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Sudbrock F, Herrmann A, Fischer T, Zimmermanns B, Baus W, Drzezga A, Schomäcker K. Influence of iodine supply on the radiation-induced DNA-fragmentation. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2017; 166:157-161. [PMID: 27452911 DOI: 10.1016/j.jenvrad.2016.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 06/06/2023]
Abstract
The protective effect of stable iodide against radiation on thyroid cells was investigated. One physiological effect of stable iodine is well-rooted: stable iodine leads to a reduced thyroid uptake of radioactive iodine. This work wants to focus on an intrinsic effect of stable iodine by which DNA-damage in cells is prevented. To investigate this intrinsic effect thyroid cells (FRTL-5) were externally irradiated by use of a linear accelerator (LINAC) applying energy doses of 0.01 Gy-400 Gy and by incubation with various activity concentrations of 131I (0.1-50 MBq/ml for 24 h). We added stable iodine (NaI) to the cells prior to external irradiation and investigated the effect of the concentration of stable iodine (1, 5, 15 μg/ml). In order to clarify whether thyroid cells have a distinctive and iodine-dependent reaction to ionizing radiation, keratinocytes (HaCaT) without NIS were exposed in the same way. As indicators for the cellular reaction, the extent of DNA fragmentation was determined (Roche, Mannheim, Germany). Both cell types showed distinct ability for apoptosis as proven with camptothecin. The addition of "cold" iodine from 1 to 15 μg/ml without irradiation ("negative control") did not change the response in both cell types. Plausibly, the radio-sensitivity of both cell types did increase markedly with increasing radiation dose but the radiation effect is diminished if iodine is added to the thyroid cells beforehand. The DNA-damage in thyroid cells after addition of cold iodine is reduced by a factor of 2-3. The skin cells did not show an significant change of radio-sensitivity depending on the presence of cold iodine. Elementary iodine possibly acts as a radical scavenger and thus markedly reduces the secondary radiation damage caused by the formation of cytotoxic radicals. This intrinsic radioprotective effect of iodine is seen only in cells with NIS.
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Reif P, Brezinka C, Fischer T, Husslein P, Lang U, Ramoni A, Zeisler H, Klaritsch P. Labour and Childbirth After Previous Caesarean Section: Recommendations of the Austrian Society of Obstetrics and Gynaecology (OEGGG). Geburtshilfe Frauenheilkd 2016; 76:1279-1286. [PMID: 28017971 DOI: 10.1055/s-0042-118335] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patient's wishes into account. In view of good success rates (60-85 %) for vaginal birth after caesarean section (VBAC) the consideration of predictive factors during antenatal birth planning has become increasingly important. This publication provides a compact management recommendation for the majority of standard clinical situations. However it cannot and does not claim to cover all possible scenarios. The consideration of all relevant factors in each individual case, and thus the ultimate decision on mode of delivery, remains the discretion and responsibility of the treating obstetrician.
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Brächer T, Heussner F, Pirro P, Meyer T, Fischer T, Geilen M, Heinz B, Lägel B, Serga AA, Hillebrands B. Phase-to-intensity conversion of magnonic spin currents and application to the design of a majority gate. Sci Rep 2016; 6:38235. [PMID: 27905539 PMCID: PMC5131322 DOI: 10.1038/srep38235] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/07/2016] [Indexed: 12/02/2022] Open
Abstract
Magnonic spin currents in the form of spin waves and their quanta, magnons, are a promising candidate for a new generation of wave-based logic devices beyond CMOS, where information is encoded in the phase of travelling spin-wave packets. The direct readout of this phase on a chip is of vital importance to couple magnonic circuits to conventional CMOS electronics. Here, we present the conversion of the spin-wave phase into a spin-wave intensity by local non-adiabatic parallel pumping in a microstructure. This conversion takes place within the spin-wave system itself and the resulting spin-wave intensity can be conveniently transformed into a DC voltage. We also demonstrate how the phase-to-intensity conversion can be used to extract the majority information from an all-magnonic majority gate. This conversion method promises a convenient readout of the magnon phase in future magnon-based devices.
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Ruf K, Fischer T, Hornung R. Influence of pre-pregnancy BMI on gestational outcome: a retrospective study. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Weidlinger S, Von Perbandt E, Fischer T, Hornung R. Active management of the third stage of labor: Does the application mode of oxytocin influence the outcome? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ruf K, Fischer T, Hornung R. Spontaneous rupture of renal angiomyoplipoma in early pregnancy: a case report. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Huhn EA, Fischer T, Göbl CS, Todesco Bernasconi M, Kreft M, Kunze M, Schoetzau A, Dölzlmüller E, Eppel W, Husslein P, Ochsenbein-Koelble N, Zimmermann R, Bäz E, Prömpeler H, Bruder E, Hahn S, Hoesli I. Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: study protocol for an international, prospective, multicentre cohort trial. BMJ Open 2016; 6:e012115. [PMID: 27733413 PMCID: PMC5073542 DOI: 10.1136/bmjopen-2016-012115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION As the accurate diagnosis and treatment of gestational diabetes mellitus (GDM) is of increasing importance; new diagnostic approaches for the assessment of GDM in early pregnancy were recently suggested. We evaluate the diagnostic power of an 'early' oral glucose tolerance test (OGTT) 75 g and glycosylated fibronectin (glyFn) for GDM screening in a normal cohort. METHODS AND ANALYSIS In a prospective cohort study, 748 singleton pregnancies are recruited in 6 centres in Switzerland, Austria and Germany. Women are screened for pre-existing diabetes mellitus and GDM by an 'early' OGTT 75 g and/or the new biomarker, glyFn, at 12-15 weeks of gestation. Different screening strategies are compared to evaluate the impact on detection of GDM by an OGTT 75 g at 24-28 weeks of gestation as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A new screening algorithm is created by using multivariable risk estimation based on 'early' OGTT 75 g and/or glyFn results, incorporating maternal risk factors. Recruitment began in May 2014. ETHICS AND DISSEMINATION This study received ethical approval from the ethics committees in Basel, Zurich, Vienna, Salzburg and Freiburg. It was registered under http://www.ClinicalTrials.gov (NCT02035059) on 12 January 2014. Data will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02035059.
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Zink A, Herrmann M, Fischer T, Böhner A, Lauffer F, Garzorz-Stark N, Biedermann T, Eyerich K. 045 Psoriasis and addictions: a neglected challenge. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tukaj S, Bieber K, Kleszczynski K, Witte M, Cames R, Kalies K, Zillikens D, Ludwig R, Fischer T, Kasperkiewicz M. 235 Topically applied heat shock protein 90 blocker 17AAG inhibits autoantibody-mediated blister-inducing cutaneous inflammation. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Haas M, Günzel K, Penzkofer T, Maxeiner A, Fischer T, Miller K, Hamm B, Asbach P, Cash H. [Implications of PI-RADS Version 1 and Updated Version 2 on the Scoring of Prostatic Lesions in Multiparametric MRI]. Aktuelle Urol 2016; 47:383-7. [PMID: 27680189 DOI: 10.1055/s-0042-111128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND A revised version of the PI-RADS scoring system has been introduced and score-related variability between version 1 and 2 may be suspected. This study aimed to assess the PI-RADS scores derived from version 1 (v1) and the updated version 2 (v2). MATERIAL AND METHODS 61 patients with biopsy-proven prostate cancer (PCa) and 90 lesions detected on pre-biopsy 3-Tesla multiparametric MRI were included in this retrospective analysis. 2 experienced radiologists scored all lesions in consensus. Lesion scores differing between PI-RADS v1 and v2 were further analyzed. Histology data from radical prostatectomy (RP) were included when available. RESULTS The PI-RADS v1 and v2 score differed in 52% of patients (32/61) and in 39% of lesions (35/90). On a lesion basis, the reason for the differences were related to sum score in v1 vs. categorical system in v2 in 51% (18/35) of lesions, cutoff between PI-RADS 4 and 5 based on lesion size in v2 as opposed to the sum score in v1 in 31% (11/35) and were inconclusive in 17% (6/35). The RP subgroup indicates enhanced detection of PCas with GS 3+3 and GS 3+4 in v2. CONCLUSION PI-RADS scores of prostatic lesions frequently differed between v1 and v2, the major reasons for these differences being score-related. In men undergoing RP, PI-RADS v2 improved detection of low risk PCa, but did not increase accuracy for discrimination of GS 3+4 vs. GS≥4+3 compared to v1. Urologists should be aware of the system-related differences when interpreting PI-RADS scores.
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Weichert A, von Schöning D, Fischer T, Thomas A. Cervical Sonoelastography and Cervical Length Measurement but not Cervicovaginal Interleukin-6 Are Predictors for Preterm Birth. Ultrasound Int Open 2016; 2:E83-9. [PMID: 27689180 DOI: 10.1055/s-0042-110317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 02/21/2016] [Accepted: 05/17/2016] [Indexed: 01/08/2023] Open
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Dörner T, Posch M, Wagner F, Hüser A, Fischer T, Mooney L, Petricoul O, Maguire P, Pal P, Doucet J, Cabanski M, Kamphausen E, Oliver S. THU0313 Double-Blind, Randomized Study of VAY736 Single Dose Treatment in Patients with Primary Sjögren's Syndrome (PSS). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5840] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schmid-Schönbein H, Rieger H, Fischer T. Blood Fluidity as a Consequence of Red Cell Fluidity: Flow Properties of Blood and Flow Behavior of Blood in Vascular Diseases. Angiology 2016. [DOI: 10.1177/000331978003100502] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Blood is known to be an extremely non-Newtonian material, the fluidity (or reciprocal of viscosity) of which can vary in vivo between that of plasma alone and zero, that is, the total lack of fluidity in the absence of coagulation. The fluidity of blood under high driving pressures and in small blood vessels is un usually high when compared to that of all other known suspensions or emul sions. The high fluidity of blood is caused by the fluidity of the red cells, which adapt to the forces of flow and participate in flow much like fluid droplets. When subjected to high forces the blood behaves dynamically like an emulsion of extremely low viscosity. In the absence of adequate flow forces, the erythro cytes are aggregated into rouleaux and rouleaux networks, which render to blood the properties of a reticulated suspension. Under these flow conditions, the fluidity of blood strongly decreases if the hematocrit value is normal or slightly elevated. If the flow forces fall below a critical level, the fluidity ap proaches zero, under which conditions the flow of blood ceases altogether (de spite the presence of residual driving pressures). The fluidity of blood is further jeopardized by an enhanced tendency to aggregation and biochemical erythro cyte rigidification, for example, by lactacidosis, hyperosmolarity, or loss of ATP. However, an actual loss of fluidity under these conditions occurs only if the biochemical changes are strictly associated with a drop in driving pressures (locally or generally). Restitution of blood fluidity can be achieved most simply by isovolumic he modilution, by defibrinogating agents, or by drugs that protect against rigid ifying effects of acidosis or other biochemical sequelae of stagnation anoxia.
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Zellinger B, Zehentmayr F, Hauser-Kronberger C, Strasser P, Bodenhofer U, Fastner G, Reitsamer R, Fischer T, Sedlmayer F. Hsa-miR-375 and local control in early stage breast cancer. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61647-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fischer T, Brothers KB, Erdmann P, Langanke M. Clinical decision-making and secondary findings in systems medicine. BMC Med Ethics 2016; 17:32. [PMID: 27209083 PMCID: PMC4875611 DOI: 10.1186/s12910-016-0113-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 05/10/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Systems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology (especially systems biology); "big data" statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems medicine knowledge and clinicians working to apply it. DISCUSSION This article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through "big data" approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the "death computer," to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their "quantified self." This paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care.
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Wolf D, Fischer T, Fazelnia C, Schilcher A, Wertaschnigg D. Misodel – erste Erfahrung einer neuen Geburtseinleitungsmethode. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hösel S, Fazelnia C, Stierle C, Fischer T, Wertaschnigg D. Postpartales akutes Nierenversagen mit thrombotischer Mikroangiopathie bei St.p. Präeklampsie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Klaassen Federspiel F, Peintinger F, Sir A, Fischer T, Reitsamer R. Technische und kosmetische Ergebnisse sowie Komplikationsraten nach Nipple sparing mastectomy (NSM) und Sofortrekonstruktion der Brust mittels Implantatabdeckung durch porcine azelluläre dermale Matrix. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1579597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Hutter J, Sir A, Fischer T, Reitsamer R. Portmetastase im Bereich der Brust nach thorakoskopischer Resektion einer Lungenmetastase bei Analkarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1579596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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70
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Gouy C, Fazelnia C, Wolfrum-Ristau P, Koch H, Mlineritsch B, Schönlieb C, Kronberger C, Bogner G, Fischer T. Primäres diffus großzelliges B-Zell-Lymphom der Zervix in der Schwangerschaft – ein Fallbericht. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1579591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Fischer T, Thomas P. Zentrale Sonografieabteilung unter Leitung der Radiologie: How to do. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fischer T, Thomas P. Von Navigation über Fusion bis zur Intervention: Ultraschall schießt aus allen Rohren. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fischer T. Sonografie basics. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fischer T. Pankreastumoren: CEUS oder doch gleich CT? Pro CEUS. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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75
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Fischer T, Martínez-Pinedo G, Hempel M, Huther L, Röpke G, Typel S, Lohs A. Expected impact from weak reactions with light nuclei in corecollapse supernova simulations. EPJ WEB OF CONFERENCES 2016. [DOI: 10.1051/epjconf/201610906002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bolten K, Thomas A, Löschmann YYN, Diederichs G, Fischer T. Die Sectionarbe in der Bildfusion. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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77
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Bogner G, Wallner V, Resenberger K, Fischer T. Welchen Einfluss hat die Lage des II. Zwillings auf das perinatale Outcome? Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bogner G, Fazelnia C, Strobl M, Fischer T, Jacobs V. Breech delivery of the second twin in all fours position of the mother. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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79
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Gharehbaghi D, Fischer T, Bogner G. Effect of corticosteroid therapy in HELLP syndrome. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schäfer G, Dobos G, Lünnemann L, Blume-Peytavi U, Fischer T, Kottner J. Using ultrasound elastography to monitor human soft tissue behaviour during prolonged loading: A clinical explorative study. J Tissue Viability 2015; 24:165-72. [DOI: 10.1016/j.jtv.2015.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 06/14/2015] [Accepted: 06/18/2015] [Indexed: 01/25/2023]
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Arreba-Tutusaus P, Mack TS, Bullinger L, Schnöder TM, Polanetzki A, Weinert S, Ballaschk A, Wang Z, Deshpande AJ, Armstrong SA, Döhner K, Fischer T, Heidel FH. Impact of FLT3-ITD location on sensitivity to TKI-therapy in vitro and in vivo. Leukemia 2015; 30:1220-1225. [PMID: 26487272 DOI: 10.1038/leu.2015.292] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Emami K, Sandel N, Tedaldi E, Fischer T, Minniti N. DIVERSITYA-02Word Reading Ability is a Better Predictor of Global Neuropsychological Performance in an Urban HIV+ Cohort. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sandel N, Emami K, Tedaldi E, Fischer T, Minniti N. NEUROPSYCHOLOGICAL DOMAINS: EXECUTIVE FUNCTIONSC-35Construct Validity of NAB Mazes and Relationship with CD4+ T-cell Nadirs in an Urban HIV+ Cohort. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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84
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Jayavelu AK, Müller JP, Bauer R, Böhmer SA, Lässig J, Cerny-Reiterer S, Sperr WR, Valent P, Maurer B, Moriggl R, Schröder K, Shah AM, Fischer M, Scholl S, Barth J, Oellerich T, Berg T, Serve H, Frey S, Fischer T, Heidel FH, Böhmer FD. NOX4-driven ROS formation mediates PTP inactivation and cell transformation in FLT3ITD-positive AML cells. Leukemia 2015; 30:473-83. [DOI: 10.1038/leu.2015.234] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 08/04/2015] [Accepted: 08/14/2015] [Indexed: 12/21/2022]
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85
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Fischer T, Kamps U. Power Maps in Goodness-of-fit Testing Based on Censored Samples. COMMUN STAT-SIMUL C 2015. [DOI: 10.1080/03610918.2013.839034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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86
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Sirsch E, Gnass I, Fischer T. [Diagnostics of pain in old age. Perspectives on a multidimensional phenomenon]. Schmerz 2015; 29:339-48. [PMID: 26238374 DOI: 10.1007/s00482-015-0026-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Old people's experience of pain differs markedly from that of younger people. Old people not only suffer from pain more often but also the pain is predominantly chronic in nature. In many cases older patients experience pain from more than one cause at any time due to multimorbidity. Against this backdrop this article examines the question of how diagnostic procedures of pain have to be specific for older patients and how these requirements are currently met in clinical practice. Diagnostic procedures in older persons need to be rooted in a biopsychosocial understanding of pain that also takes into account that the pain experience is always made up of several pain dimensions. A comprehensive understanding of pain communication also has to be taken into account as well as age-specific influences. In older persons pain assessment needs to encompass motivational affective, sensory discriminative and cognitive evaluative aspects. If pain assessment is limited to pain severity or the observation of pain behavior only, important information is lacking and important biographical, health-related, phenomenological and care-specific information cannot be used for the benefit of the patient. Different dimensions of pain cannot be used variably but need to be regarded as complementing elements; however, this approach is currently not always possible to follow through in clinical practice especially with age-related illnesses, such as dementia. Currently, only the geriatric pain interview (Geriatrisches Schmerzinterview) is available as a multidimensional tool for the assessment of pain in older people. There is a clear need for more and extended research and development of tools and processes to comprehensively assess pain in older persons.
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Fischer T, Anke T. Optimierung und Integration neuer Ultraschallmodalitäten in ein interdisziplinäres Ultraschall-Zentrum. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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88
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Baur A, Wagner M, Kilic E, Fischer T, Durmus T. Multiparametrische MRT der Prostata zur Tumordetektion bei 3 Tesla mit und ohne endorektaler Spule: Ein intraindividueller Vergleich von Bildqualität und diagnostischer Genauigkeit. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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89
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Fischer T, Thomas A. Fusion zur Interventionsplanung bei Prostata-CA. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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90
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Fischer T, Andersen K, Bengtsson U, Frosch P, Gunnarsson Y, Kreilgård B, Menné T, Shaw S, Svensson L, Wilkinson J. Clinical standardization of the TRUE Test formaldehyde patch. CURRENT PROBLEMS IN DERMATOLOGY 2015; 22:24-30. [PMID: 7587329 DOI: 10.1159/000424227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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91
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Hillerer KM, Fischer T. Maternale zerebrale Veränderungen bei Präeklampsie. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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92
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Bogner G, Kaiser J, Kametriser G, Fischer T, Sedlmayer F. Intraoperative Strahlentherapie IORT bei Rezidiv eines Zervixkarzinoms nach prim./adjuvanter Radiotherapie. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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93
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Fastner G, Hauser-Kronberger C, Moder A, Reitsamer R, Zehentmayr F, Kopp P, Fussl C, Fischer T, Dietze O, Sedlmayer F. P303 Triple negative breast cancer patients treated by boost-IOERT during breast conserving surgery. Breast 2015. [DOI: 10.1016/s0960-9776(15)70334-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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94
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Maxeiner A, Stephan C, Fischer T, Durmus T, Kilic E, Asbach P, Haas M, Günzel K, Neymeyer J, Miller K, Cash H. [Real-time MRI/US fusion-guided biopsy in biopsy-naïve and pre-biopsied patients with suspicion for prostate cancer]. Aktuelle Urol 2015; 46:34-8. [PMID: 25519051 DOI: 10.1055/s-0034-1395563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided biopsy detects more prostate cancer (PCa) than transrectal US (TRUS)-guided biopsy in patients with an indication for prostate re-biopsy. The aim of this study was a) to compare the detection rates of MRI/US fusion-guided biopsy with conventional TRUS in a double centre cohort and b) to investigate the influence of the number of pre-biopsies on the PCa detection rate. MATERIAL AND METHODS In the period from January 2012 to July 2014, 310 consecutive patients gave written informed consent and underwent 3 Tesla MRI scans of the prostate. All patients had at least one PCa suspicious lesion in the MRI and were biopsied by MRI/US fusion followed by a conventional 10-core biopsy of the prostate. Detection rates based on technique, Gleason score and number of pre-biopsies were calculated. RESULTS The overall detection rate of the study was 51% (158 patients). Among these 158 patients a histopathological Gleason score of 6 was detected in 60 patients (38%), a Gleason score of 7 in 54 patients (34%) and a Gleason score≥8 in 44 patients (28%). MRI/US fusion-guided biopsy detected 110 (69.7%) of the overall detected 158 PCa. TRUS-guided biopsy detected a higher rate of Gleason score 6 (54%) and a lower rate of Gleason score≥8 (15%) lesions in comparison to 38% Gleason 6 and 28% Gleason≥8 in the MRI/US fusion-guided biopsy, respectively. Furthermore, a lower Gleason score was observed in patients with more than one pre-biopsy. The detection rate in biopsy-naïve patients undergoing MRI/US fusion was 75% (40 patients) among 75% detected Gleason score≥7. CONCLUSION MRI/US fusion-guided biopsy detected more PCa and also more clinically significant cancer than conventional TRUS. In our cohort patients with more than one pre-biopsy showed lower Gleason scores. The included patients with an initial MRI/US fusion-guided biopsy should be further investigated.
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Grigoryev M, Thomas A, Plath L, Durmus T, Slowinski T, Diekmann F, Fischer T. Detection of microcalcifications in women with dense breasts and hypoechoic focal lesions: comparison of mammography and ultrasound. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2014; 35:554-560. [PMID: 24871694 DOI: 10.1055/s-0034-1366466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Microcalcifications in the breasts can point to breast cancer. However, there is great morphologic variety, and microcalcifications do not always correlate with malignancy. We conducted a prospective study to compare ultrasound and mammography in the detection of microcalcifications following sonographic diagnosis of a hypoechoic focal lesion in women with dense breast composition. MATERIALS AND METHODS A total of 104 lesions potentially associated with microcalcifications (82 malignant and 23 benign lesions) were included in the study. The breast was examined by ultrasound (9 MHz, Aplio XG/500) with additional use of MicroPure imaging for the demonstration and evaluation of microcalcifications. The presence of a focal lesion was verified and microcalcifications were counted at ultrasound and mammography by blinded readers. The sensitivity and specificity were determined, and ROC analysis and AUC analysis were performed. RESULTS The women had a median age of 51 years. The average number of microcalcifications detected by sonography (2.12 ± 2.77) and mammography (3.59 ± 6.35) was not significantly different (p > 0.05). Correlation of the techniques was adequate (Pearson's r = 0.616, p < 0.0001; Spearman's rho = 0.654, p < 0.0001). The intraclass correlation coefficient was K = 0.382 ± 0.072 (p < 0.0001), also indicating adequate agreement of both techniques. The sensitivity and specificity were 70%/30% for MicroPure and 45%/55% for mammography. The positive predictive value of mammography was superior to that of MicroPure (88% vs. 78%). CONCLUSION The sonographic detection of microcalcifications with MicroPure imaging in breasts with a hypoechoic focal lesion correlates well with digital mammography.
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Durmus T, Stöckel J, Slowinski T, Thomas A, Fischer T. The hyperechoic zone around breast lesions - an indirect parameter of malignancy. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2014; 35:547-553. [PMID: 25474101 DOI: 10.1055/s-0034-1385342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To evaluate an irregular perilesional hyperechoic zone as a potential criterion of malignancy on breast ultrasound and to test whether this zone correlates with perilesional T2 hyperintensity on magnetic resonance imaging (MRI). MATERIALS AND METHODS A total of 137 patients (85 malignant lesions, 52 benign lesions) who underwent breast ultrasound with a 9 - 14 MHz linear broad-spectrum transducer and consecutive ultrasound-guided biopsy were included. All patients additionally underwent breast MR imaging with dedicated breast coils at 1.5 T. The protocol included a T2-weighted sequence. Perilesional hyperechoic and T2 hyperintense areas were measured by planimetry using the slice showing maximum extension of this area. The sensitivity and specificity of the perifocal area for identifying breast malignancy were determined using ROC analysis. Correlation was assessed using Pearson analysis. RESULTS The presence of a hyperechoic zone identified malignancy with a sensitivity of 87% and a specificity of 81%. Additionally, there was a highly significant correlation of the size of the hyperechoic zone with the degree of tumor differentiation (p = 0.002) as well as with the mib-1 proliferation index (p = 0.006) and lymphangio-invasion (p = 0.02). No significant correlation was found between the hyperchoic zone and the T2 hyperintense zone on MRI (R2 = 0.16). CONCLUSION A hyperechoic zone surrounding breast lesions may serve as an additional sonomorphologic criterion of malignancy. Yet, it does not seem to correlate with edema on MRI.
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Weiss E, Abele H, Bartz C, Franz M, Fischer T, Gembruch U, Gonser M, Heim K, Kainer F, Kiefer A, König K, Ramsauer B, Reister F, Schneider KTM, Surbek D, Vetter K, Wolff F. S1-Guideline: Management of Late-term and Post-term Pregnancy: Short version - AWMF Registry Number: 015/065. Geburtshilfe Frauenheilkd 2014; 74:1099-1103. [PMID: 27231401 DOI: 10.1055/s-0034-1383314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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98
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Schnöder TM, Arreba-Tutusaus P, Griehl I, Bullinger L, Buschbeck M, Lane SW, Döhner K, Plass C, Lipka DB, Heidel FH, Fischer T. Epo-induced erythroid maturation is dependent on Plcγ1 signaling. Cell Death Differ 2014; 22:974-85. [PMID: 25394487 DOI: 10.1038/cdd.2014.186] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 09/18/2014] [Accepted: 10/06/2014] [Indexed: 12/22/2022] Open
Abstract
Erythropoiesis is a tightly regulated process. Development of red blood cells occurs through differentiation of hematopoietic stem cells (HSCs) into more committed progenitors and finally into erythrocytes. Binding of erythropoietin (Epo) to its receptor (EpoR) is required for erythropoiesis as it promotes survival and late maturation of erythroid progenitors. In vivo and in vitro studies have highlighted the requirement of EpoR signaling through Janus kinase 2 (Jak2) tyrosine kinase and Stat5a/b as a central pathway. Here, we demonstrate that phospholipase C gamma 1 (Plcγ1) is activated downstream of EpoR-Jak2 independently of Stat5. Plcγ1-deficient pro-erythroblasts and erythroid progenitors exhibited strong impairment in differentiation and colony-forming potential. In vivo, suppression of Plcγ1 in immunophenotypically defined HSCs (Lin(-)Sca1(+)KIT(+)CD48(-)CD150(+)) severely reduced erythroid development. To identify Plcγ1 effector molecules involved in regulation of erythroid differentiation, we assessed changes occurring at the global transcriptional and DNA methylation level after inactivation of Plcγ1. The top common downstream effector was H2afy2, which encodes for the histone variant macroH2A2 (mH2A2). Inactivation of mH2A2 expression recapitulated the effects of Plcγ1 depletion on erythroid maturation. Taken together, our findings identify Plcγ1 and its downstream target mH2A2, as a 'non-canonical' Epo signaling pathway essential for erythroid differentiation.
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Weller M, Thiel E, Martus P, Mohle R, Griesinger F, Rauch M, Roeth A, Hertenstein B, Fischer T, Hundsberger T, Mergenthaler HG, Junghanss C, Birnbaum T, Fischer L, Jahnke K, Herrlinger U, Pietsch T, Roth P, Bamberg M, Korfel A. AT-59 * HIGH-DOSE MTX-BASED CHEMOTHERAPY FOR PRIMARY CNS LYMPHOMA: WITH OR WITHOUT WHOLE BRAIN RADIOTHERAPY? FINAL ANALYSIS OF G-PCNSL-SG-1. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou237.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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100
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Fischer T, Sontheimer G. Medizinermangel. Staatliche Universitäten und/oder private Medical-Schools als Rettung? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1383154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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