, Mehl A, Reich S. New CAD/CAM materials and blocks for chairside procedures. INTERNATIONAL JOURNAL OF COMPUTERIZED DENTISTRY 2013; 16:173-181. [PMID: 23930578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
131
|
Perdereau E, Bagnères A‐G, Bankhead‐Dronnet S, Dupont S, Zimmermann M, Vargo EL, Dedeine F. Global genetic analysis reveals the putative native source of the invasive termite,Reticulitermes flavipes,in France. Mol Ecol 2012. [DOI: 10.1111/mec.12140] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
132
|
Got C, Shuck J, Biercevicz A, Paller D, Mulcahey M, Zimmermann M, Blaine T, Green A. Biomechanical comparison of parallel versus 90-90 plating of bicolumn distal humerus fractures with intra-articular comminution. J Hand Surg Am 2012; 37:2512-8. [PMID: 23174063 DOI: 10.1016/j.jhsa.2012.08.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 08/28/2012] [Accepted: 08/30/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the biomechanical properties of 90-90 versus mediolateral parallel plating of C-3 bicolumn distal humerus fractures. METHODS We created intra-articular AO/Orthopaedic Trauma Association C-3 bicolumn fractures in 10 fresh-frozen matched pairs of cadaveric elbows. We determined bone mineral density of the metaphyseal region with dual-energy x-ray absorptiometry. The matched pairs of elbows were randomly assigned to either 90-90 or parallel plate fixation. We tested anteroposterior displacement at a rate of 0.5 mm/s to a maximum load of ± 100 N for both the articular and entire distal humerus segments. We tested torsional stability at a displacement rate of 0.1 Hz to a maximum torque of ± 2.5 Nm. After cyclical testing, we loaded the specimens in torsion to failure. RESULTS There was no significant difference in the bone density of the paired specimens. Compared with parallel fixation, 90-90 plate fixation had significantly greater torque to failure load. Both plating constructs were equally sensitive to bone density. Both techniques had the same mode of failure in torsion, a spiral fracture extending from the medial plate at the metaphyseal-diaphyseal junction. There was no significant difference in the stiffness of fixation of the articular fragment or the entire distal segment in anteroposterior loading. CONCLUSIONS This study demonstrated that 90-90 and parallel plating had comparable biomechanical properties for fixation of comminuted intra-articular distal humerus fractures, and that 90-90 plating had greater resistance to torsional loading.
Collapse
|
133
|
Zimmermann M. [Der Schmerz: An interdisciplinary journal for 25 years!]. Schmerz 2012. [PMID: 23183987 DOI: 10.1007/s00482-012-1273-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
134
|
Zimmermann M. [Pain in the fetus: neurobiological, psychophysiological and behavioral aspects.]. Schmerz 2012; 5:122-30. [PMID: 18415186 DOI: 10.1007/bf02528097] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Until a short time ago, the view prevailed worldwide that children were less sensitive to pain than adults, and such operations as circumcision were performed in babies without adequate anesthesia or analgesia. This view is now considered a misconception, as psychophysiological and behavioral studies show that even neonates have a well-functioning nociceptive system. Nociception generally refers to the neural and sensory aspects of pain, which do not necessarily include conscious experience. There is no discontinuity in the development of the nervous system during birth, and therefore it can be concluded that the fetus is also responsive to noxious stimuli. The question arises as to the stage of ontogeny of the human at which nociceptive behavior begins. Literature on the fetal nervous system reveals that the first signs of somatosensory system function occur at week 7 of gestation and at week 22 the synaptic connection from the nervous periphery to the somatosensory cortex is becoming established. During this period, motor behavior matures, from stereotyped reflexes to spontaneously generated complex motor patterns reminiscent of the repertory of voluntary movement. From week 22 onward the electroencephalogram (EEG) shows increasingly more varied patterns, and sleep-wake states can be discerned after week 30 of gestation. Somatosensory evoked cortial potentials have been recorded from gestational week 28 onward. Substance P, a neuropeptide associated with pain in the adult nervous system, is present in the fetal spinal cord as early as week 12 of gestation, while the antinociceptive opioid peptide enkephalin does not appear until week 24. From week 15 onward, opioid peptides such as beta-endorphin appear in the pituitary; their release becomes sensitive to environmental stimuli from about week 20 onward, which can be considered the onset of pituitary stress responses. In particular, parturition and abortion induced the release of opioid peptides. Studies of conditioned behavior show that the fetus has the ability to learn. It has been hypothesized that the fetus and neonate possess a procedural memory, which is not transferred to the language-based memory of later phases of life. Learning and memory are the most essential elements for the construct of "consciousness." Therefore, a primitive type or level of consciousness might exist in the fetus. Thus, a considerable range of sensorimotor function, including memory, develops during fetal life. Anatomical, physiological and behavioral data suggest that the nociceptive system is included in this development. Although we cannot be sure at present whether the fetus consciously experiences pain, beyond the protective nociceptive behavioral responses, anesthesia should be used for invasive procedures to protect the fetus and its nervous systems.
Collapse
|
135
|
Scharf C, Ng GA, Wieczorek M, Deneke T, Furniss SS, Murray S, Debruyne P, Hobson N, Berntsen RF, Schneider MA, Hauer HA, Halimi F, Boveda S, Asbach S, Boesche L, Zimmermann M, Brigadeau F, Taieb J, Merkel M, Pfyffer M, Brunner-La Rocca HP, Boersma LVA. European survey on efficacy and safety of duty-cycled radiofrequency ablation for atrial fibrillation. Europace 2012; 14:1700-7. [PMID: 22772054 PMCID: PMC3501283 DOI: 10.1093/europace/eus188] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Duty-cycled radiofrequency ablation (RFA) has been used for atrial fibrillation (AF) for around 5 years, but large-scale data are scarce. The purpose of this survey was to report the outcome of the technique. METHODS AND RESULTS A survey was conducted among 20 centres from seven European countries including 2748 patients (2128 with paroxysmal and 620 with persistent AF). In paroxysmal AF an overall success rate of 82% [median 80%, interquartile range (IQR) 74-90%], a first procedure success rate of 72% [median 74% (IQR 59-83%)], and a success of antiarrhythmic medication of 59% [median 60% (IQR 39-72%)] was reported. In persistent AF, success rates were significantly lower with 70% [median 74% (IQR 60-92%)]; P = 0.05) as well as the first procedure success rate of 58% [median 55% (IQR 47-81%)]; P = 0.001). The overall success rate was similar among higher and lower volume centres and were not dependent on the duration of experience with duty-cycled RFA (r = -0.08, P = 0.72). Complications were observed in 108 (3.9%) patients, including 31 (1.1%) with symptomatic transient ischaemic attack or stroke, which had the same incidence in paroxysmal and persistent AF (1.1 vs. 1.1%) and was unrelated to the case load (r = 0.24, P = 0.15), bridging anticoagulation to low molecular heparin, routine administration of heparin over the long sheath, whether a transoesophageal echocardiogram was performed in every patient or not and average procedure times. CONCLUSION Duty-cycled RFA has a self-reported success and complication rate similar to conventional RFA. After technical modifications a prospective registry with controlled data monitoring should be conducted to assess outcome.
Collapse
|
136
|
Zimmermann M, Jacobs P, Fingerhut R, Torresani T, Thöny B, Blau N, Baumgartner MR, Rohrbach M. Positive effect of a simplified diet on blood phenylalanine control in different phenylketonuria variants, characterized by newborn BH4 loading test and PAH analysis. Mol Genet Metab 2012; 106:264-8. [PMID: 22607939 DOI: 10.1016/j.ymgme.2012.04.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 04/18/2012] [Indexed: 11/15/2022]
Abstract
Until today, the mainstay of phenylketonuria (PKU) treatment is a phenylalanine (Phe)-restricted diet. Strict dietary treatment decreases flexibility and autonomy and still has a major impact on patients and their families. Compliance is often poor, particularly in adolescence. The aim of this study was to investigate the effect of the intake of fruits and vegetables containing Phe less than 100 mg/100g ('simplified diet'), as recommended by WHO for all individuals, instead of classical totally restricted diet on the course and treatment control of the disease in a well-characterized PKU cohort (n=80). All individual blood Phe measurements of each patient (1992-2009) were statistically analyzed before and after diet switch. Epidemiological data, age at diagnosis, PAH mutations, BH(4) responsiveness, as well as Phe control measurements and detailed diet information were tabulated in a local database. 62.5% had BH4 loading test and 40% had PAH analysis; 50/80 switched from classical to simplified diet, including 26 classical PKU, 13 moderate PKU, 7 mild PKU and 4 mild hyperphenylalaninemia (HPA). Median Phe levels on a simplified diet did not differ significantly to the median Phe levels on classical diet in all disease groups. Our results indicate that a simplified diet has no negative effect on blood Phe control in patients with hyperphenylalaninemia, independent of severity of the phenotype or the age at diet switch, over the period of 3 years. Thus, a simpler approach to dietary treatment of PKU available to all HPA patients is more likely to be accepted and adhered by patients and might also increase quality of life.
Collapse
|
137
|
Stapleton S, Flanary J, Hamblin F, Steinbrueck S, Rodriguez L, Tuite G, Carey C, Storrs B, Lavey R, Fangusaro J, Jakacki R, Kaste S, Goldman S, Pollack I, Boyett J, Kun L, Gururangan S, Jakacki R, Dombi E, Steinberg S, Goldman S, Kieran M, Ullrich N, Widemann B, Goldman S, Fangusaro J, Lulla R, Reinholdt N, Newmark M, Urban M, Chi S, Manley P, Robison N, Kroon HA, Kieran M, Stancokova T, Husakova K, Deak L, Fangusaro J, Gururangan S, Onar-Thomas A, Packer R, Goldman S, Kaste S, Friedman H, Poussaint TY, Kun L, Boyett J, Gudrun F, Tippelt S, Zimmermann M, Rutkowski S, Warmuth-Metz M, Pietsch T, Faldum A, Bode U, Slavc I, Peyrl A, Chocholous M, Kieran M, Azizi A, Czech T, Dieckmann K, Haberler C, Macy M, Kieran M, Chi S, Cohen K, MacDonald T, Smith A, Etzl M, Naranderan A, Gore L, DiRenzo J, Trippett T, Foreman N, Dunkel I, Fisher MJ, Meyer J, Roberts T, Belasco JB, Phillips PC, Lustig R, Cahill AM, Laureano A, Huls H, Somanchi S, Denman C, Liadi I, Khatua S, Varadarajan N, Champlin R, Lee D, Cooper L, Silla L, Gopalakrishnan V, Legault G, Hagiwara M, Ballas M, Brown K, Vega E, Nusbaum A, Bloom M, Hochman T, Goldberg J, Golfinos J, Roland JT, Allen J, Karajannis M, Karajannis M, Bergner A, Giovannini M, Welling DB, Niparko J, Slattery W, Roland JT, Golfinos J, Allen J, Blakeley J, Owens C, Sung L, Lowis S, Rutkowski S, Gentet JC, Bouffet E, Henry J, Bala A, Freeman S, King A, Rutherford S, Mills S, Huson S, McBain C, Lloyd S, Evans G, McCabe M, Lee Y, Bartels U, Tabori U, Jansen L, Mabbott D, Bouffet E, Huang A, Aguilera D, Mazewski C, Fangusaro J, MacDonald T, McNall R, Hayes L, Liu Y, Castellino R, Cole D, Lester-McCully C, Widemann B, Warren K, Robison N, Campigotto F, Chi S, Manley P, Turner C, Zimmerman MA, Chordas C, Allen J, Goldman S, Rubin J, Isakoff M, Pan W, Khatib Z, Comito M, Bendel A, Pietrantonio J, Kondrat L, Hubbs S, Neuberg D, Kieran M, Wetmore C, Broniscer A, Wright K, Armstrong G, Baker J, Pai-Panandiker A, Kun L, Patay Z, Onar-Thomas A, Ramachandran A, Turner D, Gajjar A, Stewart C. CLINICAL TRIALS. Neuro Oncol 2012; 14:i16-i21. [PMCID: PMC3483342 DOI: 10.1093/neuonc/nos096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024] Open
|
138
|
Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
|
139
|
Zaghloul M, Elbeltagy M, Mousa A, Eldebawy E, Amin A, Pavelka Z, Vranova V, Valaskova I, Tomasikova L, Oltova A, Ventruba J, Mackerle Z, Kren L, Skotakova J, Zitterbart K, Sterba J, Milde T, Kleber S, Korshunov A, Witt H, Hielscher T, Koch P, Koch HG, Jugold M, Deubzer HE, Oehme I, Lodrini M, Grone HJ, Benner A, Brustle O, Gilbertson RJ, von Deimling A, Kulozik AE, Pfister SM, Ana MV, Witt O, Milde T, Hielscher T, Witt H, Kool M, Mack SC, Deubzer HE, Oehme I, Lodrini M, Benner A, Taylor MD, von Deimling A, Kulozik AE, Pfister SM, Witt O, Korshunov A, Fouyssac F, Schmitt E, Mansuy L, Marchal JC, Coffinet L, Bernier V, Chastagner P, Sperl D, Zacharoulis S, Massimino M, Schiavello E, Pizer B, Piette C, Kitanovski L, von Hoff K, Quehenberger F, Rutkowski S, Benesch M, Tzaridis TD, Witt H, Milde T, Bender S, Pfaff E, Barbus S, Bageritz J, Jones DTW, Kulozik A, Lichter P, Korshunov A, Witt O, Pfister SM, Song SH, Kang CW, Kim SH, Bandopadhayay P, Ullrich N, Goumnerova L, Scott RM, Silvera VM, Ligon KL, Marcus KJ, Robison N, Manley PE, Chi S, Kieran MW, Schiavello E, Biassoni V, Pierani P, Cesaro S, Maura M, Witt H, Mack S, Jager N, Jones DTW, Bender S, Stutz A, Milde T, Northcott PA, Fults DW, Gupta N, Karajannis M, Kulozik AE, von Deimling A, Witt O, Rutka JT, Lichter P, Korbel J, Korshunov A, Taylor MD, Pfister SM, de Rezende ACP, Chen MJ, da Silva NS, Cappellano A, Cavalheiro S, Weltman E, Currle S, Thiruvenkatam R, Murugesan M, Kranenburg T, Phoenix T, Gupta K, Gilbertson R, Rogers H, Kilday JP, Mayne C, Ward J, Adamowicz-Brice M, Schwalbe E, Clifford S, Coyle B, Grundy R, Rogers H, Mayne C, Kilday JP, Coyle B, Grundy R, Kilday JP, Mitra B, Domerg C, Ward J, Andreiuolo F, Osteso-Ibanez T, Mauguen A, Varlet P, Le Deley MC, Lowe J, Ellison DW, Gilbertson RJ, Coyle B, Grill J, Grundy RG, Fleischhack G, Pajtler K, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Gandola L, Pecori E, Scarzello G, Barra S, Mascarin M, Scoccianti S, Mussano A, Garre ML, Jacopo S, Pierani P, Viscardi E, Balter R, Bertin D, Giangaspero F, Massimino M, Pearlman M, Khatua S, Van Meter T, Koul D, Yung A, Paulino A, Su J, Dauser R, Whitehead W, Teh B, Chintagumpala M, Perek D, Drogosiewicz M, Filipek I, Polnik MP, Baginska BD, Wachowiak J, Kazmierczak B, Sobol G, Musiol K, Kowalczyk J, Slusarz HW, Peregud-Pogorzelski J, Grajkowska W, Roszkowski M, Teo WY, Chintagumpala M, Okcu F, Dauser R, Mahajan A, Adesina A, Whitehead W, Jea A, Bollo R, Paulino AC, Velez-Char N, Doerner E, Muehlen AZ, Vladimirova V, Warmuth-Metz M, Kortmann R, von Hoff K, Friedrich C, Rutkowski S, von Bueren AO, Pietsch T, Barszczyk M, Buczkowicz P, Morrison A, Tabori U, Hawkins C, Krajewski K, von Hoff K, Kammler G, Friedrich C, von Bueren A, Kortmann RD, Krauss J, Warmuth-Metz M, Rutkowski S, Ferreira C, Dieffenbach G, Barbosa C, Cuny P, Grill J, Piccinin E, Massimino M, Giangaspero F, Brenca M, Lorenzetto E, Sardi I, Genitori L, Pollo B, Bertin D, Maestro R, Modena P, MacDonald S, Ebb D, Lavally B, Yeap B, Marcus K, Tarbell N, Yock T, Schittone S, Donson A, Birks D, Amani V, Griesinger A, Handler M, Madey M, Merchant T, Foreman N, Hukin J, Ailon T, Dunham C, Carret AS, Tabori U, McNeely PD, Zelcer S, Wilson B, Lafay-Cousin L, Johnston D, Eisenstat D, Silva M, Jabado N, Yip S, Goddard K, Fryer C, Hendson G, Hawkins C, Dunn S, Singhal A, Lassen-Ramshad Y, Vestergaard A, Seiersen K, Schultz HP, Hoeyer M, Petersen JB, Moreno L, Popov S, Jury A, Al Sarraj S, Jones C, Zacharoulis S, Bowers D, Gargan L, Horton CJ, Rakheja D, Margraf L, Yeung J, Hamilton R, Okada H, Jakacki R, Pollack I, Fleming A, Jabado N, Saint-Martin C, Freeman C, Albrecht S, Montes JL. EPENDYMOMA. Neuro Oncol 2012; 14:i33-i42. [PMCID: PMC3483345 DOI: 10.1093/neuonc/nos099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
|
140
|
Schloericke E, Hoffmann M, Zimmermann M, Kraus M, Bouchard R, Roblick UJ, Hildebrand P, Nolde J, Bruch HP, Limmer S. Transperineal omentum flap for the anatomic reconstruction of the rectovaginal space in the therapy of rectovaginal fistulas. Colorectal Dis 2012; 14:604-10. [PMID: 21752173 DOI: 10.1111/j.1463-1318.2011.02719.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM Deep rectovaginal fistulas are a rare entity and pose a delicate challenge for the surgeon. The present study introduces different operative interventions involved in transperineal omental flap surgery. METHOD A retrospective analysis of all patients treated with a low or mid rectovaginal or enterovaginal fistula at the Department of Surgery of the University Hospital of Schleswig-Holstein, Campus Luebeck, was performed. Treatment results were discussed with respect to aetiology, localization, morbidity and outcome. RESULTS Between the years 2000 and 2010, a total of nine patients with a low or mid rectovaginal fistula were treated at our clinic. After local fistulectomy, all patients were additionally treated by a laparoscopically assisted omental flap reconstruction of the rectovaginal and perineal space. Eight of the nine patients received a protective ileostomy or colostomy. Only the patient with a history of Crohn's disease had no ileostomy raised. At a median follow-up of 22 months, no patient experienced recurrence of a rectovaginal fistula. Perioperative mortality was zero and minor complications were observed in 22%. Major complications were an anastomotic insufficiency after low anterior resection that was treated without further interventions. Another complication was a persistent fistula within the sphincter that needed re-operation and bovine plug repair combined with a mucosa flap. CONCLUSIONS Complete omental reconstruction of the rectovaginal space appears decisive in the operative therapy of deep rectovaginal or enterovaginal fistulas. Comparative studies on standard therapies are necessary although direct comparison of case series is difficult.
Collapse
|
141
|
Ellinghaus E, Stanulla M, Richter G, Ellinghaus D, te Kronnie G, Cario G, Cazzaniga G, Horstmann M, Panzer Grümayer R, Cavé H, Trka J, Cinek O, Teigler-Schlegel A, ElSharawy A, Häsler R, Nebel A, Meissner B, Bartram T, Lescai F, Franceschi C, Giordan M, Nürnberg P, Heinzow B, Zimmermann M, Schreiber S, Schrappe M, Franke A. Identification of germline susceptibility loci in ETV6-RUNX1-rearranged childhood acute lymphoblastic leukemia. Leukemia 2012; 26:902-9. [PMID: 22076464 PMCID: PMC3356560 DOI: 10.1038/leu.2011.302] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 09/03/2011] [Accepted: 09/21/2011] [Indexed: 02/08/2023]
Abstract
Acute lymphoblastic leukemia (ALL) is a malignant disease of the white blood cells. The etiology of ALL is believed to be multifactorial and likely to involve an interplay of environmental and genetic variables. We performed a genome-wide association study of 355 750 single-nucleotide polymorphisms (SNPs) in 474 controls and 419 childhood ALL cases characterized by a t(12;21)(p13;q22) - the most common chromosomal translocation observed in childhood ALL - which leads to an ETV6-RUNX1 gene fusion. The eight most strongly associated SNPs were followed-up in 951 ETV6-RUNX1-positive cases and 3061 controls from Germany/Austria and Italy, respectively. We identified a novel, genome-wide significant risk locus at 3q28 (TP63, rs17505102, P(CMH)=8.94 × 10(-9), OR=0.65). The separate analysis of the combined German/Austrian sample only, revealed additional genome-wide significant associations at 11q11 (OR8U8, rs1945213, P=9.14 × 10(-11), OR=0.69) and 8p21.3 (near INTS10, rs920590, P=6.12 × 10(-9), OR=1.36). These associations and another association at 11p11.2 (PTPRJ, rs3942852, P=4.95 × 10(-7), OR=0.72) remained significant in the German/Austrian replication panel after correction for multiple testing. Our findings demonstrate that germline genetic variation can specifically contribute to the risk of ETV6-RUNX1-positive childhood ALL. The identification of TP63 and PTPRJ as susceptibility genes emphasize the role of the TP53 gene family and the importance of proteins regulating cellular processes in connection with tumorigenesis.
Collapse
|
142
|
Lauscher JC, Grittner F, Stroux A, Zimmermann M, le Claire M, Buhr HJ, Ritz JP. Reduction of wound infections in laparoscopic-assisted colorectal resections by plastic wound ring drapes (REDWIL)?—a randomized controlled trial. Langenbecks Arch Surg 2012; 397:1079-85. [DOI: 10.1007/s00423-012-0954-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 04/02/2012] [Indexed: 11/29/2022]
|
143
|
Schlöricke E, Zimmermann M, Hoffmann M, Laubert T, Nolde J, Hildebrand P, Bruch HP, Bouchard R. [Surgical treatment and prognosis of rectovaginal fistulae according to their origin]. Zentralbl Chir 2012; 137:390-5. [PMID: 22473673 DOI: 10.1055/s-0031-1283884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The rectovaginal fistula is a rare entity with heterogenic causality. Its genesis seems to predict the extent of operative treatment and the prognostic outcome. The aim of this study was to present different surgical techniques in the treatment of rectovaginal fistulas and their results in correspondence to the genesis. MATERIAL AND METHODS Between 1 / 2000 and 1 / 2010, the data of patients with rectovaginal fistulas were collected. The retrospective analysis included biographic and anamnestic data as well as clinical parameters, general and specific complications and postoperative data. RESULTS In a timespan of ten years 36 patients with rectovaginal fistulas were treated. The most common causes were inflammatory diseases (n = 21) and earlier surgical measures (n = 6). Moreover tumour-associated fistulas (n = 5) and fistulas with unknown genesis (n = 4) were seen. As surgical techniques anterior resection (n = 21), transrectal flap plasty (n = 7), subtotal colectomy (n = 3), pelvine exenteration (n = 2) and rectal exstirpation (n = 1) were used. The closure of the vaginal lesion was performed by single suture (n = 25), flap plasty (n = 6), transvaginal omental plasty (n = 2) and posterior vaginal plasty (n = 1). All patients were provided with an omental plasty to perform a safe division of the concerned regions. Patients with a low fistula ( < 6 cm) were treated with transperineal omental plasty. The median follow-up was 12 months (6 - 36). Within this timespan 6 patients suffered from major complications [ARDS, anastomosis insufficiency, postoperative bleeding, recurrence of fistula (n = 3)]. Three patients died in the postoperative period (cerebellar infarct, septic complication associated with Crohn's disease, multiorgan failure in tumour recurrence). CONCLUSION The genesis of rectovaginal fistulae is an important predictor for the size of resection which can range from simple excision to exenteration. For optimal therapy the surgical intervention needs to be integrated into an interdisciplinary therapy concept.
Collapse
|
144
|
Torge A, Zimmermann M, Möricke A, Köhler R, Schrauder A, Bartram CR, Schrappe M, Stanulla M. A mathematical approach to data evaluation with focus on prediction of minimal residual disease in pediatric ALL. KLINISCHE PADIATRIE 2012. [DOI: 10.1055/s-0032-1310472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
145
|
Bonn BR, Rohde M, Zimmermann M, Burkhardt B. Differences in LOH6q and its prognostic impact on pediatric T-LBL and T-ALL. KLINISCHE PADIATRIE 2012. [DOI: 10.1055/s-0032-1310473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
146
|
Bartram T, Seidemann K, Burkhardt B, Wössmann W, Zimmermann M, Ellinghaus E, Franke A, Schreiber S, Schrappe M, Reiter A, Stanulla M. Role of three childhood acute lymphoblastic leukemia-associated SNPs in a pediatric non-Hodgkin lymphoma cohort. KLINISCHE PADIATRIE 2012. [DOI: 10.1055/s-0032-1310487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
147
|
Mangold A, Lebherz D, Papay P, Liepert J, Hlavin G, Lichtenberger C, Adami A, Zimmermann M, Klaus D, Reinisch W, Ankersmit HJ. Anti-Gal titers in healthy adults and inflammatory bowel disease patients. Transplant Proc 2012; 43:3964-8. [PMID: 22172880 DOI: 10.1016/j.transproceed.2011.09.074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 09/20/2011] [Indexed: 12/20/2022]
Abstract
INTRODUCTION ALPHA-GAL is a glycoconjugate present on cell membranes of mammals and bacteria but not humans who display anti-Gal antibodies (AB) in high titers provoked by the commensal gut flora. In the present study, we sought to determine the longitudinal course of alpha-Gal specific AB titers of all isotypes over 8 weeks among healthy adult subjects. Furthermore, we hypothesized that inflammatory bowel disease (IBD) patients display increased anti-Gal titers. MATERIALS AND METHODS We drew serum from healthy probands (n=20) weekly for 8 weeks and obtained plasma samples of from patients suffering from Crohn's disease (n=20) and ulcerative colitis (n=20). We measured anti-Gal ABs of all isotypes and total immunoglobulin (Ig) content using an enzyme-linked immunosorbent assay technique. For statistical evaluation of the longitudinal titers, we calculated confidence intervals for the slopes of a random intercept model, comparing variances between and within the probands. For group comparisons, we performed paired student t-tests and Pearson correlations. RESULTS Alpha-Gal specific IgG, IgM, IgD, and IgA titers remained unvaried within a narrow range upon longitudinal observation. Most probands did not display alpha-Gal specific IgE ABs. Crohn's disease patients showed highly increased alpha-Gal-specific IgA titers compared with control subjects (P<.01). CONCLUSION Apart from IgE, alpha-Gal-specific ABs of all isotypes remained constant over longer time periods in healthy subjects. Thus, significant titer changes actually represent increased antigen exposure and a specific anti-alpha-Gal response. Crohn's disease patients display increased anti-Gal IgA titers compared with healthy controls, which reflects a chronically impaired mucosal gut barrier in this patient cohort.
Collapse
|
148
|
Buitenkamp TD, Pieters R, Gallimore NE, van der Veer A, Meijerink JPP, Beverloo HB, Zimmermann M, de Haas V, Richards SM, Vora AJ, Mitchell CD, Russell LJ, Schwab C, Harrison CJ, Moorman AV, van den Heuvel-Eibrink MM, den Boer ML, Zwaan CM. Outcome in children with Down's syndrome and acute lymphoblastic leukemia: role of IKZF1 deletions and CRLF2 aberrations. Leukemia 2012; 26:2204-11. [PMID: 22441210 DOI: 10.1038/leu.2012.84] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Children with Down's syndrome (DS) have an increased risk of developing acute lymphoblastic leukemia (ALL) and have a low frequency of established genetic aberrations. We aimed to determine which genetic abnormalities are involved in DS ALL. We studied the frequency and prognostic value of deletions in B-cell development genes and aberrations of janus kinase 2 (JAK2) and cytokine receptor-like factor 2 (CRLF2) using array-comparative genomic hybridization, and multiplex ligation-dependent probe amplification in a population-based cohort of 34 Dutch Childhood Oncology Group DS ALL samples. A population-based cohort of 88 DS samples from the UK trials was used to validate survival estimates for IKZF1 and CRLF2 abnormalities. In total, 50% of DS ALL patients had ≥1 deletion in the B-cell development genes: PAX5 (12%), VPREB1 (18%) and IKZF1 (35%). JAK2 was mutated in 15% of patients, genomic CRLF2 rearrangements in 62%. Outcome was significantly worse in patients with IKZF1 deletions (6-year event-free survival (EFS) 45 ± 16% vs 95 ± 4%; P=0.002), which was confirmed in the validation cohort (6-year EFS 21 ± 12% vs 58 ± 11%; P=0.002). This IKZF1 deletion was a strong independent predictor for outcome (hazard ratio EFS 3.05; P=0.001). Neither CRLF2 nor JAK2 were predictors for worse prognosis. If confirmed in prospective series, IKZF1 deletions may be used for risk-group stratification in DS ALL.
Collapse
|
149
|
Broggini-Tenzer A, Orlowski K, Bley CR, Zimmermann M, Soltermann A, Vuong V, Pruschy M. 76 DYNAMIC CHANGES OF THE TUMOR MICROMILIEU UNDER TREATMENT. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
150
|
|