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Bettkober M, Wiegering VA, Härtel C, Jürgen K, Genzel D, Wirth C, Monoranu C, Nothhaft M, Woelfl M, Schlegel PG. [Case report: Unclear Inflammatory Reaction in an Eleven-Year-Old-Girl - Meningioma]. Klin Padiatr 2023; 235:373-375. [PMID: 37751769 DOI: 10.1055/a-2144-5474] [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: 09/28/2023]
Affiliation(s)
- Maxi Bettkober
- Department of Pediatrics, University Hospital Wurzburg, Würzburg, Germany
| | - Verena A Wiegering
- Department of Pediatrics, University Hospital Wurzburg, Würzburg, Germany
| | - Christoph Härtel
- Department of Pediatrics, University Hospital Wurzburg, Würzburg, Germany
| | - Krauss Jürgen
- Department of Neurosurgery, University Hospital Wurzburg, Würzburg, Germany
| | - Daniela Genzel
- Institute of Neuroradiology, University Hospital Wurzburg, Würzburg, Germany
| | - Clemens Wirth
- Institute of Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Camelia Monoranu
- Department of Neuropathology, University Hospital Wurzburg, Würzburg, Germany
| | - Matthias Nothhaft
- Department of Anaesthesiology, University Hospital Wurzburg, Würzburg, Germany
| | - Mathias Woelfl
- Department of Pediatrics, University Hospital Wurzburg, Würzburg, Germany
| | - Paul G Schlegel
- Childrens Hospitals, University Hospital Wurzburg, Würzburg, Germany
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Stock A, Brackmann H, Warmuth-Metz M, Miller E, Eyrich M, Kramm CM, Schlegel PG, Wiegering VA. DIPG- Very Long-Term Survivors - are There Factors Which May Predict a Better Outcome? Klin Padiatr 2022; 234:391-394. [PMID: 36162411 DOI: 10.1055/a-1849-1478] [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: 10/14/2022]
Affiliation(s)
- Annika Stock
- Department of Neuroradiology, University Clinic of Würzburg, Wuerzburg, Germany
| | - Heike Brackmann
- Childrens Hospitals, University of Würzburg, Würzburg, Germany
| | - Monika Warmuth-Metz
- Department of Neuroradiology, University Clinic of Würzburg, Wuerzburg, Germany
| | | | - Matthias Eyrich
- Childrens Hospitals, University of Würzburg, Würzburg, Germany
| | - Christof Maria Kramm
- Division of Pediatric Hematology and Oncology, Department of Child and Adolescent Health, Universitätsmedizin Goettingen, Göttingen, Germany
| | - Paul G Schlegel
- Childrens Hospitals, University of Würzburg, Würzburg, Germany
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Hendricks A, Müller S, Fassnacht M, Germer CT, Wiegering VA, Wiegering A, Reibetanz J. Impact of Lymphadenectomy on the Oncologic Outcome of Patients with Adrenocortical Carcinoma-A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14020291. [PMID: 35053453 PMCID: PMC8774191 DOI: 10.3390/cancers14020291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/26/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 01/21/2023] Open
Abstract
Simple Summary The concept of locoregional lymphadenectomy (LND) in adrenocortical cancer (ACC) has gained interest in recent years, but its definite prognostic and therapeutic significance remains to be established. We undertook a systematic review and meta-analysis to determine the oncologic value of LND in ACC, focusing on overall survival as the primary endpoint. Eleven studies were identified and five were included in the meta-analysis, all of them were retrospective studies. Three studies reported the impact of LND on disease-specific survival in patients with stage I–III ACC and revealed a survival benefit of LND, whereas studies including patients with stage I–IV ACC (N = 2) did not show a survival benefit of LND. In summary, our results demonstrate an oncologic benefit of LND in patients undergoing curative-intended surgery for at least localized ACC (stage I–III). Abstract (1) Background: Locoregional lymphadenectomy (LND) in adrenocortical carcinoma (ACC) may impact oncological outcome, but the findings from individual studies are conflicting. The aim of this systematic review and meta-analysis was to determine the oncological value of LND in ACC by summarizing the available literature. (2) Methods: A systematic search on studies published until December 2020 was performed according to the PRISMA statement. The primary outcome was the impact of lymphadenectomy on overall survival (OS). Two separate meta-analyses were performed for studies including patients with localized ACC (stage I–III) and those including all tumor stages (I–IV). Secondary endpoints included postoperative mortality and length of hospital stay (LOS). (3) Results: 11 publications were identified for inclusion. All studies were retrospective studies, published between 2001–2020, and 5 were included in the meta-analysis. Three studies (N = 807 patients) reported the impact of LND on disease-specific survival in patients with stage I–III ACC and revealed a survival benefit of LND (hazard ratio (HR) = 0.42, 95% confidence interval (95% CI): 0.26–0.68). Based on results of studies including patients with ACC stage I–IV (2 studies, N = 3934 patients), LND was not associated with a survival benefit (HR = 1.00, 95% CI: 0.70–1.42). None of the included studies showed an association between LND and postoperative mortality or LOS. (4) Conclusion: Locoregional lymphadenectomy seems to offer an oncologic benefit in patients undergoing curative-intended surgery for localized ACC (stage I–III).
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Affiliation(s)
- Anne Hendricks
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany; (A.H.); (S.M.); (C.-T.G.); (A.W.)
| | - Sophie Müller
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany; (A.H.); (S.M.); (C.-T.G.); (A.W.)
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany;
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany; (A.H.); (S.M.); (C.-T.G.); (A.W.)
| | - Verena A. Wiegering
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Children’s Hospital Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany;
| | - Armin Wiegering
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany; (A.H.); (S.M.); (C.-T.G.); (A.W.)
| | - Joachim Reibetanz
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany; (A.H.); (S.M.); (C.-T.G.); (A.W.)
- Correspondence:
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Thieme A, Maurus K, Ernestus K, Hirsch S, Schramm K, Wirth C, Buck A, Härtel C, Schlegel PG, Eyrich M, Woelfl M, Classen CF, Wiegering VA. Secondary Biphenotypic Acute Leukemia Following Rosai-Dorfman-Disease A Coincidence? Klin Padiatr 2021; 234:169-171. [PMID: 34911134 PMCID: PMC9113850 DOI: 10.1055/a-1699-3016] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Anne Thieme
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Katja Maurus
- Department of Pathology, University of Würzburg, Wuerzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg, Wuerzburg, Germany
| | - Steffen Hirsch
- Hopp Children's Cancer Center Heidelberg (KiTZ) and German Cancer Research Center (DKFZ) University Hospital Heidelberg, University Hospital Heidelberg Medical Clinic, Heidelberg, Germany
| | - Kathrin Schramm
- Hopp Children's Cancer Center Heidelberg (KiTZ) and German Cancer Research Center (DKFZ) University Hospital Heidelberg, University Hospital Heidelberg Medical Clinic, Heidelberg, Germany
| | - Clemens Wirth
- Institute of Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University of Würzburg, Wuerzburg, Germany
| | | | | | - Matthias Eyrich
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Mathias Woelfl
- Department of pediatric hemato-oncology, University Clinic of Würzburg, Wuerzburg, Germany
| | - Carl Friedrich Classen
- Pediatric Oncology and Hematology, University Children's Hospital Rostock, Rostock, Germany
| | - Verena A Wiegering
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
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von Lukowicz H, Schlegel PG, Eberl W, von Kries R, Morbach H, Härtel C, Haubitz I, Wiegering VA. [Acute ITP in Childhood - Do We Treat Too Much? - ESPED Evaluation]. Klin Padiatr 2021; 233:145-148. [PMID: 33662996 DOI: 10.1055/a-1377-6503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Paul G Schlegel
- Pediatrics, Klinikum der Universität Würzburg, Wurzburg, Deutschland
| | - Wolfgang Eberl
- Klinik für Kinder- und Jugendmedizin, Braunschweig, Klinikum Braunschweig, Deutschland
| | - Rüdiger von Kries
- Institut für Soziale Pädiatrie und Jugendmedizin, Abt. für Epidemiologie des Kindes- und Jugendalters mit dem Schwerpunkt Gesundheitsforschung, München, Deutschland
| | - Henner Morbach
- Pediatrics, Klinikum der Universität Würzburg, Wurzburg, Deutschland
| | - Christoph Härtel
- Pediatrics, Klinikum der Universität Würzburg, Wurzburg, Deutschland
| | - Imme Haubitz
- Pediatrics, Klinikum der Universität Würzburg, Wurzburg, Deutschland
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Manukjan G, Wiegering VA, Reindl T, Strauß G, Klopocki E, Schulze H, Andres O. Novel variants in FERMT3 and RASGRP2-Genetic linkage in Glanzmann-like bleeding disorders. Pediatr Blood Cancer 2020; 67:e28078. [PMID: 31724816 DOI: 10.1002/pbc.28078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/13/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 11/07/2022]
Abstract
Defects of platelet intracellular signaling can result in severe platelet dysfunction. Several mutations in each of the linked genes FERMT3 and RASGRP2 on chromosome 11 causing a Glanzmann-like bleeding phenotype have been identified so far. We report on novel variants in two unrelated pediatric patients with severe bleeding diathesis-one with leukocyte adhesion deficiency type III due to a homozygous frameshift in FERMT3 and the other with homozygous variants in both, FERMT3 and RASGRP2. We focus on the challenging genetic and functional variant assessment and aim to accentuate the risk of obtaining misleading results due to the phenomenon of genetic linkage.
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Affiliation(s)
- Georgi Manukjan
- Institute of Experimental Biomedicine, University Hospital Würzburg, Würzburg, Germany
| | | | - Tobias Reindl
- Department for Pediatric Hematology and Oncology, Charité-University Medicine Berlin, Berlin, Germany
| | - Gabriele Strauß
- Department for Pediatric Hematology and Oncology, Charité-University Medicine Berlin, Berlin, Germany.,Department for Pediatric Oncology and Hematology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Eva Klopocki
- Institute of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Harald Schulze
- Institute of Experimental Biomedicine, University Hospital Würzburg, Würzburg, Germany.,Centre of Inherited Blood Cell Disorders, University Hospital Würzburg, Würzburg, Germany
| | - Oliver Andres
- Department of Pediatrics, University of Würzburg, Würzburg, Germany.,Centre of Inherited Blood Cell Disorders, University Hospital Würzburg, Würzburg, Germany
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Wiegering A, Endter F, Wiegering VA, Germer CT, Maroske J. Bowl obstruction due to an incomplete obliterated omphalomesenteric duct. Klin Padiatr 2014; 226:80-1. [PMID: 24554589 DOI: 10.1055/s-0034-1366988] [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: 10/25/2022]
Affiliation(s)
- A Wiegering
- Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Germany
| | - F Endter
- Department of General Surgery, Hospital Rothenburg o.d.Tauber, Germany
| | - V A Wiegering
- Department of Pediatrics, University Hospital Wuerzburg, Germany
| | - C-T Germer
- Department of General, Visceral, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Germany
| | - J Maroske
- Department of General Surgery, Hospital Rothenburg o.d.Tauber, Germany
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Strauss A, Moskalenko V, Tiurbe C, Chodnevskaja I, Timm S, Wiegering VA, Germer CT, Ulrichs K. Goettingen Minipigs (GMP): Comparison of Two Different Models for Inducing Diabetes. Diabetol Metab Syndr 2012; 4:7. [PMID: 22390349 PMCID: PMC3309977 DOI: 10.1186/1758-5996-4-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 03/05/2012] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Preclinical experiments on large animals are indispensable for evaluating the effectiveness of diabetes therapies. Miniature swine are well suited for such studies due to their physiological and pathophysiological responses. METHODS We compare two methods for inducing diabetes in Goettingen minipigs (GMP), in five with the beta cell toxin streptozotocin (STZ) and in five other GMP by total pancreatectomy (PE). Glucose homeostasis was assessed with the intravenous glucose-tolerance test (IVGTT) and continual monitoring of interstitial glucose levels. At conclusion of the observation period, the pancreata were examined histologically. Three non-diabetic GMP served as control group. RESULTS The IVGTT revealed markedly diabetic profiles in both GMP groups. STZ-GMP were found to harbor residual C-peptides and scattered insulin-positive cells in the pancreas. PE-GMP survived the total pancreatectomy only with intensive postoperative care. CONCLUSIONS Although both methods reliably induced diabetes in GMP, the PE-GMP clearly had more health problems and required a greater expenditure of time and resources. The PE-GMP model, however, was better at eliminating endogenous insulin and C-peptide than the STZ-GMP model.
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Affiliation(s)
- Armin Strauss
- Department of General, Visceral, Vascular and Pedatric Surgery (Department of Surgery I)University Hospital of Wuerzburg, Germany
| | | | - Christian Tiurbe
- Department of General, Visceral, Vascular and Pedatric Surgery (Department of Surgery I)University Hospital of Wuerzburg, Germany
| | - Irina Chodnevskaja
- Experimental Transplantation Immunology, Department of General, Visceral, Vascular and Paediatric Surgery (Surgical Clinic I), University Hospital of Wuerzburg, Germany
| | - Stephan Timm
- Maltese Hospital and St. Franziskus Hospital, Flensburg, Germany
| | | | - Christoph-Thomas Germer
- Department of General, Visceral, Vascular and Pedatric Surgery (Department of Surgery I)University Hospital of Wuerzburg, Germany
| | - Karin Ulrichs
- Experimental Transplantation Immunology, Department of General, Visceral, Vascular and Paediatric Surgery (Surgical Clinic I), University Hospital of Wuerzburg, Germany
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