1
|
Smolle MA, Niethard M, Schrader C, Bergovec M, Tunn PU, Friesenbichler J, Scheipl S, Leithner A. Clinical and functional outcome after partial or total claviculectomy without reconstruction for oncologic causes. J Shoulder Elbow Surg 2023; 32:1967-1971. [PMID: 37044301 DOI: 10.1016/j.jse.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/19/2023] [Accepted: 03/11/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND To achieve clear margins in rare malignant clavicular neoplasms, claviculectomy may become necessary. This study aimed to review clinical, functional, and oncologic outcomes following partial or total claviculectomy without reconstruction. METHODS This study retrospectively included 15 patients from 2 tertiary sarcoma centers (mean age, 42.6 ± 20.3 years; 66.7% male patients). The median length of clinical and oncologic follow-up was 48.0 months (interquartile range [IQR], 24.0-83.5 months). Functional follow-up (Musculoskeletal Tumor Society score and QuickDASH score [short version of the Disabilities of the Arm, Shoulder and Hand questionnaire]) was available in 9 patients at a median of 36.0 months (IQR, 20.0-100.0 months). RESULTS Of the 15 patients, 7 underwent total claviculectomy; 5, partial lateral claviculectomy; and 3, partial medial claviculectomy. No postoperative complications emerged. The median Musculoskeletal Tumor Society and QuickDASH scores at latest follow-up amounted to 26.0 points (IQR, 24.0-29.0 points) and 18.0 points (IQR, 11.0-22.0 points), respectively. Notably, scores tended to be lower in patients who underwent total claviculectomy (n = 2) in comparison to partial claviculectomy (n = 7). CONCLUSION Satisfactory clinical and functional results can be achieved following partial or total claviculectomy without reconstruction, with a low complication rate and acceptable mid- to long-term function.
Collapse
Affiliation(s)
- Maria Anna Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Maya Niethard
- Tumour Orthopaedics, HELIOS Klinikum Berlin-Buch, Berlin, Germany; Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schrader
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Marko Bergovec
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Per-Ulf Tunn
- Tumour Orthopaedics, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Joerg Friesenbichler
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Susanne Scheipl
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
| |
Collapse
|
2
|
Peterson AL, Blount TH, Foa EB, Brown LA, McLean CP, Mintz J, Schobitz RP, DeBeer BR, Mignogna J, Fina BA, Evans WR, Synett S, Hall-Clark BN, Rentz TO, Schrader C, Yarvis JS, Dondanville KA, Hansen H, Jacoby VM, Lara-Ruiz J, Straud CL, Hale WJ, Shah D, Koch LM, Gerwell KM, Young-McCaughan S, Litz BT, Meyer EC, Blankenship AE, Williamson DE, Roache JD, Javors MA, Sharrieff AFM, Niles BL, Keane TM. Massed vs Intensive Outpatient Prolonged Exposure for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2249422. [PMID: 36602803 PMCID: PMC9856757 DOI: 10.1001/jamanetworkopen.2022.49422] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Improved, efficient, and acceptable treatments are needed for combat-related posttraumatic stress disorder (PTSD). OBJECTIVE To determine the efficacy of 2 compressed prolonged exposure (PE) therapy outpatient treatments for combat-related PTSD. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted among military personnel and veterans at 4 sites in Texas from 2017 to 2019. Assessors were blinded to conditions. Data were analyzed from November 2020 to October 2022. INTERVENTIONS The interventions were massed-PE, which included 15 therapy sessions of 90 minutes each over 3 weeks, vs intensive outpatient program PE (IOP-PE), which included 15 full-day therapy sessions over 3 weeks with 8 treatment augmentations. The IOP-PE intervention was hypothesized to be superior to massed-PE. MAIN OUTCOMES AND MEASURES Coprimary outcomes included the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) (CAPS-5) and the PTSD Checklist for DSM-5 (PCL-5) administered at baseline and posttreatment follow-ups. Measures ranged from 0 to 80, with higher scores indicating greater severity. Diagnostic remission and reliable change were secondary outcomes. RESULTS Among 319 military personnel and veterans screened, 234 were randomized (mean [SD] age, 39.20 [7.72] years; 182 [78%] male participants), with 117 participants randomized to IOP-PE and 117 participants randomized to massed-PE. A total of 61 participants (26%) were African American, 58 participants (25%) were Hispanic, and 102 participants (44%) were White; 151 participants (65%) were married. Linear mixed-effects models found that CAPS-5 scores decreased in both treatment groups at the 1-month follow-up (IOP-PE: mean difference, -13.85 [95% CI, -16.47 to -11.23]; P < .001; massed-PE: mean difference, -14.13 [95% CI, -16.63 to -11.62]; P < .001). CAPS-5 change scores differed from 1- to 6-month follow-ups (mean difference, 4.44 [95% CI, 0.89 to 8.01]; P = .02). PTSD symptoms increased in massed-PE participants during follow-up (mean difference, 3.21 [95% CI, 0.65 to 5.77]; P = .01), whereas IOP-PE participants maintained treatment gains (mean difference, 1.23 [95% CI, -3.72 to 1.27]; P = .33). PCL-5 scores decreased in both groups from baseline to 1-month follow-up (IOP-PE: mean difference, -21.81 [95% CI, -25.57 to -18.04]; P < .001; massed-PE: mean difference, -19.96 [95% CI, -23.56 to -16.35]; P < .001) and were maintained at 6 months (IOP-PE: mean change, -0.21 [95% CI, -3.47 to 3.06]; P = .90; massed-PE: mean change, 3.02 [95% CI, -0.36 to 6.40]; P = .08). Both groups had notable PTSD diagnostic remission at posttreatment (IOP-PE: 48% [95% CI, 36% to 61%] of participants; massed-PE: 62% [95% CI, 51% to 73%] of participants), which was maintained at 6 months (IOP-PE: 53% [95% CI, 40% to 66%] of participants; massed-PE: 52% [95% CI, 38% to 66%] of participants). Most participants demonstrated reliable change on the CAPS-5 (61% [95% CI, 52% to 69%] of participants) and the PCL-5 (74% [95% CI, 66% to 81%] of participants) at the 1-month follow-up. CONCLUSIONS AND RELEVANCE These findings suggest that PE can be adapted into compressed treatment formats that effectively reduce PTSD symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03529435.
Collapse
Affiliation(s)
- Alan L. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
- Department of Psychology, University of Texas at San Antonio, San Antonio
| | - Tabatha H. Blount
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Edna B. Foa
- Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Lily A. Brown
- Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Carmen P. McLean
- Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Jim Mintz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Richard P. Schobitz
- Department of Behavioral Health, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas
| | - Bryann R. DeBeer
- VISN-17 Center of Excellence for Returning War Veterans, Central Texas Veterans Health Care System, Waco
- Rocky Mountain Mental Illness Research Education and Clinical Center for Suicide Prevention, Department of Veterans Affairs, Aurora, Colorado
| | - Joseph Mignogna
- VISN-17 Center of Excellence for Returning War Veterans, Central Texas Veterans Health Care System, Waco
- Rocky Mountain Mental Illness Research Education and Clinical Center for Suicide Prevention, Department of Veterans Affairs, Aurora, Colorado
| | - Brooke A. Fina
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Wyatt R. Evans
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Samantha Synett
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- VISN-17 Center of Excellence for Returning War Veterans, Central Texas Veterans Health Care System, Waco
- Rocky Mountain Mental Illness Research Education and Clinical Center for Suicide Prevention, Department of Veterans Affairs, Aurora, Colorado
| | - Brittany N. Hall-Clark
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Timothy O. Rentz
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
| | - Christian Schrader
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | - Jeffrey S. Yarvis
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, Texas
- School of Social Work, Tulane University, New Orleans, Louisiana
| | - Katherine A. Dondanville
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Hunter Hansen
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Vanessa M. Jacoby
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Jose Lara-Ruiz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Department of Psychology, University of Texas at San Antonio, San Antonio
| | - Casey L. Straud
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
- Department of Psychology, University of Texas at San Antonio, San Antonio
| | - Willie J. Hale
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Department of Psychology, University of Texas at San Antonio, San Antonio
| | - Dhiya Shah
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
| | - Lauren M. Koch
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Kelsi M. Gerwell
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
| | - Brett T. Litz
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Psychological and Brain Sciences, School of Arts and Sciences, Boston University, Boston, Massachusetts
| | - Eric C. Meyer
- VISN-17 Center of Excellence for Returning War Veterans, Central Texas Veterans Health Care System, Waco
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Abby E. Blankenship
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Douglas E. Williamson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
- Durham VA Health Care System, Durham, North Carolina
| | - John D. Roache
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio
| | - Martin A. Javors
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio
| | - Allah-Fard M. Sharrieff
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, Texas
- Department of Homeland Security, Miami, Florida
| | - Barbara L. Niles
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
| | - Terence M. Keane
- Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
| |
Collapse
|
3
|
Schrader C, Ross A. A Review of PTSD and Current Treatment Strategies. Mo Med 2021; 118:546-551. [PMID: 34924624 PMCID: PMC8672952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Current treatment strategies for control of trauma-associated symptoms of Post Traumatic Stress Disorder (PTSD) have recently been updated by the Veterans Affairs (VA) and the Department of Defense (DoD, after over a decade of dedicated research. The most recent evidence is compelling that its use of trauma-focused therapies such as Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), Eye Movement, Desensitization, and Restructuring (EMDR), and others with significant trauma focus are the current gold standard for treatment. Additional medication use may be of assistance in treatment of symptomology, with special avoidance of benzodiazepines or other sedative hypnotic medications which are causal of increased intrusive and dissociative symptoms over time.
Collapse
Affiliation(s)
- Christian Schrader
- Carl R. Darnall Army Medical Center Psychiatry Residency, Fort Hood, Texas
| | - Abigail Ross
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York
| |
Collapse
|
4
|
Hendricks A, Gieseler F, Nazzal S, Bräsen JH, Lucius R, Sipos B, Claasen JH, Becker T, Hinz S, Burmeister G, Schafmayer C, Schrader C. Prognostic relevance of topoisomerase II α and minichromosome maintenance protein 6 expression in colorectal cancer. BMC Cancer 2019; 19:429. [PMID: 31072339 PMCID: PMC6507179 DOI: 10.1186/s12885-019-5631-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite rising incidence rates of colorectal malignancies, only a few prognostic tools have been implemented in proven clinical routine. Cell division and proliferation play a significant role in malignancies. In terms of colorectal cancer, the impact of proliferation associated proteins is controversially debated. The aim of our study was to examine the expression of topoisomerase II α and minichromosome maintenance protein 6 and to correlate these findings with the clinical data. METHODS Tissue samples of 619 patients in total were stained using the antibodies Ki-S4 and Ki-MCM6 targeting topoisomerase II α as well as minichromosome maintenance protein 6. The median rate of proliferation was correlated with clinical and follow up data. RESULTS The expression rate of minichromosome maintenance protein 6 is significantly higher than the proportion of topoisomerase II α in tumour cells (p < 0.001). A high expression of both proteins coincides with a beneficial outcome for the patient, indicating a favourable prognostic marker (p < 0.001 and p = 0.008). CONCLUSIONS We have demonstrated that high expression rates of proliferative markers is linked to a beneficial patient outcome. According to the general opinion, a high expression rate correlates with a poor patient outcome. In this study, we were able to refute this assertion.
Collapse
Affiliation(s)
- A Hendricks
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Hs. 18, 24105, Kiel, Germany.
| | - F Gieseler
- First Department of Medicine, UKSH, Campus Lübeck, Lübeck, Germany
| | - S Nazzal
- Department of Medicine, Baruch Padeh Poria Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Tiberias, Lower Galilee, Israel
| | - J H Bräsen
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - R Lucius
- Institute of Anatomy, University of Kiel, Kiel, Germany
| | - B Sipos
- Institute of Pathology, University of Tübingen, Tübingen, Germany
| | - J H Claasen
- Clinic of Forensic Psychiatry Nette-Gut, Weißenthurm, Germany
| | - Th Becker
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Hs. 18, 24105, Kiel, Germany
| | - S Hinz
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Hs. 18, 24105, Kiel, Germany
| | - G Burmeister
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Hs. 18, 24105, Kiel, Germany
| | - C Schafmayer
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Hs. 18, 24105, Kiel, Germany
| | | |
Collapse
|
5
|
Dressler D, Ebke M, Adib Saberi F, Schrader C. Botulinum toxin therapy in patients with oral anticoagulation: is it safe? Toxicon 2018. [DOI: 10.1016/j.toxicon.2018.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Schrader C, Lenton A, Gertonson P, Rahimi A. Redeveloping Substance Abuse Treatment for Military Personnel. Curr Psychiatry Rep 2018; 20:45. [PMID: 29779198 DOI: 10.1007/s11920-018-0911-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW We review the prevailing evidence surrounding treatment of substance use disorder (SUD), with specific focus on alcohol, tobacco, and prescription opiates, and how it informs guidelines for treating active duty military. We survey the evidence regarding preventive screening, treatment, and relapse prevention in substance misuse as it pertains to patient-centered care of the service member. RECENT FINDINGS Holistic, patient-centered care with an emphasis on identifying maladaptive use or dependence prior to progression to chronic disease is now recognized as the evidenced approach to treating substance use disorders. Early patient-guided intervention with combined behavioral and pharmacologic therapies leads to better outcomes, including greater functional status, lower relapse rates, and decreased rate of psychiatric and other comorbidities. The military has prioritized a patient-centered approach to screening, assessing, and treating SUD. Recent guideline updates represent a progressive, patient-centered approach in delivering unprecedented access to care, serving as a positive example in treating what is widely accepted as one of the country's most pressing public health concerns.
Collapse
Affiliation(s)
- Christian Schrader
- Psychiatry Residency, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA.
| | - Antoinette Lenton
- Psychiatry Residency, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA
| | - Peter Gertonson
- Psychiatry Residency, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA
| | - Alexander Rahimi
- Psychiatry Residency, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96859, USA
| |
Collapse
|
7
|
Mohr A, Heiss C, Bergmann I, Schrader C, Roemer FW, Lynch JA, Muhle C, Genant HK, Heller M. Value of micro-CT as an investigative tool for osteochondritis dissecans: A preliminary study with comparison to histology. Acta Radiol 2016; 44:532-7. [PMID: 14510761 DOI: 10.1080/j.1600-0455.2003.00113.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To evaluate micro computed tomography (micro-CT) for the assessment of osteochondritis dissecans in comparison with histology. Material and Methods: Osteochondritis dissecans lesions of 3 patients were evaluated using micro-CT (0.125 mA, 40 keV, 60 μm slice thickness, 60 μm isotropic resolution, entire sample) and light microscopy (toluidine blue, 3–5 μm slice thickness). The methods were compared regarding preparation time, detectability of tissue types and morphologic features of bone and cartilage. Results: Non-destructive micro-CT imaging of the entire sample was faster than histologic preparation of a single slice for light microscopy. Morphologic features of bone and cartilage could be imaged in a comparable way to histology. It was not possible to image cells or different tissue types of bone and cartilage with micro-CT. Conclusion: Micro-CT is a fast, non-destructive tool that may be a supplement or, if detailed histologic information is not necessary, an alternative to light microscopy for the investigation of osteochondritis dissecans.
Collapse
Affiliation(s)
- A Mohr
- Department of Diagnostic Radiology, Christian-Albrechts-University, Kiel, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Germanov G, Eder F, Schrader C. Ektopisches Schilddrüsengewebe im Ligamentum hepatoduodenale – laparoskopische Entfernung. Ein Fallbericht. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1586299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Südmeyer M, Ebersbach G, Holtmann M, Jost W, Odin P, Schrader C, Winkler C. [Practical Use of the Levodopa Pump]. Fortschr Neurol Psychiatr 2016; 84:404-10. [PMID: 27471998 DOI: 10.1055/s-0042-104503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Patients with advanced Parkinson's disease and motor complications undergoing optimized oral therapy can significantly benefit from continuous intrajejunal levodopa/carbidopa infusion applied by means of a medication pump. However, this requires a correctly positioned PEG-J tube and finely adjusted pump settings. Although this method is a routine procedure in specialist centers, no standard procedure has been defined up to now. For this reason, an expert recommendation regarding the practical application has been developed in order to standardize the procedure and facilitate patient access to this treatment option.
Collapse
Affiliation(s)
- M Südmeyer
- Heinrich-Heine-Universität, Medizinische Fakultät, Neurologische Klinik
| | - G Ebersbach
- Neurologisches Fachkrankenhaus für Bewegungsstörungen/Parkinson, Kliniken Beelitz
| | - M Holtmann
- Medizinische Klinik I, Klinikum Bremerhaven Reinkenheide
| | - W Jost
- Parkinson-Klinik Ortenau, Wolfach
| | - P Odin
- Neurologische Klinik, Klinikum Bremerhaven Reinkenheide
| | - C Schrader
- Klinik für Neurologie, Medizinische Hochschule Hannover
| | - C Winkler
- Klinik für Neurologie, Krankenhaus Lindenbrunn, Coppenbrügge
| |
Collapse
|
10
|
Lingor P, Csoti I, Koschel J, Schrader C, Winkler C, Wolz M, Reichmann H. Der geriatrische Parkinson-Patient – eine neurologische Herausforderung. Fortschr Neurol Psychiatr 2016; 84 Suppl 1:S41-7. [DOI: 10.1055/s-0042-103585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- P. Lingor
- Klinik für Neurologie, Universitätsmedizin Göttingen
| | - I. Csoti
- Gertrudis Klinik, Parkinson-Zentrum, Leun-Biskirchen
| | | | - C. Schrader
- Neurologische Klinik mit klinischer Neurophysiologie, Medizinische Hochschule Hannover
| | - C. Winkler
- Neurologische Klinik, Krankenhaus Lindenbrunn, Coppenbrügge
| | - M. Wolz
- Klinik für Neurologie und Geriatrie, ELBLANDKLINIKEN Meißen GmbH und Co KG, ELBLANDKLINIKUM Meißen, Meißen
| | | |
Collapse
|
11
|
Schielke A, Ibrahim V, Czogiel I, Faber M, Schrader C, Dremsek P, Ulrich RG, Johne R. Hepatitis E virus antibody prevalence in hunters from a district in Central Germany, 2013: a cross-sectional study providing evidence for the benefit of protective gloves during disembowelling of wild boars. BMC Infect Dis 2015; 15:440. [PMID: 26493830 PMCID: PMC4619084 DOI: 10.1186/s12879-015-1199-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 10/09/2015] [Indexed: 12/23/2022] Open
Abstract
Background In Germany, 17 % of the general human population have antibodies to hepatitis E virus (HEV) (recomLine HEV-IgG/IgM immunoassay [Mikrogen GmbH]). Wild boars represent an animal reservoir for HEV genotype 3, which is the common genotype in Germany. We estimated the seroprevalence among hunters with contact to wild boars to identify factors that may be associated with past or present HEV infection. Methods In 2013, the local veterinarian authority in a district in Central Germany attended meetings of hunters who provided blood specimens and completed a questionnaire collecting information on age, sex, hunting-related activities and consumption of wild boar meat. Specimens of wild boars were taken during drive hunts in this district during the season 2012/2013. All specimens were tested for HEV RNA and anti-HEV IgM and IgG antibodies. Log-binomial regression was used to estimate prevalence ratios (PR) for the hunters. Results Of 126 hunters (median age 55; 94 % male) 21 % tested positive for anti-HEV IgG antibodies (95 % confidence interval [CI] 13–28 %) (recomWell HEV IgG assay [Mikrogen GmbH]). Anti-HEV prevalence was highest in the age group of the 70–79-year-olds (67 %; 95 % CI 39–95 %). Wild boars showed an average anti-HEV prevalence of 41 %. HEV RNA was detected in 4/22 (18 %) liver specimens and in 1/22 (4.5 %) muscle specimens. Most wild boars were tested positive for HEV RNA (3/10; 30 %) and HEV-specific antibodies (7/15; 47 %) in the southwestern part of the district. Hunters preferring this hunting ground had a lower anti-HEV prevalence when gloves were frequently used during disembowelling of wild boars compared to hunters using gloves never or infrequently (age-adjusted PR 0.12; 95 % CI 0.02–0.86). Conclusions Hunters may benefit from wearing gloves when in contact with blood or body fluids of HEV animal reservoirs. Anti-HEV prevalence among the hunters of this study did not significantly differ from that of the general population suggesting that other factors play a major role in the epidemiology of HEV in Germany. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1199-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- A Schielke
- Robert Koch Institute (RKI), Berlin, Germany. .,Postgraduate Training for Applied Epidemiology (PAE, German Field Epidemiology Training Programme), Robert Koch Institute, Berlin, Germany. .,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - V Ibrahim
- Local Authority Wetteraukreis, Friedberg, Germany.
| | - I Czogiel
- Robert Koch Institute (RKI), Berlin, Germany.
| | - M Faber
- Robert Koch Institute (RKI), Berlin, Germany.
| | - C Schrader
- Federal Institute for Risk Assessment (BfR), Berlin, Germany.
| | - P Dremsek
- Friedrich-Loeffler-Institut (FLI), Institute for Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany.
| | - R G Ulrich
- Friedrich-Loeffler-Institut (FLI), Institute for Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany.
| | - R Johne
- Federal Institute for Risk Assessment (BfR), Berlin, Germany.
| |
Collapse
|
12
|
Dierke H, Fischer M, Schrader C, Nitsche JE, Abd-Elmageed AE, Tutsch R. Bestimmung der Auslenkung von Mikrotastern mit optischen Methoden. tm - Technisches Messen 2014; 81:305-315. [DOI: 10.1515/teme-2014-0401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Zusammenfassung
Zur Verringerung des Aufwands bei der Erfassung mikromechanischer Merkmale mit taktilen Messgeräten werden mehrere in einem Array angeordnete Taststifte benutzt, um mehrere gleichartige, auf einem Wafer angeordnete, Strukturen gleichzeitig zu messen. Normalerweise erfolgt das Auslesen des Sensorsignals elektrisch. In den hier beschriebenen Untersuchungen wurden verschiedene optische Methoden verwendet, um die spiegelnde Rückseite des Tasterarrays zu beobachten und die Auslenkung der Taststifte simultan zu detektieren. Dazu wurden ein Hartmann-Shack-Wellenfrontsensor sowie die Auswertung über Streifenprojektionsverfahren genutzt. In beiden Fällen führt eine Auslenkung der Taststifte zu einer Deformation der spiegelnden Rückseite des Tasterarrays und damit zu einer sichtbaren Veränderung im optischen Signal. Durch Vergleich mit einem Bild des unverformten Arrays als Referenz kann die Auslenkung der Taststifte bestimmt werden.
Collapse
|
13
|
Dressler D, Saberi FA, Kollewe K, Schrader C. Safety aspects of incobotulinumtoxinA high dose therapy. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Wegner F, Nabavi E, Wilke F, Ben Tayeb S, Boeck AL, Trebst C, Stangel M, Voss E, Schrader C, Ahrens J, Leffler A, Rodriguez-Raecke R, Dengler R, Geworski L, Bengel F, Berding G. Anti-LGI1 and anti-NMDA receptor encephalitis show distinct patterns of brain glucose metabolism in FDG-PET. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
15
|
Camara-Clayette V, Lecluse Y, Schrader C, Klapper W, Vainchenker W, Hermine O, Ribrag V. The NF-κB pathway is rarely spontaneously activated in mantle cell lymphoma (MCL) cell lines and patient's samples. Eur J Cancer 2013; 50:159-69. [PMID: 24135685 DOI: 10.1016/j.ejca.2013.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 09/15/2013] [Accepted: 09/16/2013] [Indexed: 12/22/2022]
Abstract
In this study, we investigated the role of NF-κB (canonical and alternative pathways) in the survival or proliferation of mantle cell lymphoma (MCL) cell lines. P50/p65 complexes were detectable by EMSA assays in 4/5 cell lines. Stable expression of a dominant-negative form of IkBa had no effect on proliferation nor on apoptosis in EBV-negative cell lines. Three out of 4 of the cell lines tested exhibited Phospho-p65 (Ser(536)). The alternative NF-κB pathway was not activated in 4/5 cell lines tested. Patient samples were also studied by Western blot, EMSA and Immunohistochemistry (IHC). No p50/p65 complexes were detected in cells freshly collected from 7 patients, but 1/7 cells exhibited Phospho-p65 (Ser(536)). We investigated immunohistochemically, the expression of NF-κB in 86 patients enrolled in two multicentre prospective trials. Patients with MCL exhibiting negative or positive cytoplasmic expression of NF-κB had a median overall survival of 35.7months compared to 22.4months for patients with nuclear NF-κB expression (p=0.0193). All these data suggest that NF-κB does not play a key role in proliferation and apoptotic processes in MCL cell lines. In patient samples, the presence of p65 in the nucleus reflecting NF-κB activation is rare but associated with a poor outcome.
Collapse
Affiliation(s)
- V Camara-Clayette
- Gustave Roussy Institut, Institut National de la Santé et de la Recherche Médicale (INSERM) unité (U) 1009, Université Paris Sud, Villejuif, France
| | - Y Lecluse
- Imaging and Cytometry Platform, Gustave Roussy Institut, Villejuif, France
| | - C Schrader
- Department of Internal Medicine and Hematology, University Hospitals of Schleswig-Holstein, Campus Kiel, Germany
| | - W Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel, Germany
| | - W Vainchenker
- Gustave Roussy Institut, Institut National de la Santé et de la Recherche Médicale (INSERM) unité (U) 1009, Université Paris Sud, Villejuif, France
| | - O Hermine
- Centre National de la Recherche Scientifique (CNRS) UMR 8147, Hôpital Necker, Paris, France; Service d'Hématologie, Hôpital Necker, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - V Ribrag
- Gustave Roussy Institut, Institut National de la Santé et de la Recherche Médicale (INSERM) unité (U) 1009, Université Paris Sud, Villejuif, France; Département de Médecine, Gustave Roussy Institut, Villejuif, France.
| |
Collapse
|
16
|
Schrader C, Tacik P, Ebke M, Dressler D. Botulinum toxin therapy in the presence of anticoagulation: Hematoma frequency. Toxicon 2013. [DOI: 10.1016/j.toxicon.2012.07.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
17
|
Rustamov N, Rodriguez-Raecke R, Kopp B, Timm L, Dengler R, Schrader C, Tacik P, Dressler D, Matthias W. The conflict adaptation effect in Parkinson's disease: a study with EEG. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
18
|
Heldmann M, Ye Z, Milenkova M, Mohhamadi B, Kollewe K, Schrader C, Dengler R, Samii A, Fellbrich A, Münte T. Dopamine agonists modulate the neural network of reward anticipation in Parkinson's disease patients. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
19
|
Zankovych S, Diefenbeck M, Bossert J, Mückley T, Schrader C, Schmidt J, Schubert H, Bischoff S, Faucon M, Finger U, Jandt KD. The effect of polyelectrolyte multilayer coated titanium alloy surfaces on implant anchorage in rats. Acta Biomater 2013; 9:4926-34. [PMID: 22902814 DOI: 10.1016/j.actbio.2012.08.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/11/2012] [Accepted: 08/08/2012] [Indexed: 02/04/2023]
Abstract
Advances have been achieved in the design and biomechanical performance of orthopedic implants in the last decades. These include anatomically shaped and angle-stable implants for fracture fixation or improved biomaterials (e.g. ultra-high-molecular-weight polyethylene) in total joint arthroplasty. Future modifications need to address the biological function of implant surfaces. Functionalized surfaces can promote or reduce osseointegration, avoid implant-related infections or reduce osteoporotic bone loss. To this end, polyelectrolyte multilayer structures have been developed as functional coatings and intensively tested in vitro previously. Nevertheless, only a few studies address the effect of polyelectrolyte multilayer coatings of biomaterials in vivo. The aim of the present work is to evaluate the effect of polyelectrolyte coatings of titanium alloy implants on implant anchorage in an animal model. We test the hypotheses that (1) polyelectrolyte multilayers have an effect on osseointegration in vivo; (2) multilayers of chitosan/hyaluronic acid decrease osteoblast proliferation compared to native titanium alloy, and hence reduce osseointegration; (3) multilayers of chitosan/gelatine increase osteoblast proliferation compared to native titanium alloy, hence enhance osseointegration. Polyelectrolyte multilayers on titanium alloy implants were fabricated by a layer-by-layer self-assembly process. Titanium alloy (Ti) implants were alternately dipped into gelatine (Gel), hyaluronic acid (HA) and chitosan (Chi) solutions, thus assembling a Chi/Gel and a Chi/HA coating with a terminating layer of Gel or HA, respectively. A rat tibial model with bilateral placement of titanium alloy implants was employed to analyze the bones' response to polyelectrolyte surfaces in vivo. 48 rats were randomly assigned to three groups of implants: (1) native titanium alloy (control), (2) Chi/Gel and (3) Chi/HA coating. Mechanical fixation, peri-implant bone area and bone contact were evaluated by pull-out tests and histology at 3 and 8 weeks. Shear strength at 8 weeks was statistically significantly increased (p<0.05) in both Chi/Gel and Chi/HA groups compared to the titanium alloy control. No statistically significant difference (p>0.05) in bone contact or bone area was found between all groups. No decrease of osseointegration of Chi/HA-coated implants compared to non-coated implants was found. The results of polyelectrolyte coatings in a rat model showed that the Chi/Gel and Chi/HA coatings have a positive effect on mechanical implant anchorage in normal bone.
Collapse
|
20
|
Dierke H, Fischer M, Abd-Elmageed A, Nitsche J, Schrader C, Tutsch R. Detection of the displacement of micro touch probes using structured illumination. 2012 International Symposium on Optomechatronic Technologies (ISOT 2012) 2012. [DOI: 10.1109/isot.2012.6403263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
21
|
Schrader C, Schielke A, Ellerbroek L, Johne R. PCR inhibitors - occurrence, properties and removal. J Appl Microbiol 2012; 113:1014-26. [PMID: 22747964 DOI: 10.1111/j.1365-2672.2012.05384.x] [Citation(s) in RCA: 1063] [Impact Index Per Article: 88.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 06/14/2012] [Accepted: 06/27/2012] [Indexed: 12/21/2022]
Abstract
The polymerase chain reaction (PCR) is increasingly used as the standard method for detection and characterization of microorganisms and genetic markers in a variety of sample types. However, the method is prone to inhibiting substances, which may be present in the analysed sample and which may affect the sensitivity of the assay or even lead to false-negative results. The PCR inhibitors represent a diverse group of substances with different properties and mechanisms of action. Some of them are predominantly found in specific types of samples thus necessitating matrix-specific protocols for preparation of nucleic acids before PCR. A variety of protocols have been developed to remove the PCR inhibitors. This review focuses on the general properties of PCR inhibitors and their occurrence in specific matrices. Strategies for their removal from the sample and for quality control by assessing their influence on the individual PCR test are presented and discussed.
Collapse
Affiliation(s)
- C Schrader
- Food Hygiene and Safety Concepts, Federal Institute for Risk Assessment, Berlin, Germany
| | | | | | | |
Collapse
|
22
|
Schrader C, Rimbach G. Determinants of paraoxonase 1 status: genes, drugs and nutrition. Curr Med Chem 2012; 18:5624-43. [PMID: 22172068 DOI: 10.2174/092986711798347216] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 11/22/2022]
Abstract
Paraoxonase 1 (PON1) is an enzyme which is mainly synthesized in the liver. PON1 circulates in the blood bound to HDL and delays or prevents the oxidation of LDL. Single nucleotide polymorphisms significantly determine PON1 status in humans. A high PON1 status may be associated with a reduced cardiovascular disease risk. By using in silico databases we suggest various transcription factors and micro RNA as putative regulators of PON1. Furthermore we predict functional partners of PON1 by using a text mining tool. Beside genetic and life style factors PON1 status may be determined by drugs (e.g., statins, fibrates) and dietary factors. Dietary modulators of PON1 status include fat and fatty acids, antioxidant vitamins (e.g. ascorbic acid, tocopherol), polyphenols and polyphenol-rich foods.
Collapse
Affiliation(s)
- C Schrader
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universtiy of Kiel, Hermann-Rodewald-Straße 6, 24118 Kiel, Germany
| | | |
Collapse
|
23
|
Schrader C, Stingele R, Brück W, Metz I, Riedel C, Schub N, Valerius T, Deuschl G, Gramatzki M, Günther A. 9229 POSTER Severe Central Nervous System (CNS) Graft Versus Host Disease (GVHD) in a Patient Without Any Other GvHD Symptoms After Allogeneic Stem Cell Transplantation. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72494-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Schrader C, Capelle HH, Kinfe TM, Blahak C, Bäzner H, Lütjens G, Dressler D, Krauss JK. GPi-DBS may induce a hypokinetic gait disorder with freezing of gait in patients with dystonia. Neurology 2011; 77:483-8. [PMID: 21775741 DOI: 10.1212/wnl.0b013e318227b19e] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Stimulation-induced hypokinetic gait disorders with freezing of gait (FOG) have been reported only recently as adverse effects of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in patients with dystonia. The aim of this work was to determine the frequency and the nature of this GPi-DBS-induced phenomenon. METHODS We retrospectively screened our database of patients with dystonia who underwent DBS. Patients with focal, segmental, or generalized dystonia of primary or tardive origin and no gait disorder due to lower limb dystonia before DBS, bilateral pallidal stimulation, and a follow-up for more than 6 months were included. Reports of adverse events were analyzed, and gait abnormalities were scored by comparing preoperative and postoperative video recordings using Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) items 3.10 (gait) and 3.11 (FOG). To assess the role of GPi-DBS in gait abnormalities, DBS was paused for 24 hours. Gait and FOG were assessed 30 minutes, 2 hours, and 24 hours after restarting DBS. Finally, a standardized adjustment algorithm was performed trying to eliminate the gait disorder. RESULTS Of a collective of 71 patients with dystonia, 6 presented with a new gait disorder (8.5%; 2 men, 4 women, mean age 61.3 years [48-69 years], 2 craniocervical, 1 DYT-1 segmental, 1 truncal, 2 tardive dystonia). GPi-DBS improved Burke-Fahn-Marsden Dystonia Rating Scale motor score by 54% and disability score by 52%. MDS-UPDRS item 3.10 worsened from 0.5 (±0.8) to 2.0 (±0.9) and item 3.11 from 0 to 2.5 (±0.5). The gait disorder displayed shuffling steps and difficulties with gait initiation and turning. Increasing voltages improved dystonia but triggered FOG, sometimes worsening over a period of a few hours. It vanished within minutes after ceasing DBS. Electrode misplacement was ruled out. In all but one patient, no optimal configuration was found despite extensive testing of settings (monopolar, bipolar, pulse width 60-210 μs, frequency 60-180 Hz). Nevertheless, a compromise between optimal stimulation for dystonia and eliciting FOG was achieved in each case. CONCLUSIONS A hypokinetic gait disorder with FOG can be a complication of GPi-DBS.
Collapse
Affiliation(s)
- C Schrader
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Hannover, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Diefenbeck M, Mückley T, Zankovych S, Bossert J, Jandt KD, Schrader C, Schmidt J, Finger U, Faucon M. Freezing of rat tibiae at -20°c does not affect the mechanical properties of intramedullary bone/implant-interface: brief report. Open Orthop J 2011; 5:219-22. [PMID: 21760868 PMCID: PMC3134982 DOI: 10.2174/1874325001105010219] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 05/06/2011] [Accepted: 05/09/2011] [Indexed: 11/22/2022] Open
Abstract
Background: The effects of freezing-thawing cycles on intramedullary bone-implant interfaces have been studied in a rat model in mechanical pull-out tests. Implants: Twenty TiAl6V4 rods (Ø 0.8 mm, length 10 mm) implanted in rat tibiae Methods: 10 rats underwent bilateral tibial implantation of titanium rods. At eight weeks, the animals were sacrificed and tibiae harvested for biomechanical testing. Eight tibiae were frozen and stored at -20°C for 14 days, the remaining eight were evaluated immediately post-harvest. Pull-out tests were used to determine maximum force and interfacial shear strength. Results: There were no significant differences between fresh and those of the frozen-thawed group in maximum force or in interfacial shear strength. Conclusion: Frozen Storage of rat tibiae containing implants at -20° C has no effects on the biomechanical properties of Bone/ Implant interface.
Collapse
Affiliation(s)
- Michael Diefenbeck
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena, Erlanger Allee 101, D-07747 Jena, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Schrader C, Böselt S, Wedemeyer J, Dressler D, Weismüller TJ. Asparagus and jejunal-through-PEG: an unhappy encounter in intrajejunal levodopa infusion therapy. Parkinsonism Relat Disord 2010; 17:67-9. [PMID: 20933456 DOI: 10.1016/j.parkreldis.2010.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 08/30/2010] [Accepted: 09/13/2010] [Indexed: 11/24/2022]
|
27
|
Boesch-Saadatmandi C, Egert S, Schrader C, Coumoul X, Barouki R, Muller MJ, Wolffram S, Rimbach G. Effect of quercetin on paraoxonase 1 activity--studies in cultured cells, mice and humans. J Physiol Pharmacol 2010; 61:99-105. [PMID: 20228421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 01/12/2010] [Indexed: 05/28/2023]
Abstract
There is increasing evidence that the HDL-associated enzyme paraoxonase 1 (PON1) may have a protective function in the atherosclerotic process. An enhancement of PON1 activity by dietary factors including flavonoids is therefore of interest. Quercetin, a flavonol frequently present in fruits and vegetables has been shown to induce PON1 in cultured liver cells, but the in vivo efficacy of a dietary quercetin supplementation has yet not been evaluated. To this end, we fed laboratory mice quercetin-enriched diets with quercetin concentrations ranging from 0.05 to 2 mg/g diet for 6 weeks and determined the expression of the hepatic PON1 gene and its protein levels. Since we could establish a moderate but significant induction of PON1 mRNA levels by dietary quercetin in mice, we aimed to proof whether healthy human volunteers, given graded supplementary quercetin (50, 100 or 150 mg/day) for two weeks, would respond with likewise enhanced plasma paraoxonase activities. However, PON1 activity towards phenylacetate and paraoxon was not changed following quercetin supplementation in humans. Differences between mice and humans regarding the PON1 inducing activity of quercetin may be related to differences in quercetin metabolism. In mice, unlike in humans, a large proportion of quercetin is methylated to isorhamnetin which exhibits, according to our reporter gene data in cultured liver cells, a potent PON1 inducing activity.
Collapse
Affiliation(s)
- C Boesch-Saadatmandi
- Institute of Human Nutrition and Food Science, Christian Albrechts University Kiel, Kiel, Germany
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Sixel-Döring F, Benecke R, Fogel W, Hilker R, Kupsch A, Lange M, Schrader C, Timmermann L, Volkmann J, Deuschl G. Tiefe Hirnstimulation bei essenziellem Tremor. Nervenarzt 2009; 80:662-5. [DOI: 10.1007/s00115-009-2703-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
29
|
Hilker R, Benecke R, Deuschl G, Fogel W, Kupsch A, Schrader C, Sixel-Döring F, Timmermann L, Volkmann J, Lange M. Tiefe Hirnstimulation bei idiopathischem Parkinson-Syndrom. Nervenarzt 2009; 80:646-55. [DOI: 10.1007/s00115-009-2695-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
30
|
Schrader C, Siggelkow S, Rollnik J, Kossev A. Gestörte Propriozeption bei amyotropher Lateralsklerose – Eine Studie mit Muskelvibration und transkranieller Magnetstimulation. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0028-1112111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
31
|
Schrader C, Peschel T, Kossev A. Verarbeitung von propriozeptiver Information beim idiopathischen Parkinson-Syndrom und der Einfluss von Levodopa. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-0028-1086015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
32
|
Kamm C, Fischer H, Garavaglia B, Kullmann S, Sharma M, Schrader C, Grundmann K, Klein C, Borggrafe I, Lobsien E, Kupsch A, Nardocci N, Gasser T. SUSCEPTIBILITY TO DYT1 DYSTONIA IN EUROPEAN PATIENTS IS MODIFIED BY THE D216H POLYMORPHISM. Neurology 2008; 70:2261-2. [DOI: 10.1212/01.wnl.0000313838.05734.8a] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
33
|
Schrader C, Peschel T, Däuper J, Rollnik J, Dengler R, Kossev A. Changes in processing of proprioceptive information in Parkinson’s disease and multiple system atrophy. Clin Neurophysiol 2008; 119:1139-46. [DOI: 10.1016/j.clinph.2008.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 12/29/2007] [Accepted: 01/10/2008] [Indexed: 10/22/2022]
|
34
|
Grosskreutz J, Bullermann A, Schrader C, Dengler R, Peschel T. Quantitative Untersuchungen zur Feinmotorik von Parkinson-Patienten mittels MIDI-Technologie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
35
|
Schrader C, Ziegenbein M, Garlipp P. Diagnostisches Dilemma – Hashimoto-Enzephephalopathie, Opiodpsychose oder wahnhafte Depression. Akt Neurol 2007. [DOI: 10.1055/s-2007-987691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
36
|
Winkler C, Schrader C, Dengler R. Continuous jejunal levodopa infusion improves motor function and reduces fluctuations in patients with advanced Parkinson's disease. Akt Neurol 2007. [DOI: 10.1055/s-2007-987891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
37
|
Lingenauber A, Schrader C, Grolle B, von der Wense A. Akute demyelinisierende Encephalomyelitis (ADEM) – eine Kasuistik. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Bogdanova D, Kossev A, Schrader C, Krampfl K, Rollnik J, Dengler R. Nachweis der kortikospinalen Schädigung bei multipler Systematrophie mit der Tripel-Stimulations-Technik. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-951933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
39
|
Teymoortash A, Schrader C, Shimoda H, Kato S, Werner JA. Evidence of lymphangiogenesis in Warthin's tumor of the parotid gland. Oral Oncol 2006; 43:614-8. [PMID: 16996778 DOI: 10.1016/j.oraloncology.2006.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 07/25/2006] [Accepted: 07/27/2006] [Indexed: 12/13/2022]
Abstract
The details of the pathogenesis of cystadenolymphoma (Warthin's tumor) of the parotid gland are still unclear. Neovascularization is considered to be a pivotal factor for solid tumor progression and biological behavior of the tumor. Using double-labeling immunohistochemistry for LYVE-1 and CD34 (specific markers for lymphatic and vascular endothelial cells, respectively) this study analyzes lymphatic vessel density (LVD) and blood vessel density (BVD) in 10 Warthin's tumors and 10 pleomorphic adenomas of the parotid gland as well as in 5 normal parotid glands and 5 normal parotid lymph nodes. There was no significant difference in the intratumoral LVD and BVD among pleomorphic adenoma and normal parotid gland tissue. In contrast, the intratumoral LVD and BVD were significantly higher in Warthin's tumor than pleomorphic adenoma, normal parotid gland and parotid lymph node (P<0.0001 versus P<0.004). The increase in lymphatic vessels in Warthin's tumor suggests that epithelial tumor cells might promote lymphangiogenesis in this kind of lesions.
Collapse
Affiliation(s)
- A Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Philipp University, Deutschhausstr. 3, 35037 Marburg, Germany.
| | | | | | | | | |
Collapse
|
40
|
Schenk JP, Günther P, Schrader C, Ley S, Furtwängler R, Leuschner I, Edelhäuser M, Graf N, Tröger J. [Childhood kidney tumors -- the relevance of imaging]. Radiologe 2006; 45:1112-23. [PMID: 16151729 DOI: 10.1007/s00117-005-1260-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Kidney tumors represent 6.2% of malignant tumors in children. History, clinical course and radiological findings are necessary elements in the differential diagnosis of the different renal tumors. In the case of nephroblastoma, chemotherapy is based solely on the radiological diagnosis without prior histology. In therapy-optimizing studies of the Society of Pediatric Oncology and Hematology, preoperative chemotherapy is performed. Therapy monitoring is performed in the course of and after preoperative chemotherapy to verify tumor response. Radiological staging plays a significant role in deciding on further treatment and in operative planning. Three-dimensional visualization of the abdominal situs can assist preoperative planning. In summary, diagnostic imaging in renal tumors in children plays a role in differential diagnosis, staging, monitoring of therapy, and surgical planning.
Collapse
Affiliation(s)
- J-P Schenk
- Abteilung Pädiatrische Radiologie, Universitätsklinik Heidelberg.
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Schenk JP, Schrader C, Zieger B, Furtwängler R, Leuschner I, Ley S, Graf N, Troeger J. [Reference radiology in nephroblastoma: accuracy and relevance for preoperative chemotherapy]. ROFO-FORTSCHR RONTG 2006; 178:38-45. [PMID: 16392056 DOI: 10.1055/s-2005-858836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE A reference radiologic diagnosis was carried out for the purpose of quality control and in order to achieve high diagnostic accuracy in the ongoing trial and study SIOP 2001/GPOH for renal tumors during childhood. The aim of the present study is to evaluate the value of diagnostic imaging and the benefit of reference evaluation at a pediatric radiology center. MATERIALS AND METHODS In 2004 the imaging studies of 97 patients suspected of having a renal tumor were presented at the beginning of therapy. Diagnostic imaging was compared to the primary imaging results and the histological findings and was analyzed in regard to the therapeutic consequence (primary chemotherapy without prior histology). 77 MRI, 35 CT and 67 ultrasound examinations of 47 girls and 50 boys (mean age 4 years; one day to 15.87 years old) were analyzed. In addition to the histological findings, the reference pathological results were submitted in 86 cases. Results from the primary imaging corresponding to the histology and results from the reference radiology corresponding to the histology were statistically compared in a binomial test. RESULTS In 76 of the reference-diagnosed Wilms' tumors, 67 were confirmed histologically. In 72 cases preoperative chemotherapy was initiated. In 5 cases neither a Wilms' tumor nor a nephroblastomatosis was found. 16 of 21 cases (76 %) with reference-diagnosed non-Wilms' tumors were selected correctly. The results of the primary imaging corresponded to the histology in 71 cases, and those of the reference radiology in 82 cases. The statistical evaluation showed that the results of the reference radiology were significantly better (p = 0.03971). CONCLUSION Reference radiological evaluation improved the diagnostic accuracy with therapeutic relevance. The differentiation of different renal tumors is not completely possible using imaging methods. The rate of patients with false preoperative chemotherapy for all renal neoplasms is currently 5.2 % and 1 % for benign renal tumors.
Collapse
Affiliation(s)
- J-P Schenk
- Pädiatrische Radiologie, Universitätsklinik Heidelberg.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Schrader C, Tiemann M, Zirrgiebel U, Günther A, Janssen D, Gramatzki M. Dramatic improvement of POEMS syndrome by stem cell transplantation parallels decrease in VEGF and BFGF level. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
43
|
Köhler B, Grosskreutz J, Mangold A, Schrader C, Dengler R, Becker H, Peschel T. Hinweise für Veränderungen im Bereich des kortikalen somatosensorischen und visuellen Systems bei der zervikalen Dystonie: Eine voxelbasierte trimodale MRT-Studie. Akt Neurol 2006. [DOI: 10.1055/s-2006-953035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
44
|
Schrader C, Peschel T, Rollnik J, Dengler R, Kossev A. Cortical processing of proprioceptive input is different in idiopathic Parkinson's disease and multiple system atrophy. Akt Neurol 2006. [DOI: 10.1055/s-2006-953041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Petersen M, Grosskreutz J, Mangold A, Schrader C, Dengler R, Becker H, Peschel T. In vivo Neuropathologie bei idiopathischem Parkinson-Syndrom: Eine Korrelationsanalyse mittels voxelbasiertem trimodalem MRT. Akt Neurol 2006. [DOI: 10.1055/s-2006-953466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
46
|
Bullermann A, Grosskreutz J, Dengler R, Schrader C, Peschel T. Parkinson-Patienten am Klavier: Quantitative Untersuchungen zur Feinmotorik mittels MIDI-Technologie. Akt Neurol 2006. [DOI: 10.1055/s-2006-953174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
47
|
Abstract
AIMS Irradiation-induced sialadenitis is a significant cause of morbidity in head and neck cancer patients receiving radiotherapy. Neither the exact aetiopathology of chronic irradiation-induced sialadenitis nor the mechanisms leading to atrophy of the glandular cells associated with an increase in extracellular matrix are understood. The aim of our study was to determine the phenotype of the inflammatory infiltrate and to study its distribution in the affected submandibular glands. METHODS AND RESULTS Paraffin-embedded submandibular glands from a homogeneous group of 19 patients with advanced oropharyngeal cancer who received conventional radiotherapy to the primary site and upper neck were analysed. In all patients the radiation dose and field were approximately equal. The submandibular glands were obtained during neck dissection. To characterize the lymphoid infiltrate, all tissue sections were immunostained for T cells (CD3, CD4, CD8), cytotoxic T cells (granzyme B), B cells (CD20), and macrophages (Ki-M1p). A histopathological classification into four grades was established based on the degree of glandular atrophy, fibrosis and lymphocytic infiltration. Phenotypic analysis of submandibular gland sections revealed that the great majority of lymphocytic infiltrates were cytotoxic T cells associated with acinar cell destruction. CONCLUSIONS The significantly elevated frequencies of cytotoxic cells in the submandibular glands of patients with irradiation-induced sialadenitis suggest that cell-mediated immune mechanisms may play a part in the pathogenesis of this disease.
Collapse
Affiliation(s)
- A Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
| | | | | | | | | |
Collapse
|
48
|
Schrader C, Janssen D, Klapper W, Siebmann JU, Meusers P, Brittinger G, Kneba M, Tiemann M, Parwaresch R. Minichromosome maintenance protein 6, a proliferation marker superior to Ki-67 and independent predictor of survival in patients with mantle cell lymphoma. Br J Cancer 2005; 93:939-45. [PMID: 16189522 PMCID: PMC2361659 DOI: 10.1038/sj.bjc.6602795] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Minichromosome maintenance protein 6 (MCM6) is one of six proteins of the MCM family which are involved in the initiation of DNA replication and thus represent a marker of proliferating cells. Since the level of cell proliferation is the most valuable predictor of survival in mantle cell lymphoma (MCL), we investigated lymph node biopsy specimens from 70 patients immunohistochemically with a monoclonal antibody against MCM6. The percentage of MCM6 expressing lymphoma cells ranged from 12.0 to 95.6%, with a mean of 61.0%, and was significantly higher than the percentage of Ki-67-positive cells (P<0.0001). Surprisingly, the ratio of MCM6-positive cells to Ki-67-positive cells was higher than in normal stimulated peripheral blood mononuclear cells, indicating a cell early G1-phase arrest in MCL. A high MCM6 expression level of more than 75% positive cells was associated with a significantly shorter overall survival time (16 months) compared to MCL with a low MCM6 expression level of less than 25% (no median reached, P<0.0001). Multivariate analysis revealed MCM6 to be an independent predictor of survival that is superior to the international prognostic factor and the Ki-67 index. Therefore, aside from gene expression profiling, immunohistochemical detection of MCM6 seems to be the most promising marker for predicting the outcome in MCL.
Collapse
Affiliation(s)
- C Schrader
- Second Department of Internal Medicine and Hematology, University Hospital of Schleswig-Holstein, Campus Kiel, Chemnitzstr. 33, 24116 Kiel, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Schenk JP, Schrader C, Furtwängler R, Ko HS, Leuschner I, Graf N, Troeger J. [MRI-morphology and staging of congenital mesoblastic nephroma: evaluation of a collection with 20 patients]. ROFO-FORTSCHR RONTG 2005; 177:1373-9. [PMID: 16170706 DOI: 10.1055/s-2005-858359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To differentiate classic and cellular type of congenital mesoblastic nephroma (CMN) in MRI and to evaluate MRI for staging according to the Societe Internationale de Oncologie Pediatrique (SIOP). MATERIAL AND METHODS MRI examinations of 20 children with CMN (age 1st to 16th months, classic type n = 11, cellular type n = 7, mixed type n = 2) were analyzed retrospectively. Cysts, necrosis, hemmorhage in the tumor, signal intensity, tumor structure, thrombosis and dilatation of renal vein, crossing of the body midline, peripheral contrast-enhancement, tumor volume and existence of a tumor pseudocapsule in contrast to the residual kidney were described. The radiologic stage was compared with the histopathologic stage (infiltration of perirenal fat and infiltration of the renal sinus). RESULTS Tumors of the classic type (mean volume 67.9 ml) had necrosis in 1 case, crossed the midline in 1 case, had no cysts or bleeding, and had a peripheral contrast-enhancement in 1 case, and were heterogeneous in 9 cases. The cellular type (mean volume 302.8 ml) had tumor necrosis in 6 cases, bleeding in 3 cases, cysts in 3 cases, crossed the midline in 4 cases, and peripheral contrast enhancement in 2 cases, and was predominantly heterogeneous. Mixed tumor types (7 ml and 202 ml) had tumor necrosis in 1 case and crossed the midline in 1 case, a peripheral contrast enhancement in 2 cases and a homogenous structure in 1 case. The signal intensity in T1 w and T2 w images was not specific. The renal vein was inconspicuous in all children. The evaluation of the infiltration in perirenal fatty tissue was true positive in 1 case, true negative in 10 cases, false negative in 4 cases and false positive in 5 cases. The infiltration of the renal hilus was true positive in 10 children, false positive in 8 cases and true negative in 2 cases. CONCLUSION A typical finding of CMN in MRI is a heterogeneous tumor without demarcation from the rest of the kidney parenchyma by a pseudocapsule. The cellular type of CMN tends to have a higher tumor volume and shows more necrosis, bleeding and cysts than the classic type in MRI. A peripheral contrast-enhancement in MRI is not characteristic for any type of CMN. Local tumor staging is not possible with MRI.
Collapse
Affiliation(s)
- J P Schenk
- Abt. Päd. Radiologie Universitätsklinik Heidelberg, Im Neuenheimer Feld 153, 69120 Heidelberg.
| | | | | | | | | | | | | |
Collapse
|
50
|
Schrader C, Hahn M, Peschel T, Dengler R, Knapp W, Berding G. Orthostatic hypotension in Parkinson syndromes correlates to the degree of cardiac denervation assessed by HED PET. Akt Neurol 2005. [DOI: 10.1055/s-2005-919212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|