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Dannehl D, Jakob D, Mergel F, Estler A, Engler T, Volmer L, Frevert ML, Matovina S, Englisch A, Tegeler CM, Rohner A, Seller A, Hahn M, Pfister K, Fink A, Popp I, Lorenz S, Tabatabai G, Juhasz-Böss I, Janni W, Brucker S, Taran FA, Hartkopf A, Schäffler H. The efficacy of sacituzumab govitecan and trastuzumab deruxtecan on stable and active brain metastases in metastatic breast cancer patients-a multicenter real-world analysis. ESMO Open 2024; 9:102995. [PMID: 38636292 PMCID: PMC11039313 DOI: 10.1016/j.esmoop.2024.102995] [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: 01/17/2024] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Fifteen to thirty percent of all patients with metastatic breast cancer (MBC) develop brain metastases (BCBMs). Recently, the antibody-drug conjugates (ADCs) sacituzumab govitecan (SG) and trastuzumab deruxtecan (T-DXd) have shown to be highly effective in the treatment of MBC. However, there are only limited data whether these macromolecules are also effective in patients with BCBMs. We therefore aimed to examine the efficacy of SG and T-DXd in patients with stable and active BCBMs in a multicenter real-world analysis. PATIENTS AND METHODS Female patients with stable or active BCBMs who were treated with either SG or T-DXd at three breast centers in Germany before 30 June 2023 were included. As per local clinical praxis, chemotherapy efficacy was evaluated by whole-body computed tomography and cranial magnetic resonance imaging at baseline and at least every 3 months according to local standards. Growth dynamics of BCBMs were assessed by board-certified neuroradiologists. RESULTS Of 26 patients, with a median of 2.5 prior therapy lines in the metastatic setting (range 2-15), 12 (43%) and 16 (57%) patients received SG and T-DXd, respectively. Out of the 12 patients who received SG, 2 (17%) were subsequently treated with T-DXd. Five out of 12 (42%) and 5 out of 16 (31%) patients treated with SG and T-DXd, respectively, had active BCBMs at treatment initiation. The intracranial disease control rate was 42% [95% confidence interval (CI) 13% to 71%] for patients treated with SG and 88% (95% CI 72% to 100%) for patients treated with T-DXd. After a median follow-up of 12.7 months, median intracranial progression-free survival was 2.7 months (95% CI 1.6-10.5 months) for SG and 11.2 months (95% CI 7.5-23.7 months) for T-DXd. CONCLUSIONS SG and T-DXd showed promising clinical activity in both stable and active BCBMs. Further prospective clinical studies designed to investigate the efficacy of modern ADCs on active and stable BCBMs are urgently needed.
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Affiliation(s)
- D Dannehl
- Department of Women's Health, Tuebingen University, Tuebingen.
| | - D Jakob
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg
| | - F Mergel
- Department of Gynecology and Obstetrics, Ulm University, Ulm
| | - A Estler
- Department of Radiology, Section for Diagnostic and Interventional Neuroradiology, Tuebingen
| | - T Engler
- Department of Women's Health, Tuebingen University, Tuebingen
| | - L Volmer
- Department of Women's Health, Tuebingen University, Tuebingen
| | - M-L Frevert
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg
| | - S Matovina
- Department of Women's Health, Tuebingen University, Tuebingen
| | - A Englisch
- Department of Women's Health, Tuebingen University, Tuebingen
| | - C M Tegeler
- Department of Women's Health, Tuebingen University, Tuebingen
| | - A Rohner
- Department of Women's Health, Tuebingen University, Tuebingen
| | - A Seller
- Department of Women's Health, Tuebingen University, Tuebingen
| | - M Hahn
- Department of Women's Health, Tuebingen University, Tuebingen
| | - K Pfister
- Department of Gynecology and Obstetrics, Ulm University, Ulm
| | - A Fink
- Department of Gynecology and Obstetrics, Ulm University, Ulm
| | - I Popp
- Department of Radiation Oncology, University Medical Center Freiburg, Freiburg
| | - S Lorenz
- Department of Radiology, Ulm University, Ulm
| | - G Tabatabai
- Center for Neurooncology, Comprehensive Cancer Center, Tuebingen University, Tuebingen, Germany
| | - I Juhasz-Böss
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg
| | - W Janni
- Department of Gynecology and Obstetrics, Ulm University, Ulm
| | - S Brucker
- Department of Women's Health, Tuebingen University, Tuebingen
| | - F-A Taran
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg
| | - A Hartkopf
- Department of Women's Health, Tuebingen University, Tuebingen; Department of Gynecology and Obstetrics, Ulm University, Ulm
| | - H Schäffler
- Department of Gynecology and Obstetrics, Ulm University, Ulm
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Caro C, Florek A, Hahn M, Marx M. Color Doppler Sonography Assisted Subcutaneous Mastectomy with Inferior Pedicled Nipple-Areola Complex in Female-to-Male Transsexuals: A Retrospective Cohort Analysis. Aesthetic Plast Surg 2024; 48:1126-1132. [PMID: 35701593 DOI: 10.1007/s00266-022-02945-0] [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] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/09/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The surgical goals of gender reassignment surgery of the breast in female-to male transsexuals (FMT) is the aesthetic shaping of a male thoracic wall with minimal scarring, while preserving the sensitivity of the nipple-areola complex (NAC). For large and ptotic breasts, we perform a mastectomy over an inframammary access with inferior pedicled NAC under color Doppler visualization of the perforators. This paper presents the technique, including complications and assessment of quality of life, as part of a unicentric analysis. METHODS This was a retrospective analysis of 23 patients (46 mastectomies) performed between September 2014 and September 2020. The complication rate and the number of corrective surgeries were recorded for quality assessment. A semiquantitative score was used to evaluate aesthetic outcome, nipple sensitivity, quality of life, and sexuality. RESULTS A total of 46 mastectomies were performed in 23 patients. The patient survey showed high patient satisfaction. Loss of nipple sensitivity was observed after one mastectomy (2.17%). In 91.67% of cases, patients reported that their appearance reflected how they feel on the inside. In 75% of cases, patients reported feeling equal to other men. The overall complication rate was 10.87%. Shape correction due to persistent excess of volume was rare (2.17%, equivalent to one mastectomy). CONCLUSION Subcutaneous mastectomy with inferior nipple pedicle can be performed with a high degree of safety and satisfaction in FMT. Color Doppler-guided visualization of the perforator vessels is helpful in allowing a thin pedicle preparation, thus reducing the need for secondary surgeries to optimize the shape. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- C Caro
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Heinrich-Zille-Str. 13, 01445, Radebeul, Germany.
| | - A Florek
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Heinrich-Zille-Str. 13, 01445, Radebeul, Germany
| | - M Hahn
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - M Marx
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Heinrich-Zille-Str. 13, 01445, Radebeul, Germany
- Department of Women's Health, University of Tübingen, Tübingen, Germany
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3
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Stuhec M, Hahn M, Taskova I, Bayraktar I, Fitzgerald I, Molitschnig L, Tatarević A, Lindner N, Agnoletto L, da Costa FA. Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health. Int J Clin Pharm 2023; 45:1286-1292. [PMID: 37755642 PMCID: PMC10600282 DOI: 10.1007/s11096-023-01643-4] [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: 05/29/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
A large proportion of the world's disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.
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Affiliation(s)
- Matej Stuhec
- Department of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia.
- Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, Ormoz, Slovenia.
| | - M Hahn
- Department of Mental Health, Varisano Hospital Frankfurt Hoechst, Frankfurt, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - I Taskova
- Psychiatric Hospital Bohnice, Prague, Czech Republic
- Department of Applied Pharmacy, Faculty of Pharmacy, Masaryk University, Brno, Czech Republic
| | - I Bayraktar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - I Fitzgerald
- Pharmacy Department, St Patrick's University Hospital, Dublin 8, Ireland
- School of Pharmacy, University College Cork, Cork, Ireland
| | - L Molitschnig
- Pharmacy Department, Hospital of Elisabethians, Graz, Austria
| | | | - N Lindner
- Pharmacy Department, Vienna General Hospital-Medical University Campus, Vienna, Austria
| | - L Agnoletto
- Hospital Pharmacy, Rovigo Hospital, Rovigo, Italy
| | - F Alves da Costa
- Research Institute for Medicines, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
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Boeer B, Helms G, Pasternak J, Roehm C, Kofler L, Haefner HM, Moehrle M, Heim E, Fischer H, Brucker SY, Hahn M. Back to the future: breast surgery with tumescent local anesthesia (TLA)? Arch Gynecol Obstet 2023; 308:935-940. [PMID: 36872392 PMCID: PMC10348980 DOI: 10.1007/s00404-023-06938-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/16/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE Breast surgery is usually performed under general anesthesia. Tumescent local anesthesia (TLA) offers the possibility to anesthetize large areas with highly diluted local anesthetic. METHODS In this paper, the implementation, and experiences with TLA in the field of breast surgery are discussed. CONCLUSION For carefully selected indications, breast surgery in TLA represents an alternative to ITN.
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Affiliation(s)
- B Boeer
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.
| | - G Helms
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - J Pasternak
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - C Roehm
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - L Kofler
- Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
| | - H M Haefner
- Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
| | - M Moehrle
- Praxisklinik Haut Und Venen, Tuebingen, Germany
| | - E Heim
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - H Fischer
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - S Y Brucker
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - M Hahn
- Department of Women's Health, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
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5
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Dannehl D, Dijkstra T, Gutsfeld R, Au AV, Volmer L, Engler T, Hahn M, Hawighorst-Knapstein S, Chaudhuri A, Wallwiener M, Bauer A, Brucker S, Wallwiener S, Hartkopf A. P010 Retrospective modeling of adherence to endocrine therapy in early breast cancer using real-world claims data. Breast 2023. [DOI: 10.1016/s0960-9776(23)00129-7] [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: 03/15/2023] Open
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6
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Gröschel S, Uphaus T, Gröschel K, Hahn M. P-100 Delirium in patients with acute cerebrovascular disease during visitation restrictions due to COVID-19 pandemic: A stroke-unit perspective. Clin Neurophysiol 2023. [PMCID: PMC9988268 DOI: 10.1016/j.clinph.2023.02.117] [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: 03/08/2023]
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Hahn M, Dreimann M, Matschke J, Lohner L, Püschel K. Ja, vom Lebensretter zur Gefahr – „Out of position“ macht den Unterschied. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00582-0] [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: 10/14/2022]
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8
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Rief A, Kühn T, Peintinger F, Hartmann S, Stickeler E, de Boniface J, Gentilini O, Ruf F, Fröhlich S, Thill M, Hauptmann M, Berger T, Wihlfahrt K, Karadeniz GC, Rubio IT, Gasparri ML, Kontos M, Bonci EA, Niinikoski L, Murawa D, Appelgren M, Hahn M, Pristauz-Telsnigg G, Czihak J, Banys-Paluchowski M. AXSANA – AXillary Surgery After NeoAdjuvant Treatment: Eine prospektive, multizentrische Kohortenstudie der EUBREAST-Studiengruppe zur Bewertung verschiedener chirurgischer Verfahren des axillären Stagings bei initial nodal-positiven PatientInnen nach neoadjuvanter Chemotherapie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750235] [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: 10/17/2022] Open
Affiliation(s)
- A Rief
- Medizinische Universität Graz, Univ. Klinik für Frauenheilkunde und Geburtshilfe, Graz, Österreich
| | - T Kühn
- Klinikum Esslingen, Klinik für Frauenheilkunde und Geburtshilfe, Esslingen, Deutschland
| | - F Peintinger
- Medizinische Universität Graz, Univ. Klinik für Frauenheilkunde und Geburtshilfe, Graz, Österreich
| | - S Hartmann
- Universitätsklinikum Rostock, Klinik für Frauenheilkunde und Geburtshilfe, Rostock, Deutschland
| | - E Stickeler
- Universitätsklinikum Aachen, Klinik für Frauenheilkunde und Geburtshilfe, Aachen, Deutschland
| | - J de Boniface
- Karolinska Institutet, Dept. of Molecular Medicine and Surgery, Stockholm, Sweden
- Capio St. Göran’s Hospital, Dept. of Surgery, Stockholm, Sweden
| | | | - F Ruf
- Universitätsklinikum Schleswig-Holstein, Klinik für Frauenheilkunde und Geburtshilfe, Campus Lübeck, Lübeck, Deutschland
| | - S Fröhlich
- Universitätsklinikum Rostock, Klinik für Frauenheilkunde und Geburtshilfe, Rostock, Deutschland
| | - M Thill
- AGAPLESION Markus Krankenhaus, Klinik für Gynäkologie und gynäkologische Onkologie, Frankfurt am Main, Deutschland
| | - M Hauptmann
- Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland
| | - T Berger
- Müritz-Klinikum Waren, Klinik für Frauenheilkunde und Geburtshilfe, Waren, Deutschland
| | - K Wihlfahrt
- Universitätsklinikum Schleswig-Holstein, Klinik für Frauenheilkunde und Geburtshilfe, Campus Kiel, Kiel, Deutschland
| | - G Cakmak Karadeniz
- Zonguldak BEUN The School of Medicine, General Surgery Department, Breast and Endocrine Unit, Kozlu/Zonguldak, Turkey
| | - I T Rubio
- Clínica Universidad de Navarra, Breast Surgical Unit, Madrid, Spain
| | - M L Gasparri
- Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland
- University of the Italian Switzerland (USI), Faculty of Biomedicine, Lugano, Switzerland
| | - M Kontos
- 1st Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E-A Bonci
- Department of Surgical Oncology,” Prof. Dr. Ion Chiricuță” Institute of Oncology, Cluj-Napoca, Romania
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - L Niinikoski
- Breast Surgery Unit, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - D Murawa
- Department of General Surgery and Surgical Oncology, Collegium Medicum, University of Zielona Góra, Zielona Góra, Poland
| | - M Appelgren
- Karolinska Institutet, Dept. of Molecular Medicine and Surgery, Stockholm, Sweden
| | - M Hahn
- Department für Frauengesundkeit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - G Pristauz-Telsnigg
- Medizinische Universität Graz, Univ. Klinik für Frauenheilkunde und Geburtshilfe, Graz, Österreich
| | - J Czihak
- LKH Villach, Abteilung für Gynäkologie und Geburtshilfe, Villach, Österreich
| | - M Banys-Paluchowski
- Universitätsklinikum Schleswig-Holstein, Klinik für Frauenheilkunde und Geburtshilfe, Campus Lübeck, Lübeck, Deutschland
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9
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Caro C, Freude W, Florek A, Morgenstern S, Boeer B, Roehm C, Hahn M, Marx M. Simultaneous correction of a pectus excavatum with tubular breast deformity using a custom-made silicone implant. Arch Gynecol Obstet 2021; 303:1025-1037. [PMID: 33389096 DOI: 10.1007/s00404-020-05898-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
Pectus excavatum (PE) is one of the most common congenital deformities of the thorax and is characterized by a depressed sternum with reduction of the antero-posterior thoracic diameter. Although the majority of patients with PE have no physiologic limitations, it is often associated with psychological problems influencing the patients' quality of life. Surgical treatment options show particular variation with regard to invasiveness and morbidity of the respective procedures. Surgical treatment using a custom-made silicone implant represents a less invasive alternative for patients without further accompanying physical symptoms. This article describes the simultaneous correction of a PE combined with tubular breast deformity using this minimally invasive technique.
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Affiliation(s)
- C Caro
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Radebeul, Germany
| | - W Freude
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Radebeul, Germany
| | - A Florek
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Radebeul, Germany
| | - S Morgenstern
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Radebeul, Germany
| | - B Boeer
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - C Roehm
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - M Hahn
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - M Marx
- Department of Plastic, Reconstructive and Breast Surgery, Elbland Hospital Radebeul, Radebeul, Germany.
- Department of Women's Health, University of Tübingen, Tübingen, Germany.
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Paepke S, Thill M, Peisker U, Ohlinger R, Gruber I, Malter W, Kümmel S, Hahn M, Kühn T, Reinisch M, Stachs A, Reimer T. One size fits all? Novel pulse biopsy platform offers improved needle control, high tissue yield and multiple needle options – pre-clinical results. Breast 2021. [DOI: 10.1016/s0960-9776(21)00172-7] [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: 10/21/2022] Open
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11
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Andes FT, Adam S, Hahn M, Aust O, Frey S, Grueneboom A, Nitschke L, Schett G, Steffen U. The human sialic acid-binding immunoglobulin-like lectin Siglec-9 and its murine homolog Siglec-E control osteoclast activity and bone resorption. Bone 2021; 143:115665. [PMID: 33007530 DOI: 10.1016/j.bone.2020.115665] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 03/27/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 02/08/2023]
Abstract
Regulation of osteoclast differentiation and function is a central element in bone homeostasis. While the role of soluble factors, such as cytokines, hormones and growth factors, in controlling osteoclast differentiation has been intensively characterized, the function of surface receptors is less well understood. Sialic acid-binding immunoglobulin-like lectin (Siglec)-9 and its murine homolog Siglec-E are sialic acid-recognizing inhibitory receptors from the CD33-related Siglec-family and mainly expressed on myeloid cells. We found Siglec-9 and Siglec-E to be expressed at all stages of human and murine osteoclastogenesis, respectively. Siglec-E knockout mice displayed lower bone mass despite unchanged osteoclast numbers and an increased bone formation rate. Ex vivo osteoclast assays using Siglec-E knockout cells or a blocking antibody against human Siglec-9 confirmed the suppressive effect of Siglec-9/Siglec-E on osteoclast function. Although osteoclast numbers were unchanged or even slightly decreased, the blockade/absence of Siglec-9/Siglec-E resulted in an augmented resorption activity of mature osteoclasts. This increased resorption activity was associated with enlarged actin rings. Together, our results suggest Siglec-9/Siglec-E to inhibit osteoclast activation independently from osteoclast differentiation and thereby propose a new mechanism for the control of local bone resorption.
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Affiliation(s)
- F T Andes
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - S Adam
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - M Hahn
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - O Aust
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - S Frey
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - A Grueneboom
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - L Nitschke
- Department of Genetics, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - G Schett
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - U Steffen
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany.
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12
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Hahn M, Preibsch H. [Interventional techniques for the breast]. Radiologe 2021; 61:159-165. [PMID: 33427890 DOI: 10.1007/s00117-020-00800-4] [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] [Accepted: 12/16/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Interventional methods of the breast serve as percutaneous minimally invasive diagnostic tools in case of suspicious findings in the breast or axilla. Further indications are lesion localization and the minimally invasive therapeutic approach. OBJECTIVES Aim of this paper is to give an overview of the existing methods, their indications and the imaging techniques for guidance. On the basis of the most recent publications, clinical management is described.
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Affiliation(s)
- M Hahn
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Calwerstr. 7, 72076, Tübingen, Deutschland.
| | - H Preibsch
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
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Boeer B, Schneider J, Schoenfisch B, Röhm C, Paepke S, Oberlechner E, Ohlinger R, Hartkopf A, Brucker SY, Hahn M, Marx M. Lysine-urethane-based tissue adhesion for mastectomy-an approach to reducing the seroma rate? Arch Gynecol Obstet 2020; 303:181-188. [PMID: 33146769 PMCID: PMC7854407 DOI: 10.1007/s00404-020-05801-1] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/16/2020] [Indexed: 11/05/2022]
Abstract
Purpose Postoperative seromas are a problem in the surgical treatment of breast cancer. The aim of the study was to evaluate whether the lysine-urethane-based tissue adhesive TissuGlu® without drainage is equal/ non-inferior to standard mastecomy with drainage. Methods The study was designed as a prospective, randomized, multicentre non-inferiority study comparing the use of TissuGlu® without drainage with standard wound care with a drain insertion in ablative breast procedures. The number of clinical interventions, quality of life and wound complications were followed-up for 90 days in both groups. Results Although the statistical power was not reached, twice as many clinical interventions were performed in the TissuGlu® group than in the drainage group, especially aspirations of clinically relevant seromas (p = 0.014). The TissuGlu® group produced overall less wound fluid, but developed a clinically relevant seroma (100% vs. 63%) which made an intervention necessary. Less hospitalisation time was observed in the TissuGlu® group, but the complication rate was higher. There was no significant difference in regards to postoperative pain. In summary the non-inferiority of TissuGlu® compared to standard drainage couldn’t be reached. Discussion The present evaluation shows no advantage of the tissue adhesive TissuGlu® in terms of seroma formation and frequency of intervention compared to a standard drainage for mastectomies, but the shorter inpatient stay certainly has a positive effect on the quality of life.
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Affiliation(s)
- B Boeer
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany.
| | - J Schneider
- Department of Urology, Klinikum Am Steinenberg, Reutlingen, Germany
| | - B Schoenfisch
- Research Institute for Women's Health, University of Tuebingen, Tuebingen, Germany
| | - C Röhm
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany
| | - S Paepke
- Department of Obstetrics and Gynaecology, Technical University of Munich, Munich, Germany
| | - E Oberlechner
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany
| | - R Ohlinger
- Department of Gynaecology and Obstetrics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - A Hartkopf
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany
| | - S Y Brucker
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany
| | - M Hahn
- Department of Women's Health, University Hospital of Tuebingen, Calwerstraße 7, 72076, Tuebingen, Germany
| | - M Marx
- Department of Plastic, Reconstructive and Breast Surgery, Elblandklinikum Radebeul, Radebeul, Germany
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Ries C, Boese CK, Stürznickel J, Koehne T, Hubert J, Pastor MF, Hahn M, Meier SL, Beil FT, Püschel K, Amling M, Rolvien T. Age-related changes of micro-morphological subchondral bone properties in the healthy femoral head. Osteoarthritis Cartilage 2020; 28:1437-1447. [PMID: 32795512 DOI: 10.1016/j.joca.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 03/20/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Alterations in the subchondral bone (SCB) are likely to play a decisive role in the development of osteoarthritis (OA). Since aging represents a major risk factor for OA, the aim of the current study was to assess the microstructural changes of the subchondral bone in the femoral head during aging. DESIGN Femoral heads and matched iliac crest biopsies of 80 individuals (age 21-99 years) were collected post-mortem. The bone microstructure of the subchondral trabecular bone as well as the cartilage thickness (Cg.Th) and subchondral bone plate thickness (SCB.Th) were quantified using histomorphometry. The different subregions of the SCB were also imaged by quantitative backscattered electron imaging (qBEI) in 31 aged cases to assess the bone mineral density distribution (BMDD). RESULTS The detected linear decline of bone volume per tissue volume (BV/TV) in the femoral head with aging (Slope, 95% CI: -0.208 to -0.109 %/yr.) was primarily due to a decrease in trabecular thickness (Tb.Th, Slope, 95% CI: -0.774 to -0.343 μm/yr). While SCB.Th declined with aging (Slope, 95% CI: -1.941 to -0.034 μm/yr), no changes in Cg.Th were detected (Slope, 95% CI: -0.001 to 0.005 mm/yr). The matrix mineralization of the subchondral bone was lower compared to the trabecular bone and also decreased with aging. CONCLUSIONS Regular changes of the SCB during aging primarily involve a reduction of Tb.Th, SCB.Th and matrix mineralization. Our findings facilitate future interpretations of early and late OA specimens to decipher the role of the SCB in OA pathogenesis.
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Affiliation(s)
- C Ries
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
| | - C K Boese
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany
| | - J Stürznickel
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - T Koehne
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Orthodontics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - J Hubert
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M-F Pastor
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Orthopedic Surgery, Medical School Hannover, DIAKOVERE Annastift, Hannover, Germany
| | - M Hahn
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - S L Meier
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - F T Beil
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Püschel
- Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - T Rolvien
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
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15
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Gürgan S, Gruber I, Fugunt R, Sandru M, Helms G, Röhm C, Böer B, Hoopmann U, Hartkopf A, Hahn M. Das seltene Metastasierungsort: Intramammäre und cutane Metastasen des siegelringzelliges Magenkarzinoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718274] [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: 10/23/2022] Open
Affiliation(s)
- S Gürgan
- Universitätsfrauenklinik Tübingen
| | - I Gruber
- Universitätsfrauenklinik Tübingen
| | - R Fugunt
- Universitätsfrauenklinik Tübingen
| | - M Sandru
- Universitätsfrauenklinik Tübingen
| | - G Helms
- Universitätsfrauenklinik Tübingen
| | - C Röhm
- Universitätsfrauenklinik Tübingen
| | - B Böer
- Universitätsfrauenklinik Tübingen
| | | | | | - M Hahn
- Universitätsfrauenklinik Tübingen
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16
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Sandru M, Gruber I, Boer B, Fugunt R, Gürgan S, Heinecke V, Helms G, Hoopmann U, Röhm C, Hahn M. Evaluation eines DEGUM Mammasonographie-Qualitätszirkels. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717873] [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: 10/23/2022] Open
Affiliation(s)
- M Sandru
- Institut für Frauengesundheit Tübingen
| | - I Gruber
- Institut für Frauengesundheit Tübingen
| | - B Boer
- Institut für Frauengesundheit Tübingen
| | - R Fugunt
- Institut für Frauengesundheit Tübingen
| | - S Gürgan
- Institut für Frauengesundheit Tübingen
| | | | - G Helms
- Institut für Frauengesundheit Tübingen
| | | | - C Röhm
- Institut für Frauengesundheit Tübingen
| | - M Hahn
- Institut für Frauengesundheit Tübingen
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17
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Matovina S, Engler T, Müller H, Grischke EM, Hahn M, Brucker SY, Hartkopf AD. Vergleich von biosimilarem Trastuzumab (ABP 980, Kanjinti®) mit dem Originalantikörper (Herceptin®) anhand der pCR-Rate nach neoadjuvanter Therapie bei frühem HER2-positivem Mammakarzinom. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717859] [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: 10/23/2022] Open
Affiliation(s)
| | - T Engler
- Universitätsfrauenklinik Tübingen
| | - H Müller
- Universitätsfrauenklinik Tübingen
| | | | - M Hahn
- Universitätsfrauenklinik Tübingen
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18
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Volmer L, Engler T, Staebler A, Hahn M, Kommoss S, Krämer B, Brucker S, Hartkopf A. Erstmanifestation eines Muir-Torre-Syndroms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718332] [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: 10/23/2022] Open
Affiliation(s)
- L Volmer
- Universitätsfrauenklinik Tübingen
| | - T Engler
- Universitätsfrauenklinik Tübingen
| | | | - M Hahn
- Universitätsfrauenklinik Tübingen
| | | | - B Krämer
- Universitätsfrauenklinik Tübingen
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19
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Bodizs LC, Hahn M. Automatisierung der Vorbereitung von Sicherheitsstudien und Absicherungskonzepten mittels Energiebilanz. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055475] [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: 11/10/2022]
Affiliation(s)
- L.-C. Bodizs
- Evonik Operations GmbH Process Safety Paul-Baumann-Str. 1 45772 Marl Deutschland
| | - M. Hahn
- Evonik Operations GmbH Process Safety Paul-Baumann-Str. 1 45772 Marl Deutschland
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20
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Chai C, Cox B, Yaish D, Gross D, Rosenberg N, Amblard F, Shemuelian Z, Gefen M, Korach A, Tirosh O, Lanton T, Link H, Tam J, Permyakova A, Ozhan G, Citrin J, Liao H, Tannous M, Hahn M, Axelrod J, Arretxe E, Alonso C, Martinez-Arranz I, Betés PO, Safadi R, Salhab A, Amer J, Tber Z, Mengshetti S, Giladi H, Schinazi RF, Galun E. Agonist of RORA Attenuates Nonalcoholic Fatty Liver Progression in Mice via Up-regulation of MicroRNA 122. Gastroenterology 2020; 159:999-1014.e9. [PMID: 32450149 PMCID: PMC7722250 DOI: 10.1053/j.gastro.2020.05.056] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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] [Received: 10/02/2019] [Revised: 04/07/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Development of nonalcoholic steatohepatitis (NASH) is associated with reductions in hepatic microRNA122 (MIR122); the RAR related orphan receptor A (RORA) promotes expression of MIR122. Increasing expression of RORA in livers of mice increases expression of MIR122 and reduces lipotoxicity. We investigated the effects of a RORA agonist in mouse models of NASH. METHODS We screened a chemical library to identify agonists of RORA and tested their effects on a human hepatocellular carcinoma cell line (Huh7). C57BL/6 mice were fed a chow or high-fat diet (HFD) for 4 weeks to induce fatty liver. Mice were given hydrodynamic tail vein injections of a MIR122 antagonist (antagomiR-122) or a control antagomiR once each week for 3 weeks while still on the HFD or chow diet, or intraperitoneal injections of the RORA agonist RS-2982 or vehicle, twice each week for 3 weeks. Livers, gonad white adipose, and skeletal muscle were collected and analyzed by reverse-transcription polymerase chain reaction, histology, and immunohistochemistry. A separate group of mice were fed an atherogenic diet, with or without injections of RS-2982 for 3 weeks; livers were analyzed by immunohistochemistry, and plasma was analyzed for levels of aminotransferases. We analyzed data from liver tissues from patients with NASH included in the RNA-sequencing databases GSE33814 and GSE89632. RESULTS Injection of mice with antagomiR-122 significantly reduced levels of MIR122 in plasma, liver, and white adipose tissue; in mice on an HFD, antagomiR-122 injections increased fat droplets and total triglyceride content in liver and reduced β-oxidation and energy expenditure, resulting in significantly more weight gain than in mice given the control microRNA. We identified RS-2982 as an agonist of RORA and found it to increase expression of MIR122 promoter activity in Huh7 cells. In mice fed an HFD or atherogenic diet, injections of RS-2982 increased hepatic levels of MIR122 precursors and reduced hepatic synthesis of triglycerides by reducing expression of biosynthesis enzymes. In these mice, RS-2982 significantly reduced hepatic lipotoxicity, reduced liver fibrosis, increased insulin resistance, and reduced body weight compared with mice injected with vehicle. Patients who underwent cardiovascular surgery had increased levels of plasma MIR122 compared to its levels before surgery; increased expression of plasma MIR122 was associated with increased levels of plasma free fatty acids and levels of RORA. CONCLUSIONS We identified the compound RS-2982 as an agonist of RORA that increases expression of MIR122 in cell lines and livers of mice. Mice fed an HFD or atherogenic diet given injections of RS-2982 had reduced hepatic lipotoxicity, liver fibrosis, and body weight compared with mice given the vehicle. Agonists of RORA might be developed for treatment of NASH.
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Affiliation(s)
- Chofit Chai
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Bryan Cox
- Laboratory of Biochemical Pharmacology Emory University, Department of Pediatrics, Atlanta, Georgia
| | - Dayana Yaish
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Devora Gross
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Nofar Rosenberg
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Franck Amblard
- Laboratory of Biochemical Pharmacology Emory University, Department of Pediatrics, Atlanta, Georgia
| | - Zohar Shemuelian
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Maytal Gefen
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Amit Korach
- Cardiothoracic Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Oren Tirosh
- Institute of Biochemistry, Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Tali Lanton
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Henrike Link
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Joseph Tam
- Obesity and Metabolism Laboratory, Multidisciplinary Center for Cannabinoid Research, Faculty of Medicine, The Institute for Drug Research, The Hebrew University of Jerusalem, Israel
| | - Anna Permyakova
- Obesity and Metabolism Laboratory, Multidisciplinary Center for Cannabinoid Research, Faculty of Medicine, The Institute for Drug Research, The Hebrew University of Jerusalem, Israel
| | - Gunes Ozhan
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey
| | - Jonathan Citrin
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Haixing Liao
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mirna Tannous
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Michal Hahn
- Institute of Biochemistry, Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Jonathan Axelrod
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Enara Arretxe
- OWL Metabolomics, Bizkaia Technology Park, Derio, Spain
| | | | | | | | - Rifaat Safadi
- Liver Unit, Gastroenterology Institute, Department of Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Ahmad Salhab
- Liver Unit, Gastroenterology Institute, Department of Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Johnny Amer
- Liver Unit, Gastroenterology Institute, Department of Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Zahira Tber
- Laboratory of Biochemical Pharmacology Emory University, Department of Pediatrics, Atlanta, Georgia
| | - Seema Mengshetti
- Laboratory of Biochemical Pharmacology Emory University, Department of Pediatrics, Atlanta, Georgia
| | - Hilla Giladi
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Raymond F. Schinazi
- Laboratory of Biochemical Pharmacology Emory University, Department of Pediatrics, Atlanta, Georgia
| | - Eithan Galun
- Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Jerusalem, Israel.
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21
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Zelber-Sagi S, Ivancovsky-Wajcman D, Fliss-Isakov N, Hahn M, Webb M, Shibolet O, Kariv R, Tirosh O. Serum Malondialdehyde is Associated with Non-Alcoholic Fatty Liver and Related Liver Damage Differentially in Men and Women. Antioxidants (Basel) 2020; 9:antiox9070578. [PMID: 32630732 PMCID: PMC7401879 DOI: 10.3390/antiox9070578] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are associated with increased oxidative stress and lipid peroxidation, but large studies are lacking. The aim was to test the association of malondialdehyde (MDA), as a marker of oxidative damage of lipids, with NAFLD and liver damage markers, and to test the association between dietary vitamins E and C intake and MDA levels. Methods: A cross-sectional study was carried out among subjects who underwent blood tests including FibroMax for non-invasive assessment of NASH and fibrosis. MDA was evaluated by reaction with Thiobarbituric acid and HPLC-fluorescence detection method. NAFLD was diagnosed by abdominal ultrasound. Findings: MDA measurements were available for 394 subjects. In multivariate analysis, the odds for NAFLD were higher with the rise of MDA levels in a dose–response manner, adjusting for age, gender, BMI, and lifestyle factors. Only among men, higher serum MDA was associated of higher odds for NAFLD and NASH and/or fibrosis (OR = 2.59, 95% CI 1.33–5.07, P = 0.005; OR = 2.04, 1.02–4.06, P = 0.043, respectively). Higher vitamin E intake was associated with lower odds of high serum MDA level (OR = 0.28 95% CI 0.13–0.62, P = 0.002). In conclusion, serum MDA is associated with NAFLD and markers of NASH or fibrosis among men. Dietary vitamin E may be protective among women.
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Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa 3498838, Israel;
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423914, Israel; (N.F.-I.); (M.W.); (O.S.); (R.K.)
- Correspondence: ; Tel.: +972-3-6973984
| | | | - Naomi Fliss-Isakov
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423914, Israel; (N.F.-I.); (M.W.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Michal Hahn
- Institute of Biochemistry, Food Science and Nutrition, The RH Smit Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rechovot 76100001, Israel; (M.H.); (O.T.)
| | - Muriel Webb
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423914, Israel; (N.F.-I.); (M.W.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Oren Shibolet
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423914, Israel; (N.F.-I.); (M.W.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Revital Kariv
- Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv 6423914, Israel; (N.F.-I.); (M.W.); (O.S.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Oren Tirosh
- Institute of Biochemistry, Food Science and Nutrition, The RH Smit Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rechovot 76100001, Israel; (M.H.); (O.T.)
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22
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Hahn M, Weskott HP. [Not Available]. Ultraschall Med 2019; 40:S1. [PMID: 31645069 DOI: 10.1055/s-0039-1696043] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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23
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Jung B, Iacono P, Benediktus K, Hahn M, Göggerle G, Wolf J, Nickolaus P. P273 BI 443651 and BI 1265162 demonstrate in vitro inhibition of epithelial sodium channel (ENaC) in the Ussing chamber. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30566-1] [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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24
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Jung B, Iacono P, Hahn M, Borsch M, Hoffmann A, Nickolaus P. P275 Both BI 443651 and BI 1265162 demonstrate inhibition of the liquid absorption from the rat airway epithelium in vivo. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30568-5] [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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Abstract
BACKGROUND Drug-drug interaction databases are an important tool to increase drug safety in polypharmacy. There are several drug interaction databases available but it is unclear which one shows the best results and therefore increases safety for the user of the databases and the patients. So far, there has been no validation of German drug interaction databases. GOAL Validation of German drug interaction databases regarding the number of hits, mechanisms of drug interaction, references, clinical advice, and severity of the interaction. METHODS A total of 36 drug interactions which were published in the last 3-5 years were checked in 5 different databases. Besides the number of hits, it was also documented if the mechanism was correct, clinical advice was given, primary literature was cited, and the severity level of the drug-drug interaction was given. RESULTS All databases showed weaknesses regarding the hit rate of the tested drug interactions, with a maximum of 67.7% hits. The highest score in this validation was achieved by MediQ with 104 out of 180 points. PsiacOnline achieved 83 points, arznei-telegramm® 58, ifap index® 54 and the ABDA-database 49 points. Based on this validation MediQ seems to be the most suitable databank for the field of psychopharmacotherapy. DISCUSSION The best results in this comparison were achieved by MediQ but this database also needs improvement with respect to the hit rate so that the users can rely on the results and therefore increase drug therapy safety.
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Affiliation(s)
- M Hahn
- Vitos Klinik Eichberg, Kloster-Eberbach-Str.4, 65346, Eltville, Deutschland.
| | - S C Roll
- Vitos Klinik Eichberg, Kloster-Eberbach-Str.4, 65346, Eltville, Deutschland
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Stern SA, Weaver HA, Spencer JR, Olkin CB, Gladstone GR, Grundy WM, Moore JM, Cruikshank DP, Elliott HA, McKinnon WB, Parker JW, Verbiscer AJ, Young LA, Aguilar DA, Albers JM, Andert T, Andrews JP, Bagenal F, Banks ME, Bauer BA, Bauman JA, Bechtold KE, Beddingfield CB, Behrooz N, Beisser KB, Benecchi SD, Bernardoni E, Beyer RA, Bhaskaran S, Bierson CJ, Binzel RP, Birath EM, Bird MK, Boone DR, Bowman AF, Bray VJ, Britt DT, Brown LE, Buckley MR, Buie MW, Buratti BJ, Burke LM, Bushman SS, Carcich B, Chaikin AL, Chavez CL, Cheng AF, Colwell EJ, Conard SJ, Conner MP, Conrad CA, Cook JC, Cooper SB, Custodio OS, Dalle Ore CM, Deboy CC, Dharmavaram P, Dhingra RD, Dunn GF, Earle AM, Egan AF, Eisig J, El-Maarry MR, Engelbrecht C, Enke BL, Ercol CJ, Fattig ED, Ferrell CL, Finley TJ, Firer J, Fischetti J, Folkner WM, Fosbury MN, Fountain GH, Freeze JM, Gabasova L, Glaze LS, Green JL, Griffith GA, Guo Y, Hahn M, Hals DW, Hamilton DP, Hamilton SA, Hanley JJ, Harch A, Harmon KA, Hart HM, Hayes J, Hersman CB, Hill ME, Hill TA, Hofgartner JD, Holdridge ME, Horányi M, Hosadurga A, Howard AD, Howett CJA, Jaskulek SE, Jennings DE, Jensen JR, Jones MR, Kang HK, Katz DJ, Kaufmann DE, Kavelaars JJ, Keane JT, Keleher GP, Kinczyk M, Kochte MC, Kollmann P, Krimigis SM, Kruizinga GL, Kusnierkiewicz DY, Lahr MS, Lauer TR, Lawrence GB, Lee JE, Lessac-Chenen EJ, Linscott IR, Lisse CM, Lunsford AW, Mages DM, Mallder VA, Martin NP, May BH, McComas DJ, McNutt RL, Mehoke DS, Mehoke TS, Nelson DS, Nguyen HD, Núñez JI, Ocampo AC, Owen WM, Oxton GK, Parker AH, Pätzold M, Pelgrift JY, Pelletier FJ, Pineau JP, Piquette MR, Porter SB, Protopapa S, Quirico E, Redfern JA, Regiec AL, Reitsema HJ, Reuter DC, Richardson DC, Riedel JE, Ritterbush MA, Robbins SJ, Rodgers DJ, Rogers GD, Rose DM, Rosendall PE, Runyon KD, Ryschkewitsch MG, Saina MM, Salinas MJ, Schenk PM, Scherrer JR, Schlei WR, Schmitt B, Schultz DJ, Schurr DC, Scipioni F, Sepan RL, Shelton RG, Showalter MR, Simon M, Singer KN, Stahlheber EW, Stanbridge DR, Stansberry JA, Steffl AJ, Strobel DF, Stothoff MM, Stryk T, Stuart JR, Summers ME, Tapley MB, Taylor A, Taylor HW, Tedford RM, Throop HB, Turner LS, Umurhan OM, Van Eck J, Velez D, Versteeg MH, Vincent MA, Webbert RW, Weidner SE, Weigle GE, Wendel JR, White OL, Whittenburg KE, Williams BG, Williams KE, Williams SP, Winters HL, Zangari AM, Zurbuchen TH. Initial results from the New Horizons exploration of 2014 MU 69, a small Kuiper Belt object. Science 2019; 364:364/6441/eaaw9771. [PMID: 31097641 DOI: 10.1126/science.aaw9771] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/16/2019] [Indexed: 11/02/2022]
Abstract
The Kuiper Belt is a distant region of the outer Solar System. On 1 January 2019, the New Horizons spacecraft flew close to (486958) 2014 MU69, a cold classical Kuiper Belt object approximately 30 kilometers in diameter. Such objects have never been substantially heated by the Sun and are therefore well preserved since their formation. We describe initial results from these encounter observations. MU69 is a bilobed contact binary with a flattened shape, discrete geological units, and noticeable albedo heterogeneity. However, there is little surface color or compositional heterogeneity. No evidence for satellites, rings or other dust structures, a gas coma, or solar wind interactions was detected. MU69's origin appears consistent with pebble cloud collapse followed by a low-velocity merger of its two lobes.
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Affiliation(s)
- S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA.
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J R Spencer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - W M Grundy
- Lowell Observatory, Flagstaff, AZ 86001, USA
| | - J M Moore
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA
| | - D P Cruikshank
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78238, USA.,Department of Physics and Astronomy, University of Texas, San Antonio, TX 78249, USA
| | - W B McKinnon
- Department of Earth and Planetary Sciences and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - J Wm Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A J Verbiscer
- Department of Astronomy, University of Virginia, Charlottesville, VA 22904, USA
| | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D A Aguilar
- Independent consultant, Carbondale, CO 81623, USA
| | - J M Albers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T Andert
- Universität der Bundeswehr München, Neubiberg 85577, Germany
| | - J P Andrews
- Southwest Research Institute, Boulder, CO 80302, USA
| | - F Bagenal
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - M E Banks
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - B A Bauer
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - K E Bechtold
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C B Beddingfield
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - N Behrooz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K B Beisser
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S D Benecchi
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - E Bernardoni
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - R A Beyer
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - S Bhaskaran
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - C J Bierson
- Earth and Planetary Science Department, University of California, Santa Cruz, CA 95064, USA
| | - R P Binzel
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - E M Birath
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M K Bird
- Argelander-Institut für Astronomie, University of Bonn, Bonn D-53121, Germany.,Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | - D R Boone
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A F Bowman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - V J Bray
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - D T Britt
- Department of Physics, University of Central Florida, Orlando, FL 32816, USA
| | - L E Brown
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R Buckley
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M W Buie
- Southwest Research Institute, Boulder, CO 80302, USA
| | - B J Buratti
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - L M Burke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S S Bushman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B Carcich
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA.,Cornell University, Ithaca, NY 14853, USA
| | - A L Chaikin
- Independent science writer, Arlington, VT 05250, USA
| | - C L Chavez
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - A F Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - E J Colwell
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S J Conard
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M P Conner
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C A Conrad
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J C Cook
- Pinhead Institute, Telluride, CO 81435, USA
| | - S B Cooper
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - O S Custodio
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C M Dalle Ore
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - C C Deboy
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - P Dharmavaram
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - G F Dunn
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A M Earle
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A F Egan
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J Eisig
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R El-Maarry
- Department of Earth and Planetary Sciences, Birkbeck, University of London, London WC1E 7HX, UK
| | - C Engelbrecht
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B L Enke
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C J Ercol
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - E D Fattig
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - C L Ferrell
- Southwest Research Institute, Boulder, CO 80302, USA
| | - T J Finley
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J Firer
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - W M Folkner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M N Fosbury
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G H Fountain
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J M Freeze
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - L Gabasova
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - L S Glaze
- NASA Headquarters, Washington, DC 20546, USA
| | - J L Green
- NASA Headquarters, Washington, DC 20546, USA
| | - G A Griffith
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - Y Guo
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Hahn
- Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | - D W Hals
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D P Hamilton
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - S A Hamilton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J J Hanley
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A Harch
- Cornell University, Ithaca, NY 14853, USA
| | - K A Harmon
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - H M Hart
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J Hayes
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C B Hersman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T A Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J D Hofgartner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M E Holdridge
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Horányi
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - A Hosadurga
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A D Howard
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904, USA
| | - C J A Howett
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S E Jaskulek
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D E Jennings
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - J R Jensen
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R Jones
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - H K Kang
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D J Katz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D E Kaufmann
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J J Kavelaars
- National Research Council of Canada, Victoria, BC V9E 2E7, Canada
| | - J T Keane
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - G P Keleher
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Kinczyk
- Marine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - M C Kochte
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - P Kollmann
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S M Krimigis
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G L Kruizinga
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - D Y Kusnierkiewicz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M S Lahr
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T R Lauer
- National Optical Astronomy Observatory, Tucson, AZ 26732, USA
| | - G B Lawrence
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J E Lee
- NASA Marshall Space Flight Center, Huntsville, AL 35812, USA
| | | | - I R Linscott
- Independent consultant, Mountain View, CA 94043, USA
| | - C M Lisse
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A W Lunsford
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D M Mages
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - V A Mallder
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - N P Martin
- Independent consultant, Crested Butte, CO 81224, USA
| | - B H May
- Independent collaborator, Windlesham GU20 6YW, UK
| | - D J McComas
- Southwest Research Institute, San Antonio, TX 78238, USA.,Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D S Mehoke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T S Mehoke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - H D Nguyen
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J I Núñez
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A C Ocampo
- NASA Headquarters, Washington, DC 20546, USA
| | - W M Owen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - G K Oxton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A H Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M Pätzold
- Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | | | | | - J P Pineau
- Stellar Solutions, Palo Alto, CA 94306, USA
| | - M R Piquette
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - S B Porter
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Protopapa
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E Quirico
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - J A Redfern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A L Regiec
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - D C Reuter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D C Richardson
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - J E Riedel
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M A Ritterbush
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - S J Robbins
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D J Rodgers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G D Rogers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D M Rose
- Southwest Research Institute, Boulder, CO 80302, USA
| | - P E Rosendall
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K D Runyon
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M G Ryschkewitsch
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M M Saina
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - P M Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | - J R Scherrer
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - W R Schlei
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B Schmitt
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - D J Schultz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D C Schurr
- NASA Headquarters, Washington, DC 20546, USA
| | - F Scipioni
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - R L Sepan
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R G Shelton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - M Simon
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K N Singer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E W Stahlheber
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - J A Stansberry
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - A J Steffl
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D F Strobel
- Johns Hopkins University, Baltimore, MD 21218, USA
| | - M M Stothoff
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - T Stryk
- Roane State Community College, Oak Ridge, TN 37830, USA
| | - J R Stuart
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M E Summers
- George Mason University, Fairfax, VA 22030, USA
| | - M B Tapley
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A Taylor
- KinetX Aerospace, Tempe, AZ 85284, USA
| | - H W Taylor
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R M Tedford
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H B Throop
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - L S Turner
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - O M Umurhan
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - J Van Eck
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D Velez
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M H Versteeg
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M A Vincent
- Southwest Research Institute, Boulder, CO 80302, USA
| | - R W Webbert
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S E Weidner
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - G E Weigle
- Independent consultant, Burden, KS 67019, USA
| | - J R Wendel
- NASA Headquarters, Washington, DC 20546, USA
| | - O L White
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - K E Whittenburg
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | | | - S P Williams
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - H L Winters
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A M Zangari
- Southwest Research Institute, Boulder, CO 80302, USA
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De Colle C, Weidner N, Heinrich V, Brucker S, Hahn M, MacMillan K, Lamprecht U, Gaupp S, Voigt O, Zips D. EP-1317 Hyperthermic chest wall re-irradiation in recurrent breast cancer: a prospective observational study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31737-2] [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: 11/15/2022]
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Hartkopf AD, Brucker SY, Taran FA, Harbeck N, von Au A, Naume B, Pierga JY, Hoffmann O, Beckmann MW, Rydén L, Fehm T, Aft R, Montserrat S, Walter V, Rack B, Schuetz F, Borgen E, Ta MH, Bittner AK, Fasching P, Fernö M, Krawczyk N, Weilbaecher K, Margelí M, Hahn M, Jueckstock J, Domschke C, Bidard FC, Kasimir-Bauer S, Schoenfisch B, Kurt AG, Wallwiener M, Gebauer G, Wallwiener D, Janni W, Pantel K. Abstract GS5-07: International pooled analysis of the prognostic impact of disseminated tumor cells from the bone marrow in early breast cancer: Results from the PADDY study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs5-07] [Citation(s) in RCA: 3] [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: 11/16/2022]
Abstract
Abstract
Introduction
As early breast cancer might relapse even after complete removal of breast and lymphnodes, the disease must persist in secondary sites. The detection of disseminated tumor cells (DTC) in the bone marrow (BM) has been described as a surrogate of residual disease. Various trials showed an impaired prognosis of DTC positive early breast cancer (EBC) patients. The PADDY (Pooled Analysis of DTC Detection in Early Breast Cancer) study is a large international pooled analysis that aimed to assess the prognostic impact of DTC detection in patients with EBC.
Methods
A pre-specified protocol was followed, and centers known to practice BM sampling for DTC detection were contacted for individual patient data. Patients with EBC, with available follow-up data and BM sampling before any anti-cancer treatment were eligible. BM aspirates were collected at the time of primary surgery. DTC were identified by antibody (A45-B/B3, AE1/AE3, 2E11 and E29) staining against cytokeratin. The DTC status was compared to other prognostic factors using the chi-squared test. Univariate log-rank test and multivariate cox regression were used to compare survival of DTC positive versus DTC negative patients.
Results
Individual data from 10,320 patients (11 centers from Europe and USA) were included with a median follow-up of 91 months. Of all patients, 2,823 (27.4 %) were DTC positive. DTC detection was associated with higher tumor grade, higher T stage, nodal positivity, ER and PR negativity, and HER2 positivity (all p<0.001). In univariate analyses, overall, breast cancer specific, disease-free and distant disease-free survival (OS, BCSS, DFS, DDFS) were significantly shorter in DTC positive patients with p-values of <0.001. Multivariate analyses showed the DTC status to be an independent prognostic marker for OS, BCSS, DFS and DDFS with hazard ratios (HR) and 95%-confidence intervals (CI) of 1.23 (95%-CI: 1.06-1.42, p=0.007), 1.38 (95%-CI: 1.11-1.72, p=0.004), 1.29 (95%-CI: 1.10-1.50, p=0.001) and 1.32 (95%-CI: 1.10-1.58, p=0.003), respectively.
Conclusions
Detection of DTC in the bone marrow is an independent prognostic marker in patients with non-metastatic breast cancer. Further studies should investigate the impact of DTC on metastatic cancer progression and their role for clinical decision making.
Citation Format: Hartkopf AD, Brucker SY, Taran F-A, Harbeck N, von Au A, Naume B, Pierga J-Y, Hoffmann O, Beckmann MW, Rydén L, Fehm T, Aft R, Montserrat S, Walter V, Rack B, Schuetz F, Borgen E, Ta M-H, Bittner A-K, Fasching P, Fernö M, Krawczyk N, Weilbaecher K, Margelí M, Hahn M, Jueckstock J, Domschke C, Bidard F-C, Kasimir-Bauer S, Schoenfisch B, Kurt AG, Wallwiener M, Gebauer G, Wallwiener D, Janni W, Pantel K. International pooled analysis of the prognostic impact of disseminated tumor cells from the bone marrow in early breast cancer: Results from the PADDY study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS5-07.
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Affiliation(s)
- AD Hartkopf
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - SY Brucker
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F-A Taran
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Harbeck
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A von Au
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Naume
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J-Y Pierga
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - O Hoffmann
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - MW Beckmann
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Rydén
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Fehm
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Aft
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Montserrat
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Walter
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Rack
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Schuetz
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Borgen
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M-H Ta
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A-K Bittner
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Fasching
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Fernö
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Krawczyk
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Weilbaecher
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Margelí
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Hahn
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Jueckstock
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Domschke
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F-C Bidard
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Kasimir-Bauer
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Schoenfisch
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - AG Kurt
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Wallwiener
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Gebauer
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Wallwiener
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Janni
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Pantel
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hoffmann SM, Kappel D, Fech A, Enderle MD, Weiss M, Hahn M, Brucker SY, Kraemer B. Thermal effects of a novel electrosurgical device for focused preparation in breast surgery tested in a specified porcine tissue ex vivo breast model using infrared measurement. Arch Gynecol Obstet 2019; 299:835-840. [PMID: 30607596 DOI: 10.1007/s00404-018-5024-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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/14/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE This article investigates the qualities and thermal effects of a novel electrosurgical device (PT) which has been designed by ERBE Elektromedizin GmbH, Germany, for the preparation of critical locations such as in skin-sparing or nipple-sparing techniques and compares it to a standard device (SD) in a porcine ex vivo breast model using an heat map generated by infrared thermography. METHODS In total, 42 abdominal wall specimens of porcine tissue consisting of the skin and the underlying subcutaneous and muscle layer were alternately dissected using one of the devices and pre-settings. During the preparation with the two devices, the epicutaneous temperature was measured by an infrared camera (VarioCam, Jenoptik, Germany) and the maximum temperature as well as the slope of the temperature rise was analysed. RESULTS The use of PT shows significantly lower values for [Formula: see text] compared to SD. This effect was independent from the chosen mode. Using the same instrument in different modes, the use of AutoCut mode showed a significant reduction of [Formula: see text] at all indicated time points (SD: p < 0.0001 and PT: p < 0.0001). In summary, the combination of AutoCut + PT showed the lowest rise in temperature, whereas the combination of DryCut + SD led to the highest rise in temperature. The temperature difference between these two settings was 13.84 °C, which means a possible temperature reduction of 67% can be achieved by the right choice of device and its tailored mode. CONCLUSIONS The novel PT shows a significant reduction in epicutaneous temperature and a significant reduction of the slope of temperature rise most probably by a more focused application of energy compared to SD.
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Affiliation(s)
- S M Hoffmann
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany.
| | - D Kappel
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - A Fech
- ERBE Elektromedizin GmbH, Waldhoernlestr. 17, 72070, Tübingen, Germany
| | - M D Enderle
- ERBE Elektromedizin GmbH, Waldhoernlestr. 17, 72070, Tübingen, Germany
| | - M Weiss
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - M Hahn
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - S Y Brucker
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - B Kraemer
- Department of Obstetrics and Gynecology, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
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Bosse K, Oberlechner E, Hoffmann A, Fugunt R, Böer B, Gruber I, Helms G, Hoopmann U, Röhm C, Hartkopf A, Komoss S, Faust U, Pohle A, Dufke A, Nguyen H, Kehrer M, Schroeder C, Heinrich T, Rieß O, Staebler A, Vogel U, Taran FA, Brucker SY, Marx M, Wallwiener D, Hahn M. Prädiktive Testung bei Familienangehörigen von BRCA1, BRCA2 und CHEK2 Mutationsträgerinnen am Universitätsbrustzentrum Tübingen – eine klinische retrospektive unizentrische Kohortenstudie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671360] [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: 10/28/2022] Open
Affiliation(s)
- K Bosse
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - E Oberlechner
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - A Hoffmann
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - R Fugunt
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - B Böer
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - I Gruber
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - G Helms
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - U Hoopmann
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - C Röhm
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - A Hartkopf
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - S Komoss
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - U Faust
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - A Pohle
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - A Dufke
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - H Nguyen
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - M Kehrer
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - C Schroeder
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - T Heinrich
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - O Rieß
- Institut für Medizinische Genetik und angewandte Genomik, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - A Staebler
- Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - U Vogel
- Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - FA Taran
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - SY Brucker
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - M Marx
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - D Wallwiener
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
| | - M Hahn
- Department für Frauengesundheit, Universitätsfauenklinik Tübingen, Tübingen, Deutschland
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Simoes E, Graf J, Sokolov AN, Grischke EM, Hartkopf AD, Hahn M, Weiss M, Abele H, Seeger H, Brucker SY. 10-Jahres-Überlebensrate und Geburtsoutcomes bei Schwangerschafts-assoziiertem Brustkrebs. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671020] [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: 10/28/2022] Open
Affiliation(s)
- E Simoes
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
- Stabstelle Sozialmedizin, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - J Graf
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
- Universität Tübingen, Medizinische Fakultät, Bereich Studium und Lehre, Tübingen, Deutschland
| | - AN Sokolov
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
| | - EM Grischke
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - AD Hartkopf
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - M Hahn
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - M Weiss
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - H Abele
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - H Seeger
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - SY Brucker
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
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Arthanayaka TP, Beiersdorfer P, Brown GV, Hahn M, Hell N, Lockard TE, Savin DW. Measurements of the effective electron density in an electron beam ion trap using extreme ultraviolet spectra and optical imaging. Rev Sci Instrum 2018; 89:10E119. [PMID: 30399824 DOI: 10.1063/1.5036758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/08/2018] [Indexed: 06/08/2023]
Abstract
In an electron beam ion trap (EBIT), the ions are not confined to the electron beam, but rather oscillate in and out of the beam. As a result, the ions do not continuously experience the full density of the electron beam. To determine the effective electron density, n e,eff, experienced by the ions, the electron beam size, the nominal electron density n e, and the ion distribution around the beam, i.e., the so-called ion cloud, must be measured. We use imaging techniques in the extreme ultraviolet (EUV) and optical to determine these. The electron beam width is measured using 3d → 3p emission from Fe xii and xiii between 185 and 205 Å. These transitions are fast and the EUV emission occurs only within the electron beam. The measured spatial emission profile and variable electron current yield a nominal electron density range of n e ∼ 1011-1013 cm-3. We determine the size of the ion cloud using optical emission from metastable levels of ions with radiative lifetimes longer than the ion orbital periods. The resulting emission maps out the spatial distribution of the ion cloud. We find a typical electron beam radius of ∼60 μm and an ion cloud radius of ∼300 μm. These yield a spatially averaged effective electron density, n e,eff, experienced by the ions in EBIT spanning ∼ 5 × 109-5 × 1011 cm-3.
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Affiliation(s)
- T P Arthanayaka
- Columbia Astrophysics Laboratory, New York, New York 10027, USA
| | - P Beiersdorfer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G V Brown
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Hahn
- Columbia Astrophysics Laboratory, New York, New York 10027, USA
| | - N Hell
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T E Lockard
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D W Savin
- Columbia Astrophysics Laboratory, New York, New York 10027, USA
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Hahn M, Fugunt R, Schoenfisch B, Oberlechner E, Gruber I, Hoopmann U, Roehm C, Helms G, Taran F, Hartkopf A, Warzecha H, Wiesinger B, Brucker S, Boeer B. High intensity focused ultrasound (HIFU) for the treatment of symptomatic breast fibroadenoma. Int J Hyperthermia 2018; 35:463-470. [DOI: 10.1080/02656736.2018.1508757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- M. Hahn
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - R. Fugunt
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - B. Schoenfisch
- Research Institute for Women’s Health, University of Tuebingen, Tuebingen, Germany
| | - E. Oberlechner
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - I.V. Gruber
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - U. Hoopmann
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - C. Roehm
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - G. Helms
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - F.A. Taran
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - A.D. Hartkopf
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - H. Warzecha
- Department of Pathology, University Hospital of Tuebingen, Tuebingen, Germany
| | - B. Wiesinger
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - S.Y. Brucker
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
- Research Institute for Women’s Health, University of Tuebingen, Tuebingen, Germany
| | - B. Boeer
- Department of Women’s Health, University Hospital of Tuebingen, Tuebingen, Germany
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Preibsch H, Wanner LK, Staebler A, Hahn M, Siegmann-Luz KC. Malignancy rates of B3-lesions in breast magnetic resonance imaging - do all lesions have to be excised? BMC Med Imaging 2018; 18:27. [PMID: 30200900 PMCID: PMC6131767 DOI: 10.1186/s12880-018-0271-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 09/10/2017] [Accepted: 08/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximately 10% of all MRI-guided vacuum-assisted breast biopsies (MR-VAB) are histologically classified as B3 lesions. In most of these cases surgical excision is recommended. The aim of our study was to evaluate the malignancy rates of different B3 lesions which are visible on MRI to allow a lesion-adapted recommendation of further procedure. METHODS Retrospective analysis of 572 consecutive MR-VAB was performed. Inclusion criteria were a representative (=successful) MR-VAB, histologic diagnosis of a B3 lesion and either the existence of a definite histology after surgical excision or proof of stability or regression of the lesion on follow-up MRI. Malignancy rates were evaluated for different histologies of B3 lesions. Lesion size and lesion morphology (mass/non-mass enhancement) on MRI were correlated with malignancy. RESULTS Of all MR-VAB 43 lesions fulfilled the inclusion criteria. The malignancy rate of those B3 lesions was 23.3% (10/43). The highest malignancy rate was found in atypical ductal hyperplasia (ADH) lesions (50.0%; 4/8), 33.3% (2/6) in flat epithelial atypia (FEA), 28.6% (2/7) in lobular intraepithelial neoplasia (LIN) and 12.5% (2/16) in papillary lesions (PL). All 6 complex sclerosing lesions were benign. Mass findings were significantly more frequently malignant (31.3%, 10/32; p < 0.05) than non-mass findings (0/11). Small lesions measuring 5-10 mm were most often malignant (35.0%; 7/20). All large lesions (> 20 mm) were not malignant (0/10). Intermediate sized lesions (11-20 mm) turned out to be malignant in 23.1% (3/13). CONCLUSIONS The malignancy rate of B3 lesions which were diagnosed after MR-VAB was 23.3%. ADH, FEA and LIN showed considerable malignancy rates (50%, 33% and 29%) and should therefore undergo surgical excision. None of the cases, which were diagnosed as radial scars, non-mass enhancement or larger lesions (> 20 mm) were malignant. Here, a follow-up MRI seems to be advisable to avoid unnecessary operations. TRIAL REGISTRATION Retrospective study design, waived by the IRB.
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Affiliation(s)
- H Preibsch
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - L K Wanner
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
| | - A Staebler
- Department of Pathology and Neuropathology, University Hospital Tuebingen, Liebermeisterstr. 8, 72076, Tuebingen, Germany
| | - M Hahn
- Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - K C Siegmann-Luz
- Diagnostic Breast Centre and Breast Cancer Screening Brandenburg East, Koepenicker Str. 29, 15711, Koenigs Wusterhausen, Germany
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Abstract
SummaryThe aim of the study was to evaluate the long-term results 4 years after a single-session, sonographically guided, transcatheter foam sclerotherapy. Patients, methods: We treated 20 patients with a total of 22 legs with varicoses of the greater saphenous vein (GSV, EpAsPr). Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. 20 legs or 91% in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm) could be followed up 4 years later. Results: During the follow up period one leg showed clinical signs of recurrence and underwent surgery, two legs received a single additional sclerotherapy during the four years period. Examination four years after showed in 6 legs clinical signs of recurrence without notice of clinical symptoms by the patients. This gives a clinical recurrence rate of 40% (8 of 20 patients). Duplex sonography showed flow in the region of the saphenofemoral junction in a total of 13 legs (65% of the reexamined GSVs) with an average vessel diameter of 3.7 ± 1.6mm (range 2 to 7 mm). Retreatments in 3 GSV of the 6 clinically relapsed GSV by a single injection of sclerosing foam showed an occlusion in 100% two weeks after. Conclusion: Transcatheter foam sclerotherapy of the GSV shows better clinical long-term results compared to known data of liquid sclerotherapy. Sonographically detected recurrency of the GSV could easily be retreated by a single session of foam sclerotherapy. Foam sclerotherapy is a promising and seriously to be taken option in the treatment of the insufficient GSV.
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Almer C, Hahn M, de Bock F, Fischer J. The socio-economic impacts of complex health-related interventions at the community-level. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.069] [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: 11/13/2022] Open
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Abstract
OBJECTIVE We evaluated the qualitative and quantitative changes of medications during the stay on a geriatric-psychiatric ward where the medication was optimized by a clinical pharmacist, and after discharge. The goal of the study was to analyze the continuity of the medication at the transfer from hospital to ambulatory care. METHODS We interviewed 41 patients on the phone about their drug regimen 4 and 12 weeks after discharge. Medications were compared to their discharge medication. The number of medications from the PRISCUS list of inappropriate medications for the elderly as well as the number of drug interactions was documented. The drug interaction database MediQ was used to identify and classify the drug-drug interactions. RESULTS During the hospitalization of the patients, 101 interventions of the clinical pharmacist were recommended and accepted. In cooperation with the physicians, the number of drug interactions decreased by 44% and the number of PRISCUS list medications by 42%. Only 4 weeks after discharge, 54 drugs for 27 patients (66%) had already been changed. During the following 8 weeks, another 44 medications were changed in 14 patients (35%). The total number of drugs after discharge did not change. The number of moderate drug interactions (p = 0.17) of medications from the PRISCUS list increased (p = 0.77), but not significantly. CONCLUSION While the interventions of a clinical pharmacist can lead to a reduction in drug interactions and inappropriate medication for the elderly during the hospitalization, the medication was changed after discharge in numerous cases. In a detailed analysis it was found that some of the changes increased the number of drug interactions as well as the number of potentially inappropriate medications for the elderly. A drug interaction check after discharge could prevent drug interactions and medication errors. Also the nationwide medication plan can help to prevent medication errors by the prescribing physician as well as by the patient.
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Affiliation(s)
- M Hahn
- Vitos Klinik Eichberg, Kloster-Eberbach-Str.4, 65346, Eltville, Deutschland.
| | - S C Roll
- Vitos Klinik Eichberg, Kloster-Eberbach-Str.4, 65346, Eltville, Deutschland
| | - J Klein
- Pharmakologie für Naturwissenschaftler, FB 14, Goethe-Universität Frankfurt, Max-von-Laue Str. 9, 60438, Frankfurt, Deutschland
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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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Shtriker MG, Hahn M, Taieb E, Nyska A, Moallem U, Tirosh O, Madar Z. Fenugreek galactomannan and citrus pectin improve several parameters associated with glucose metabolism and modulate gut microbiota in mice. Nutrition 2017; 46:134-142.e3. [PMID: 28993009 DOI: 10.1016/j.nut.2017.07.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/20/2017] [Accepted: 07/23/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Galactomannans derived from fenugreek confer known health benefits; however, there is little information regarding health benefits of citrus pectin (CP) and its association with gut microbiome metabolites. The aim of this study was to examine links between galactomannan and CP consumption, microbiota development, and glucose metabolism. DESIGN Male C57 BL/6 J mice ages 7 to 8 wk were fed ad libitum with a normal diet or one supplemented with 15% of either galactomannan or CP. At 3 wk, an oral glucose tolerance test was performed. Animals were sacrificed at 4 wk and relevant organs were harvested. RESULTS Fiber enrichment led to reductions in weight gain, fasting glucose levels, and total serum cholesterol (P < 0.05). Compared with mice fed the normal diet, microbiota populations were altered in both fiber groups and were found to be richer in Bacteroidetes rather than Firmicutes (P < 0.05). The modification was significantly greater in galactomannan-fed than in CP-fed mice (P < 0.0001). Also, enhanced levels of the short-chain fatty acid (SCFA) propionate were found in the cecal contents of CP-fed animals (P < 0.05). Protein expression levels of monocarboxylate transporter 1, which may promote transport of SCFA, were measured in the large intestines after fiber consumption. Enhanced adenosine monophosphate-activated protein kinase (AMPK) activation was observed in livers of galactomannan-fed mice (P < 0.05). CONCLUSION Consumption of diets containing soluble fibers, as used in this study, resulted in gut microbiota comprising a healthier flora, and led to positive effects on weight, glycemic control, and liver β oxidation via AMPK.
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Affiliation(s)
- Miriam G Shtriker
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Hahn
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Elise Taieb
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Abraham Nyska
- Sackler School of Medicine, Tel Aviv University, and Consultant in Toxicologic Pathology, Timrat, Israel
| | - Uzi Moallem
- Department of Ruminant Science, Institute of Animal Sciences, Volcani Center, Bet-Dagan, Israel
| | - Oren Tirosh
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Zecharia Madar
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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Preibsch H, Blumenstock G, Oberlechner E, Brucker SY, Hahn M, Staebler A, Wiesinger B, Claussen CD, Nikolaou K, Siegmann-Luz KC. Preoperative breast MR Imaging in patients with primary breast cancer has the potential to decrease the rate of repeated surgeries. Eur J Radiol 2017; 94:148-153. [PMID: 28712698 DOI: 10.1016/j.ejrad.2017.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/02/2017] [Revised: 06/13/2017] [Accepted: 06/26/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE The impact of preoperative MRI on re-excisions and mastectomy rate is discussed controversially in the literature. Aim of this study was to evaluate the effect of preoperative breast MRI on the surgical procedure and rate of repeated surgeries. MATERIAL AND METHODS A total of 991 consecutive patients in the years 2009 and 2010 with 1036 primary breast cancers were retrospectively analyzed. Sixty percent (599 patients with 626 cancers) received preoperative breast MRI. Planned surgical procedures before and after MRI and numbers of repeated surgeries in patients with (MR+ ) and without preoperative MRI (MR-) were compared. RESULTS The result of preoperative MRI changed the surgical procedure in 25% (157/626) of the cases. In 81% (127/157), MRI was beneficial for the patients, as otherwise occult carcinomas were removed (n=122) or further biopsy could be prevented (n=5). Mastectomy rates did not differ between MR+ and MR- group (39% vs. 39%). On multiple regression analysis, the MR+ group had a lower chance for repeated surgery (p<0.05). CONCLUSION Preoperative MRI could lower the chance for repeated surgery in patients with primary breast cancer. The rate of mastectomy did not differ between patients undergoing preoperative MRI and those who did not.
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Affiliation(s)
- H Preibsch
- University Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
| | - G Blumenstock
- Institute for Clinical Epidemiology and Applied Biometry,University of Tuebingen, Silcherstraße 5, 72076, Tuebingen, Germany
| | - E Oberlechner
- Department of Women's Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - S Y Brucker
- Department of Women's Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - M Hahn
- Department of Women's Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - A Staebler
- Institute of Pathology and Neuropathology, University Hospital Tuebingen, Liebermeisterstr. 8, 72076 Tuebingen, Germany
| | - B Wiesinger
- University Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - C D Claussen
- University Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - K Nikolaou
- University Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany
| | - K C Siegmann-Luz
- Diagnostic Breast Center and Mammography Screening, Brandenburg Ost, Koepenicker Straße 29, 15711, Koenigs Wusterhausen, Germany
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von Engelhardt LV, Hahn M, Schulz T, Peikenkamp K, Jerosch J. Changes of the bone structure after cap resurfacing arthroplasty of the humeral head. Orthop Traumatol Surg Res 2017; 103:493-498. [PMID: 28323247 DOI: 10.1016/j.otsr.2017.02.005] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/09/2017] [Accepted: 02/21/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although humeral head resurfacing with a cap is relatively common in clinical practice, clinical studies about the changes of the bone are rare. The aim of this study was to analyse qualitative and quantitative changes of the bone after cup arthroplasty. Our hypothesis is that the implant leads to a new functional load with remarkable changes of the bone underneath the cap. MATERIAL AND METHODS Overall, 12 explanted caps with adherent bone tissues, retrieved at the revision surgery, were collected for histological examination. None of these implants were revised for loosening. Afterwards, there was a qualitative evaluation of the bone as well an assessment of established quantitative bone tissue parameters. Results were analyzed in correlation to the time to revision surgery, as well as to patient's age. RESULTS A significant decrease of the bone volume and trabecular architecture underneath the cap was already observed after a relatively short lifetime. The quantitatively measured bone loss does not depend on the patient's age, but correlates significantly with the lifetime of the implants. In contrast to these findings within the central areas, an increased bone remodeling with bone densifications and microcallus formations was noticed at the edge of the cap in most cases. DISCUSSION A significant reduction of the bone volume underneath the cap and remarkable changes of the trabecular architecture confirm our hypothesis. Even if these changes did not lead to a clinically relevant loosening in our series, they might influence revision surgeries. Thus, these findings might be of interest, especially when a non-stemmed reversed or anatomical revision arthroplasty with a central metaphyseal press-fit fixation is chosen. LEVEL OF EVIDENCE IV - retrospective or historical series.
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Affiliation(s)
- L V von Engelhardt
- Faculty of Health, University of Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany; Department of Orthopedics, Trauma and Sports Medicine, Johanna-Etienne-Krankenhaus, Am Hasenberg 46, 41462 Neuss, Germany.
| | - M Hahn
- Department of Osteology and Biomechanics, Universtiy Medical Center Hamburg-Eppendorf, Lottestraße 59, 22529 Hamburg, Germany
| | - T Schulz
- Biomechanics Research Laboratory, University of Applied Sciences Münster, Campus Steinfurt, Stegerwaldstraße 39, 48565 Steinfurt, Germany
| | - K Peikenkamp
- Biomechanics Research Laboratory, University of Applied Sciences Münster, Campus Steinfurt, Stegerwaldstraße 39, 48565 Steinfurt, Germany
| | - J Jerosch
- Faculty of Health, University of Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
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Hahn M, Bürckert JP, Luttenberger CA, Klebow S, Hess M, Al-Maarri M, Vogt M, Reißig S, Hallek M, Wienecke-Baldacchino A, Buch T, Muller CP, Pallasch CP, Wunderlich FT, Waisman A, Hövelmeyer N. Aberrant splicing of the tumor suppressor CYLD promotes the development of chronic lymphocytic leukemia via sustained NF-κB signaling. Leukemia 2017; 32:72-82. [DOI: 10.1038/leu.2017.168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/24/2017] [Accepted: 05/22/2017] [Indexed: 11/10/2022]
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Müller-Schimpfle M, Graf O, Madjar H, Fuchsjäger M, Golatta M, Hahn M, Mundinger A, Schreer I, Weismann C, Schultz-Wendtland R, Helbich T. BI-RADS die 5. – Eine Kurzmitteilung aus deutsch-/österreichischer Sicht. ROFO-FORTSCHR RONTG 2017; 188:E2. [PMID: 28511201 DOI: 10.1055/s-0035-1567207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hadji P, Boekhoff J, Hahn M, Hellmeyer L, Hars O, Kyvernitakis I. Pregnancy-associated osteoporosis: a case-control study. Osteoporos Int 2017; 28:1393-1399. [PMID: 28074248 DOI: 10.1007/s00198-016-3897-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 09/06/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED The etiology and underlying mechanisms of pregnancy-associated osteoporosis (PAO) are still unknown, since no systematic analyses exist. Our results indicate that PAO is a heterogeneous, rare but severe disease including a substantial number of fractures with a significant delay from first symptom to diagnose. INTRODUCTION Pregnancy-associated osteoporosis (PAO) is a rare but severe type of premenopausal osteoporosis. Most common symptom includes acute lower back pain due to vertebral fracture predominantly occurring in the last trimester of pregnancy or immediately postpartum. The exact underlining mechanisms and risk factors of PAO are still unknown, and up to date, there are no published systematic analyses. METHODS We identified 102 PAO patients and matched them with 102 healthy controls according to age, region, and gravidity to evaluate risk factors in a large and homogenous population of women. RESULTS The baseline characteristics and anthropometric data of the two study groups were similar. Eighty-eight percent of the patients with PAO suffered from one or more fractures with a mean of 3.3 fractures per patient. The most common fracture site was the thoracolumbar spine, whereas 29, 37, 48, and 35% of the patients reported fractures at TH11, TH12, L1, and L2, respectively. PAO patients suffered more frequently from excessive dental problems in childhood (p < 0.001). The control group performed significantly more frequently sports both before (p < 0.002) and after puberty (p < 0.01). Compared to the controls, the patients with PAO reported twice as often severe diseases during pregnancy (p < 0.029). Hereby, the frequency of immobilization was twice as often in the PAO group compared to that in the control group (p < 0.005). CONCLUSIONS Our results indicate that PAO is a heterogeneous, rare but severe disease including a substantial number of fractures with a significant delay from first symptom to diagnose. Increased awareness is warranted to immediately start effective treatment.
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Affiliation(s)
- P Hadji
- Department of Bone Oncology, Gynecological Endocrinology and Reproductive Medicine, German Reference Centre for Pregnancy-Associated Osteoporosis, Nordwest Hospital of the Goethe-University of Frankfurt, Steinbacher Hohl 2-26, 60488, Frankfurt a. M, Germany.
- Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.
| | - J Boekhoff
- Department of Obstetrics and Gynecology, Philipps-University of Marburg, Marburg, Germany
| | - M Hahn
- Department of Obstetrics and Gynecology, Philipps-University of Marburg, Marburg, Germany
| | - L Hellmeyer
- Department of Obstetrics and Gynecology, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - O Hars
- Statistical Institute Dr. Hars, Berlin, Germany
| | - I Kyvernitakis
- Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany
- Department of Obstetrics and Gynecology, Buergerhospital of the Goethe-University of Frankfurt, Frankfurt, Germany
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Preibsch H, Richter V, Bahrs SD, Hattermann V, Wietek BM, Bier G, Kloth C, Blumenstock G, Hahn M, Staebler A, Nikolaou K, Wiesinger B. Repeated surgeries in invasive lobular breast cancer with preoperative MRI: Role of additional carcinoma in situ and background parenchymal enhancement. Eur J Radiol 2017; 90:181-187. [PMID: 28583631 DOI: 10.1016/j.ejrad.2017.02.045] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/04/2016] [Accepted: 02/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. METHODS Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. RESULTS Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). CONCLUSIONS Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence.
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Affiliation(s)
- H Preibsch
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.
| | - V Richter
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - S D Bahrs
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - V Hattermann
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - B M Wietek
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - G Bier
- Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - C Kloth
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - G Blumenstock
- Institute for Clinical Epidemiology and Applied Biometry, University of Tuebingen, Silcherstraße 5, 72076 Tuebingen, Germany
| | - M Hahn
- Department of Gynecology and Obstetrics, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - A Staebler
- Institute of Pathology and Neuropathology, University Hospital Tuebingen, Liebermeisterstr. 8, 72076 Tuebingen, Germany
| | - K Nikolaou
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - B Wiesinger
- Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Hartkopf A, Wallwiener M, Andress J, Walter C, Chao C, Turner M, Weidenauer H, Hahn M, Taran A. Oncotype DX® Breast Recurrence ScoreTM (RS) distribution in primary breast cancer patients in Germany. Breast 2017. [DOI: 10.1016/s0960-9776(17)30302-8] [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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47
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Isaacson KB, Krämer B, Taran A, Kraemer D, Brucker S, Hahn M. Laparoscopic Radiofrequency Volumetric Thermal Ablation (RFVTA) of Symptomatic Myomas and Laparoscopic Myomectomy (LM): Clinical Outcomes at Three Years from a Randomized Trial of Uterine-Sparing Techniques. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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48
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Hoffmann S, Oberlechner E, Gruber I, Röhm C, Helms G, Marx M, Warzecha H, Staebler A, Wallwiener D, Brucker SY, Hahn M. Führt die präoperative zytologische oder histologische Sicherung sonographisch suspekter oder pathologischer Lymphknoten beim primären Mammakarzinom zu einer operativen Übertherapie? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592810] [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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49
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Ott C, Brucker SY, Fugunt R, Hartkopf A, Helms G, Oberlechner E, Röhm C, Staebler A, Wiesinger B, Wittek B, Marx M, Hahn M. Ist eine Reduktion der Nachresektionsrate beim primären Mammakarzinom durch die intraoperative ultraschallassistierte Tumorresektion möglich? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592818] [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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50
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Hartkopf A, Fehm T, Hahn M, Walter C, Wallwiener M, Taran FA, Brucker S. Nachweis disseminierter Tumorzellen im Knochenmark von Männern mit Mammakarzinom im Frühstadium. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592724] [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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