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Wagner D, Wienerroither V, Scherrer M, Thalhammer M, Faschinger F, Lederer A, Hau HM, Sucher R, Kornprat P. Value of sarcopenia in the resection of colorectal liver metastases-a systematic review and meta-analysis. Front Oncol 2023; 13:1241561. [PMID: 37841447 PMCID: PMC10569723 DOI: 10.3389/fonc.2023.1241561] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/07/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Sarcopenia is defined as a decline in muscle function as well as muscle mass. Sarcopenia itself and sarcopenic obesity, defined as sarcopenia in obese patients, have been used as surrogates for a worse prognosis in colorectal cancer. This review aims to determine if there is evidence for sarcopenia as a prognostic parameter in colorectal liver metastases (CRLM). Methods PubMed, Embase, Cochrane Central, Web of Science, SCOPUS, and CINAHL databases were searched for articles that were selected in accordance with the PRISMA guidelines. The primary outcomes were overall survival (OS) and disease-free survival (DFS). A random effects meta-analysis was conducted. Results After eliminating duplicates and screening abstracts (n = 111), 949 studies were screened, and 33 publications met the inclusion criteria. Of them, 15 were selected after close paper review, and 10 were incorporated into the meta-analysis, which comprised 825 patients. No significant influence of sarcopenia for OS (odds ratio (OR), 2.802 (95% confidence interval (CI), 1.094-1.11); p = 0.4) or DFS (OR, 1.203 (95% CI, 1.162-1.208); p = 0.5) was found, although a trend was defined toward sarcopenia. Sarcopenia significantly influenced postoperative complication rates (OR, 7.905 (95% CI, 1.876-3.32); p = 0.001) in two studies where data were available. Conclusion Existing evidence on the influence of sarcopenia on postoperative OS as well as DFS in patients undergoing resection for CRLM exists. We were not able to confirm that sarcopenic patients have a significantly worse OS and DFS in our analysis, although a trend toward this hypothesis was visible. Sarcopenia seems to influence complication rates but prospective studies are needed.
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Konstantiniuk P, Leitner M, Thalhammer M, Schramayer G, Cohnert T. Smoking is a Significant Risk-Factor for Postoperative Cerebral Events in Cabg and Simultaneous Internal Carotid Endarterectomy. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.06.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Golob-Schwarzl N, Wodlej C, Kleinegger F, Gogg-Kamerer M, Birkl-Toeglhofer AM, Petzold J, Aigelsreiter A, Thalhammer M, Park YN, Haybaeck J. Eukaryotic translation initiation factor 6 overexpression plays a major role in the translational control of gallbladder cancer. J Cancer Res Clin Oncol 2019; 145:2699-2711. [PMID: 31586263 PMCID: PMC6800842 DOI: 10.1007/s00432-019-03030-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gallbladder cancer (GBC) is a rare neoplasia of the biliary tract with high mortality rates and poor prognosis. Signs and symptoms of GBC are not specific and often arise at late stage of disease. For this reason, diagnosis is typically made when the cancer is already in advanced stages, and prognosis for survival is less than 5 years in 90% of cases. Biomarkers to monitor disease progression and novel therapeutic alternative targets for these tumors are strongly required. Commonly, dysregulated protein synthesis contributes to carcinogenesis and cancer progression. In this case, protein synthesis directs translation of specific mRNAs, and, in turn, promotes cell survival, invasion, angiogenesis, and metastasis of tumors. In eukaryotes, protein synthesis is regulated at its initiation, which is a rate-limiting step involving eukaryotic translation initiation factors (eIFs). We hypothesize that eIFs represent crossroads in the development of GBC, and might serve as potential biomarkers. The study focus was the role of eIF6 (an anti-association factor for the ribosomal subunits) in GBC. METHODS In human GBC samples, the expression of eIF6 was analyzed biochemically at the protein (immunohistochemistry, immunoblot analyses) and mRNA levels (qRT-PCR). RESULTS High levels of eIF6 correlated with shorter overall survival in biliary tract cancer (BTC) patients (n = 28). Immunohistochemical data from tissue microarrays (n = 114) demonstrated significantly higher expression levels of eIF6 in GBC compared to non-neoplastic tissue. Higher eIF6 expression on protein (immunoblot) and mRNA (qRT-PCR) level was confirmed by analyzing fresh frozen GBC patient samples (n = 14). Depletion of eIF6 (using specific siRNA-mediated knockdown) in Mz-ChA-2 and TFK-1 cell lines inhibited cell proliferation and induced apoptosis. CONCLUSION Our data indicates that eIF6 overexpression plays a major role in the translational control of GBC, and indicates its potential as a new biomarker and therapeutic target in GBC.
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Affiliation(s)
- Nicole Golob-Schwarzl
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- Institute of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Christina Wodlej
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine, Graz, Austria
| | - Florian Kleinegger
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- Department for Biomedical Research, Core Facility Alternative Biomodels and Preclinical Imaging, Medical University of Graz, Graz, Austria
| | - Margit Gogg-Kamerer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - Johannes Petzold
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Ariane Aigelsreiter
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Michael Thalhammer
- Department of General Surgery, Medical University of Graz, Graz, Austria
| | - Young Nyun Park
- Department of Pathology, Yonsei University, College of Medicine Soul, Seoul, South Korea
| | - Johannes Haybaeck
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria.
- Center for Biomarker Research in Medicine, Graz, Austria.
- Department of Pathology, Medical Faculty, Otto-von-Guericke-University, Leipziger Straße 44, 39210, Magdeburg, Germany.
- Department of Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.
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Kleinegger F, Hofer E, Wodlej C, Golob-Schwarzl N, Birkl-Toeglhofer AM, Stallinger A, Petzold J, Orlova A, Krassnig S, Reihs R, Niedrist T, Mangge H, Park YN, Thalhammer M, Aigelsreiter A, Lax S, Garbers C, Fickert P, Rose-John S, Moriggl R, Rinner B, Haybaeck J. Pharmacologic IL-6Rα inhibition in cholangiocarcinoma promotes cancer cell growth and survival. Biochim Biophys Acta Mol Basis Dis 2019; 1865:308-321. [DOI: 10.1016/j.bbadis.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/25/2018] [Accepted: 11/07/2018] [Indexed: 02/08/2023]
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Stotz M, Liegl-Atzwanger B, Posch F, Mrsic E, Thalhammer M, Stojakovic T, Bezan A, Pichler M, Gerger A, Szkandera J. Blood-Based Biomarkers Are Associated with Disease Recurrence and Survival in Gastrointestinal Stroma Tumor Patients after Surgical Resection. PLoS One 2016; 11:e0159448. [PMID: 27454486 PMCID: PMC4959723 DOI: 10.1371/journal.pone.0159448] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/01/2016] [Indexed: 12/18/2022] Open
Abstract
Background Inflammatory blood count biomarkers may improve recurrence risk stratification and inform long-term prognosis of cancer patients. Here, we quantify the prognostic impact of blood-based biomarkers on recurrence risk and long-term survival in a large cohort of gastrointestinal stroma tumor (GIST) patients after curative surgery. Methods One-hundred-forty-nine consecutive GIST patients were followed-up for a median period of 4.8 years. Local recurrence, distant metastasis, and death occurred in 9, 21, and 31 patients, respectively. Time-to-event and competing risk analysis were applied to study the association between haemoglobin (Hb) level, white blood cell count (WBC), neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte/monocyte ratio (LMR), and platelet/lymphocyte ratio (PLR) with risk of local or distant recurrence (RR), recurrence free survival (RFS), and overall survival (OS). Results A low Hb (p = 0.029), and elevations in the parameters WBC (p = 0.004), NLR (p = 0.015) and dNLR (p = 0.037) were associated with a poor OS in GIST patients in multivariate analysis. Moreover, a low Hb (p = 0.049) and an elevated WBC (p = 0.001), NLR (p = 0.007), dNLR (p = 0.043) and PLR (p = 0.024) were independently associated with decreased RFS after adjusting for Miettinen score. However, only an increase of dNLR/NLR showed a significant association to higher RR (p = 0.048). Inclusion of NLR or PLR to Miettinen risk score did not reasonably improve the clinical risk prediction of 2-year RFS. Conclusion Low Hb, elevated WBC, elevated dNLR, and elevated PLR are independent prognostic factors for a worse clinical outcome in GIST patients after curative resection.
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Affiliation(s)
- Michael Stotz
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Graz, Austria
| | | | - Florian Posch
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Edvin Mrsic
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Michael Thalhammer
- Division of General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Angelika Bezan
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
- Research Unit for non-coding RNAs and genome editing in cancer, Division of Clinical Oncology, Medical University of Graz, Graz, Austria
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, United States of America
| | - Armin Gerger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Medical University of Graz, Graz, Austria
| | - Joanna Szkandera
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Graz, Austria
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Hoerl G, Ledinski G, Kager G, Thalhammer M, Koestenberger M, Juergens G, Gary T, Cvirn G. Virtually same oxidizability of LDL but higher Lp(a) levels in arterial compared to venous plasma. Chem Phys Lipids 2014; 184:38-41. [PMID: 25240239 DOI: 10.1016/j.chemphyslip.2014.09.004] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/02/2014] [Accepted: 09/15/2014] [Indexed: 10/24/2022]
Abstract
Plaque formation is confined to the arterial trunk. We assumed that due to the higher aeration of arterial compared to venous blood, higher levels of the atherogenic agent oxidized LDL might be present in arteries, contributing to plaque formation. We aimed to compare (i) the basal oxidative status of LDL in arterial and venous blood and (ii) the susceptibility of arterial and venous LDL to oxidation. The basal oxidative status of LDL was determined by measuring lipid hydroperoxide (LPO) concentrations, plasma levels of auto-antibodies against oxidized LDL, and by measuring oxidation-specific epitopes on LDL particles. The oxidizability of arterial vs. venous LDL (catalyzed by copper) was estimated by monitoring the time-course of conjugated dienes formation. Interestingly, we found the same basal oxidative status of LDL in arterial and venous plasma. LPO concentrations and levels of auto-antibodies against oxidized LDL were similar in arterial and venous plasma and amounts of oxidation-specific epitopes were similar on the respective LDL particles. Moreover, we found similar susceptibilities of arterial and venous LDL to (copper-mediated) oxidation. Lag-times until the onset of conjugated diene formation were slightly shorter in arterial compared to venous LDL in the presence of 5 μM, but not in the presence of 1 μM CuCl2. Additionally, we found significantly higher levels of the atherogenic lipoprotein(a) in arterial plasma. We conclude that not higher oxidizability of arterial LDL but higher arterial lipoprotein(a) levels might help to explain why sclerosis is confined to the arterial trunk.
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Affiliation(s)
- Gerd Hoerl
- Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz A-8010, Austria
| | - Gerhard Ledinski
- Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz A-8010, Austria
| | - Gerd Kager
- Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz A-8010, Austria
| | | | | | - Guenther Juergens
- Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz A-8010, Austria
| | - Thomas Gary
- Department of Angiology, Medical University of Graz, Graz, Austria
| | - Gerhard Cvirn
- Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz A-8010, Austria.
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Gwinner J, Thalhammer M. Full Discretisations for Nonlinear Evolutionary Inequalities Based on Stiffly Accurate Runge-Kutta and hp-Finite Element Methods. Found Comut Math 2013; 14:913-949. [PMID: 26029034 PMCID: PMC4447081 DOI: 10.1007/s10208-013-9179-3] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 09/10/2013] [Accepted: 10/08/2013] [Indexed: 06/04/2023]
Abstract
The convergence of full discretisations by implicit Runge-Kutta and nonconforming Galerkin methods applied to nonlinear evolutionary inequalities is studied. The scope of applications includes differential inclusions governed by a nonlinear operator that is monotone and fulfills a certain growth condition. A basic assumption on the considered class of stiffly accurate Runge-Kutta time discretisations is a stability criterion which is in particular satisfied by the Radau IIA and Lobatto IIIC methods. In order to allow nonconforming hp-finite element approximations of unilateral constraints, set convergence of convex subsets in the sense of Glowinski-Mosco-Stummel is utilised. An appropriate formulation of the fully discrete variational inequality is deduced on the basis of a characteristic example of use, a Signorini-type initial-boundary value problem. Under hypotheses close to the existence theory of nonlinear first-order evolutionary equations and inequalities involving a monotone main part, a convergence result for the piecewise constant in time interpolant is established.
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Affiliation(s)
- J. Gwinner
- Institut für Mathematik und Rechneranwendung, Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, 85577 Neubiberg, Germany
| | - M. Thalhammer
- Institut für Mathematik, Leopold–Franzens Universität Innsbruck, Technikerstrasse 13/7, 6020 Innsbruck, Austria
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Thalhammer M, Altziebler S, Karlo C, Schöllnast H, Uribe G, Lackner C, Langner C, Mischinger H. 88 POSTER Metastases to the pancreas from renal cell carcinoma. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70523-6] [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] Open
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Tiesenhausen K, Hessinger M, Konstantiniuk P, Tomka M, Baumann A, Thalhammer M, Portugaller H. Surgical Conversion of Abdominal Aortic Stent-grafts—Outcome and Technical Considerations. Eur J Vasc Endovasc Surg 2006; 31:36-41. [PMID: 16226904 DOI: 10.1016/j.ejvs.2005.08.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2005] [Accepted: 08/22/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the outcome of patients with stented abdominal aortic aneurysms who had to undergo open aneurysm repair with partial or total stent-graft removal. METHODS Between October 1996 and December 2003, 117 patients with abdominal aortic aneurysms underwent endovascular repair. When open surgery was necessary during the initial and same anaesthesia as stent-graft implantation, it was defined as immediate conversion. When conversion was performed during a second anaesthesia, we defined it as late (acute or elective) conversion. RESULTS A total of 33 patients underwent conversion to open surgery. In 7 (6%) patients, immediate conversion was necessary due to stent-graft misplacement and obstruction of the renal arteries (n=4), type Ia endoleaks (n=2) and stent-graft dislocation into the aneurysm sac (n=1). During a mean follow-up period of 39.6 months (min 0.03 months, max 80.4 months), 26 (23.6%) of the remaining 110 patients underwent late conversion to open surgery for endoleak (n=12), rupture (n=6), thrombosis (n=4), graft fatigue (n=2), aorto-duodenal fistula (n=1), and recurring peripheral embolisms (n=1). The mortality of acute conversion was 38% (5 of 13). Elective conversion did not lead to any mortality. CONCLUSION Acute conversion of stented abdominal aortic aneurysms is associated with a high mortality. Elective stent-graft explantation with open aortic reconstruction is a safe but complex procedure.
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Affiliation(s)
- K Tiesenhausen
- Department of Vascular Surgery, University Hospital Graz, Graz, Austria.
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Abstract
HISTORY AND CLINICAL FINDINGS A 48-year-old patient had been suffering from postalimentary hypoglycemias for several months, occurring regularly 2 hours after a meal. 5 years before, repeated fundaplications as well as a selective proximal vagotomy due to reflux oesophagitis had been performed. INVESTIGATIONS Physical examination revealed no pathological findings. The diurnal blood sugar profile with hourly capillary glucose measurement showed a physiological fasting glucose homeostasis and two-hour postprandial decrease of blood glucose down to 20 mg/dl. The oral glucose tolerance test revealed a noticeable insulin secretion with a pathologically increased insulin/glucose index. Scintigraphy demonstrated an initially delayed, then accelerated gastric emptying as a consequence of the selective proximal vagotomy. DIAGNOSIS, TREATMENT AND COURSE A postalimentary hypoglycemia by hypersecretion of insulin in the context of a post-gastrectomy late dumping syndrome was diagnosed. A surgical pyloroplasty was not effective. In addition to the modification of eating habits, treatment with subcutaneous applied octreotide (Sandostatin), a somatostatin-analogue, was initiated. CONCLUSIONS Postalimentary hypoglycemia can be assigned to late dumping syndrome in most cases already by ascribed history taking. The correct diagnosis can be achieved by an oral glucose tolerance test with measurement of insulin secretion and gastric emptying scintigraphy. Beside other therapeutical options the treatment with octreotide is a promising alternative with manageable side effects.
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Affiliation(s)
- M Thalhammer
- 3. Medizinische Abteilung, Krankenhaus München Neuperlach.
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Billing A, Thalhammer M, Eissner HJ, Jauch KW, Inthorn D. [Economic aspects of intensive care medicine--cost and reimbursement according to diagnosis related grouping]. Zentralbl Chir 2005; 129:440-6. [PMID: 15616906 DOI: 10.1055/s-2004-832392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We analyse relevant modifications of the new German diagnosis related reimbursement system for 2004. It is difficult to judge the consequences of financing intensive care systems by such flat rates. In our surgical ICU total treatment costs were 1 050.-euro /day and 11 530.-euro /patient. Comparison of our total costs and German federal calculation 2003 for long-term ventilation revealed that our costs resulting from a tertiary unit topped the average by 36-60 %. Already the present reimbursement was not cost rewarding. Evaluation according to the 2003 criteria resulted in profound further deterioration to a cost covering of only 49 %. The 2004 system, however, allows for better differentiation of patients and should result in improved reimbursement of long-term ventilation. Further professional analysis of the DRG system is essential for its "learning" development.
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Affiliation(s)
- A Billing
- Chirurgische Klinik und Poliklinik, Universitätsklinikum München, Klinikum Grosshadern.
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Schweiger W, El-Shabrawi A, Werkgartner G, Bacher H, Cerwenka H, Thalhammer M, Mischinger HJ. Impact of parenchymal transection by Ultracision® harmonic scalpel in elective liver surgery. Eur Surg 2004. [DOI: 10.1007/s10353-004-0099-y] [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: 11/29/2022]
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Billing A, Thalhammer M, Hornung H, Eissner HJ, Jauch KW, Auburger G. [DRG and maximal care hospitals. Extent and causes of underfinancing]. Chirurg 2004; 75:M249-52. [PMID: 15543650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- A Billing
- Klinikum der Universität München, Chirurgische Klinik und Poliklinik-Grosshadern, Marchioninistrasse 1, 81377 Munich, Germany
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Schoellnast H, Reittner P, Thalhammer M, Preidler K, Szolar D. [Acute abdominal pain: CT diagnosis of omental volvulus]. ROFO-FORTSCHR RONTG 2002; 174:1461-2. [PMID: 12424678 DOI: 10.1055/s-2002-35347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Regitnig P, Moser R, Thalhammer M, Luschin-Ebengreuth G, Ploner F, Papadi H, Tsybrovskyy O, Lax SF. Microsatellite analysis of breast carcinoma and corresponding local recurrences. J Pathol 2002; 198:190-7. [PMID: 12237878 DOI: 10.1002/path.1193] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Local recurrence is a serious complication of breast carcinoma that reduces quality of life and influences prognosis. The aim of this study was to determine whether local recurrences of breast carcinoma are genetically related to the primary tumours. Forty cases of locally recurrent breast carcinomas (median onset: 3.6 years after primary surgery) were analysed: 22 patients had undergone breast-conserving therapy and 18 mastectomy. Eighteen microsatellites on chromosomes 2p, 3p, 5q, 10q, 11p, 11q, 13q, 17q, 17p, 18p were amplified by PCR using fluorescent-labelled primers, automatically detected after polyacrylamide gel electrophoresis and analysed for loss of heterozygosity (LOH) or microsatellite instability (MSI). Follow-up data were available for 39 cases with a median value of 89 months. All LOH and MSI found in the primary tumours were also present in the corresponding recurrences, indicating that they are genetically related to the primary tumours and not secondary malignancies in the same breast. MSI was found in three cases, of which one harboured MSI at more than two loci. The median value of LOH per case was significantly higher in the recurrent (four per case) compared to the primary tumours (two per case; p < 0.001, Mann-Whitney test), reflecting the genotype of tumour progression. Early local recurrence was associated with specific LOH for TP53.15 (p = 0.018, log-rank test) in the primary tumours. LOH on D13S1699 or D17S855 was associated with lymph node metastases (p = 0.024 and p = 0.019, respectively; chi-square test). In addition, tumour grade, lack of oestrogen or progesterone receptor expression, young patient age and early appearance of local recurrence significantly correlated with poor survival. The development of local recurrence despite clear resection margins may result from residual DCIS distant from the invasive carcinoma, homing of circulating tumour cells, or genetically altered, histologically normal breast tissue not immediately adjacent to the invasive carcinoma.
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Affiliation(s)
- Peter Regitnig
- Department of Pathology, University of Graz, Auenbrugger Platz 25, A-8036 Graz, Austria
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Detter C, Reichenspurner H, Boehm DH, Thalhammer M, Raptis P, Schütz A, Reichart B. Minimally invasive direct coronary artery bypass grafting (MIDCAB) and off-pump coronary artery bypass grafting (OPCAB): two techniques for beating heart surgery. Heart Surg Forum 2002; 5:157-62. [PMID: 12114131] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Coronary bypass surgery can be performed less invasively by avoiding cardiopulmonary bypass (CPB). We present our experiences with beating heart bypass surgery performed through a minithoracotomy or sternotomy. METHODS From May 1997 to September 1999, 340 patients were included in a prospective study. Of these patients, 111 (group 1) underwent minimally invasive direct coronary artery bypass grafting (MIDCAB) through an antero-lateral minithoracotomy, and 229 (group 2) had off-pump coronary artery bypass grafting (OPCAB) through a full sternotomy. A pressure stabilizer was used for MIDCAB and a suction stabilizer for OPCAB surgery. Early postoperative angiography was performed on 48% of patients in group 1 and 45% of those in group 2. Statistical analysis was applied to compare the variables from both groups and a probability value of less than 0.05 was considered significant. RESULTS In all MIDCAB grafts, revascularization was performed by a single left internal mammary artery (LIMA) graft to the left anterior descending coronary artery (LAD). This procedure was completed in 96.4% of patients without CPB. Conversion to sternotomy was necessary for one patient (0.9%). In the OPCAB group, an average of 1.7 grafts per patient were revascularized, of which 98 were single, 99 double, and 32 triple. Of the OPCAB group, 12% of patients were redo operations and 17% had severe comorbidities. Conversion to CPB was necessary for 10 patients (4.4%) because of hemodynamic instability. No cerebrovascular accident (CVA) was seen in any group. There were no hospital deaths in the MIDCAB group, but there were three deaths (1.3%) in the OPCAB group. Age, previous bypass surgery, and severe comorbidities did not influence early mortality. Early postoperative reoperation due to graft failure was necessary for three patients (2.7%) after MIDCAB and for three patients (1.3%) after OPCAB. Confirmed by angiography, the early postoperative total graft patency rate was 96.2% in the MIDCAB group and 96.6% in the OPCAB group; the perfect patency rate (no stenosis greater than 50%) was 92.4% and 93.1%, respectively. CONCLUSIONS Coronary bypass surgery without the use of CPB is feasible and safe, and offers good early results. Nevertheless, MIDCAB grafting is a challenging technique and should only be performed in selected patients with favorable coronary anatomy. On the other hand, with the sternotomy approach, exposure of all vessels was well tolerated and made complete revascularization feasible. OPCAB can be performed safely even on high-risk patients.
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Affiliation(s)
- Christian Detter
- Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilian-University, Munich, Germany.
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Abstract
Fractures of the spine represent a severe complication particularly in patients with ankylosing spondylitis because of high morbidity and mortality. We report on a patient with a hyperextension fracture of the lumbar spine, leading to disruption of the aorta and caval vein.
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Affiliation(s)
- K Tiesenhausen
- Klinische Abteilung für Gefässchirurgie, Universitätsklinik Graz, Auenbruggerplatz 29, 8036 Graz, Ostereich
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Detter C, Reichenspurner H, Boehm DH, Thalhammer M, Schütz A, Reichart B. Single vessel revascularization with beating heart techniques -- minithoracotomy or sternotomy? Eur J Cardiothorac Surg 2001; 19:464-70. [PMID: 11306314 DOI: 10.1016/s1010-7940(01)00616-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [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: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of the study was to evaluate the best surgical approach in off-pump single vessel revascularization of the left anterior descending coronary artery (LAD). METHODS In 256 patients a single left internal mammary artery (LIMA) to LAD bypass was performed with beating heart techniques through a left anterior minithoracotomy (minimally invasive direct coronary artery bypass (MIDCAB), n=129) or a full sternotomy (off-pump coronary artery bypass (OPCAB), n=127). RESULTS In the OPCAB group, significantly more severe comorbidities (P=0.001) and redo-operations were noted (P<0.001). Conversion to sternotomy or CPB was necessary in five MIDCAB patients and one OPCAB patient. No cerebrovascular accident was seen in both groups. There was no hospital death in MIDCAB- and two deaths in OPCAB procedures (P=ns). There was a significant reduction in time of surgery (P=0.028) and coronary occlusion (P=0.009) in the OPCAB group. No differences in postoperative ventilation time, ICU stay and length of hospital stay were recorded between groups. Wound infections occurred in six MIDCAB patients (4.7%) and one OPCAB patient (0.8%). Early postoperative reoperation due to graft failure was necessary in three patients after MIDCAB and two patients after OPCAB (P=ns). Confirmed by angiography, the early graft patency rate was 96 and 98%, respectively (P=ns). CONCLUSIONS Both beating heart techniques showed good results with low hospital mortality, low early complications and comparable angiographic results. Nevertheless, MIDCAB is a challenging technique as demonstrated by the longer times of surgery and coronary occlusion with a tendency towards a higher risk of conversion and wound infection. Thus, this technique should only be performed in selected patients with favourable coronary anatomy. Through a sternotomy approach, single vessel revascularization can be performed safely off-pump even in high-risk patients.
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Affiliation(s)
- C Detter
- Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilian-University, Marchioninistrasse 15, D-81366 Munich, Germany.
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Tiesenhausen K, Amann W, Thalhammer M, Koch G. [Primary bacterial aortitis]. Zentralbl Chir 2000; 125:275-9. [PMID: 10769448] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Primary bacterial aortitis represents a rare disease with a high lethality. From June 1997 to April 1999 5 patients with an abdominal aortic infection were treated by resection of the infected aorta and in-situ reconstruction or by extra-anatomic bypass. There was no treatment in one case because of the infaust prognosis. 3 patients survived, one with a paraparesis as a result of spinal ischemia. On the basis of our patients the pathogenesis, clinical symptoms with diagnosis and the therapeutic options are discussed.
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Affiliation(s)
- K Tiesenhausen
- Klinische Abteilung für Gefässchirurgie, Universitätsklinik Graz
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Abstract
The implantation of covered stents or stentgrafts has increased greatly in the last few years for the endovascular reconstruction of arterial aneurysms. We report of three patients experiencing severe septic complications after stentgraft implantation. Endovascular stentgraft infection is a serious complication with high morbidity and mortality. General antibiotic prophylaxis seems to be indicated when implanting stentgrafts.
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Affiliation(s)
- K Tiesenhausen
- Klinische Abteilungen für Gefässchirurgie, Universitätsklinik Graz, Austria
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Tiesenhausen K, Amann W, Koch G, Brodmann M, Thalhammer M, Wolf G. Die Kumarinnekrose - eine lebensbedrohliche Komplikation. Zeitschrift f�r Herz-, Thorax- und Gef��chirurgie 1999. [DOI: 10.1007/s003980050085] [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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Tiesenhausen K, Amann W, Thalhammer M, Aschauer M. Aplasia of the vena cava inferior as a cause for recurring thrombosis of the lower extremities and pelvic veins. VASA 1999; 28:289-92. [PMID: 10611848 DOI: 10.1024/0301-1526.28.4.289] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Congenital anomalies of the caval vein are often associated with other abnormalities such as heart defects, situs inversus or a polysplenia-asplenia-syndrome. An isolated, congenital malformation like aplasia of the inferior vena cava is a rare finding. A review of the embryology and abnormalities, diagnostics, clinical signs and treatment is given together with the histories of two patients having thrombosis of the lower extremities and pelvic veins, caused by aplasia of the inferior vena cava. After thrombotic complications caused by vena cava aplasia there is high risk of recurrence. Those patients should be anticoagulated for lifetime.
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Affiliation(s)
- K Tiesenhausen
- Department of Vascular Surgery, University Hospital, Graz, Austria
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Tiesenhausen K, Amann W, Thalhammer M, Koch G. [Posttraumatic aneurysm of the brachiocephalic trunk: a rare injury]. Unfallchirurg 1999; 102:808-10. [PMID: 10525626 DOI: 10.1007/s001130050485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report on a posttraumatic aneurysm of the brachiocephalic trunk, something which is rather rare. The injury was caused by blunt chest trauma following a car accident. Computed tomography could not find the brachiocephalic lesion. In patients with fractures of the upper ribs after blunt chest trauma, angiography should be done to exclude severe injuries of the aorta and brachiocephalic vessels.
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Affiliation(s)
- K Tiesenhausen
- Klinische Abteilung für Gefässchirurgie, Universitätsklinik Graz
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Abstract
INTRODUCTION Primary bacterial infection of an artery is difficult to diagnose, especially at the beginning of the illness. Most of the patients come for emergency treatment in the phase of rupture. METHODS The course of illness in four patients serves as background for discussion of the problems of diagnosis and therapy. RESULTS Bacterial infection of arteries shows a high rate of complications and, for the aorta, high mortality. CONCLUSION If fever of uncertain origin is combined with pain of the stomach or of the back, or with a painful reddish swelling on a limb, this rare disease should be considered in the differential diagnosis.
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Affiliation(s)
- K Tiesenhausen
- Klinische Abteilung für Gefässchirurgie, Universitätsklinik Graz
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Smola M, Kriegl D, Promberger H, Kronberger L, Raith J, Gröll R, Cerwenka H, Kern R, Thalhammer M, Hinkel W, Preissegger K. Preoperative identification of node negative axillary lymph nodes in breast cancer by highly significant electron beam computertomography (EBG). Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(98)80284-0] [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: 11/26/2022]
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Cerwenka H, Hoff M, Rosanelli G, Hauser H, Thalhammer M, Smola MG, Klimpfinger M. Experience with a high speed biopsy gun in breast cancer diagnosis. Eur J Surg Oncol 1997; 23:206-7. [PMID: 9236891 DOI: 10.1016/s0748-7983(97)92268-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Pre-operative determination of histology and receptor status is important in optimizing the management of breast cancer. The purpose of our study was to evaluate the high speed biopsy gun in 109 patients with palpable breast tumours. High speed biopsies were performed using the system BIP High Speed Multi 22 with 16-gauge-needles at a speed of 30 m/s. All biopsies could be used for frozen sections and for determination of receptor status. In 81 patients (74.3%) malignant breast tumours were diagnosed, and three patients (2.8%) had highly suspicious lesions. The oestrogen receptor status was negative in 32%, progesterone receptor status negative in 41%. In one patient (0.9%) a high grade non-Hodgkin's lymphoma of B-cell-type was diagnosed. In 21.1% benign tumours were found. In one patient a malignant tumour was missed at biopsy (0.9% false-negative). It was concluded that high speed biopsy is a reliable and simple method for preoperative sampling of breast lesions.
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Affiliation(s)
- H Cerwenka
- Department of General Surgery, Karl-Franzens University, School of Medicine, Graz, Austria
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Thalhammer M. [Basic formulation of the tasks of special education in rehabilitating the physically handicapped]. Rehabilitation (Stuttg) 1985; 24:143-5. [PMID: 2931783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Special educational reflexion is directed at, and analyses, the ever specific situation of the child with a physical disability, in order to attain the conditions enabling subjective and intersubjective reality to be formed and stabilized. 'Dealing with the external world' means complex and differentiated perception and internalization, particularly, subjectively relevant and meaningful activity: all this describes the individual learning and achievement behaviour of the child with a physical disablement. 'Achievement' becomes a category of high subjective significance, which requires constant intersubjective recognition. Motor behaviour as an objectifyable phenomenon must be distinguished from personal motor activity, at however limited a level of constitutional and functional motor competency it may occur. Expectation of success, and the avoidance of failure, are intrinsic constituents of educational reality in dealing with a physically disabled child. As Krappmann puts it, the achievement the individual must accomplish as a condition for enabling his participation in communication processes to occur, is designated as the category of identity.
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Sager WD, Thalhammer M, Fueger GF. [Comparison of brain scintigraphy with 99mTc-pertechnate and 99mTc-citrate]. Nuklearmedizin 1977; 16:257-9. [PMID: 600806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
20 patients with ultimately proven cerebral lesion were studied consecutively with 99mTc-pertechnetate and 99mTc-citrate. A comparison of the brain scans showed neoplastic lesions to be visualized more clearly with 99mTc-citrate, and vascular lesions to be demonstrated better with 99mTc-pertechnetate. Comparative brain scanning utilizing 99mTc-citrate and 99mTc-pertechnetate facilitates the differentiation between acute brain infarcts and neoplastic lesions which is difficult or may be impossible by cerebral computer tomography. The reduced radiation exposure from 99mTc-citrate and its superior usefulness in the visualization of neoplastic lesions suggest its use as the primary brain scanning agent.
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Sager WD, Thalhammer M, Fueger GF. Vergleichende Hirnszintigraphie mit 99mTc-Pertechne-tat und 99mTc-Zitrat. Nuklearmedizin 1977. [DOI: 10.1055/s-0037-1620641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung20 Patienten mit nachgewiesenen zerebralen Läsionen wurden mit 99mTc-Pertechneta t und 99mTc-Zitratuntersucht . Der Vergleich der Gehirnszintigramme ergab, daß neoplastische Veränderungen besser mit 99mTc-Zitrat und Enzephalomalazien besser mit 99mTc-Pertechneta t darstellbar waren.Vergleichende Szintigramme, bei denen 99mTc-Pertechneta t und 99mTc-Zitrat verwendet wurden, unterstützten die Differenzierung zwischen Enzephalomalazie und neoplastischen Veränderungen, die allein durch die Computertomographie nicht oder nur schwer möglich war. Die geringere Strahlenbelastung durch 99mTc-Zitrat und seine bessere Anwendbarkeit zur Darstellung von neoplastischen Veränderungen macht es zum primär einzusetzenden Agens für die Gehirnszintigraphie.
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Thalhammer M. [Intraesophageal accessory lung]. Beitr Pathol 1972; 146:396-404. [PMID: 5056076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Pickel H, Thalhammer M. [Chondrosarcoma of the Fallopian tube]. Geburtshilfe Frauenheilkd 1971; 31:1243-8. [PMID: 5135620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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