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Affiliation(s)
- S Diederich
- Institut für Diagnostische und Interventionelle Radiologie, Marien Hospital Düsseldorf, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Rochusstraße 2, 40479, Düsseldorf, Deutschland.
| | - H Prosch
- Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Österreich
| | - C Herold
- Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Österreich
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Diederich S. [German Glossary for Structured Reporting in Chest Radiology]. ROFO-FORTSCHR RONTG 2015. [PMID: 26218472 DOI: 10.1055/s-0035-1553222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schulz J, Kötz K, Ventz M, Diederich S, Quinkler M. Reduction in daily hydrocortisone dose in adrenal insufficiency improves significantly bone mineral density – Results from a 2-years prospective trial. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547706] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The increasing availability of computed tomography has meant that the number of incidentally detected solitary pulmonary nodules (SPN) has greatly increased in recent years. A reasonable management of these SPN is necessary in order to firstly be able to detect malignant lesions early on and secondly to avoid upsetting the patient unnecessarily or carrying out further stressful diagnostic procedures. This review article shows how the dignity of SPNs can be estimated and based on this how the management can be accomplished taking established guidelines into consideration.
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Affiliation(s)
- F Poschenrieder
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93042, Regensburg, Deutschland
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Wang Y, Hammersen S, Diederich S, Moskopp D. Analysis of the value of bilateral inferior petrosal Sinus sampling (BIPSS) in Cushing's syndrome. Can BIPSS be employed to guide surgical resection? Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Berhane Y, Joseph T, Kehler H, Hisanaga T, Embury-Hyatt C, Diederich S, McGreevy KH, Handel K, Cottam-Birt C, Pasick J. Characterization of a Low Pathogenic Avian Influenza H5N2 Virus Isolated from a Turkey Breeder Flock in Manitoba, Canada. Avian Dis 2014; 58:1-7. [DOI: 10.1637/10591-061213-reg.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Diederich S. Screening Bronchialcarcinom: aktueller Stellenwert und Ausblick. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345789] [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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Diederich S. Röntgenquiz Thorax. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345861] [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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Diederich S. FFF Thoraxradiologie: Management pulmonaler Rundherde. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345859] [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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Hanusch FM, Fischer E, Lang K, Diederich S, Endres S, Allolio B, Beuschlein F, Reincke M, Quinkler M. Sleep quality in patients with primary aldosteronism. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1336659] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Biering H, Königbauer MJ, Schulte HM, Diederich S. Retrospective elevation of diagnosis, therapy and healthcare provision data of patients with Acromegaly in specialised centres across Germany - Establishment and evaluation of a questionnaire. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1336739] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Biering H, Moenig B, Basilowski N, Wachholz L, Diederich S, Schulte HM, Pospisil H. Health care service in Cushing's syndrome: Establishment and evaluation of an electronic questionnaire. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1336740] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Thomson CA, Wang Y, Jackson LM, Olson M, Wang W, Liavonchanka A, Keleta L, Silva V, Diederich S, Jones RB, Gubbay J, Pasick J, Petric M, Jean F, Allen VG, Brown EG, Rini JM, Schrader JW. Pandemic H1N1 Influenza Infection and Vaccination in Humans Induces Cross-Protective Antibodies that Target the Hemagglutinin Stem. Front Immunol 2012; 3:87. [PMID: 22586427 PMCID: PMC3347682 DOI: 10.3389/fimmu.2012.00087] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [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: 02/16/2012] [Accepted: 04/04/2012] [Indexed: 02/02/2023] Open
Abstract
Most monoclonal antibodies (mAbs) generated from humans infected or vaccinated with the 2009 pandemic H1N1 (pdmH1N1) influenza virus targeted the hemagglutinin (HA) stem. These anti-HA stem mAbs mostly used IGHV1-69 and bound readily to epitopes on the conventional seasonal influenza and pdmH1N1 vaccines. The anti-HA stem mAbs neutralized pdmH1N1, seasonal influenza H1N1 and avian H5N1 influenza viruses by inhibiting HA-mediated fusion of membranes and protected against and treated heterologous lethal infections in mice with H5N1 influenza virus. This demonstrated that therapeutic mAbs could be generated a few months after the new virus emerged. Human immunization with the pdmH1N1 vaccine induced circulating antibodies that when passively transferred, protected mice from lethal, heterologous H5N1 influenza infections. We observed that the dominant heterosubtypic antibody response against the HA stem correlated with the relative absence of memory B cells against the HA head of pdmH1N1, thus enabling the rare heterosubtypic memory B cells induced by seasonal influenza and specific for conserved sites on the HA stem to compete for T-cell help. These results support the notion that broadly protective antibodies against influenza would be induced by successive vaccination with conventional influenza vaccines based on subtypes of HA in viruses not circulating in humans.
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Affiliation(s)
- C A Thomson
- The Biomedical Research Centre, University of British Columbia Vancouver, BC, Canada
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Bobbert T, Mai K, Brechtel L, Schulte HM, Weger B, Pfeiffer AFH, Spranger J, Diederich S. Leptin and endocrine parameters in marathon runners. Int J Sports Med 2012; 33:244-8. [PMID: 22261828 DOI: 10.1055/s-0031-1291251] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Endurance training may lead to different hormonal alterations e. g., exercised induced hypothalamic ovarian/testicular dysfunction. The aim of this study was to reveal new connections between physical exercise, leptin and hormonal responses. 36 male participants of the Berlin-Marathon had their blood samples taken 2 days before the marathon. Hormones of the hypothalamic-pituitary axis and leptin were correlated with the training status and the achieved marathon time. Leptin correlated with the achieved marathon time after being adjusted for age and BMI (r=0.607, p<0.001) and was lowest in the best trained runners. Additionally, when the group was divided into quartiles of their achieved marathon time, significantly increased cortisol, fT4, cortisol/DHEAS ratio and decreased IGF-1 levels were observed in the slowest group. In the better trained group, a decrease of testosterone/DHT ratio and an increase of testosterone/cortisol ratio were observed. Our study supports the thesis of a linear relationship between physical fitness and leptin variations in the physiological range. We found an increased anabolic hormonal response in well trained marathon runners and hormonal reactions of increased stress in less trained runners. As the stress-induced neuroendocrine adaptations in our study group are associated with more higher leptin values, the pathophysiological role of decreased leptin values seems to be limited to overtrained athletes.
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Affiliation(s)
- T Bobbert
- Charité, Department of Endocrinolgy, Diabetes and Nutrition, Berlin, Germany.
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Koetz KR, Ventz M, Diederich S, Quinkler M. Bone mineral density is not significantly reduced in adult patients on low-dose glucocorticoid replacement therapy. J Clin Endocrinol Metab 2012; 97:85-92. [PMID: 21994966 DOI: 10.1210/jc.2011-2036] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with primary adrenal insufficiency (PAI) and patients with congenital adrenal hyperplasia (CAH) receive glucocorticoid replacement therapy, which might cause osteoporosis. OBJECTIVES Questions addressed by this study were: 1) Is bone mineral density (BMD) reduced in PAI and CAH on lower glucocorticoid doses than previously reported? 2) Is BMD in PAI influenced by the type of glucocorticoid used? and 3) Does DHEA treatment affect BMD in PAI women? DESIGN AND PATIENTS We conducted a prospective, cross-sectional study including 81 PAI patients and 41 CAH patients. MAIN OUTCOME MEASURES BMD was measured by dual-energy x-ray absorptiometry. Serum levels of bone turnover markers, minerals, vitamins, hormones, and urinary crosslinks were measured. RESULTS PAI and CAH patients received average daily hydrocortisone doses of 12.0 ± 2.7 mg/m(2) (range, 4.9-19.1) and 15.5 ± 7.8 mg/m(2) (range, 5.7-33.7), respectively. BMD varied within the normal reference range (-2 to +2) in both cohorts. However, lower Z-scores for femoral neck and Ward's region were found in CAH compared to PAI women, but not in men. Prednisolone treatment showed significant lower osteocalcin levels and lower Z-scores for lumbar spine and femoral neck compared to PAI patients on hydrocortisone. PAI women treated with DHEA had significantly lower urinary collagen crosslinks and bone alkaline phosphatase, and significantly higher Z-scores in lumbar spine and femoral Ward's region compared to non-DHEA-treated women. CONCLUSIONS Adult PAI and CAH patients on low glucocorticoid doses showed normal BMD within the normal reference range. The use of longer acting prednisolone resulted in significantly lower BMD in PAI. In addition, DHEA treatment may have a beneficial effect on bone in Addison's women.
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Affiliation(s)
- K R Koetz
- Department of Clinical Endocrinology, Charite Campus Mitte, Charite University Medicine, D-10117 Berlin, Germany
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Diederich S. Das metabolische Syndrom – eine (neue) Frauenkrankheit? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1295373] [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: 10/15/2022] Open
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Abstract
The poor outcome in symptomatic lung cancer patients and the much better prognosis when lung cancer is diagnosed and treated at early asymptomatic stages call for screening. As lung cancer predominantly affects smokers and individuals exposed to other carcinogens, screening programs need not include the whole population but only these risk groups. Every screening program will tend to better identify the more indolent tumours that grow slowly enough to be detected by screening before symptoms develop, whereas aggressive fast-growing tumours may present as interval cancers despite screening (length-time bias). Some malignant tumours detected with screening may never cause the person’s death due to competing causes for death, particularly in heavy smokers, such as cardiovascular disease or other cancers (overdiagnosis bias). If a cancer is still lethal despite detection through screening, the affected individual may live longer with the diagnosis of cancer but not longer altogether (lead-time bias). It is likely that this will have a negative effect on that individual’s quality of life. Participation in screening programs may have beneficial as well as adverse effects on smoking habits; in the worst case it may encourage people to continue smoking. Trials assessing chest radiography or sputum microscopy have not demonstrated a reduction in lung cancer mortality through screening, probably because the tests were not sensitive enough. computed tomography promises better sensitivity. Other modern tests such as fibre optic bronchoscopy, analysis of molecular markers or genetic testing in serum, sputum or exhaled air are not yet ready for clinical practice.
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Affiliation(s)
- S Diederich
- Department of Diagnostic and Interventional Radiology, Marien Hospital, Rochusstr. 2, D-40479 Düsseldorf, Germany.
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. Pneumologie 2011; 65:e51-75. [DOI: 10.1055/s-0030-1256562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
HISTORY AND CLINICAL FINDINGS A 22 year old obese woman with type 1 diabetes for 17 years and poor metabolic control despite continuous insulin infusion (case 1). Case 2 was a 16 year-old girl of normal weight in whom diabetes mellitus type 1 was diagnosed accidentally. Her 54 year old father was and had been treated for diabetes mellitus type 1 for 10 years. He was poorly controlled and associated with polyneuropathy and history of myocardial infarction (case 3). INVESTIGATIONS In Case 1 the C-peptide test was negative, glutamic acid decarboxylase- and IA2-antibodies were not demonstrated. Cases 2 and 3 showed normal C-peptide, tests for GAD-, IA2- and ICA antibodies were negative. A nucleotid substitution in intron 1 of the HNF-4α gene was demonstrated. TREATMENT AND COURSE All three patients were treated with liraglutide. There was a reduction in HbA(1c), glucose fluctuations, hypoglycaemia, daily insulin dose and body weight, as well as an improvement of well-being and quality of life. CONCLUSION These case reports indicate that GLP-1 analogs may reduce postprandial and fasting glucose levels in non-type 2 diabetic patients, independently or residual beta cell function. Further studies are needed to evaluate the benefits of treatment with liraglutide in patients with type 1 or type 3 diabetes.
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Affiliation(s)
- D Deiss
- Endokrinologikum am Gendarmenmarkt, Berlin.
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Deiss D, Gross U, Diederich S. Nucleotidaustausch im Intron 1 des HNF-4α Gens ist assoziiert mit phänotypisch unterschiedlichen Diabetesformen und neuen Therapiemöglichkeiten. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277475] [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: 10/18/2022]
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Mai K, Meinus S, Assmann A, Bobbert T, Andres J, Biedasek K, Maser-Gluth C, Wudy S, Hartmann M, Pfeiffer A, Diederich S, Spranger J. Potential mechanism of rosiglitazone induced myocellular insulin sensitivity-effects of rosiglitazone on 11β-hydroxysteroid dehydrogenase type 1 expression in skeletal muscle. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277365] [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: 10/18/2022]
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Diederich S. Falldiskussion Thoraxdiagnostik. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278718] [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: 10/18/2022]
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Diederich S. Mediastinum und Hili. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278856] [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: 10/18/2022]
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Vogelmeier C, Worth H, Pfeifer M, Karg O, Reck M, Schütte W, Diederich S, Biederer J, Heussel CP, Kauczor HU, Wormanns D, Rehbock B, Loose R. [Joint statement of the German Respiratory Society and the German Roentgenological Society on the early detection of lung cancer by low-dose CT]. Pneumologie 2011; 65:5-6. [PMID: 21243560 DOI: 10.1055/s-0030-1256112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Vogelmeier
- Für die Deutsche Gesellschaft für Pneumologie und Beatmungsforschung
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Diederich S, Quinkler M, Mai K, Schöneshöfer M, Baehr V, Pfeiffer A, Oelkers W, Eigendorff E. In vivo activity of 11β-hydroxysteroid dehydrogenase type 1 in man: effects of prednisolone and chenodesoxycholic acid. Horm Metab Res 2011; 43:66-71. [PMID: 20925019 DOI: 10.1055/s-0030-1267170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The 11β-hydroxysteroid dehydrogenases (11β-HSDs) play a pivotal role in glucocorticoid (GC) action. 11β-HSD1 is a predominant reductase, activating GCs from inert metabolites, whereas 11β-HSD2 is a potent dehydrogenase inactivating GCs. Knowing the metabolic effects of GCs, a selective inhibition of 11β-HSD1 represents a potential target for therapy of impaired glucose tolerance, insulin insensitivity and central obesity. In vitro, 11β-HSD1 is selectively inhibited by chenodesoxycholic acid (CDCA) and upregulated under GC exposure. Therefore, we aimed to investigate the effects of CDCA and prednisolone on hepatic 11β-HSD1 activity in vivo by measuring 11-reduction of orally given cortisone (E) acetate to cortisol (F). CDCA or placebo was given to 5 male healthy volunteers within a randomised cross-over trial before and after oral administration of 12.5 mg E acetate at 8:00 h. For measurement of in vivo effects of GCs on 11β-HSD1 activity, hepatic reduction of 25 mg E acetate before and after treatment with prednisolone (30 mg for 6 days) was determined in 7 healthy males. Serum GC levels were determined using a fully automated liquid chromatographic system. CDCA had no effect on the activity of 11β-HSD1 in vivo. Prednisolone therapy leads to a marked rise in serum F concentrations and an elevated F/E serum ratio. This proves GC-induced activation of hepatic 11β-HSD1, which could not be extinguished by a parallel increase of IGF-1 under prednisolone. CDCA does not affect in vivo activity of 11β-HSD1 when given in therapeutic dosages. During GC treatment, increased hepatic activation of E to F may aggravate metabolic side effects of GCs such as seen in the metabolic syndrome.
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Affiliation(s)
- S Diederich
- Department of Endocrinology, Diabetes and Nutrition, Charité Campus Benjamin Franklin, Berlin, Germany.
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Diederich S. Pitfalls in assessment of tumor response with RECIST criteria. Cancer Imaging 2011. [DOI: 10.1102/1470-7330.2011.9044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. Pneumologie 2010; 65:39-59. [DOI: 10.1055/s-0030-1255961] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Staging systems aim to describe malignant tumours in a standardized fashion to assist in therapy planning and estimation of prognosis, allow comparison of different therapeutic strategies, facilitate communication between individuals and institutions, improve our knowledge of malignant disease and ultimately improve the outcome for patients. With the continuous increase in data and, ideally, our understanding of a disease and its potential therapy, every staging system requires continuous adjustment. The TNM staging system by the International Union against Cancer (UICC) is applied worldwide and revised regularly, with intervals aiming at a compromise between up-to-date information on the one hand and providing continuity by avoiding too short-lived revisions on the other hand. The 6th edition was published in 2002 and the 7th edition was published in 2009. The 7th edition became current from January 2010 on.
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Affiliation(s)
- S Diederich
- Department of Diagnostic and Interventional Radiology, Marien Hospital Düsseldorf, Germany.
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker JH, Freitag L, Lübbe AS, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum RP, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle RM, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heussel CP, Hilbe W, Hoffmeyer F, Horneber M, Huber RM, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang SM, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen HW, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. [Prevention, diagnosis, therapy, and follow-up of lung cancer]. Pneumologie 2010; 64 Suppl 2:e1-164. [PMID: 20217630 DOI: 10.1055/s-0029-1243837] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Diederich S. Thorax – Fälle 3 und 4 zum Röntgenquiz. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252190] [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: 10/19/2022]
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Diederich S. Malignes Lymphom. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252477] [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: 10/19/2022]
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Diederich S. Management of incidental pulmonary nodules in patients with and without previous malignancy. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252211] [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: 10/19/2022]
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Abstract
This article describes the aetiology, epidemiology and clinical significance of incidental non-solid pulmonary nodules. Non-solid nodules are more likely malignant. If malignant, they are mostly due to atypical adenomatous hyperplasia and bronchioloalveolar carcinoma. As these may be negative on positron emission tomography and slow growing, the diagnostic algorithms that are used for solid nodules have to be modified for non-solid nodules.
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Affiliation(s)
- S Diederich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Marien Hospital Düsseldorf, Academic Teaching Hospital, Rochusstrasse 2, D-40479 Düsseldorf, Germany.
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Diederich S. Fall 2342. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1233814] [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: 10/19/2022]
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Diederich S, Eidt S, Lüthen R. [Multiple bilateral pulmonary nodes following breast cancer]. Dtsch Med Wochenschr 2009; 134:981-4. [PMID: 19401963 DOI: 10.1055/s-0029-1222554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HISTORY AND ADMISSION FINDINGS Multiple new pulmonary nodules were demonstrated at chest radiography in a 69-year-old woman who had been treated for breast cancer ten years previously. INVESTIGATIONS Laboratory tests suggested mild inflammation. Pulmonary function tests demonstrated small airways disease. But because of an atypical morphology at computed tomography (CT), metastases were considered unlikely. CT-guided percutaneous biopsy revealed cryptogenic organizing pneumonia (COP). TREATMENT AND COURSE Oral medication with decreasing doses of steroids resulted in clinical and radiological improvement. CONCLUSIONS Even in a patient with known malignancy the differential diagnosis of multiple bilateral pulmonary nodules includes a variety of conditions and is meticulous, if necessary invasive diagnostic procedures are required.
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Affiliation(s)
- S Diederich
- Institut für Diagnostische und Interventionelle Radiologie / Nuklearmedizin, Marien Hospital Düsseldorf.
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Born-Frontsberg E, Reincke M, Rump LC, Hahner S, Diederich S, Lorenz R, Allolio B, Seufert J, Schirpenbach C, Beuschlein F, Bidlingmaier M, Endres S, Quinkler M. Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn's Registry. J Clin Endocrinol Metab 2009; 94:1125-30. [PMID: 19190103 DOI: 10.1210/jc.2008-2116] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Primary aldosteronism (PA) is associated with vascular end-organ damage. OBJECTIVE Our objective was to evaluate differences regarding comorbidities between the hypokalemic and normokalemic form of PA. DESIGN AND SETTING This was a retrospective cross-sectional study collected from six German centers (German Conn's registry) between 1990 and 2007. PATIENTS Of 640 registered patients with PA, 553 patients were analyzed. MAIN OUTCOME MEASURES Comorbidities depending on hypokalemia or normokalemia were examined. RESULTS Of the 553 patients (61 +/- 13 yr, range 13-96), 56.1% had hypokalemic PA. The systolic (164 +/- 29 vs. 155 +/- 27 mm Hg; P < 0.01) and diastolic (96 +/- 18 vs. 93 +/- 15 mm Hg; P < 0.05) blood pressures were significantly higher in hypokalemic patients than in those with the normokalemic variant. The prevalence of cardiovascular events (angina pectoris, myocardial infarction, chronic cardiac insufficiency, coronary angioplasty) was 16.3%. Atrial fibrillation occurred in 7.1% and other atrial or ventricular arrhythmia in 5.2% of the patients. Angina pectoris and chronic cardiac insufficiency were significantly more prevalent in hypokalemic PA (9.0 vs. 2.1%, P < 0.001; 5.5 vs. 2.1%, P < 0.01). Overall, cerebrovascular comorbidities were not different between hypokalemic and normokalemic patients, however, stroke tended to be more prevalent in normokalemic patients. CONCLUSIONS Our data indicate a high prevalence of comorbidities in patients with PA. The hypokalemic variant is defined by a higher morbidity than the normokalemic variant regarding some cardiovascular but not cerebrovascular events. Thus, PA should be sought not only in hypokalemic but also in normokalemic hypertensives because high-excess morbidity occurs in both subgroups.
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Affiliation(s)
- E Born-Frontsberg
- Medizinische Klinik-Innenstadt, Klinikum der Universität München, München, Germany.
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Diederich S. Benigne und maligne Raumforderungen der Lunge. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221126] [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]
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Diederich S. Ösophaguskarzinom. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221183] [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]
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Diederich S. Lungenkarzinom-Screening mit CT: aktueller Stand. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1220992] [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]
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Diederich S. Sind orale Kontrastmittel bei Follow-up-Untersuchungen notwendig? Radiologe 2009; 49:293-4. [DOI: 10.1007/s00117-009-1828-9] [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]
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Mai K, Bobbert T, Reinecke F, Andres J, Maser-Gluth C, Wudy SA, Möhlig M, Weickert MO, Hartmann MF, Schulte HM, Diederich S, Pfeiffer AFH, Spranger J. Intravenous lipid and heparin infusion-induced elevation in free fatty acids and triglycerides modifies circulating androgen levels in women: a randomized, controlled trial. J Clin Endocrinol Metab 2008; 93:3900-6. [PMID: 18664538 DOI: 10.1210/jc.2008-0714] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism and associated with obesity and impaired glucose metabolism. Despite the high prevalence of PCOS and the considerable clinical impact, the precise interplay between metabolism and hyperandrogenemia is not entirely clear. OBJECTIVE The objective of the study was to analyze the effects of iv lipid and heparin infusion on circulating androgen levels in healthy women. DESIGN This was a randomized, controlled, crossover trial. SETTING The study was conducted at an endocrinology center. PATIENTS Patients included 12 healthy young women during the early follicular phase of two subsequent cycles. INTERVENTION After an overnight fast, a 20% lipid/heparin or a saline/heparin infusion was administered in random order for 330 min. MAIN OUTCOME MEASURES A detailed characterization of androgen metabolism was performed. RESULTS Elevations in free fatty acids and triglycerides, induced by lipid/heparin infusion, elevates the levels of androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone, 5alpha-dihydrotestosterone, estrone, and 17beta-estradiol. Urinary excretion of DHEA, DHEAS, 5-androstene-3beta,17beta-diol, and the sum of urinary excreted DHEA and its 16-hydroxylated downstream metabolites, 16alpha-hydroxy-DHEA and 5-androstene-3beta,16alpha,17beta-triol, were reduced. CONCLUSION The mechanism of iv lipid and heparin infusion-induced elevation of circulating androgens described here might contribute to the development of hyperandrogenism in women with PCOS and suggests that lowering of hyperlipidemia might be a potential therapeutic target in patients with PCOS to treat hyperandrogenemia.
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Affiliation(s)
- K Mai
- Department of Endocrinology, Diabetes, and Nutrition, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany
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Diederich S. Blick in die Zukunft: Interventionell-radiologische Methoden in der Tumortherapie. Radiologe 2008. [DOI: 10.1007/s00117-008-1717-7] [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]
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Biederer J, Wildberger J, Reuter M, Bolte H, Fink C, Tuengerthal S, Rehbock B, Hieckel HG, Wormanns D, Diederich S, Hofmann-Preiss K, Lörcher U, Heussel C. Protokollempfehlungen für die Computertomografie der Lunge. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1081445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Diederich S. CT-Perfusion zur Therapieplanung des Rektumkarzinoms? Radiologe 2008. [DOI: 10.1007/s00117-008-1644-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quinkler M, Jussli J, Bähr V, Pfeiffer AFH, Lepenies J, Diederich S. Effect of immunosuppressive and other drugs on the cortisol-cortisone shuttle in human kidney and liver. Horm Metab Res 2007; 39:555-9. [PMID: 17712719 DOI: 10.1055/s-2007-984472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Impaired 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) has been suggested in patients with hypertension or renal disease, where it may contribute to sodium retention and hypertension. 11beta-HSD1, which is expressed predominantly in liver and adipose tissue, influences glucose homeostasis and fat distribution by altering intracellular cortisol (F) concentrations. We tested immunosuppressive drugs that cause hypertension, and substances that interfere with steroidogenesis or influence glucose homeostasis for their ability to influence the inhibition of 11beta-HSD isozymes. METHODS For inhibition experiments, we used microsomes prepared from unaffected parts of human liver segments and resected human kidney cortex because of hepatocarcinoma or renal cell cancer. The inhibitory potency of several compounds was evaluated in concentrations from 10(-9)-10(-5) mol/l. RESULTS Only sirolimus, but not cyclosporine A, tacrolimus, mycophenolate mofetil, or azathioprine showed a slight inhibition of 11beta-HSD2 activity. None of the drugs that inhibit steroidogenesis (suramine, mitotane, etomidate, and aminogluthethimide) or steroid metabolism (rifampicine) influenced 11beta-HSDs, nor did ginsenoides Re, Rc, and Rb1. Among sulfonylureas, only gliclazide decreased significantly 11beta-HSD1 activity. CONCLUSIONS Increased blood pressure due to immunosuppressive drugs is probably not caused by direct inhibition of 11beta-HSD2. An additional glucose lowering effect of sulfonylurea gliclazide may be due to its ability to inhibit 11beta-HSD1.
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Affiliation(s)
- M Quinkler
- Clinical Endocrinology, Department of Internal Medicine, Center for Gastroenterology, Heptology and Endocrinology, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
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Diederich S, Mai K, Bähr V, Helffrich S, Pfeiffer A, Perschel FH. The Simultaneous Measurement of Plasma-Aldosterone- and -Renin-Concentration Allows Rapid Classification of all Disorders of the Renin-Aldosterone System. Exp Clin Endocrinol Diabetes 2007; 115:433-8. [PMID: 17647140 DOI: 10.1055/s-2007-973061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The determination of the plasma aldosterone (PAC) to the plasma renin concentration (PRC) ratio is an accepted screening tool for primary hyperaldosteronism (PHyperA). DESIGN To assess the diagnostic significance of this ratio for other disorders of the renin-aldosterone-system (RAS), we examined 60 patients with different adrenal diseases, 32 patients with essential hypertension and 76 normotensive healthy volunteers. The aldosterone (pmol/L) and renin (mU/L) concentrations were measured in one plasma sample by an automated chemiluminescence assay (Nichols Advantage). RESULTS Patients with PHyperA (n=31) had a PAC/PRC ratio between 105 and 2328 and could be distinguished without overlap from the essential hypertension group (ratio: range 2.7-49) and normal healthy volunteers (ratio: range 0.9-71). Fourteen patients with primary hypoaldosteronism showed low PAC/PRC ratios (range 0.21-0.98) and low PAC values (range: 42-100). Seven patients with secondary hypoaldosteronism had normal PAC/PRC ratios (range 2.8-23.2) and low PAC values (range: 42-116). Eight patients with secondary hyperaldosteronism had normal PAC/PRC ratios (range 7.8-67.9) and elevated PAC values (range: 803-2917). The graphic presentation of these data allowed the differentiation of all major disorders of the RAS. CONCLUSIONS The measurement of PAC/PRC ratios using this automated system provides a sensitive and rapid screening method for PHyperA. Moreover, the measurement of both the PAC and the PAC/PRC ratio allows differentiation of other disorders of the RAS.
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Affiliation(s)
- S Diederich
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
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Bähr V, Oelkers W, Pfeiffer AFH, Diederich S. Metabolism of Synthetic Steroids by the Human Placenta. Placenta 2007; 28:588-9. [PMID: 16820201 DOI: 10.1016/j.placenta.2006.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 04/27/2006] [Accepted: 05/11/2006] [Indexed: 11/25/2022]
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Schirpenbach C, Reuschl S, Segmiller F, Klempau C, Beuschlein F, Bidlingmaier M, Diederich S, Endres S, Hahner S, Lorenz R, Quinkler M, Rump LC, Reincke M. The national Conn's registry: Objectives and first results. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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