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Boukovala M, Modest DP, Ricard I, Fischer von Weikersthal L, Decker T, Vehling-Kaiser U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Peveling Genannt Reddemann C, Graeven U, Schuch G, Schwaner I, Heinrich K, Neumann J, Jung A, Held S, Stintzing S, Heinemann V, Michl M. Evaluation of the inflammation-based modified Glasgow Prognostic Score (mGPS) as a prognostic and predictive biomarker in patients with metastatic colorectal cancer receiving first-line chemotherapy: a post hoc analysis of the randomized phase III XELAVIRI trial (AIO KRK0110). ESMO Open 2024; 9:103374. [PMID: 38744100 DOI: 10.1016/j.esmoop.2024.103374] [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] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The inflammation-based modified Glasgow Prognostic Score (mGPS) combines serum levels of C-reactive protein and albumin and was shown to predict survival in advanced cancer. We aimed to elucidate the prognostic impact of mGPS on survival as well as its predictive value when combined with gender in unselected metastatic colorectal cancer (mCRC) patients receiving first-line chemotherapy in the randomized phase III XELAVIRI trial. PATIENTS AND METHODS In XELAVIRI, mCRC patients were treated with either fluoropyrimidine/bevacizumab followed by additional irinotecan at first progression (sequential treatment arm; Arm A) or upfront combination of fluoropyrimidine/bevacizumab/irinotecan (intensive treatment arm; Arm B). In the present post hoc analysis, survival was evaluated with respect to the assorted mGPS categories 0, 1 or 2. Interaction between mGPS and gender was analyzed. RESULTS Out of 421 mCRC patients treated in XELAVIRI, 362 [119 women (32.9%) and 243 men (67.1%)] were assessable. For the entire study population a significant association between mGPS and overall survival (OS) was observed [mGPS = 0: median 28.9 months, 95% confidence interval (CI) 25.9-33.6 months; mGPS = 1: median 21.4 months, 95% CI 17.6-26.1 months; mGPS = 2: median 16.8 months, 95% CI 14.3-21.2 months; P < 0.00001]. Similar results were found when comparing progression-free survival between groups. The effect of mGPS on survival did not depend on the applied treatment regimen (P = 0.21). In female patients, a trend towards longer OS was observed in Arm A versus Arm B, with this effect being clearly more pronounced in the mGPS cohort 0 (41.6 versus 25.5 months; P = 0.056). By contrast, median OS was longer in male patients with an mGPS of 1-2 treated in Arm B versus Arm A (20.8 versus 17.4 months; P = 0.022). CONCLUSION We demonstrate the role of mGPS as an independent predictor of OS regardless of the treatment regimen in mCRC patients receiving first-line treatment. mGPS may help identify gender-specific subgroups that benefit more or less from upfront intensive therapy.
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Affiliation(s)
- M Boukovala
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | - D P Modest
- Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - I Ricard
- Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | | | - T Decker
- Private Oncological Practice, Ravensburg
| | | | - J Uhlig
- Private Oncological Practice, Naunhof
| | - M Schenk
- Krankenhaus Barmherzige Brüder Regensburg, Regensburg
| | | | - B Peuser
- Onkologische Praxis am Diakonissenhaus, Leipzig
| | | | | | - U Graeven
- Kliniken Maria Hilf GmbH, Mönchengladbach
| | - G Schuch
- Hämatologisch-Onkologische Praxis Altona, Hamburg
| | - I Schwaner
- Onkologische Schwerpunktpraxis Kurfürstendamm, Berlin
| | - K Heinrich
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | - J Neumann
- Institute of Pathology, Ludwig-Maximilians-University of Munich
| | - A Jung
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg; Institute of Pathology, Ludwig-Maximilians-University of Munich
| | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - S Stintzing
- Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - M Michl
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München.
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Weiss L, Fischer LE, Heinemann V, Gieseler F, Hoehler T, Mayerle J, Quietzsch D, Reinacher-Schick A, Schenk M, Seipelt G, Siveke JT, Stahl M, Kaiser U, Waldschmidt DT, Dorman K, Zhang D, Westphalen CB, Boeck S, Haas M. Changes over time in the course of advanced pancreatic cancer treatment with systemic chemotherapy: a pooled analysis of five clinical trials from two decades of the German AIO study group. ESMO Open 2024; 9:102944. [PMID: 38503144 PMCID: PMC10966158 DOI: 10.1016/j.esmoop.2024.102944] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Over the past two decades, our group has conducted five multicenter trials focusing on first-line systemic therapy for patients with advanced pancreatic cancer. The current pooled analysis was designed to evaluate prognosis over time and the impact of clinical characteristics on survival. PATIENTS AND METHODS Individual patient data were derived from five prospective, controlled, multicenter trials conducted by the 'Arbeitsgemeinschaft Internistische Onkologie' (AIO): 'Gem/Cis', 'Ro96', 'RC57', 'ACCEPT' and 'RASH', which recruited patients between December 1997 and January 2017. RESULTS Overall, 912 patients were included. The median overall survival (OS) for all assessable patients was 7.1 months. OS significantly improved over time, with a median OS of 8.6 months for patients treated from 2012 to 2017 compared with 7.0 months from 1997 to 2006 [hazard ratio (HR) 1.06; P < 0.004]. Eastern Cooperative Oncology Group performance status (HR 1.48; P < 0.001), use of second-line treatment (HR 1.51; P < 0.001), and Union for International Cancer Control (UICC) stage (III versus IV) (HR 1.34, P = 0.002) had a significant impact on OS. By contrast, no influence of age and gender on OS was detectable. Comparing combination therapy with single-agent chemotherapy did not demonstrate a survival benefit, nor did regimens containing epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) such as afatinib or erlotinib, compared with chemotherapy-only arms. Patients with early-onset pancreatic cancer (age at study entry of ≤50 years, n = 102) had a similar OS compared with those >50 years (7.1 versus 7.0 months; HR 1.13; P = 0.273). The use of a platinum-containing regimen was not associated with better outcomes in patients with early-onset pancreatic cancer. CONCLUSIONS Within this selected group of patients treated within prospective clinical trials, survival has shown improvement over two decades. This effect is likely attributable to the availability of more effective combination therapies and treatment lines, rather than to any specific regimen, such as those containing EGFR-TKIs. In addition, concerning age and sex subgroups, the dataset did not provide evidence for distinct clinical behavior.
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Affiliation(s)
- L Weiss
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - L E Fischer
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - V Heinemann
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - F Gieseler
- Clinic of Hematology and Oncology, University Hospital Schleswig-Holstein-Campus Lübeck, Lübeck
| | - T Hoehler
- Department of Medicine I, Prosper Hospital, Recklinghausen
| | - J Mayerle
- Comprehensive Cancer Center, LMU Munich, Munich; Department of Medicine II, LMU Munich, Munich
| | - D Quietzsch
- Department of Medical Oncology, Klinikum Chemnitz, Chemnitz
| | - A Reinacher-Schick
- Department of Hematology and Oncology, St. Josef Hospital, Ruhr University Bochum
| | - M Schenk
- Department of Haematology and Oncology, Krankenhaus Barmherzige Brüder, Regensburg
| | | | - J T Siveke
- Bridge Institute of Experimental Tumor Therapy and DKTK Division of Solid Tumor Translational Oncology, University Hospital Essen, University of Duisburg-Essen, Essen
| | - M Stahl
- Department of Medical Oncology, Evang. Kliniken Essen-Mitte, Essen
| | - U Kaiser
- Palliativmedizinisches Netzwerk Landshut, Landshut
| | - D T Waldschmidt
- Department of Gastroenterology and Hepatology, University of Cologne, Cologne
| | - K Dorman
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - D Zhang
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - C B Westphalen
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - S Boeck
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich; Department of Hematology and Oncology, München Klinik Neuperlach, Munich, Germany
| | - M Haas
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; Department of Hematology and Oncology, München Klinik Neuperlach, Munich, Germany.
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Serrano Comes C, Pastor Leary C, Hörmann-Kröpfl M, Schenk M, Weiss G. P-141 The good, the bad and the ugly – The fate of collapsed blastocysts in frozen embryo transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.136] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the clinical outcome of collapsed blastocysts without signals of re-expansion in frozen embryo transfers (FET)?
Summary answer
FET of non-re-expanded blastocysts after thawing showed a live-birth rate in 11.5% of the cases. Embryos vitrified on day 5 revealed the best results.
What is known already
Embryo viability is crucial for FET to be successful. Since the introduction of vitrification techniques, outcomes have improved substantially and are even comparable to fresh transfers. Nevertheless, some indicators may help predict the outcome of frozen-thawed blastocysts. Blastocoele re-expansion after thawing has been widely studied and is a strong predictor of clinical pregnancy outcome. However, accurate data on non-re-expanded blastocysts after FET is still not available. Hence, this study aims to evaluate the clinical outcome of non-re-expanded blastocyst after FET.
Study design, size, duration
The retrospective study was designed and conducted at the Kinderwunsch Institut Schenk GmbH (Dobl, Austria). Data was collected from FET performed between 2017 and 2021. In total, 104 FET cycles of collapsed blastocysts were analysed. All the transfers performed were single embryo transfers (SET). Patient’s average age was of 33.6 years at the time of embryo vitrification. Embryos were excluded if they showed more fragmentation than before vitrification.
Participants/materials, setting, methods
Patients were divided into two groups following the time of blastocyst cryopreservation: day 5 (44 SET) and day 6 (60 SET); which was dependant on the time of blastocoel expansion. They were further divided according to the trophectoderm quality: good (42 SET) and poor (62 SET) and the overall embryo quality, considering trophectoderm and inner cell mass (ICM): good (37 SET) and poor (67 SET). In both cases quality was assessed before vitrification.
Main results and the role of chance
A total of 104 collapsed blastocysts were transferred (SET). 16.3% of the patients had a positive biochemical pregnancy. 11.5% of the pregnancies resulted in a live birth and 4.8% of the pregnancies ended in abortion. FET with day 5 non-re-expanded blastocysts after thawing showed better results than day 6 thawed blastocysts regarding biochemical pregnancy (29.5% vs 6.6%, p = 0.02) and live birth rate (20.4% vs 5%, p = 0.017). Good embryo quality before vitrification showed a trend for better clinical outcome, however, results were not significant. A good trophectoderm quality before vitrification revealed a live birth rate of 16.7% compared to 8.1% in poor trophectoderm quality. Regarding overall embryo quality (trophectoderm and ICM quality) the results were 14.3% deliveries for good quality blastocysts vs 7.6% for poor quality blastocysts.
Limitations, reasons for caution
The sample size may be seen as a study limitation. However, statistically significant results were obtained. Nonetheless, results should be confirmed with a bigger sample size.
Wider implications of the findings
The present study revealed a lower chance of live birth for non-re-expanded blastocysts after thawing, which should nevertheless not be overlooked; specially in cases with good quality embryos frozen and thawed on day 5. Transfer of collapsed embryos after thawing would be recommended taking into consideration the study results.
Trial registration number
Not Applicable
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Affiliation(s)
- C Serrano Comes
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
| | - C Pastor Leary
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
| | - M Hörmann-Kröpfl
- Das Kinderwunsch Institut Schenk GmbH, Clinical Embryology , Dobl bei Graz, Austria
| | - M Schenk
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
- Medical University of Graz, Institute of Human Genetics , Graz, Austria
| | - G Weiss
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
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4
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Andreone A, Schenk M, Ferrario M, Guerrero S. Development of sweet confectioneries produced from pilot‐scale UV‐C treated orange juice, low‐methoxyl pectin and different sugar‐substitute blends. Impact on physicochemical, rheological and sensory properties. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.16403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Antonella Andreone
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias
- Scholar of CONICET ‐ Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ). Buenos Aires Argentina
| | - M. Schenk
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias
- CONICET ‐ Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ)
| | - M. Ferrario
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias
- CONICET ‐ Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ)
| | - S. Guerrero
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Industrias
- CONICET ‐ Universidad de Buenos Aires, Instituto de Tecnología de Alimentos y Procesos Químicos (ITAPROQ)
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5
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Al-Batran SE, Lorenzen S, Homann N, Thuss-Patience P, Schenk M, Lindig U, Kretzschmar A, Heuer V, Goekkurt E, Haag G, Riera Knorrenschild J, Bolling C, Hofheinz R, Siebenhuener A, Irahara N, Kopp C, Waberer L, Pauligk C, Götze T, Gaiser T. 1429P Pathological regression in patients with microsatellite instability (MSI) receiving perioperative atezolizumab in combination with FLOT vs. FLOT alone for resectable esophagogastric adenocarcinoma: Results from the DANTE trial of the German Gastric Group at the AIO and SAKK. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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6
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Kopp C, Lorenzen S, Gaiser T, Thuss-Patience P, Schenk M, Lindig U, Kretzschmar A, Heuer V, Goekkurt E, Haag G, Riera Knorrenschild J, Bolling C, Hofheinz R, Siebenhuener A, Irahara N, Waberer L, Pauligk C, Götze T, Homann N, Al-Batran SE. 1430P Frequency of PD-L1 positivity and microsatellite instability (MSI) in the DANTE trial: Perioperative atezolizumab with FLOT versus FLOT alone in patients with resectable esophagogastric adenocarcinoma. A randomized, open-label phase IIb trial of the German gastric group at the AIO and SAKK. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Bankstahl U, Al-Batran SE, Piso P, Lorenzen S, Ostrzyzek M, Pauligk C, Habibzade T, Schenk M, Schlenska-Lange A, Reim D, Bechstein W, Königsrainer A, Mönig S, Rau B, Schwarzbach M, Götze T. 1440TiP Preventive HIPEC in combination with perioperative FLOT versus FLOT alone for resectable diffuse type gastric and gastroesophageal junction type II/III adenocarcinoma: The phase III “PREVENT” trial of the AIO/CAOGI/ACO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1549] [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: 11/27/2022] Open
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Schenk M, Voroshilina E, Boldyreva M, Koranda M, Reinschissler N, Weiss G. P–196 Bacterial influence on oocyte quality - the secret of a successful fertilization. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.195] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is there a difference in bacterial composition of follicular fluid between oocytes developing a good quality blastocyst and oocytes that fail fertilization?
Summary answer
Follicular fluids of oocytes failing fertilization show a different bacterial profile compared to follicular fluids of oocytes that were successfully fertilized.
What is known already
The presence of pathogens in the female reproductive tract has been intensively investigated. Lactobacillus species are mainly associated with a healthy genital tract and good prognosis for a successful pregnancy. Studies of the bacterial composition of follicular fluids have been mainly undertaken in women participating in reproductive medicine treatment because of the nature to obtain the specimen. In most studies follicular fluids have been pooled for analysis. Information on separately collected follicular fluids is still rare. We hypothesized that the composition of bacteria within follicular fluids is responsible for the success of the fertilization process.
Study design, size, duration
The study was designed and conducted at the Kinderwunsch Institut Schenk GmbH (Dobl, Austria) together with DNA-Technology. Follicular fluids from 46 patients undergoing IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) treatment were included and analyzed.
Participants/materials, setting, methods
Follicular fluids from 46 patients were collected separately. 2 follicular fluids from each patient were screened for common bacteria of the genital tract. One from an oocyte developing a good quality blastocyst and one displaying fertilization failures. Samples were analyzed for bacterial composition using the Femoflor16 (DNA-Technology).
Main results and the role of chance
Quantitative analysis revealed a higher total bacteria mass in follicles from oocytes that failed fertilization. Furthermore, Lactobacillus were not present in those follicles compared to good blastocyst follicles. In addition, Chlamydia trachomatis was found mainly in follicular fluid of not fertilized oocytes together with Eubacterium, Gardnarella and Trichomonas species. Interestingly, a trend of elevated levels of Ureaplasma species in follicular fluids of oocytes developing good quality blastocysts was observed.
Limitations, reasons for caution
Contamination of follicular fluids due to the procedure of oocyte pick up and follicular fluid retrieval cannot be completely excluded. Results should be confirmed with a higher sample size.
Wider implications of the findings: We assume that different bacterial compositions in follicular fluids are responsible for the destiny of the oocyte. It is tempting to speculate that bacterial analysis of follicular fluids may be beneficial to select to best oocytes in future IVF/ICSI treatments.
Trial registration number
Not applicable
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Affiliation(s)
- M Schenk
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
| | - E Voroshilina
- Ural State Medical University, Research, Yekaterinburg, Russia C.I.S
| | - M Boldyreva
- Ural State Medical University, Research, Yekaterinburg, Russia C.I.S
- DNA-Technology, Research, Moscow, Russia C.I.S
| | - M Koranda
- DNA-Technology, Research, Moscow, Russia C.I.S
| | - N Reinschissler
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
| | - G Weiss
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
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9
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Kremenovic M, Schenk M, Lee DJ. Clinical and molecular insights into BCG immunotherapy for melanoma. J Intern Med 2020; 288:625-640. [PMID: 32128919 DOI: 10.1111/joim.13037] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 09/10/2019] [Revised: 11/23/2019] [Accepted: 01/24/2020] [Indexed: 01/25/2023]
Abstract
The incidence of cutaneous melanoma and the mortality rate of advanced melanoma patients continue to rise globally. Despite the recent success of immunotherapy including ipilimumab and pembrolizumab checkpoint inhibitors, a large proportion of patients are refractory to such treatment modalities. The application of mycobacteria such as Bacillus Calmette-Guérin (BCG) in the treatment of various malignancies, including cutaneous melanoma, has been clearly demonstrated after almost a century of observations and experimentation. Intralesional BCG (IL-BCG) immunotherapy is a highly efficient and cost-effective treatment option for inoperable stage III in-transit melanoma, as recommended in the National Comprehensive Cancer Network Guidelines. IL-BCG has shown great efficacy in the regression of directly injected metastatic melanoma lesions, as well as distal noninjected nodules in immunocompetent patients. Clinical and preclinical studies have shown that BCG serves as a strong immune modulator, inducing the recruitment of various immune cells that contribute to antitumour immunity. However, the specific mechanism of BCG-mediated tumour immunity remains poorly understood. Comparative genome analyses have revealed that different BCG strains exhibit distinct immunological activity and virulence, which might impact the therapeutic response and clinical outcome of patients. In this review, we discuss the immunostimulatory potential of different BCG substrains and highlight clinical studies utilizing BCG immunotherapy for the treatment of cutaneous melanoma. Furthermore, the review focuses on the cellular and molecular mechanisms of the BCG-induced immune responses of both the innate and adaptive arms of the immune system. Furthermore, the review discussed the administration of BCG as a monotherapy or in combination with other immunotherapeutic or chemotherapeutic agents.
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Affiliation(s)
- M Kremenovic
- From the, Institute of Pathology, Experimental Pathology, Universitat Bern, Bern, Switzerland
| | - M Schenk
- From the, Institute of Pathology, Experimental Pathology, Universitat Bern, Bern, Switzerland
| | - D J Lee
- Division of Dermatology, Department of Medicine, The Lundquist Institute, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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García Carrillo M, Ferrario M, Schenk M, Guerrero S. Effect of an UV-C Light-Based Hurdle Strategy for Carrot-Orange Juice Processing on Candida parapsilosis Inactivation and Physiological State: Impact on Juice Sensory and Physicochemical Quality Parameters. FOOD BIOPROCESS TECH 2020. [DOI: 10.1007/s11947-020-02540-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Al-Batran SE, Hofheinz R, Schmalenberg H, Strumberg D, Goekkurt E, Angermeier S, Zander T, Potenberg J, Kopp HG, Pink D, Siegler G, Schenk M, De Vita F, Maiello E, Gaiser T, Sookthai D, Bankstahl U, Pauligk C, Götze T, Homann N. 1424MO Perioperative FLOT plus ramucirumab versus FLOT alone for resectable esophagogastric adenocarcinoma– Updated results and subgroup analyses of the randomized phase II/III trial RAMSES/FLOT7 of the German AIO and Italian GOIM. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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12
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Schenk M, Reichmann R, Koelman L, Pfeiffer AFH, Rudovich NN, Aleksandrova K. Intra-individual reproducibility of galectin-1, haptoglobin, and nesfatin-1 as promising new biomarkers of immunometabolism. Metabol Open 2020; 6:100034. [PMID: 32812932 PMCID: PMC7424788 DOI: 10.1016/j.metop.2020.100034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/27/2020] [Revised: 03/11/2020] [Accepted: 03/15/2020] [Indexed: 11/16/2022] Open
Abstract
Background Galectin-1, haptoglobin, and nesfatin-1 have recently emerged as promising biomarkers implicated in immunometabolism. However, whether single blood measurements of these analytes could be suitable for large-scale human studies has not yet been evaluated. Methods The concentrations of galectin-1, haptoglobin, and nesfatin-1 were measured over a 4-month period in 207 healthy adults with median age of 56.7 years. Biomarker intra-individual reproducibility was assessed based on calculation of intraclass correlation coefficients (ICCs) and examining Bland-Altman plots. Results The overall ICCs were excellent for nesfatin-1 (ICC: 0.89 (95% CI: 0.86, 0.92), and good for galectin-1 and haptoglobin (ICCs: 0.70 (95% CI: 0.61, 0.77) and 0.67 (95% CI: 0.57, 0.74), respectively). Bland-Altman plots supported a high level of agreement between repeated biomarker measurements. Conclusions Assay measurements of galectin-1, haptoglobin, and nesfatin-1 showed good to excellent within-subject reproducibility over a 4-month period, indicating that they may serve as feasible and reliable biomarkers for assessing metabolic inflammation in population research.
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Affiliation(s)
- Matthew Schenk
- Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Robin Reichmann
- Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Liselot Koelman
- Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Andreas F H Pfeiffer
- German Centre for Diabetes Research, Germany.,Research Group Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
| | - Natalia N Rudovich
- German Centre for Diabetes Research, Germany.,Division of Endocrinology and Diabetes, Department of Internal Medicine, Spital Bülach, Bülach, Switzerland
| | - Krasimira Aleksandrova
- Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
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13
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Al-Batran SE, Pauligk C, Hofheinz R, Lorenzen S, Wicki A, Siebenhuener A, Schenk M, Thuss-Patience P, Kretzschmar A, Bolling C, Eigendorff E, Angermeier S, Pink D, Geissler M, Goekkurt E, Schmalenberg H, Waberer L, Talbot J, Goetze T, Homann N. Perioperative atezolizumab in combination with FLOT versus FLOT alone in patients with resectable esophagogastric adenocarcinoma: DANTE, a randomized, open-label phase II trial of the German Gastric Group of the AIO and the SAKK. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Schenk M, Eichelmann F, Schulze MB, Rudovich N, Pfeiffer AF, di Giuseppe R, Boeing H, Aleksandrova K. Reproducibility of novel immune-inflammatory biomarkers over 4 months: an analysis with repeated measures design. Biomark Med 2019; 13:639-648. [PMID: 31157547 DOI: 10.2217/bmm-2018-0351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: Assessment of the feasibility and reliability of immune-inflammatory biomarker measurements. Methods: The following biomarkers were assessed in 207 predominantly healthy participants at baseline and after 4 months: MMF, TGF-β, suPAR and clusterin. Results: Intraclass correlation coefficients (95% CIs) ranged from good for TGF-β (0.75 [95% CI: 0.33-0.90]) to excellent for MMF (0.81 [95% CI: 0.64-0.90]), clusterin (0.83 [95% CI: 0.78-0.87]) and suPAR (0.91 [95% CI: 0.88-0.93]). Measurement of TGF-β was challenged by the large number of values below the detection limit. Conclusion: Single measurements of suPAR, clusterin and MMF could serve as feasible and reliable biomarkers of immune-inflammatory pathways in biomedical research.
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Affiliation(s)
- Matthew Schenk
- Senior Scientist Group Nutrition, Immunity & Metabolism, Department of Nutrition & Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Fabian Eichelmann
- Senior Scientist Group Nutrition, Immunity & Metabolism, Department of Nutrition & Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,German Centre for Diabetes Research, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Natalia Rudovich
- German Centre for Diabetes Research, Germany.,Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,Department of Endocrinology, Diabetes & Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany.,Division of Endocrinology & Diabetes, Department of Internal Medicine, Spital Bülach, Bülach, Switzerland
| | - Andreas F Pfeiffer
- German Centre for Diabetes Research, Germany.,Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,Department of Endocrinology, Diabetes & Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
| | - Romina di Giuseppe
- Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Krasimira Aleksandrova
- Senior Scientist Group Nutrition, Immunity & Metabolism, Department of Nutrition & Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
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15
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Coogan AN, Schenk M, Palm D, Uzoni A, Grube J, Tsang AH, Kolbe I, McGowan NM, Wandschneider R, Colla M, Oster H, Thome J, Faltraco F. Impact of adult attention deficit hyperactivity disorder and medication status on sleep/wake behavior and molecular circadian rhythms. Neuropsychopharmacology 2019; 44:1198-1206. [PMID: 30758328 PMCID: PMC6785110 DOI: 10.1038/s41386-019-0327-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 10/11/2018] [Revised: 12/28/2018] [Accepted: 01/22/2019] [Indexed: 11/09/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric condition that has been strongly associated with changes in sleep and circadian rhythms. Circadian rhythms are near 24-h cycles that are primarily generated by an endogenous circadian timekeeping system, encoded at the molecular level by a panel of clock genes. Stimulant and non-stimulant medication used in the management of ADHD has been shown to potentially impact on circadian processes and their behavioral outputs. In the current study, we have analyzed circadian rhythms in daily activity and sleep, and the circadian gene expression in a cohort of healthy controls (N = 22), ADHD participants not using ADHD-medication (N = 17), and participants with ADHD and current use of ADHD medication (N = 17). Rhythms of sleep/wake behavior were assessed via wrist-worn actigraphy, whilst rhythms of circadian gene expression were assessed ex-vivo in primary human-derived dermal fibroblast cultures. Behavioral data indicate that patients with ADHD using ADHD-medication have lower relative amplitudes of diurnal activity rhythms, lower sleep efficiency, more nocturnal activity but not more nocturnal wakenings than both controls and ADHD participants without medication. At the molecular level, there were alterations in the expression of PER2 and CRY1 between ADHD individuals with no medication compared to medicated ADHD patients or controls, whilst CLOCK expression was altered in patients with ADHD and current medication. Analysis of fibroblasts transfected with a BMAL1:luc reporter showed changes in the timing of the peak expression across the three groups. Taken together, these data support the contention that both ADHD and medication status impact on circadian processes.
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Affiliation(s)
- A N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - M Schenk
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - D Palm
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - A Uzoni
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - J Grube
- Institute for Neurobiology, University of Lübeck, Lübeck, Germany
| | - A H Tsang
- Institute for Neurobiology, University of Lübeck, Lübeck, Germany
| | - I Kolbe
- Institute for Neurobiology, University of Lübeck, Lübeck, Germany
| | - N M McGowan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - R Wandschneider
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - M Colla
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - H Oster
- Institute for Neurobiology, University of Lübeck, Lübeck, Germany
| | - J Thome
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany.
| | - F Faltraco
- Department of Psychiatry, Laboratory of Molecular Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
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16
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Wirsching J, Graßmann S, Eichelmann F, Harms LM, Schenk M, Barth E, Berndzen A, Olalekan M, Sarmini L, Zuberer H, Aleksandrova K. Development and reliability assessment of a new quality appraisal tool for cross-sectional studies using biomarker data (BIOCROSS). BMC Med Res Methodol 2018; 18:122. [PMID: 30400827 PMCID: PMC6219097 DOI: 10.1186/s12874-018-0583-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 10/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background Biomarker-based analyses are commonly reported in observational epidemiological studies; however currently there are no specific study quality assessment tools to assist evaluation of conducted research. Accounting for study design and biomarker measurement would be important for deriving valid conclusions when conducting systematic data evaluation. Methods We developed a study quality assessment tool designed specifically to assess biomarker-based cross-sectional studies (BIOCROSS) and evaluated its inter-rater reliability. The tool includes 10-items covering 5 domains: ‘Study rational’, ‘Design/Methods’, ‘Data analysis’, ‘Data interpretation’ and ‘Biomarker measurement’, aiming to assess different quality features of biomarker cross-sectional studies. To evaluate the inter-rater reliability, 30 studies were distributed among 5 raters and intraclass correlation coefficients (ICC-s) were derived from respective ratings. Results The estimated overall ICC between the 5 raters was 0.57 (95% Confidence Interval (CI): 0.38–0.74) indicating a good inter-rater reliability. The ICC-s ranged from 0.11 (95% CI: 0.01–0.27) for the domain ‘Study rational’ to 0.56 (95% CI: 0.40–0.72) for the domain ‘Data interpretation’. Conclusion BIOCROSS is a new study quality assessment tool suitable for evaluation of reporting quality from cross-sectional epidemiological studies employing biomarker data. The tool proved to be reliable for use by biomedical scientists with diverse backgrounds and could facilitate comprehensive review of biomarker studies in human research. Electronic supplementary material The online version of this article (10.1186/s12874-018-0583-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Wirsching
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Sophie Graßmann
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Fabian Eichelmann
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Laura Malin Harms
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Matthew Schenk
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Eva Barth
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Alide Berndzen
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Moses Olalekan
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Leen Sarmini
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Hedwig Zuberer
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. .,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany.
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17
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Ferrario M, Schenk M, García Carrillo M, Guerrero S. Development and quality assessment of a turbid carrot-orange juice blend processed by UV-C light assisted by mild heat and addition of Yerba Mate (Ilex paraguariensis) extract. Food Chem 2018; 269:567-576. [PMID: 30100474 DOI: 10.1016/j.foodchem.2018.06.149] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/06/2018] [Revised: 06/27/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
Carrot-orange juice processed by UV-C (10.6 kJ/m2) assisted with mild heat (H, 50 °C) and yerba mate addition (E) was obtained. UV-C/H + E treated juice was examined for native flora, polyphenol content (PC), total antioxidant activity (TAA), colour, turbidity, °Brix and pH along storage (4 °C). Consumer profiling studies were performed. UV-C/H + E provoked 2.6-5.7 native flora log reductions, preventing from recovery during 24 day-storage. The UV-C/H + E juice exhibited a significant increase in PC (720.2 µg/mL) and TAA (5.5 mg/mL) compared to untreated (PC = 205.0 µg/mL/TAA = 0.7 mg/mL) and single treated juices (PC = 302.1-408.0 µg/mL/TAA = 0.7-2.4 mg/mL), remaining constant throughout storage. UV-C/H + E juice exhibited scarce changes in colour. Nevertheless, increases in °Brix and turbidity were observed compared to single treatments. A cluster sensory analysis revealed that one group showed a marked interest in UVC/H + E beverages with herbal taste and strong aroma. CATA question revealed that some improvements should be introduced in order to satisfy the consumers' ideally beverage.
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Affiliation(s)
- M Ferrario
- Departamento de Industrias, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, (1428) C.A.B.A., Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina, Argentina.
| | - M Schenk
- Departamento de Industrias, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, (1428) C.A.B.A., Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina, Argentina
| | - M García Carrillo
- Departamento de Industrias, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, (1428) C.A.B.A., Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina, Argentina
| | - S Guerrero
- Departamento de Industrias, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, (1428) C.A.B.A., Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina, Argentina.
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18
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Modest D, von Weikersthal LF, Decker T, Vehling-Kaiser U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Reddemann CPG, Graeven U, Schuch G, Schwaner I, Stahler A, Jung A, Kirchner T, Held S, Stintzing S, Giessen-Jung C, Heinemann V. Age and RAS status to select patients with metastatic colorectal cancer (mCRC) for initial sequential versus combination therapy including fluoropyrimidines (FP), irinotecan (Iri) and bevacizumab (Bev): XELAVIRI- study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.019] [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: 11/13/2022] Open
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19
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Haas M, Siveke JT, Schenk M, Lerch MM, Caca K, Freiberg-Richter J, Fischer von Weikersthal L, Kullmann F, Reinacher-Schick A, Fuchs M, Kanzler S, Kunzmann V, Ettrich TJ, Kruger S, Westphalen CB, Held S, Heinemann V, Boeck S. Efficacy of gemcitabine plus erlotinib in rash-positive patients with metastatic pancreatic cancer selected according to eligibility for FOLFIRINOX: A prospective phase II study of the 'Arbeitsgemeinschaft Internistische Onkologie'. Eur J Cancer 2018; 94:95-103. [PMID: 29549862 DOI: 10.1016/j.ejca.2018.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/13/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In metastatic pancreatic ductal adenocarcinoma (mPDAC) treatment, erlotinib is known to be more effective in patients developing skin rash. Treatment with the FOLFIRINOX regimen is only performed in fit patients following defined inclusion criteria. The present study investigates the efficacy of gemcitabine plus erlotinib (gem/erlotinib) in rash-positive patients fit for FOLFIRINOX. PATIENTS AND METHODS For this prospective phase II study, 150 patients were recruited in 20 centres. All patients received gem/erlotinib for 4 weeks (run-in phase); the subsequent treatment was determined by the development of skin rash: patients with rash grades 1-4 continued with gem/erlotinib, rash-negative patients were switched to FOLFIRINOX. Primary study end-point was to achieve a 1-year survival rate in rash-positive patients ≥40%. RESULTS Ninety patients were deemed positive for skin rash by the end of the run-in phase, showing a 1-year survival rate of 40.0% (95% confidence interval [CI] 29.8-50.9). Median overall survival (OS) was 10.1 months, progression-free survival (PFS) was 3.8 months and overall response rate (ORR) was 23.3%. Patients switched to FOLFIRINOX (n = 27) had a 1-year survival rate of 48.1% (95% CI 28.7-68.1), a median OS of 10.9 months, a median PFS of 6.6 months and an ORR of 33.3%. Rash-negative patients had a lower quality of life at baseline but seemed to experience an improved control of pain during FOLFIRINOX. CONCLUSIONS First-line treatment with gem/erlotinib was effective in fit, rash-positive mPDAC patients achieving a 1-year survival rate comparable to previous reports for FOLFIRINOX. The study was registered at clinicaltrials.gov (NCT0172948) and Eudra-CT (2011-005471-17).
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Affiliation(s)
- M Haas
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
| | - J T Siveke
- 2nd Medical Department, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Solid Tumor Translational Oncology (DKTK, Partner Site Essen), West German Cancer Center, University Hospital Essen, Essen, Germany
| | - M Schenk
- Department of Haematology and Oncology, Hospital Barmherzige Brüder, Regensburg, Germany
| | - M M Lerch
- Department of Medicine A, Universitätsmedizin Greifswald, Ernst-Moritz-Arndt University, Greifswald, Germany
| | - K Caca
- Department of Internal Medicine I, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | | | | | - F Kullmann
- Department of Medicine I, Klinikum Weiden, Weiden, Germany
| | - A Reinacher-Schick
- Department of Haematology and Oncology, St. Josef-Hospital, Ruhr University, Bochum, Germany
| | - M Fuchs
- Department of Gastroenterology, Hepatology and Gastrointestinal Oncology, Klinikum Bogenhausen, Munich, Germany
| | - S Kanzler
- Department of Internal Medicine II, Leopoldina Krankenhaus Schweinfurt, Schweinfurt, Germany
| | - V Kunzmann
- Department of Medical Oncology, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - T J Ettrich
- Department of Internal Medicine I, University of Ulm, Ulm, Germany
| | - S Kruger
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - C B Westphalen
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - S Boeck
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
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20
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Modest D, Fischer von Weikersthal L, Decker T, Vehling-Kaiser U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Peveling Genannt Reddemann C, Graeven U, Schuch G, Schwaner I, Stahler A, Jung A, Held S, Stintzing S, Giessen-Jung C, Heinemann V. Sequential first-line therapy of metastatic colorectal cancer (mCRC) starting with fluoropyrimidine (FP) plus bevacizumab (BEV) vs. initial FP plus irinotecan (IRI) and BEV: German AIO KRK0110 (ML22011) study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.013] [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: 11/14/2022] Open
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21
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Hehlmann R, Lauseker M, Saußele S, Pfirrmann M, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Müller MC, Jeromin S, Proetel U, Kohlbrenner K, Voskanyan A, Rinaldetti S, Seifarth W, Spieß B, Balleisen L, Goebeler MC, Hänel M, Ho A, Dengler J, Falge C, Kanz L, Kremers S, Burchert A, Kneba M, Stegelmann F, Köhne CA, Lindemann HW, Waller CF, Pfreundschuh M, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Pezzutto A, Schenk M, Brossart P, Geer T, Bildat S, Schäfer E, Hochhaus A, Hasford J. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia 2017; 31:2398-2406. [PMID: 28804124 PMCID: PMC5668495 DOI: 10.1038/leu.2017.253] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [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: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.
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Affiliation(s)
- R Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- IBE, Universität München, Munich, Germany
| | - S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - S Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - H J Kolb
- Medizinische Klinik III, Universität München, Munich, Germany
| | - A Neubauer
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - D K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - C Nerl
- Klinikum Schwabing, Munich, Germany
| | | | | | - D Heim
- Universitätsspital, Basel, Switzerland
| | | | - A Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - U Proetel
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - K Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - S Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - W Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - B Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - M C Goebeler
- Medizinische Klinik und Poliklinik, Universitätsklinikum, Würzburg, Germany
| | - M Hänel
- Klinik für innere Medizin 3, Chemnitz, Germany
| | - A Ho
- Medizinische Klinik V, Universität Heidelberg, Heidelberg, Germany
| | - J Dengler
- Onkologische Schwerpunktpraxis, Heilbronn, Germany
| | - C Falge
- Medizinische Klinik 5, Klinikum Nürnberg-Nord, Nürnberg, Germany
| | - L Kanz
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | - S Kremers
- Caritas Krankenhaus, Lebach, Germany
| | - A Burchert
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - M Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - F Stegelmann
- Klinik für Innere Medizin 3, Universitätsklinikum, Ulm, Germany
| | - C A Köhne
- Klinik für Onkologie und Hämatologie, Oldenburg, Germany
| | | | - C F Waller
- Innere Medizin 1, Universitätsklinikum, Freiburg, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin 1, Universität des Saarlandes, Homburg, Germany
| | - K Spiekermann
- Medizinische Klinik III, Universität München, Munich, Germany
| | - W E Berdel
- Medizinische Klinik A, Universitätsklinikum, Münster, Germany
| | - L Müller
- Onkologie Leer UnterEms, Leer, Germany
| | - M Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - J Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | - D W Beelen
- Klinik für Knochenmarktransplantation, Essen, Germany
| | - M Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - H Link
- Klinik für Innere Medizin 3, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - B Hertenstein
- 1. Medizinische Klinik, Klinikum Bremen Mitte, Bremen, Germany
| | | | - M Wernli
- Kantonsspital, Aarau, Switzerland
| | - F Schlegel
- St Antonius-Hospital, Eschweiler, Germany
| | - R Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - M de Wit
- Vivantes Klinikum Neukölln, Berlin, Germany
| | - L Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - H Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - M Hahn
- Onkologie Zentrum, Ansbach, Germany
| | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - C Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | - P Schafhausen
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - W Verbeek
- Ambulante Hämatologie und Onkologie, Bonn, Germany
| | - M J Eckart
- Internistische Schwerpunktpraxis, Erlangen, Germany
| | | | | | - M Schenk
- Barmherzige Brüder, Regensburg, Germany
| | - P Brossart
- Medizinische Klinik 3, Universität, Bonn, Germany
| | - T Geer
- Diakonie, Schwäbisch Hall, Germany
| | - S Bildat
- Medizinische Klinik 2, Herford, Germany
| | - E Schäfer
- Onkologische Schwerpunktpraxis, Bielefeld, Germany
| | - A Hochhaus
- Klinik für Innere Medizin 2, Universitätsklinikum, Jena, Germany
| | - J Hasford
- IBE, Universität München, Munich, Germany
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Wirz S, Schenk M, Hofbauer H, Kieselbach K. [Mechanisms of chronification in tumor pain?]. MMW Fortschr Med 2017; 159:78-81. [PMID: 28357731 DOI: 10.1007/s15006-017-9437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Stefan Wirz
- CURA - katholisches Krankenhaus im Siebengebirge, Siebengebirge, Deutschland.
- Abteilung für Anästhesie, Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Schülgenstr. 15, D- 53604, Bad Honnef, Deutschland.
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Hofbauer H, Schenk M, Kieselbach K, Wirz S. [Use of methadone for support of oncological treatment? : Statement of the working group on tumor pain of the German Pain Society]. Schmerz 2017; 31:2-4. [PMID: 28044195 DOI: 10.1007/s00482-016-0183-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H Hofbauer
- Sektion Schmerztherapie, Klinik für Anästhesiologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - M Schenk
- Schmerzzentrum Berlin, Berlin, Deutschland
| | - K Kieselbach
- Interdisziplinäres Schmerzzentrum - ISZ, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin - Zentrum für Schmerzmedizin, CURA - katholisches Krankenhaus im Siebengebirge, Schülgenstr. 15, 53604, Bad Honnef, Deutschland.
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Krämer B, Rothmund R, Schenk M, Kruck S, Mischinger J, Ederer M, Wagenpfeil J, Nold B, Neugebauer A, Biber U, Enderle MD, Tsaousidis C. Bipolare Thermofusion von biologischem Gewebe: thermoSEAL als neuer Mode für die Gefäßversiegelung. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593066] [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] Open
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Balin S, Stenger S, Pellegrni M, Ochoa M, Schenk M, Modlin R. 010 Polycytotoxic T cells protect against intracellular infection. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.034] [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: 11/16/2022]
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Wagenpfeil J, Schollig C, Mayer V, Nold B, Ederer M, Neugebauer A, Rothmund R, Kramer B, Schwentner C, Schenk M, Wallwiener D, Stenzl A, Enderle M, Sawodny O, Feuer R. Finite-element-modeling of egg white as a substitute for tissue coagulation during bipolar radiofrequency-induced thermofusion. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:5791-6. [PMID: 26737608 DOI: 10.1109/embc.2015.7319708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Radiofrequency-induced thermofusion is a frequently used electrosurgical procedure for the sealing of blood vessels. A disadvantage of vessel sealing instruments is that the generated thermal energy spreads to the surrounding tissue and may irreversibly damage it. This is particularly problematic when operating close to sensitive structures such as nerves. Given their advantages, there is nonetheless a lot of interest in using bipolar vessel sealing for surgical procedures. To select instruments that may be safely used in such cases, it is important to reliably quantify the thermal spread to the surrounding tissue. Mathematical models can help to evaluate the transient behavior, that is the evolution of the thermal spread over time, more precisely. A finite element model allows for a detailed analysis of inhomogeneities in the spatial temperature distribution. As a first step towards a finite model of the bipolar vessel sealing process, a model of the coagulation of chicken egg white is presented here. Egg white has thermal and electrical properties that are very similar to tissue, making it suitable as a substitute for the analysis of the coagulation process. It has the additional advantage, that the spatial and temporal evolution of the thermal spread can be visually gauged. The presented model describes the experimentally observed spatial temperature distribution, the shape of the coagulated egg white, and the formation of hotspots. Furthermore, it is shown that the model can correctly predict the shape of the coagulated egg white in further experiments.
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Albrecht V, Schäfer N, Stürmer EK, Driessen A, Betsche L, Schenk M, Maegele M. Practice management of acute trauma haemorrhage and haemostatic disorders across German trauma centres. Eur J Trauma Emerg Surg 2015; 43:201-214. [DOI: 10.1007/s00068-015-0608-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/18/2015] [Indexed: 11/24/2022]
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Wagenpfeil J, Nold B, Fischer K, Neugebauer A, Rothmund R, Krämer B, Brucker S, Mischinger J, Schwentner C, Schenk M, Wallwiener D, Stenzl A, Enderle M, Sawodny O, Ederer M. A mathematical model of bipolar radiofrequency-induced thermofusion. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:5683-6. [PMID: 25571285 DOI: 10.1109/embc.2014.6944917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Bipolar radiofrequency-induced thermofusion has become a widely accepted method successfully used in open and particularly in minimally-invasive surgery for the sealing of blood vessels and tissue of up to several millimeters diameter. Despite its wide-spread application, the thermofusion process itself is not well understood on a quantitative and dynamic level, and manufacturers largely rely on trial-and-error methods to improve existing instruments. To predict the effect of alternative generator control strategies and to allow for a more systematic approach to improve thermofusion instruments, a mathematical model of the thermofusion process is developed. The system equations describe the spatial and temporal evolution of the tissue temperature due to Joule heating and heat transfer, and the loss of tissue water due to vaporization. The resulting effects on the tissue properties, most importantly the electrical resistivity, heat capacity and thermal conductivity, are considered as well. Experimental results indicate that the extent of the lateral thermal damage is directly affected by Joule heating of the lateral tissue. The experimental findings are supported by simulation results using the proposed mathematical model of thermofusion.
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Driessen A, Schäfer N, Albrecht V, Schenk M, Fröhlich M, Stürmer EK, Maegele M. Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy. Eur J Trauma Emerg Surg 2014; 41:413-20. [PMID: 26037989 DOI: 10.1007/s00068-014-0455-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 07/23/2014] [Accepted: 10/06/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. METHODS To assess local differences in infrastructure, logistics and clinical management of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. RESULTS 446/1,540 delegates completed the questionnaire yielding a response rate of 29%. The majority specified to work as consultants/senior physicians (47.3%) in general (36.1%) or trauma/orthopaedic surgery (44.5%) of level I (70%) or level II (19%) trauma centres. Clinical assessment (>80%) and standard coagulation assays (74.6%) are the most frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30% of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69%) have implemented local protocols based on international and national guidelines using conventional blood products, e.g. packed red blood cell concentrates (93.3%), fresh frozen plasma concentrates (93.3%) and platelet concentrates (83%), and antifibrinolytics (100%). 89% considered the continuous intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. CONCLUSIONS This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma-associated coagulopathy amongst international centres. Ongoing work will focus on geographical differences.
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Affiliation(s)
- A Driessen
- Department of Orthopaedic Surgery, Traumatology and Sports Traumatology, Cologne-Merheim Medical Centre (CMMC), Witten/Herdecke University (Campus Cologne-Merheim), Ostmerheimerstr 200, 51109, Cologne, Germany,
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Uhlemann F, Kretschmar O, Schenk M, Obradovic M. BeGrowTM - ein neuer Stent mit speziellem Design für wachsende Gefäße Erste Ergebnisse einer präklinischen Tierstudie. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1393984] [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: 10/24/2022]
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Lerchbaum E, Pilz S, Trummer C, Rabe T, Schenk M, Heijboer AC, Obermayer-Pietsch B. Serum vitamin D levels and hypogonadism in men. Andrology 2014; 2:748-54. [PMID: 25044703 DOI: 10.1111/j.2047-2927.2014.00247.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 03/11/2014] [Revised: 06/16/2014] [Accepted: 06/18/2014] [Indexed: 12/14/2022]
Abstract
There is inconsistent evidence on a possible association of vitamin D and androgen levels in men. We therefore aim to investigate the association of 25-hydroxyvitamin D (25(OH)D) with androgen levels in a cohort of middle-aged men. This cross-sectional study included 225 men with a median (interquartile range) age of 35 (30-41) years. We measured 25(OH)D, total testosterone (TT) and SHBG concentrations. Hypogonadism was defined as TT <10.4 nmol/L. We found no significant correlation of 25(OH)D and androgen levels. Furthermore, androgen levels were not significantly different across 25(OH)D quintiles. The overall prevalence of hypogonadism was 21.5% and lowest in men within 25(OH)D quintile 4 (82-102 nmol/L). We found a significantly increased risk of hypogonadism in men within the highest 25(OH)D quintile (>102 nmol/L) compared to men in quintile 4 (reference) in crude (OR 5.10, 1.51-17.24, p = 0.009) as well as in multivariate adjusted analysis (OR 9.21, 2.27-37.35, p = 0.002). We found a trend towards increased risk of hypogonadism in men within the lowest 25(OH)D quintile (≤43.9 nmol/L). In conclusion, our data suggest that men with very high 25(OH)D levels (>102 nmol/L) might be at an increased risk of hypogonadism. Furthermore, we observed a trend towards increased risk of hypogonadism in men with very low vitamin D levels indicating a U-shaped association of vitamin D levels and hypogonadism. With respect to risk of male hypogonadism, our results suggest optimal serum 25(OH)D concentrations of 82-102 nmol/L.
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Affiliation(s)
- E Lerchbaum
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria; University Women's Hospital, Heidelberg, Germany
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Krüger J, Koppmann J, Nau P, Brockhinke A, Schenk M, Hansen N, Werner U, Kohse-Höinghaus K. From Precursors to Pollutants: Some Advances in Combustion Chemistry Diagnostics. Eur Chem Tech J 2014. [DOI: 10.18321/ectj174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The present assessment and prediction of potential pollutant emissions from combustion systems often rely on dedicated combustion models. Their validation depends on the critical examination of the relevant chemical reaction pathways. To this end, a number of combustion diagnostic techniques are available<br />which can probe important chemical constituents in situ, thus providing direct information on the progress of the combustion reactions. Here, some recent experimental advances for the investigation of a suite of targets from molecular intermediates and soot precursors to nascent particles will be presented. Examples include the application of quantum cascade laser absorption spectroscopy (QCLAS), molecular-beam mass<br />spectrometry (MBMS) with different ionization schemes, photoelectron–photoion coincidence (PEPICO) spectroscopy, helium ion microscopy (HIM), and polarization-modulated infrared reflection–absorption spectroscopy (PM-IRRAS).<br /><br />
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Schenk M. Infektionen und Krebs: Viren als Auslöser von Darmkrebs? Dtsch Med Wochenschr 2014; 139:761-3. [DOI: 10.1055/s-0033-1353979] [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]
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Wirz S, Wiese CHR, Zimmermann M, Junker U, Heuser-Grannemann E, Schenk M. [Rapid release fentanyl administration forms. Comments of the Working Group on Tumor Pain of the German Pain Society]. Schmerz 2014; 27:76-80. [PMID: 23377349 DOI: 10.1007/s00482-013-1292-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The spectrum of indications for rapid release fentanyl preparations is controversial. For this reason the Working Group on Tumor Pain will formulate comments on how to deal with these substances. Breakthrough pain should receive individualized therapy; therefore, the use of opioids of various galenic formulations seems to be advisable. New rapid release fentanyl preparations are suitable for alleviating spontaneous breakthrough pain in tumor patients due to a rapid but short-acting effect. However, a prior optimization of the analgesic basis medication is absolutely necessary. Uncontrolled prescription for non-cancer pain must be criticized due to the problem of addiction. The medical profession should be informed about the benefits of rapid release fentanyl preparations but must also be made aware of the risk of a rapid development of addiction and tolerance. A self-commitment of the pharmaceutical industry to waive advertising for the dangerous off-label use would be desirable. In the opinion of the Working Group on Tumor Pain the use of fentanyl should be openly discussed and further scientific investigations are imperative with the aim of formulating clear recommendations.
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Affiliation(s)
- S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerztherapie, Palliativmedizin, CURA Kath. Krankenhaus im Siebengebirge, Schülgenstr. 15, 53604, Bad Honnef, Deutschland.
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Thiel C, Katt T, Schenk M, Grasshoff C, Morgalla MH, Peter A, Königsrainer A, Thiel K. How much oxidative stress exists without the liver? Z Gastroenterol 2014; 52:43-9. [PMID: 24420798 DOI: 10.1055/s-0033-1356362] [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: 10/25/2022]
Abstract
BACKGROUND Oxidative stress (OS) represents an important pathogenetic factor of acute liver failure and chronic liver diseases. To elucidate whether the liver itself is a major source of OS, the present study was performed to assess OS and antioxidant status in an anhepatic porcine model. METHODS Six pigs underwent a total hepatectomy, five pigs were sham operated. OS and antioxidant status were evaluated by measuring plasma concentrations of malondialdehyde (MDA), xanthine oxidase (XO), superoxide dismutase (SOD) and the ferric reducing ability of plasma (FRAP). They were sampled at the start of the experiment, immediately after surgery, and then at 8 and 16 hours post hepatectomy. RESULTS Increased concentrations of MDA were observed in anhepatic pigs postoperatively (p < 0.02) and 8 hours after hepatectomy (p < 0.003) compared to controls. XO activity increased soon after hepatectomy (22.6 ± 5.4 mU/L versus 3.3 ± 2.1 mU/L in sham animals, p < 0.03) but returned to normal values in the further course. SOD levels did not change during the observational period in both groups. FRAP values rose significantly in the anhepatic animals compared to control (p < 0.015). A significant positive correlation was observed between MDA levels and FRAP levels (Spearman's ρ = 0.62; p < 0.0001). CONCLUSIONS These findings show that hepatectomy does not completely prevent the occurrence of OS because the production and regulation of OS are also located outside the liver.
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Affiliation(s)
- C Thiel
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen
| | - T Katt
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen
| | - M Schenk
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen
| | - C Grasshoff
- Department of Anesthesiology, University Hospital Tuebingen
| | - M H Morgalla
- Department or Neurosurgery, University Hospital Tuebingen
| | - A Peter
- Division of Endocrinology, Diabetology, Angiology, Nephrology, Pathobiochemistry and Clinical Chemistry, Department of Internal Medicine, University Hospital Tuebingen
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen
| | - K Thiel
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen
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Schenk M. „Pro Quote Medizin“ - mehr Frauen in Führungspositionen. Dtsch Med Wochenschr 2013. [DOI: 10.1055/s-0032-1330205] [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]
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Schenk M, Illing R, Rogenhofer N, Schleussner E, Seelinger G, Toth B. Kein Vorteil durch den Einsatz von niedermolekularem Heparin bei Patientinnen mit Abortus habitualis - Ergebnisse der ETHIG II Studie. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347785] [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] Open
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Schenk M. Neue Diagnose bei verhaltensauffälligen Kindern: sinnvolle Ergänzung oder „Modekrankheit“? Dtsch Med Wochenschr 2013; 138:822-3. [DOI: 10.1055/s-0032-1330183] [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]
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Rempp H, Voigtländer M, Schenk M, Enderle D, Greiner TO, Scharpf M, Neugebauer A, Hoffmann R, Claussen CD, Clasen S. Gas-gekühlte Radiofrequenzablation als Alternative zur herkömmlichen Radiofrequenzablation und zur Mikrowellenablation: eine In-vivo-Vergleichsstudie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1329762] [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]
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Schenk M. Innere Uhr und Zeitumstellung. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1329075] [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]
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Schenk M. [External examination of the corpse]. Dtsch Med Wochenschr 2012; 137:p19. [PMID: 22692813 DOI: 10.1055/s-0032-1301819] [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: 10/28/2022]
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Schenk M. Obduktion - virtuell oder klassisch? Dtsch Med Wochenschr 2012; 137:p11. [DOI: 10.1055/s-0032-1301811] [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: 10/28/2022]
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Schenk M. Spätfolgen von Krebs im Kindesalter. Dtsch Med Wochenschr 2012; 137 Suppl 1:S7-10. [DOI: 10.1055/s-0032-1301851] [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: 10/28/2022]
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