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Boeck S, Jung A, Laubender RP, Neumann J, Egg R, Goritschan C, Vehling-Kaiser U, Winkelmann C, Fischer von Weikersthal L, Clemens MR, Gauler TC, Märten A, Klein S, Kojouharoff G, Barner M, Geissler M, Greten TF, Mansmann U, Kirchner T, Heinemann V. EGFR pathway biomarkers in erlotinib-treated patients with advanced pancreatic cancer: translational results from the randomised, crossover phase 3 trial AIO-PK0104. Br J Cancer 2012; 108:469-76. [PMID: 23169292 PMCID: PMC3566829 DOI: 10.1038/bjc.2012.495] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: We aimed to identify molecular epidermal growth factor receptor (EGFR) tissue biomarkers in pancreatic cancer (PC) patients treated with the anti-EGFR agent erlotinib within the phase 3 randomised AIO-PK0104 study. Methods: AIO-PK0104 was a multicenter trial comparing gemcitabine/erlotinib followed by capecitabine with capecitabine/erlotinib followed by gemcitabine in advanced PC; primary study end point was the time-to-treatment failure after first- and second-line therapy (TTF2). Translational analyses were performed for KRAS exon 2 mutations, EGFR expression, PTEN expression, the EGFR intron 1 and exon 13 R497K polymorphism (PM). Biomarker data were correlated with TTF, overall survival (OS) and skin rash. Results: Archival tumour tissue was available from 208 (74%) of the randomised patients. The KRAS mutations were found in 70% (121 out of 173) of patients and exclusively occurred in codon 12. The EGFR overexpression was detected in 89 out of 181 patients (49%) by immunohistochemistry (IHC), and 77 out of 166 patients (46%) had an EGFR gene amplification by fluorescence in-situ hybridisation (FISH); 30 out of 171 patients (18%) had a loss of PTEN expression, which was associated with an inferior TTF1 (first-line therapy; HR 0.61, P=0.02) and TTF2 (HR 0.66, P=0.04). The KRAS wild-type status was associated with improved OS (HR 1.68, P=0.005); no significant OS correlation was found for EGFR–IHC (HR 0.96), EGFR–FISH (HR 1.22), PTEN–IHC (HR 0.77), intron 1 (HR 0.91) or exon 13 R497K PM (HR 0.83). None of the six biomarkers correlated with the occurrence of skin rash. Conclusion: The KRAS wild-type was associated with an improved OS in erlotinib-treated PC patients in this phase 3 study; it remains to be defined whether this association is prognostic or predictive.
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Boeck S, Ormanns S, Laubender R, Jung A, Siveke J, Haas M, Kirchner T, Heinemann V. 477 pERK Expression in Erlotinib-treated Patients with Advanced Pancreatic Cancer: a Translational Subgroup Analysis From the Randomized AIO-PK0104 Phase III Trial. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Heinemann V, Laubender R, Modest D, Jung A, von Weikersthal LF, Vehling-Kaiser U, Giessen C, Kirchner T, Mansmann U, Stintzing S. Development of a Predictive Score Using Amphiregulin (AREG), Epiregulin (EREG) and Egfr-Fish Expression Levels to Determine Treatment Efficacy in Mcrc Patients Receiving Cetuximab-Based Therapy. Analysis of the German AIO CRC-0104 Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33211-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Reu S, Neumann J, Kirchner T. [Mucinous neoplasms of the vermiform appendix, Pseudomyxoma peritonei, and the new WHO classification]. DER PATHOLOGE 2012; 33:24-30. [PMID: 22179200 DOI: 10.1007/s00292-011-1542-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Mucinous neoplasms of the appendix are rare tumors, some of them characterized by an enigmatic discrepancy between a benign morphologic appearance and an aggressive biologic potential, associated with a poor prognosis and high mortality. The clinical picture of pseudomyxoma peritonei is, with few exceptions, caused by mucinous appendiceal neoplasms and differs in many aspects from usual peritoneal carcinomatosis. The controversy regarding terminology, diagnostic criteria, classification and therapy of these tumors has lasted for decades. The revised edition of the World Health Organization Classification of Tumors of the Digestive System proposes a uniform reporting system for mucinous appendiceal neoplasms and the peritoneal disease associated with it, thereby creating a comparable basis for pathological diagnosis, clinical therapy and further scientific studies.
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Reu S, Neumann J, Kirchner T. [Gastrointestinal mixed adenoneuroendocrine carcinomas. An attempt at classification of mixed cancers]. DER PATHOLOGE 2012; 33:31-8. [PMID: 22293787 DOI: 10.1007/s00292-011-1552-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Mixed adenoneuroendocrine carcinomas (MANECs) are a challenge for the diagnostics and the concept of a histogenetic tumor typing. They are classified into three malignant subgroups: high grade malignant MANECs combine an adenoma or adenocarcinoma with a small cell or large cell neuroendocrine carcinoma, intermediate grade malignant MANECs consist of a neuroendocrine tumor (NET grade 1 or 2), often a globlet cell carcinoid and a poorly differentiated adenocarcinoma or diffuse carcinoma of signet ring cell type. The prototype of a low grade malignant MANEC is the globlet cell carcinoid. Molecular analysis indicates a common clonal origin of the different components in MANECs. The prognosis is determined by the most aggressive tumor component. The pathogenesis of MANECs is apparently a sequence of increasing malignant transformation which leads either from an adenoma/adenocarcinoma to a small or large cell neuroendocrine carcinoma or from a neuroendocrine tumor (NET), often a globlet cell carcinoid to a poorly differentiated adenocarcinoma or a diffuse carcinoma of signet ring cell type.
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Dietel M, Enk A, Lehmann A, Bauer J, Garbe C, Kellner U, Kirchner T, Jung A, Kreipe H, Merkelbach-Bruse S, Büttner R, Rüschoff J, Schlake W, Schirmacher P, Penzel R, Stadler R. BRAF-Mutationstestung beim metastasierten malignen Melanom. DER PATHOLOGE 2012; 33:352-6. [DOI: 10.1007/s00292-012-1609-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kirchner T. Pathologie: Mehr als TNM? ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1310636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stintzing S, Fischer von Weikersthal L, Decker T, Vehling-Kaiser U, Jäger E, Heintges T, Stoll C, Giessen C, Modest DP, Neumann J, Jung A, Kirchner T, Scheithauer W, Heinemann V. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer-subgroup analysis of patients with KRAS: mutated tumours in the randomised German AIO study KRK-0306. Ann Oncol 2012; 23:1693-9. [PMID: 22219013 DOI: 10.1093/annonc/mdr571] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The AIO KRK-0306 trial compares the efficacy of infusional 5-fluorouracil, folinic acid, irinotecan (FOLFIRI) plus cetuximab with FOLFIRI plus bevacizumab in first-line treatment of metastatic colorectal cancer (mCRC). In October 2008, an amendment terminated the inclusion of patients with KRAS-mutated tumours. This subgroup of patients is evaluated in the present analysis, while the study is ongoing for patients with KRAS wild-type tumours. METHODS Patients were randomly assigned to FOLFIRI (Tournigand regimen) every 2 weeks plus cetuximab (400 mg/m2 day 1, followed by 250 mg/m2 weekly=arm A) or bevacizumab (5 mg/kg every 2 weeks=arm B). Among 336 randomised patients, KRAS mutation was demonstrated in 100 assessable patients. The primary study end point was objective response rate (ORR). RESULTS ORR was 44% [95% confidence interval (CI) 29% to 59%] in arm A versus 48% (95% CI, 33% to 62%) in arm B. Progression-free survival was 7.5 versus 8.9 months (hazard ratio: 1.0) and overall survival was 22.7 versus 18.7 months (hazard ratio: 0.86) in arms A versus B, respectively. CONCLUSIONS This is the first head to head comparison of cetuximab versus bevacizumab in first-line treatment of mCRC. In the present evaluation of patients with KRAS-mutated tumours, neither strategy demonstrated a clearly superior outcome.
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Braun T, Betz C, Ledderose G, Havel M, Stelter K, Kohnel T, Straus G, Waschke J, Kirchner T, Briner H, Simmen D, Caversaccio M, Wormald P, Jones N, Leunig A. Endoscopic sinus surgery training courses: benefit and problems - a multicentre evaluation to systematically improve surgical training. Rhinology 2012. [DOI: 10.4193/rhin11.266] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Modest D, Jung A, Moosmann N, Laubender R, Giessen C, Schulz C, Haas M, Neumann J, Boeck S, Kirchner T, Heinemann V, Stintzing S. The influence of KRAS and BRAF mutations on the efficacy of cetuximab-based first-line therapy of metastatic colorectal cancer: An analysis of the AIO KRK-0104-trial. Int J Cancer 2011; 131:980-6. [DOI: 10.1002/ijc.26467] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 09/14/2011] [Indexed: 11/09/2022]
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Weiler C, Schietzsch M, Kirchner T, Nerlich AG, Boos N, Wuertz K. Age-related changes in human cervical, thoracal and lumbar intervertebral disc exhibit a strong intra-individual correlation. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 21 Suppl 6:S810-8. [PMID: 21837413 DOI: 10.1007/s00586-011-1922-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 07/11/2011] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Intervertebral disc (IVD) degeneration is characterized as a multifactorial disease, in which the hereditary background is thought to be of high importance. Accordingly, one would expect all spinal levels (lumbar/cervical/thoracal) to be affected by above-average disc degeneration in genetically predisposed individuals. The aim of this study, therefore, was to analyze the amount of degenerative changes in different spine levels in humans from different ages. MATERIALS AND METHODS In detail, the presence, localization and abundance of histomorphological changes in the annulus fibrosus (AF) and nucleus pulposus (NP) in the cervical (C5/C6), thoracic (T2/T3) and lumbar (L2/L3) spine were investigated in complete autopsy IVD specimens (47 individuals) covering a complete age range (0-95 years). RESULTS Results indicate that the highest degree of histo-degenerative changes were observed in the NP in all spine levels and showed an age-related expression pattern. With regard to the different spine levels, lumbar disc specimen showed significantly more degenerative changes compared to cervical and thoracic discs, whereas no statistical difference was observed between cervical and thoracic discs. In summary, highest grades of degeneration were observed in lumbar discs (especially in the NP). Intra-individual correlations between the degeneration score in the different levels showed a significant individual concordance. CONCLUSIONS The intra-individual correlation of degenerative changes in all three examined spine regions further supports the notion that individual, i.e. genetic factors are strong predisposing factor for the development of age-related disc alterations.
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Hübener C, Delius M, Deppe C, Schulze A, Vogeser M, Kirchner T, Schubert S, Hasbargen U, Friese K. Entbindung versus Prolongation der Schwangerschaft – Bedeutung des Interleukin 6 im Fruchtwasser in der Entscheidungsfindung bei vorzeitiger Wehentätigkeit und V.a. Amnioninfektionssyndrom. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Kirchner T, Lara S. Stress and depression symptoms in patients with multiple sclerosis: the mediating role of the loss of social functioning. Acta Neurol Scand 2011; 123:407-13. [PMID: 20880067 DOI: 10.1111/j.1600-0404.2010.01422.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Depression symptoms are very frequent in patients with multiple sclerosis (MS) and have been associated with several quality of life indicators, especially physical and social functioning. The objectives were as follows: (i) to analyse the extent to which the loss of physical and social functioning may explain the depression symptoms observed in 65 Spanish patients diagnosed with MS; and (ii) to analyse the degree to which loss of social functioning may act as a mediator between depression symptoms and the stress associated with the disease. MATERIALS AND METHODS Participants were 65 Spanish patients diagnosed with MS and recruited from several MS centres and foundations. RESULTS The loss of social functioning had greater explanatory power as regards depression symptoms than did the loss of physical functions. Social functioning was also found to have an important mediating effect between MS stress and depression symptoms: specifically, more than half (52%) of the relationship between MS stress and depression symptoms was mediated by the perceived loss of social functions in Spanish patients with MS. CONCLUSION The importance of social functioning for Spanish patients with MS may have noteworthy implications when designing prevention and treatment programmes aimed at improving their quality of life.
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Stintzing S, Neumann J, Jung A, Fischer von Weikersthal L, Decker T, Vehling-Kaiser U, Jaeger E, Heintges T, Stoll C, Modest DP, Kirchner T, Scheithauer W, Heinemann V. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (mCRC): Analysis of patients with KRAS-mutated tumors in the randomized German AIO study KRK-0306. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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65
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Boeck SH, Jung A, Laubender RP, Neumann J, Egg R, Goritschan C, Vehling-Kaiser U, Winkelmann C, Fischer von Weikersthal L, Clemens MR, Gauler TC, Marten A, Klein S, Kojouharoff G, Barner M, Geissler M, Greten TF, Mansmann U, Kirchner T, Heinemann V. Molecular markers of the EGFR pathway in erlotinib-treated patients with advanced pancreatic cancer (APC): Translational analyses of a randomized, cross-over AIO phase III trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kirchner T, Munoz D, Forns M, Penarrubia J, Balasch J. Identifying by means of coping typologies and primary appraisal the likelihood of positive -hCG test results in women undergoing IVF treatment: a preliminary study. Hum Reprod 2011; 26:1138-43. [DOI: 10.1093/humrep/der028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Faber C, Horst D, Hlubek F, Kirchner T. Overexpression of Dicer predicts poor survival in colorectal cancer. Eur J Cancer 2011; 47:1414-9. [PMID: 21345667 DOI: 10.1016/j.ejca.2011.01.006] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 12/20/2010] [Accepted: 01/19/2011] [Indexed: 12/16/2022]
Abstract
AIMS The RNASE III endonuclease Dicer is one of the key enzymes of microRNA biogenesis. The influence of Dicer-expression in tumour cells on the prognosis of patients with several cancers has been studied with controversial results among different cancer types. To date no one has examined the effect of this biomarker on survival in colorectal carcinoma. Thus, we aimed to study the influence of Dicer expression on survival in colorectal cancer. METHODS We performed immunohistochemical analyses on formalin-fixed paraffin embedded (FFPE) cancer tissue with an antibody against the Dicer protein. Tumour material from 237 cases was available from patients with colorectal adeonocarcinomas with moderate differentiation (G2) and without evidence of lymph-node (N0) or distant metastasis (M0). Sixty-four cases were in T2 and 173 in T3 stages. A tissue microarray (TMA) was constructed with each tumour in triplicate. Each tumour was assigned to a scoring scale of 0-3, depending on the cytoplasmatic expression of Dicer. A Kaplan-Maier analysis was performed and the log-rank test was used for significance levels by using SPSS v.17 software. RESULTS The expression of Dicer in colorectal carcinoma shows a strong association with poor survival (cancer specific survival=CSS, p<0,001) as well as with reduced progression free survival (PFS, p<0,001). In the group with no Dicer staining there was no recorded relapse (0/15) compared with 10/18 relapses in the group with the strongest staining of Dicer. CONCLUSIONS Strong expression of the central microRNA biosynthesis enzyme Dicer predicts poor prognosis in patients with colorectal cancer. This is in line with investigations on prostate cancer. Contradictory, in breast, lung and ovary cancer Dicer has been shown to be a marker of good prognosis. Further studies on the cellular functions of Dicer need to address these issues.
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Jung A, Jaitner S, Schäffauer AJ, Kirchner T. [mRNA quantification. The next challenge in routine diagnostics]. DER PATHOLOGE 2010; 31 Suppl 2:280-4. [PMID: 20824431 DOI: 10.1007/s00292-010-1378-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The application of predictive biomarkers results in an increase in the response rates and overall survival of cancer patients. This had been shown impressively for the detection of mutations in the proto-oncogenes KRAS and EGFR for the application of anti-EGFR targeted therapies in metastatic colorectal carcinomas and non-small-cell lung cancer, respectively. This mutation detection is of a qualitative nature. In addition, predictive biomarkers are known for the use of the commonly administered chemotherapeutics 5-fluorouracil, platinum-containing complexes, and Irinotecan, which are normally identical to the targets of the therapeutic compounds. The determination of these predictive biomarkers also results in an increase in response rates and overall survival. However, this detection is done via the quantitative determination of mRNA expression levels, implying greater efforts in detection, knowledge of cut-off levels, and higher requirements for nationwide establishment.
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Kirchner T, Patiño C. Stress and depression in Latin American immigrants: the mediating role of religiosity. Eur Psychiatry 2010; 25:479-84. [PMID: 20619614 DOI: 10.1016/j.eurpsy.2010.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 04/06/2010] [Accepted: 04/09/2010] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Migrating implies a high level of stress that may destabilise immigrants' mental health. The sense of spiritual fulfilment (feelings of faith, religiosity, and transcendence beyond ordinary material life) can mitigate the stress and benefit mental health. The objective of the present study was to analyze the relationship between migratory stress, religiosity and depression symptoms, as well as the mediating role of religiosity between migratory stress and depression symptoms. METHOD Participants were 295 Latin American immigrants living in Barcelona (Spain), 186 of whom (63.1%) were women and 109 (36.9%) were men. They were recruited from a Spanish NGO by means of a consecutive-case method. RESULTS The results showed an inverse relationship between religiosity and depression symptoms, but only in women. Likewise, in women, the sense of spiritual fulfilment had mediating value in buffering the relationship between stress and depression symptoms. This mediating value of spiritual fulfilment was not observed in men. For both genders religiosity was inversely related with stress. In addition, it was observed that the sense of religiosity decreases as the time since immigration passes. CONCLUSIONS These results may be of importance in clinical practice for prevention and therapeutic intervention with Latin American immigrants. As sense of transcendence and social support from the religious community are intertwined, it is difficult to specifically attribute the observed benefit of religiosity to the former versus the later.
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Gallmeier E, Bader D, Seeliger H, Assmann G, Buchner D, de Toni E, Kirchner T, Bruns CJ, Goke B, Schäfer C. Tissue microarray analysis to evaluate the role of heat shock protein 27 as a potential biomarker in pancreatic cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e21053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jung A, Baretton GB, Dietl M, Gabbert HE, Kloor M, Kreipe H, Schlake W, Tannapfel A, Kirchner T. Success and consequences of the German quality assurance system for the molecular-pathological detection of KRAS mutations in the treatment of metastatic colorectal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pereda N, Forns M, Kirchner T, Muñoz D. Use of the Kidcope to identify socio-economically diverse Spanish school-age children's stressors and coping strategies. Child Care Health Dev 2009; 35:841-50. [PMID: 19645828 DOI: 10.1111/j.1365-2214.2009.00991.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The process by which children cope with stressful events is a very relevant topic. However, few systematic efforts have been made to design age-specific measures. METHODS This study examined problems commonly experienced by children, ages between 7 and 12 years, from two different sources: a primary school mainly enrolling families of medium socio-economic status, and an after-school social care centre from a socially and economically deprived neighbourhood. Data were obtained using the younger version of the Kidcope. RESULTS Almost 55% of the sample reported a problem related to others with no differences observed in age, gender or school group. The strategies that children considered the most effective were 'social support' (35%), 'emotional regulation' (33%) and 'wishful thinking' (32%). The children from disadvantaged backgrounds reported different problems mainly related with 'victimization and violence', 'moving house' and conflicts with 'norms and rules' and tended to use avoidant strategies to face them, which could be related to the perception of uncontrollability of these stressors. CONCLUSIONS This study reported the first descriptive results in the type of problems and coping strategies of two different social groups of Spanish children using the Kidcope. The Kidcope can be useful to screen children for coping abilities at an early age living under stressful conditions in underprivileged sectors of society.
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Mehmel H, Kirchner T, Schaarschmidt U. Pulsatives Flußmodell des Herzens zur Validierung neuer echokardiographischer Verfahren in der Regurgitationsvolumenbestimmung. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1998.43.s1.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kriegl L, Horst D, Kirchner T, Jung A. ß-Catenin binding partners TCF4 and LEF1 differ with respect to their prognostic relevance in colorectal cancer. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2009. [DOI: 10.1055/s-0029-1242276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jung A, Baretton G, Dietel M, Gabbert H, Kreipe H, Schlake W, Tannapfel A, von Knebel Döberitz M, Kirchner T. The German quality assurance system for the molecular-pathological detection of KRAS-mutations in colorectal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4018 Background: In the beginning of 2008 the EMEA (European Medicines Agency) approved with panitumumab for the first time an EGFR (epidermal growth factor receptor) targeting therapy for patients with metastatic colorectal cancer overexpressing the EGFR and showing wildtypic sequences in the KRAS gene as a predictive biomarker. Thus, the need for assuring the quality of laboratories emerged. The German Society for Pathology in cooperation with the Federation of the German Pathologist supported by an unrestricted financial grant of Amgen Germany arranged a quality assurance system (QAS). In this context two round- robin tests were carried out which results are presented here. Methods: Collection of results from two round -robin tests and their statistical analysis applying binary classification tests. Results: Test sets of 4 histological sections from ten different cases of colorectal tumors with known mutational status of the KRAS gene were prepared for the round-robin tests. The method for the mutation detection was unrestricted. A total of 74 participants from universities (44 - 59.5 %) or other institutions (30 - 40.5 %) attended the tests. 11 participants (14.8 %) failed the test (6 universities: 13.6 %, 5 institutions: 16.6 %). For the analysis didesoxy-sequencing (DDS: 55 - 66.2 %), ARMS®-PCR (8 - 10.4 %), melting-point analysis (MPA: 7 - 9.1 %), pyrosequencing (PS: 6 - 7.8 %), hybridization (HYB: 4 - 5.2 %), or SSCP (1 - 1.3 %) were used, in which some participants (3) used more than one method. It turned out that all methods employed for the testing gave similar results when comparing the rate of correct or wrong hits or the rate of false positive detection: DDS (0.92, 0.07, 0.02), ARMS®-PCR (0.91, 0.08, 0.05), MPA (0.94, 0.06, 0.04), PS (0.95, 0.05, 0.03) or HYB (0.90, 0.10, 0.08). Conclusions: The quality of the molecular-pathological detection of KRAS mutations as precondition for an EGFR targeted therapy should be tested since about 15 % of laboratories did not meet a sufficient grade. For the mutation detection no method seemed superior. [Table: see text]
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