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Jacobson ME, Seshadri RS, Morimoto R, Grinich E, Haag C, Nguyen K, Simpson EL. Early intervention and disease modification in atopic dermatitis-the current state of the field and barriers to progress. J Eur Acad Dermatol Venereol 2024; 38:665-672. [PMID: 38063244 DOI: 10.1111/jdv.19699] [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] [Received: 07/07/2023] [Accepted: 10/24/2023] [Indexed: 03/26/2024]
Abstract
Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin disease representing a major source of global disability burden. Disease-modifying therapies are showing promise in chronic inflammatory disorders such as rheumatoid arthritis and Crohn's disease with method and timing of initial treatment impacting long-term disease outcomes. Whether disease-modifying therapies, specifically those used as an early interventional approach, impacts disease course and comorbidity development in AD is not well-understood. We reviewed the progress in disease modification strategies, emphasizing early intervention approaches in common (or proto-typical) inflammatory diseases. Although more common in other fields, disease modification approaches are becoming increasingly investigated in dermatology, though studies in AD are lacking. Despite significant limitations in ongoing and completed studies, early data are promising and suggest that both the choice and timing of early intervention approach can affect long-term disease course and comorbidity development. To best improve AD patient outcomes, more research is needed to further explore the impact of early disease-modifying therapies. Future studies should focus on identifying the most effective approaches and extend the early results to a more inclusive set of comorbidities and longer-term outcomes.
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Affiliation(s)
- M E Jacobson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - R S Seshadri
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - R Morimoto
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - E Grinich
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - C Haag
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - K Nguyen
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - E L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
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Dunning D, Ahmed S, Foulkes L, Griffin C, Griffiths K, Leung JT, Parker J, Piera Pi-Sunyer B, Sakhardande A, Bennett M, Haag C, Montero-Marin J, Packman D, Vainre M, Watson P, Kuyken W, Williams JMG, Ukoumunne OC, Blakemore SJ, Dalgleish T. The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial. Evid Based Ment Health 2022; 25:ebmental-2022-300460. [PMID: 35820991 PMCID: PMC9340025 DOI: 10.1136/ebmental-2022-300460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/15/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Previous research suggests that mindfulness training (MT) appears effective at improving mental health in young people. MT is proposed to work through improving executive control in affectively laden contexts. However, it is unclear whether MT improves such control in young people. MT appears to mitigate mental health difficulties during periods of stress, but any mitigating effects against COVID-related difficulties remain unexamined. OBJECTIVE To evaluate whether MT (intervention) versus psychoeducation (Psy-Ed; control), implemented in after-school classes: (1) Improves affective executive control; and/or (2) Mitigates negative mental health impacts from the COVID-19 pandemic. METHODS A parallel randomised controlled trial (RCT) was conducted (Registration: https://osf.io/d6y9q/; Funding: Wellcome (WT104908/Z/14/Z, WT107496/Z/15/Z)). 460 students aged 11-16 years were recruited and randomised 1:1 to either MT (N=235) or Psy-Ed (N=225) and assessed preintervention and postintervention on experimental tasks and self-report inventories of affective executive control. The RCT was then extended to evaluate protective functions of MT on mental health assessed after the first UK COVID-19 lockdown. FINDINGS Results provided no evidence that the version of MT used here improved affective executive control after training or mitigated negative consequences on mental health of the COVID-19 pandemic relative to Psy-Ed. No adverse events were reported. CONCLUSIONS There is no evidence that MT improves affective control or downstream mental health of young people during stressful periods. CLINICAL IMPLICATIONS We need to identify interventions that can enhance affective control and thereby young people's mental health.
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Affiliation(s)
- Darren Dunning
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - S Ahmed
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - L Foulkes
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - C Griffin
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - K Griffiths
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - J T Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - J Parker
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | | | - A Sakhardande
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - M Bennett
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - C Haag
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - Jesus Montero-Marin
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
| | - D Packman
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Maris Vainre
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - P Watson
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
| | - J Mark G Williams
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
| | - Obioha C Ukoumunne
- NIHR CLAHRC South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Sarah-Jayne Blakemore
- Institute of Cognitive Neuroscience, University College London, London, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, Cambridgeshire, UK
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Cordes M, Kuwert T, Haag C, Raue F. A Novel Mutation of the Calcium Sensing Receptor Gene in a Franconian Kindred: Heterozygous Mutation c.1697_1698delTG Exon 6. Horm Metab Res 2017; 49:142-146. [PMID: 27926951 DOI: 10.1055/s-0042-120415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Familial hypocalciuric hypercalcemia (FHH) belongs to the disorders of a disturbed calcium homeostasis. Genetically, the disorder is inherited in an autosomal-dominant trait and represents an inactivating mutation of the calcium sensing receptor (CaSR) gene. We identified a Franconian kindred in which 6 individuals could be tested by molecular genetic means. In 5 individuals of 3 generations, the mutation could be classified as c.1697_1698delTG. This novel germline mutation creates a premature stop codon leading to a loss of 510 amino acids of the protein. The detection of CaSR gene mutations is suitable to differentiate states of hypercalcemia and may help to avoid invasive procedures such as parathyroidectomies.
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Affiliation(s)
- M Cordes
- Radiologisch-Nuklearmedizinisches Zentrum, Nürnberg, Germany
| | - T Kuwert
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Nürnberg, Germany
| | - C Haag
- Endokrinologisch-Nuklearmedizinische Gemeinschaftspraxis, Molekulargenetisches Labor, Heidelberg, Germany
| | - F Raue
- Endokrinologisch-Nuklearmedizinische Gemeinschaftspraxis, Molekulargenetisches Labor, Heidelberg, Germany
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Bauer S, Riegger M, Reichert W, Blakeney WG, Haag C. [Complete proximal hamstring tendon tear : Anchor-based sliding suture technique for reduction and fixation]. Unfallchirurg 2016; 119:1043-1048. [PMID: 27896365 DOI: 10.1007/s00113-016-0276-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S Bauer
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland.
| | - M Riegger
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - W Reichert
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - W G Blakeney
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - C Haag
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
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Bauer S, Riegger M, Friedrich KJ, Reichert W, Blakeney WG, Haag C. [Proximal rupture of the hamstring tendon : From clinical presentation to diagnosis and therapy]. Unfallchirurg 2016; 119:1031-1042. [PMID: 27896364 DOI: 10.1007/s00113-016-0277-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Rupture of the proximal tendon enthesis of the hamstring muscle (ICM) accounts for approximately 10% of all injuries of the ICM. It occurs most commonly in athletes and active middle-aged individuals. The complete rupture of all three tendons in active patients is generally seen as an indication for surgical repair of the tendon enthesis; however, the correct diagnosis is often not reached in a timely manner. This can lead to prolonged symptoms with pain, weakness and neuralgia. Operative treatment consists of anchor repair of the tendons resulting in good clinical outcome in several case series. Good knowledge of the anatomy and operative approach are mandatory to avoid complications as well as compliance with a gradual rehabilitation scheme to allow tendon to bone healing. The main aim of this review is to highlight the typical history, clinical presentation and examination technique to reach an immediate clinical diagnosis which should be confirmed with a magnetic resonance imaging (MRI) scan.
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Affiliation(s)
- S Bauer
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland.
| | - M Riegger
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - K J Friedrich
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - W Reichert
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - W G Blakeney
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
| | - C Haag
- Schulter-, Sport- und arthroskopische Chirurgie, Klinik für Unfallchirurgie, Kreiskrankenhaus Lörrach, Spitalstr. 25, 79539, Lörrach, Deutschland
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Affiliation(s)
- R Dettmeyer
- Institute of Forensic Medicine, Justus-Liebig-University, Giessen, Germany.
| | - A Baasner
- Centre for Familial Breast and Ovarian Cancer, University of Cologne, Germany
| | - C Haag
- Institute of Pathology, Klinikum Solingen, Germany
| | - M Schlamann
- Institute of Forensic Medicine, Justus-Liebig-University, Giessen, Germany; Department of Neuroradiology, Justus-Liebig University, Giessen, Germany
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Letz S, Gllaudo M, Quinkler M, Bogner U, Haag C, Schulze E, Frank-Raue K, Raue F, Mayr B, Schoefl C. Dominant negative CaSR mutants: Biochemical function, inheritance and clinical phenotypes. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Letz S, Elbelt U, Strasburger CJ, Haag C, Schulze E, Frank-Raue K, Raue F, Mayr B, Schöfl C. CaSR mutants disrupting the disulfide bond between C582 and C568 in the cysteine-rich domain of the CaSR do not act as dominant negative mutants. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372055] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Letz S, Haag C, Schulze E, Frank-Raue K, Raue F, Mayr B, Schöfl C. Activating CaSR mutations causing Bartter syndrome type 5 are characterized by a distinctly diminished inhibitory phosphorylation on amino acid T888. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Letz S, Haag C, Schulze E, Frank-Raue K, Mayr B, Raue F, Schöfl C. Activating mutations of the calcium-sensing receptor: The calcilytics ATF-936 and AXT-914 attenuate mutants causing autosomal dominant hypocalcemia and Bartter syndrome type 5. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1336667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Frank-Raue K, Leidig-Bruckner G, Lorenz A, Rondot S, Haag C, Schulze E, Büchler M, Raue F. [Hereditary variants of primary hyperparathyroidism--MEN1, MEN2, HPT-JT, FHH, FIHPT]. Dtsch Med Wochenschr 2011; 136:1889-94. [PMID: 21915802 DOI: 10.1055/s-0031-1286358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The challenge in diagnosing primary hyperparathyroidism (HPT) is to detect hereditary cases before first surgery. About 5% of cases are hereditary and integral component of multiple endocrine neoplasia type 1 and 2 (MEN1/MEN2), hyperparathyroidism-jaw tumor syndrome (HPT-JT), familial hypocalciuric hypercalcemia (FHH), and familial isolated hyperparathyroidism (FIHPT). Aim of this study was to evaluate similarities and differences in hereditary varieties of HPT. PATIENTS 80 patients with hereditary HPT were evaluated in a retrospective analysis between 1980 and 2010 concerning clinical findings, family history, therapy, biochemical and molecular-genetic findings and follow-up. RESULTS 80 patients with hereditary HPT are described, 52 belonged to MEN1, 15 to MEN2, 7 to HPT-JT, 4 to FHH and 2 to FIHPT kindreds. Penetrance of HPT was highest in MEN1 (85%), followed by HPT-JT (64%), FHH (28.5%), and MEN2 (8%). Youngest age at diagnosis of HPT was 7 and 16 years in the MEN2/HPT-JT group. Serum Calcium was highest in the HPT-JT group (3.6 mM), recurrencies of HPT were highest in the MEN1 group (40.5%). Parathyroid cancer solely occurred in the HPT-JT group. In single cases HPT occurs in FHH. CONCLUSION Among the different varieties of hereditary HPT MEN1-HPT is most frequent and carries the utmost recurrence rate. Early diagnosis of HPT-JT syndrome is important because of the occurrence of parathyroid cancer. Single cases of HPT in FHH are described. Preoperative diagnosis of hereditary HPT has therapeutic consequences concerning extent of surgery and implications concerning patient and family care.
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Affiliation(s)
- K Frank-Raue
- Endokrinologische Gemeinschaftspraxis und molekulargenetisches Labor, Heidelberg.
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Evers C, Heidemann PH, Dunstheimer D, Schulze E, Haag C, Janssen JWG, Fischer C, Jauch A, Moog U. Pseudoautosomal inheritance of Léri-Weill syndrome: what does it mean? Clin Genet 2011; 79:489-94. [DOI: 10.1111/j.1399-0004.2010.01488.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schuhmacher C, Schlag P, Lordick F, Hohenberger W, Heise J, Haag C, Gretschel S, Mauer ME, Lutz M, Siewert JR. Neoadjuvant chemotherapy versus surgery alone for locally advanced adenocarcinoma of the stomach and cardia: Randomized EORTC phase III trial #40954. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4510] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4510 Background: Combined pre- and postoperative chemotherapy improves overall survival in operable gastric cancer, although postoperative treatment is not feasible in half of the patients. We conducted a randomized phase III trial with thorough attention to preoperative staging and to the extent of surgical resection to assess the value of neoadjuvant chemotherapy (CTx). Methods: Patients with locally advanced adenocarcinoma of the stomach and cardia were randomized between primary surgery or two 48-day cycles of weekly folinic acid 500 mg/m2/2h, 5-FU 2,000 mg/m2/24h plus biweekly cisplatin 50 mg/m2/1h followed by surgery. The study was designed to detect an improvement in median survival from 17 months with surgery to 24 months with CTx plus surgery (HR=0.708, power of 80%, type I error of 4% to allow for an interim analysis). It was planned to randomize 360 patients in order to observe the 262 deaths required for the final analysis. Results: From 7/99 to 2/04, 144 patients were randomized (72:72) with comparable baseline characteristics. Median follow-up is 4.4 years. Based on 67 deaths, overall survival between the two arms did not differ (HR=0.84; 95% CI: 0.52 to 1.35; p=0.466). Median survival exceeded 36 months in both arms. Due to low accrual, this trial was stopped early. The unexpected long median survival in the surgery arm would have made the primary objective difficult to reach anyway. Based on 77 events, difference in time to progression was borderline significant (HR=0.66; 95% CI, 0.42–1.03; p=0.065). Response rate to CTx was 35.2% (95% CI: 23.7%-45.7%). The R0-resection rate was 81.9 % after CTx as compared to 66.7% with surgery alone (P=0.036). There were no major differences in intra- or postoperative complications. Conclusions: This prematurely closed trial showed a significantly increased rate of R0 resections after CTx although it could not demonstrate a survival benefit. The outcome after a radical surgical procedure alone with extended lymphadenectomy was better than expected. No significant financial relationships to disclose.
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Affiliation(s)
- C. Schuhmacher
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - P. Schlag
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - F. Lordick
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - W. Hohenberger
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - J. Heise
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - C. Haag
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - S. Gretschel
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - M. E. Mauer
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - M. Lutz
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
| | - J. R. Siewert
- Klinikum Rechts der Isar, Chirurgische Klinik der TU München, Muenchen, Germany; Charite - Universitaetsmedizin Berlin, Berlin, Germany; Technische Universitaet Muenchen, Muenchen, Germany; Universitaetsklinik Erlangen, Erlangen, Germany; Heinrich-Heine Universitätsklinik Düsseldorf, Duesseldorf, Germany; Universitaetsklinikum Carl Gustav Carus, Dresden, Germany; EORTC, Brussels, Belgium; Caritasklinik St. Theresa, Saarbrucken, Germany
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Gräßel E, Donath C, Lauterberg J, Haag C, Neubauer S. Demenzkranke und Pflegestufen: Wirken sich Krankheitssymptome auf die Einstufung aus? Gesundheitswesen 2008; 70:129-36. [DOI: 10.1055/s-2008-1062733] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Reusch J, Haag C, Raue F, Badenhoop K. Relapsing Pheochromocytoma in a Chinese Women Caused by a Novel Mutation in Exon 6 of the SDHB Gene: A Case Report. Exp Clin Endocrinol Diabetes 2007; 115:616-8. [DOI: 10.1055/s-2007-984436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rus R, Bumke-Vogt C, Schnell S, Andreas J, Bähr V, Haag C, Schulze E, Frank-Raue K, Raue F, Schöfl C. Functional analysis of six novel mutations of the calcium-sensing receptor in familial hypocalciuric hypercalcemia and autosomal dominant hypocalcemia. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Rondot S, Frank-Raue K, Haag C, Spilcke-Liss E, Schulze E, Raue F. Genetic analysis of multiple endocrine neoplasia type 1 by direct sequencing and multiplex ligation dependent probe amplification (MLPA). Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Haag C, Schulze E, Frank-Raue K, Raue F. Hyperparathyroidism-jaw tumor syndrome (HPT-JT): A case report with parathyroid carcinoma. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Abstract
The calcium-sensing receptor has a key role in calcium homeostasis, it is involved in the regulation of the serum calcium level within minutes via the secretion and action of parathyroid and the excretion of calcium in the kidney in a negative feedback manner. Mutations of the calcium sensing receptor gene leads to inactivating and activating mutations resulting in diseases with hypercalcaemia and hypocalcaemia. The loss of function mutations are associated with familial benign hypocalciuric hypercalcaemia (FHH), an autosomal dominant disease characterised by lifelong mild hypercalcaemia, low urinary calcium excretion, and inappropriate high parathyroid hormone levels, sometimes difficult to distinguish from mild asymptomatic primary hyperparathyroidism. Patients with FHH did not profit from parathyroidectomy, a calcium lowering therapy is not necessary. The gain of function mutations of the calcium-sensing receptor are associated with autosomal dominant hypocalcaemia (ADH), a disease characterised by a generally asymptomatic hypocalcaemia, inappropriately high urinary calcium excretion and normal PTH levels. A therapy to raise the serum calcium concentration has to be done carefully and is only indicated in symptomatic patients, because of enhancement of hypercalciuria with the risk of nephrocalcinosis and nephrolithiasis. Molecular genetic analysis of the calcium sensing receptor gene facilitates the sometimes difficult diagnosis. The development of compounds modulating the calcium sensing receptor function and thereby the section of PTH may become an important role in treatment of diseases of calcium metabolism.
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Affiliation(s)
- F Raue
- Molecular genetic laboratory, endocrine practice, Heidelberg, Germany.
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20
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Heinemann V, Quietzsch D, Gieseler F, Gonnermann M, Schönekäs H, Rost A, Neuhaus H, Haag C, Clemens M, Heinrich B, Vehling-Kaiser U, Fuchs M, Fleckenstein D, Gesierich W, Uthgenannt D, Einsele H, Holstege A, Hinke A, Schalhorn A, Wilkowski R. Randomized phase III trial of gemcitabine plus cisplatin compared with gemcitabine alone in advanced pancreatic cancer. J Clin Oncol 2006; 24:3946-52. [PMID: 16921047 DOI: 10.1200/jco.2005.05.1490] [Citation(s) in RCA: 482] [Impact Index Per Article: 26.8] [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: 12/17/2022] Open
Abstract
PURPOSE To compare the effectiveness and tolerability of gemcitabine plus cisplatin with single-agent gemcitabine as first-line chemotherapy for locally advanced or metastatic pancreatic cancer. PATIENTS AND METHODS Patients with advanced adenocarcinoma of the pancreas were randomly assigned to receive either gemcitabine 1,000 mg/m2 and cisplatin 50 mg/m2 given on days 1 and 15 of a 4-week cycle (GemCis arm) or gemcitabine alone at a dose of 1,000 mg/m2 on days 1, 8, and 15 of a 4-week regimen (Gem arm). The primary end point was overall survival; secondary end points were progression-free survival, response rate, safety, and quality of life. RESULTS One hundred ninety-five patients were enrolled and showed baseline characteristics well balanced between treatment arms. Combination treatment in the GemCis arm was associated with a prolonged median progression-free survival (5.3 months v 3.1 months; hazard ratio [HR] = 0.75; P = .053). Also, median overall survival was superior for patients treated in the GemCis arm as compared with the Gem arm (7.5 v 6.0 months), an advantage which did not, however, reach statistical significance (HR = 0.80; P = .15). Tumor response rates were comparable between treatment arms (10.2% v 8.2%). The rate of stable disease was, however, greater in the combination arm (60.2% v 40.2%; P < .001). Grade 3 to 4 hematologic toxicity did not exceed 15% in both treatment arms. CONCLUSION These results support the efficacy and safety of an every-2-weeks treatment with gemcitabine plus cisplatin. Median overall survival and progression-free survival were more favorable in the combination arm as compared with gemcitabine alone, although the difference did not attain statistical significance.
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Affiliation(s)
- Volker Heinemann
- Medizinische Klinik und Poliklinik III, Klinikum Grosshadern, Munich, Germany.
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21
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Abstract
Foreign bodies are common in the head and face. We investigated the use of image-guided navigation systems for the removal of foreign bodies in 10 patients between 1998 and 2004. In all cases foreign bodies were retrieved. There were no major complications. Image-guided removal of foreign bodies is safe and valuable.
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Affiliation(s)
- G Eggers
- Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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22
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Hopkins-Broyles D, Gemeinhart N, Apoorva S, Haag C, Woeltje K. Soap and lotion trial: Healthcare workers narrow the choices for hand hygiene. Am J Infect Control 2005. [DOI: 10.1016/j.ajic.2005.04.171] [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: 11/24/2022]
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23
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Rondot S, Haag C, Frank-Raue K, Schulze E, Raue F. Analysis of polymorphisms in the MEN 1 gene and Calcium sensing receptor gene in sporadic primary hyperparathyroidism. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Haag C, Varma C, Hentze S, Schulze E, Raue F. A novel splice site mutation in the SDH-B gene in familial paragangliomas. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-862974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Haag C, Schulze E, Raue F. Detection of deletions of the SHOX gene in patients with LWD, ISS and Turner Syndrome. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-863004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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26
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Haag C, Mühling J, Bettega G, Hofele C. Computer assisted positioning of the mandibular condyle using the “orthopilot” system. Int J Oral Maxillofac Surg 2005. [DOI: 10.1016/s0901-5027(05)81274-3] [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: 11/17/2022]
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27
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Haag C, Schulze E, Frank-Raue K, Raue F. A new missense mutation in the calcium-sensing receptor in a hypocalcemic and hypercalciuric patient. Exp Clin Endocrinol Diabetes 2004. [DOI: 10.1055/s-2004-819192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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28
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Affiliation(s)
- O Schorr
- Institut für Prozessrechentechnik, Automation und Robotik, Universität Karlsruhe (TH), Deutschland
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29
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Schorr O, Pernozzoli A, Haag C, Brief J, Raczkowsky J, Hassfeld S, Wörn H. [A process and architecture model for computer-assisted surgery]. BIOMED ENG-BIOMED TE 2003; 47 Suppl 1 Pt 1:86-9. [PMID: 12451780 DOI: 10.1515/bmte.2002.47.s1a.86] [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: 11/15/2022]
Affiliation(s)
- O Schorr
- Institut für Prozessrechentechnik, Automation und Robotik, Universität Karlsruhe (TH), Germany.
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30
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Ziegler CM, Haag C, Mühling J. Treatment of recurrent temporomandibular joint dislocation with intramuscular botulinum toxin injection. Clin Oral Investig 2003; 7:52-5. [PMID: 12673439 DOI: 10.1007/s00784-002-0187-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2002] [Accepted: 10/22/2002] [Indexed: 10/25/2022]
Abstract
Recurrent dislocation of the mandibular condyle poses a difficult problem for affected patients. In the course of time, dislocations often become more frequent and more difficult to avoid. Even with good patient compliance, conservative treatment is often not sufficient. Operative procedures have also been described for the treatment of temporomandibular joint dislocation. However, these interventions are invasive, involving open arthrotomy with possible complications, and cannot safely guarantee a successful outcome. On the other hand, botulinum toxin injections into the lateral pterygoid muscles offer the option of a predictable and prolonged period without renewed dislocation. We present the results of this treatment carried out in 21 patients with recurrent temporomandibular joint dislocation. Four patients were treated following unsuccessful physical therapy and the use of occlusal splints. The remaining 17 patients were treated for a number of conditions resulting in dislocation, including some with senile dementia and mental impairment in whom compliance with conservative measures was poor or completely absent. Injections were given on a 3-month basis in order to have a sustained effect. Within the study period of 6 months to 3 years, only two of the 21 patients suffered further dislocation. There were no side effects recorded as a result of treatment.
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Affiliation(s)
- Christoph M Ziegler
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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31
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Abstract
Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.
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Affiliation(s)
- H Schmal
- Chirurgiche Universitätsklinik, Albert-Ludwigs-Universität Freiburg, Abteilung Unfallchirurgie.
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32
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Honecker F, Kollmannsberger C, Quietzsch D, Haag C, Schroeder M, Spott C, Hartmann JT, Baronius W, Hempel V, Kanz L, Bokemeyer C. Phase II study of weekly paclitaxel plus 24-h continuous infusion 5-fluorouracil, folinic acid and 3-weekly cisplatin for the treatment of patients with advanced gastric cancer. Anticancer Drugs 2002; 13:497-503. [PMID: 12045461 DOI: 10.1097/00001813-200206000-00008] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [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: 12/15/2022]
Abstract
The aim of this study was to evaluate the toxicity and efficacy of combination chemotherapy with weekly 24-h continuous infusion of 5-fluorouracil (5-FU)/folinic acid, weekly paclitaxel and 3-weekly cisplatin in patients with unresectable, locally advanced or metastatic gastric adenocarcinoma. Between November 1999 and November 2001, 29 chemotherapy-naive patients (13 male and 16 female) with a median age of 56 years (range 22-72) were consecutively enrolled at three centers. 5-FU 2 g/m2 was given weekly over 24 h i.v. preceded by folinic acid 500 mg/m2 as a 2-h infusion. Paclitaxel 80 mg/m2 was administered as a 1-h infusion weekly and cisplatin 50 mg/m2 as 1-h infusion on days 8 and 29. Six weeks of therapy (days 1, 8, 15, 22, 29 and 36) followed by 1 week of rest was considered one cycle. A median of 3 cycles (range 1-5) was administered to 29 patients with a total of 73 cycles applied. All patients were assessable for toxicity and survival, 28 patients were assessable for response (one patient received less than one complete cycle and could not be evaluated for response). Four patients (14%) obtained a complete response and 10 patients (34%) a partial response (overall response rate 48%, 95% CI 29-68%). Seven patients (24%) had stable disease. Seven patients (24%) had progressive disease during or within 4 weeks after treatment. The median progression-free and overall survival times were 8 months (range 1-23) and 11 months (range 1-23), respectively. Overall toxicity was acceptable. Hematological toxicity was favorable with only one patient (3%) experiencing WHO grade 3/4 leukocytopenia and one patient (3%) WHO grade 3/4 anemia. Non-hematologic WHO grade 3/4 toxicities included alopecia in 19 (66%), nausea/vomiting in six (21%), diarrhea in six (21%), neurotoxicity grade 3 in three (10%) and infection in three (10%) patients. A total of 42 applications (10%) (range 0-5) had to be postponed and dose reductions of at least one drug was necessary in 37% of applications. In three patients (10%) treatment was stopped because of toxicity. All patients were treated on an outpatient basis. Thus, the combination of weekly paclitaxel, cisplatin and continuously infused 5-FU/folinic acid appears to be a highly active regimen for the treatment of patients with advanced gastric cancer. Compared with our previous experience with the same combination of drugs but using paclitaxel at 175 mg/m2 given every 3 weeks, the protocol with weekly application of paclitaxel 80 mg/m2 shows a reduced incidence of hematologic toxicity, particularly leukopenia. Other organ toxicities apart from a slightly higher incidence of peripheral neuropathy were comparable between the two treatment protocols. Efficacy with a response rate of 50% was well preserved by this weekly regimen.
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Affiliation(s)
- F Honecker
- Department of Hematology/Oncology, University of Tübingen Medical Center, 72076 Tübingen, Germany
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33
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Haag C, Ehninger G. [Indications for chemotherapy in cancers of the esophagus, stomach and pancreas]. Z Gastroenterol 2002; 40 Suppl 1:S68-S70. [PMID: 11930294 DOI: 10.1055/s-2002-23615] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
During the last years the chemotherapy in osophageal, stomach and pancreatic cancer demonstrated some success. Radiochemotherapy for esophageal cancer is indicated as neoadjuvant therapy before surgery in locally advanced cancer or in patients with other diseases, which do not allow surgery. In stomach cancer patient there is a clear indication for chemotherapy in metastatic disease and within clinical trials as neoadjuvant chemotherapy in locally advanced cancer. In pancreatic cancer patient the chemotherapy shows less success comparing to other gastrointestinal cancer; it is part of the palliative concept with other therapeutic strategies.
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Affiliation(s)
- C Haag
- Medizinische Klinik I, Universitätsklinikum Carl-Gustav-Carus der Technischen Universität Dresden, Germany.
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34
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Platzbecker U, Prange-Krex G, Bornhäuser M, Koch R, Soucek S, Aikele P, Haack A, Haag C, Schuler U, Berndt A, Rutt C, Ehninger G, Hölig K. Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs. Transfusion 2001; 41:184-9. [PMID: 11239220 DOI: 10.1046/j.1537-2995.2001.41020184.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [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: 11/20/2022]
Abstract
BACKGROUND Recombinant human G-CSF is widely used to mobilize PBPCs in healthy donors for allogeneic transplantation. There have been concerns about donor safety because of splenic ruptures during G-CSF application. To address this problem, changes in splenic size in 91 healthy donors during G-CSF mobilization of allogeneic PBPCs were investigated. STUDY DESIGN AND METHODS For mobilization, G-CSF in a dosage of 7.5 microg per kg per day was administered for 5 days and PBPC collection started Day 5. Splenic size was determined by ultrasound before G-CSF application was started and on the day of the first apheresis. RESULTS The mean increase in splenic length was 11 mm (range, 0-28 mm; p<0.0001), whereas a mean increase of 5 mm in width (range, 0-14 mm; p<0.0001) was measured. No major side effects could be observed. There was no significant correlation between the increase in splenic size and the hematologic values, or the age and body-mass index. In a multivariant analysis, no independent risk factor for the development of a spleen enlargement over 19 mm in length and 9 mm in thickness was found in 20 percent of investigated donors. CONCLUSION In this prospective trial, a significant spleen enlargement was observed in healthy donors during G-CSF mobilization of allogeneic PBPCs. Further investigations are needed to define the degree of spleen enlargement with higher G-CSF dosages to improve donor safety.
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Affiliation(s)
- U Platzbecker
- Medical Clinic I, the Institute of Transfusion Medicine, the Institute of Radiology, and the Institute of Biometry, University Hospital Carl Gustav Carus, Dresden, Germany.
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35
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Abstract
The present study examined latent inhibition (LI) effects in 17 acute and 16 partially remitted schizophrenic patients, and in 20 healthy controls, by measuring manual response latencies and event-related potentials (ERPs) during an association learning task. ERPs were recorded to elucidate the role of attention in the LI effect. Subjects performed a go/no-go task with an auditory conditional stimulus predicting a visual go command. Half of the subjects in each diagnostic group were pre-exposed to the conditional stimulus which had been used as an irrelevant distractor in a preceding discrimination task. Independent of diagnostic group membership, pre-exposed subjects showed slower manual responses to go stimuli than non-pre-exposed subjects, reflecting a robust LI effect. The N100 wave after the conditional stimuli, however, showed a differential pattern: pre-exposure increased N100 amplitudes in acute schizophrenics, whereas pre-exposed control subjects showed a trend for decreased N100. The amplitude of the contingent negative variation (CNV) was unaffected by pre-exposure. The ERP results suggest that acute schizophrenics have a deficit in learned inattention to irrelevant stimuli. However, the intact LI effect in schizophrenics at the motor speed level shows that human LI is a complex phenomenon depending on the tasks and measures used.
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Affiliation(s)
- N Kathmann
- Department of Psychiatry, Ludwig-Maximilians-Universität München, Nussbaumstrasse 7, 80336, Munich, Germany.
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36
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Kollmannsberger C, Quietzsch D, Haag C, Lingenfelser T, Schroeder M, Hartmann JT, Baronius W, Hempel V, Clemens M, Kanz L, Bokemeyer C. A phase II study of paclitaxel, weekly, 24-hour continous infusion 5-fluorouracil, folinic acid and cisplatin in patients with advanced gastric cancer. Br J Cancer 2000; 83:458-62. [PMID: 10945491 PMCID: PMC2374647 DOI: 10.1054/bjoc.2000.1295] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To evaluate the toxicity and efficacy of combination chemotherapy with paclitaxel, cisplatin and 24 h continuous infusion of 5-FU/folinic acid in patients (pts) with unresectable, locally advanced or metastatic gastric adenocarcinoma. Forty-five chemotherapy-naive pts (28 male and 17 female) with a median age of 60 years (range 35-74) were enrolled. 5-FU 2 g/m2 was given weekly over 24 h i.v. preceded by folinic acid 500 mg/m2 as a 2 h infusion. Paclitaxel 175 mg/m2 was administered as a 3 h-infusion on days 1 and 22 and cisplatin 50 mg/m2 as 1 h infusion on days 8 and 29. Six weeks of therapy (days 1, 8, 15, 22, 29, 36) followed by 2 weeks rest were considered one cycle. A median of 3 cycles (range 1-4) were administered to 45 pts assessable for response, survival and toxicity. Five pts (11%) obtained a CR and 18 pts (40%) a PR (ORR 51%; 95% CI: 35.8-66.3%). Responses were achieved in the liver, lymph nodes, lungs and at the site of the primary tumour. Nine pts (20%) had stable disease. Thirteen pts (29%) were considered to have failed treatment, 8 pts (18%) due to progressive disease and 5 pts (11%) who did not receive one complete cycle of therapy due to acute non-haematologic toxicity. The median progression-free and overall survival times were 9 months (range 1-36+) and 14 months (range 2-36+), respectively. Neutropenia WHO III(o)/IV(o) occurred in 7 pts (15%) with only 1 pt having grade IV. Additional non-haematologic WHO III(o)/IV(o) toxicities included nausea/vomiting in 5 (11%), alopecia in 22 (49%), and diarrhoea in 1 patient each (2%). Dose reductions or treatment delays were necessary in 8 pts (17%), mainly due to neutropenia. All pts were treated on an outpatient basis. The combination of paclitaxel, cisplatin and continuously infused 5-FU/folinic acid appears to be a highly active regimen for the treatment of pts with advanced gastric cancer. While the overall acceptable toxicity allows its use in the palliative setting, it may also be an attractive option to be tested for neoadjuvant or adjuvant treatment.
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Affiliation(s)
- C Kollmannsberger
- Department of Hematology/Oncology, University of Tuebingen Medical Center, Tuebingen, Germany
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Grunze H, Gallinat J, Haag C, Hegerl U. Psychopathological and auditory evoked potential correlates of ketamine psychosis--a single case report. Schizophr Res 2000; 41:386-8. [PMID: 10708350 DOI: pmid/10708350] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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38
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Padberg F, Zwanzger P, Thoma H, Kathmann N, Haag C, Greenberg BD, Hampel H, Möller HJ. Repetitive transcranial magnetic stimulation (rTMS) in pharmacotherapy-refractory major depression: comparative study of fast, slow and sham rTMS. Psychiatry Res 1999; 88:163-71. [PMID: 10622338 DOI: 10.1016/s0165-1781(99)00092-x] [Citation(s) in RCA: 169] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In previous studies, fast repetitive transcranial magnetic stimulation (rTMS) with a frequency > 1 Hz demonstrated substantial antidepressant effects compared to sham rTMS. However, it is not clear whether fast rTMS is superior to slow rTMS (frequency < or = 1 Hz) which is safe at therapeutically promising higher intensities. The aim of this double-blind study was to compare the action of fast, slow and sham rTMS. Eighteen patients with pharmacotherapy-resistant major depression were randomized to receive fast (10 Hz), slow (0.3 Hz) or sham rTMS with 250 stimuli/day for 5 successive days. rTMS was applied at 90% motor threshold intensity to the left dorsolateral prefrontal cortex. Scores on the Hamilton Depression Rating Scale (HDRS), but not on the Montgomery-Asberg Depression Rating Scale (MADRS), showed a statistically significant time x group interaction with a reduction of 19% after slow rTMS. However, the effect was clinically marginal and not reflected by self-rating scores. Verbal memory and reaction performance were not impaired after rTMS, and there was even a statistically significant time x group interaction with improvement of verbal memory performance after fast rTMS. In conclusion, this study further supported the safety of rTMS but does not show any clinically meaningful antidepressant efficacy of rTMS at 250 daily stimuli over 5 days in pharmacotherapy-refractory major depression.
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Affiliation(s)
- F Padberg
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany.
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39
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Abstract
The differential diagnosis of psychogenic vs. organic amnestic syndromes may cause difficulty in certain cases. Here, we report a case of psychogenic amnesia which occurred after alcohol intoxication and mild head trauma. The initial memory deficit was very severe consisting of near-complete retrograde amnesia and anterograde amnesia covering 12 hours. The deficits resolved within a 4-week period of time. Brain CT and MRI scans revealed two circumscribed lesions of the right temporal lobe which were interpreted as old posttraumatic lesions. To ascertain the diagnosis, diffusion-weighted MR imaging (DWI) and brain perfusion SPECT were performed. The basal temporal lobes neither showed focal changes of perfusion, nor enhanced signal intensity on DWI as has been recently reported in patients with transient global amnesia. Later, the dissociative nature of the disorder could be confirmed by the exploration of recent psychological conflicts and the delayed type of recovery. We regard diffusion-weighted MRI as a powerful means to differentiate acute amnestic syndromes.
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Affiliation(s)
- T Back
- Neurologische Klinik, Klinikum Grosshadern, München
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40
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Abstract
Considering the high morbidity and mortality of deep-seated opportunistic mycoses in severely immunosuppressed patients, strategies for prophylaxis appear to be indicated. Exposure to Aspergillus spp. can be prevented by air filtration which has been shown to reduce the rate of infection. However, Candida infections are predominantly caused by colonizing fungi; therefore drug prophylaxis is more promising. Prospective randomized studies proved the effectiveness of fluconazole (FLU) to prevent infections in patients after bone marrow transplantation.
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Affiliation(s)
- U S Schuler
- Medizinische Klinik I, Universitätsklinikum Carl Gustav Carus, Technischen Universität Dresden, FR Germany
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41
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Haag C, Merkle K. [Clinical and radiologic results of surgically treated patellar dislocation]. Unfallchirurgie 1997; 23:210-5. [PMID: 9446277] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this retrospective study 72 patients were followed up clinically and radiologically after surgical treatment for dislocation of the patella. The period of observation varied between 13 and 76 months, with an average of 32 months. Acute traumatic dislocation of the patella was only rarely encountered (n = 6 [8%]). Primary dislocation occurred most frequently during the second and third decades of life. Chondral and osteochondral fractures were fairly frequent (n = 24 [33%]). Additional injuries involved the anterior cruciate ligament, the medial collateral ligament and the menisci. At clinical examination 32 patients (44%) could be assessed as "very good" and "good" (classification of Larsen and Lauridsen). Redislocation occurred in 12 patients (16.7%). The radiological condition of the patella and that of the trochlea femoris were assessed in terms of the classification of Wiberg and Baumgartl and of Hepp, respectively. The condylar-joint angle (Brattström) and the condylar depth index (Ficat and Bizou) were also evaluated.
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Affiliation(s)
- C Haag
- Abteilung Unfallchirurgie der Chirurgischen Universitätsklinik Freiburg
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Voderholzer U, Laakmann G, Becker U, Haag C, Baghai T, Riemann D, Demisch L. Circadian profiles of melatonin in melancholic depressed patients and healthy subjects in relation to cortisol secretion and sleep. Psychiatry Res 1997; 71:151-61. [PMID: 9271788 DOI: 10.1016/s0165-1781(97)00048-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Circadian secretion of melatonin was measured in melancholic depressed patients (n = 9) and age- and sex-matched healthy control patients (n = 9). The mean age of the depressed patients was 29 years, i.e. younger than in most earlier studies, and a drug-free interval of 3 weeks preceded the investigations. Melatonin secretion was similar in depressed patients and healthy subjects with no significant differences at any of the time points, thus not confirming earlier studies in which depressed patients were found to have lower melatonin levels than control patients. The discrepancy between our result and earlier studies may be explained by different patient characteristics such as age, duration of illness, previous treatment, and alcohol intake. It is conceivable that a diminution of nocturnal melatonin secretion in depressed patients might only occur during the long-term course of the depressive illness and/or its pharmacological treatment.
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Affiliation(s)
- U Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital of the Albert-Ludwigs-Universität Freiburg, Germany
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Voderholzer U, Müller N, Haag C, Riemann D, Straube A. Periodic limb movements during sleep are a frequent finding in patients with Gilles de la Tourette's syndrome. J Neurol 1997; 244:521-6. [PMID: 9309560 DOI: 10.1007/s004150050136] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [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: 02/05/2023]
Abstract
Gilles de la Tourette's syndrome (GTS) and restless legs syndrome (RLS) are two different neurological disorders with common features such as involuntary movements. In both disorders a disturbance of the dopaminergic system has been considered among other possible mechanisms. Since periodic leg movements (PLMS) during sleep are the predominant objective finding in RLS, the aim of this study was to investigate sleep parameters in GTS patients with particular emphasis on PLMS. Seven drug-free patients with GTS and seven age- and sex-matched healthy controls were studied polysomnographically, including superficial electromyogram (EMG) leads on all four extremities. A high number of PLMS were found in five of seven, and periodic arm movements in four of seven GTS patients. Total sleep time was significantly lower (P < 0.05) in the GTS patients than in the controls, which confirms earlier findings. The presence of PLMS in GTS might point towards evidence for a pathophysiological relationship between GTS and RLS, which, however, is not supported by the different responses to pharmacological treatments.
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Affiliation(s)
- U Voderholzer
- Albert-Ludwigs-University Freiburg, Department of Psychiatry, Germany
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Abstract
Transcranial magnetic stimulation (TMS) has been used since a decade to investigate the central motor system in the neurological routine diagnostic. From this experience TMS has proved to be a save and well tolerated procedure. In the past few years several studies investigated TMS to electrically stimulate deeper brain regions to find antidepressive effects in analogy to electro convulsive therapy (ECT). This could be of great advantage as TMS is well tolerated and does not require general anesthesia. There have been some case reports and also some controlled clinical studies on TMS as a therapeutic tool. The results of these studies have been promising. Many questions regarding technical and clinical aspects remain to be answered. In the future however TMS could be a valuable addition in the treatment of depression.
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Affiliation(s)
- C Haag
- Psychiatrische Klinik, der Universität, München
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Günther W, Müller N, Knesewitsch P, Haag C, Trapp W, Banquet JP, Stieg C, Alper KR. Functional EEG mapping and SPECT in detoxified male alcoholics. Eur Arch Psychiatry Clin Neurosci 1997; 247:128-36. [PMID: 9224905 DOI: 10.1007/bf03033066] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fifteen alcoholics diagnosed according to DSM-III-R, who were detoxified for at least 2 weeks and showed no clinical withdrawal signs, were investigated with 16 channel EEG mapping during resting, manumotor and music perception conditions, and were compared with 13 control persons. Single photon emission computed tomography (SPECT) using hexa-methyl-propilene-amine-oxime (HMPAO) labeled with 99m-technetium (99mTc) as tracer was performed separately (in patients only) and submitted to semiquantitative region of interest (ROI) analysis in 2 slices, 6 and 10 cm above canthomeatal line, respectively. Resting EEG showed increased power values in fast beta frequency band for the detoxified alcoholics. On cortical stimulation, patients showed signs of pathological EEG reactivity. Correlations of EEG parameters to cerebral blood flow (CBF) values (patients only) yielded coefficients around zero for all frequency bands (signs of uncoupling). All findings point to organic brain dysfunctions in these patients which extend beyond the period of withdrawal.
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Affiliation(s)
- W Günther
- Psychiatric University Hospital, Munich, Germany
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Günther W, Müller N, Trapp W, Haag C, Putz A, Straube A. Quantitative EEG analysis during motor function and music perception in Tourette's syndrome. Eur Arch Psychiatry Clin Neurosci 1996; 246:197-202. [PMID: 8832197 DOI: 10.1007/bf02188953] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 02/02/2023]
Abstract
Gilles de la Tourette's syndrome (TS) is a neurobehavioral disorder of childhood onset that is characterized by motor and vocal tics and associated behavioral disturbances including obsessive-compulsive symptoms. We performed 30 channel quantitative electroencephalograms (EEGs) on 13 Tourette patients and 26 controls and studied both resting and manumotor/music perception activation conditions. Resting EEGs did not show any differences between patients and controls, as known from the literature. However, during simple and complex hand movements, as well as music perception tasks, there were subtle differences predominantly in alpha frequency. They suggested reduced brain activation during motor tasks in frontal and central regions, and on music perception in temporal and parietal regions, respectively. These findings may add evidence to the functional neuroanatomy of Tourette syndrome, affecting more areas than disturbed motor circuits.
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Affiliation(s)
- W Günther
- Psychiatric University Hospital Munich, Germany
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Haag C, Kathmann N, Hock C, Günther W, Voderholzer U, Laakmann G. Lateralization of the Bereitschaftspotential to the left hemisphere in patients with major depression. Biol Psychiatry 1994; 36:453-7. [PMID: 7811841 DOI: 10.1016/0006-3223(94)90640-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fourteen patients with major depression and 18 healthy subjects performed a Bereitschaftspotential (BP) paradigm, which required them to clench the right fist at self-paced intervals. The BP was calculated as the integrated negative amplitude from BP onset to movement onset. The latter was defined by recording the electromyogram (EMG) from the right forearm. To evaluate lateralization, the integrated BPs at C3, C4, P3, and P4 were analyzed. In depressives, a significant asymmetry of the BP to the left was found, whereas in normals the BP was nearly symmetrically distributed around the midline. Three patients were retested when clinically improved. At that time the asymmetry to the left hemisphere had nearly vanished. This asymmetry to the left hemisphere is interpreted as a cortical deactivation of the right cerebral hemisphere and seems to be a state marker of depression.
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Affiliation(s)
- C Haag
- Psychiatric Hospital, University of Munich, Germany
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Haag C, Wagner G, Blum U. [Angiography detection and embolization of a hemodynamically significant hemorrhage from the right dorsal penile artery in symphysis rupture]. Unfallchirurgie 1994; 20:169-173. [PMID: 8091546 DOI: 10.1007/bf02588163] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Pelvic fractures are frequently complicated by concomitant vascular lacerations involving, particularly, branches originating from the internal iliac arteries. Massive hemorrhage may be difficult to be treated surgically. In such cases interventional radiology can be helpful and able to treat definitely extensive hemorrhage caused by pelvic trauma.
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Affiliation(s)
- C Haag
- Abteilung Unfallchirurgie, Albert-Ludwigs-Universität Freiburg
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Günther W, Klages U, Mayr M, Haag C, Müller N, Hantschk I, Streck P, Steinberg R, Baghai T, Banquet JP. EEG mapping investigations of psychomotor and music perception brain dysfunction in untreated schizophrenic patients. Neurophysiol Clin 1993; 23:516-28. [PMID: 8127321 DOI: 10.1016/s0987-7053(05)80142-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Twenty-six untreated schizophrenic inpatients and 34 control persons were investigated using 16-channel EEG mapping during resting, manumotor and music perception tasks. Power values of activation tasks were each referenced to a separate, immediately preceding resting condition, using conventional delta, theta, alpha and 2 beta frequency bands. Results in delta and alpha bands, which maximally separated the two groups, are reported only for space reasons. Results indicated a "nonreactivity" (in all frequency bands) on the two activation paradigms in schizophrenic patients as a group. Major gender effects were obtained in normal persons, but not signs of nonreactivity comparable to patients. Subdividing patients exclusively by means of their EEG changes on activation produced meaningful clinical subgroups of "positive/negative" schizophrenics. This latter finding could contribute towards clinical utility of EEG mapping in psychiatry.
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Affiliation(s)
- W Günther
- Psychiatric University Hospital, Munich, Germany
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Günther W, Giunta R, Klages U, Haag C, Steinberg R, Satzger W, Jonitz L, Engel R. Findings of electroencephalographic brain mapping in mild to moderate dementia of the Alzheimer type during resting, motor, and music-perception conditions. Psychiatry Res 1993; 50:163-76. [PMID: 8272452 DOI: 10.1016/0925-4927(93)90028-g] [Citation(s) in RCA: 19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Sixteen-channel electroencephalographic (EEG) brain mapping studies were carried out under resting conditions in 41 patients with mild to moderate dementia of the Alzheimer type, diagnosed according to DSM-III-R criteria. The patients showed diffuse patterns of EEG slowing, as known from the literature. They showed increases of theta power in large bilateral brain areas and bitemporal increases of delta power as compared with both age-matched and younger control subjects. In addition, the patients had increased beta activity in comparison with the younger control group, but not with the age-matched control subjects. Functional brain mapping revealed decreases of EEG power during manual-motor and music-perception tasks in delta frequencies for patients, which was not seen in either of the two control groups. All frequency bands revealed major gender-related differences in EEG activity, which should receive more attention in future research.
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Affiliation(s)
- W Günther
- Department of Psychiatry, Nervenklinik, Bamberg, Germany
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