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Heidenreich A, Bach C, Pfister D. [Palliative surgery for metastatic prostate cancer]. Urologie 2024; 63:241-253. [PMID: 38418597 DOI: 10.1007/s00120-024-02285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 03/01/2024]
Abstract
Androgen deprivation in combination with novel hormonal agents, docetaxel, or in combination with abiraterone/prednisone plus docetaxel or darolutamid plus docetaxel represent the standard therapeutic approach in metastatic hormone-sensitive prostate cancer (mHSPC). Patients with low-risk prostate cancer also benefit from additional radiation therapy or radical prostatectomy in terms of progression-free and overall survival. Despite favorable response rates, basically all patients will develop castration resistant prostate cancer (CRPC) within 2.5 to 4 years. In addition to systemic chemotherapy, second-line hormonal treatment of systemic application of radionuclides such as radium223 or 177Lu-PSMA represent salvage management options. However, nowadays about 50-65% of patients will develop symptoms due to local progression of prostate cancer which is the result of improved oncological outcomes with significantly prolonged survival times due to the new medical treatment options. Management of such symptomatic local progression will become more important in upcoming years so that all uro-oncologists need to be aware of the various surgical management options. Complications of the lower urogenital tract such as recurrent gross hematuria ± bladder clotting and with the necessity for red blood cell transfusions, subvesical obstruction and acute urinary retention, rectourethral or rectovesical fistulas might be managed by palliative surgery such as palliative transurethral resection of the prostate (TURP), radical cystectomy, radical cystoprostatectomy with urinary diversion, and pelvic exenteration. Symptomatic or asymptomatic obstruction of the upper urinary tract might be managed by endoluminal or percutaneous urinary diversion, ureteral reimplantation, ileal ureter replacement, or implantation of the Detour® system (Coloplast GmbH, Hamburg, Germany).
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Affiliation(s)
- Axel Heidenreich
- Klinik für Urologie, Uro-Onkologie, roboter-assistierte und spezielle urologische Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
- Klinik für Urologie, Medizinische Universität Wien, Wien, Österreich.
| | - Christian Bach
- Klinik für Urologie, Uro-Onkologie, roboter-assistierte und spezielle urologische Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - David Pfister
- Klinik für Urologie, Uro-Onkologie, roboter-assistierte und spezielle urologische Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Heidenreich A, Bach C, Pfister D. [Palliative urologic surgery for metastatic prostate cancer: what needs to be considered in the future?]. Aktuelle Urol 2024. [PMID: 38232756 DOI: 10.1055/a-2226-9243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Androgen deprivation in combination with novel hormonal agents, docetaxel or the combination of abiraterone/prednisone plus docetaxel or darolutamide plus docetaxel represent the standard therapeutic approach in metastatic hormone-sensitive prostate cancer (mHSPC). Patients with low-risk prostate cancer also benefit from additional radiation therapy or radical prostatectomy in terms of progression-free and overall survival. Despite favourable response rates, basically all patients will develop castration-resistant prostate cancer (CRPC) within 2.5 to 4 years. Systemic chemotherapy, second-line hormonal treatment or systemic application of radionuclides such as Radium-223 or 177Lu-PSMA represent salvage management options. As the new medical treatment options have led to an improved oncological outcome with significantly prolonged survival times, about 50% to 65% of patients will develop symptoms due to local progression of prostate cancer. The management of such symptomatic local progression will become more important in upcoming years, which means that all uro-oncologists need to be aware of the various surgical management options. If complications of the lower urogenital tract occur, for example repetitive gross haematuria with or without bladder clotting and with the necessity for red blood cell transfusions, subvesical obstruction, acute urinary retention or rectourethral or rectovesical fistulas, these may be managed by palliative surgery such as palliative TURP, radical cystectomy, radical cystoprostatectomy with urinary diversion, and pelvic exenteration. Symptomatic or asymptomatic obstruction of the upper urinary tract can be managed by endoluminal or percutaneous urinary diversion, ureteral reimplantation, ileal ureter replacement, or implantation of a Detour system. However, an individualised and risk-adapted treatment strategy needs to be developed for each single patient to achieve an optimal therapeutic outcome with improvement of both symptoms and quality of life. In specific clinical situations, best supportive care may be an adequate option.
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Affiliation(s)
- Axel Heidenreich
- Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln, Germany
| | - Christian Bach
- Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln, Germany
| | - David Pfister
- Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln, Germany
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Misher C, Dumais M, Vachani C, Bach C, Villalona S, Arnold-Korzeniowski K, Rodriguez A, Metz JM, Hill-Kayser CE. Implementing Standardized Patient Education in Radiation Oncology. Int J Radiat Oncol Biol Phys 2023; 117:e417-e418. [PMID: 37785376 DOI: 10.1016/j.ijrobp.2023.06.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patient education empowers patients, improving their health status during and after cancer treatment (Howell et al., 2017). We hypothesize that standardizing healthcare provider delivery of educational materials (HPE) using an electronic medical record (EMR) will increase delivery to patients (pts). MATERIALS/METHODS During the study period (9/2020 - 11/2022) 13,650 pts in a multi-centered single health system (HS) received HPE and were analyzed in a retrospective convenience sample frame. There were 16,769 education touchpoints from Radiation Oncology departments (RO) and 8,269 from Medical Oncology (MO) departments. Provision of HPE was standardized in RO during this era. Relationship of ethnicity, age, and sex/gender to receipt of HPE at single vs multiple time points across the HS was examined using association analysis. RESULTS Within the combined sample taken from RO and MO departments in the HS the mean pt age was 64y (7 - >90); 71% of pts identified as white, 95.7% non-Hispanic, and 55% female. Across ethnicity, age, and sex/gender, increased HPE was provided in RO vs MO departments (p < 0.001). Distribution of HPE in RO was equal between male and female pts (73%), while distribution to female pts was higher than male in MO. (60% vs 57%, p < 0.001). Receipt of HPE at more than one time point was increased in RO across cancer types (Table 1). In RO, 73% of patients received education at more than one time point, compared to 58.7% in other departments (p < 0.001). Receipt of HPE at more than one time point was increased in RO for patients identifying as American Indian or Alaska Native (84% vs 0, p = 0.001, n = 28), Asian (73.4% vs 56%, p < 0.001, n = 824), and Black (75% vs 60%, p < 0.001, n = 4005). HPE was received at more than one time point in RO in 75.7% of patients age 7-39, 76.4% 40-64, 71.2% 65-79, and 67.6% in those 80 and above, compared to 62.0%, 63.2%, 56.3%, and 49.2%, respectively in MO departments (p = <0.01). CONCLUSION Standardization of HPE within RO increased delivery to patients across gender, race/ethnicity, age, and cancer diagnosis, particularly regarding number of educational touchpoints for patients in underserved populations based on race and age. Our results suggest that widespread standardization of HPE is likely to improve distribution of education to all patient groups and should be systematically supported.
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Affiliation(s)
| | - M Dumais
- Temple University, Philadelphia, PA
| | | | - C Bach
- Penn Medicine, Philadelphia, PA
| | - S Villalona
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | | | - J M Metz
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
| | - C E Hill-Kayser
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
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Schwarzer-Fischer E, Abel J, Sieder-Katzmann J, Propst M, Bach C, Scheithauer U, Michaelis A. Study on CerAMfacturing of Novel Alumina Aerospike Nozzles by Lithography-Based Ceramic Vat Photopolymerization (CerAM VPP). Materials (Basel) 2022; 15:ma15093279. [PMID: 35591613 PMCID: PMC9102029 DOI: 10.3390/ma15093279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022]
Abstract
Advanced ceramics are recognized as key enabling materials possessing combinations of properties not achievable in other material classes. They provide very high thermal, chemical and mechanical resistance and typically exhibit lower densities than metals. These properties predestine ceramics for many different applications, especially those in space. Aerospike nozzles promise an increased performance compared to classic bell nozzles but are also inherently more complex to manufacture due to their shape. Additive manufacturing (AM) drastically simplifies or even enables the fabrication of very complex structures while minimizing the number of individual parts. The applicability of ceramic AM (“CerAMfacturing”) on rocket engines and especially nozzles is consequently investigated in the frame of the “MACARONIS” project, a cooperation of the Institute of Aerospace Engineering at Technische Universität Dresden and the Fraunhofer Institute for Ceramic Technologies and Systems (IKTS) in Dresden. The goal is to develop novel filigree aerospike nozzles with 2.5 N and 10 N thrust. For this purpose, CerAM VPP (ceramic AM via Vat Photopolymerization) using photoreactive and highly particle-filled suspensions was utilized. This contribution gives an overview of the component development starting from CAD modeling, suspension development based on alumina AES-11C, heat treatment and investigation of the microstructure of the sintered components. It could be shown that modifying the suspension composition significantly reduced the formation of cracks during processing, resulting in defect-free filigree aerospike nozzles for application in space.
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Affiliation(s)
- Eric Schwarzer-Fischer
- Fraunhofer Institut für Keramische Technologien und Systeme (IKTS), Winterbergstraße 28, 01277 Dresden, Germany; (J.A.); (U.S.); (A.M.)
- Correspondence: ; Tel.: +49-351-2553-7625
| | - Johannes Abel
- Fraunhofer Institut für Keramische Technologien und Systeme (IKTS), Winterbergstraße 28, 01277 Dresden, Germany; (J.A.); (U.S.); (A.M.)
| | - Jan Sieder-Katzmann
- Institute of Aerospace Engineering, Chair of Space Systems, Technische Universität Dresden, Helmholtzstr. 10, 01069 Dresden, Germany; (J.S.-K.); (M.P.); (C.B.)
| | - Martin Propst
- Institute of Aerospace Engineering, Chair of Space Systems, Technische Universität Dresden, Helmholtzstr. 10, 01069 Dresden, Germany; (J.S.-K.); (M.P.); (C.B.)
| | - Christian Bach
- Institute of Aerospace Engineering, Chair of Space Systems, Technische Universität Dresden, Helmholtzstr. 10, 01069 Dresden, Germany; (J.S.-K.); (M.P.); (C.B.)
| | - Uwe Scheithauer
- Fraunhofer Institut für Keramische Technologien und Systeme (IKTS), Winterbergstraße 28, 01277 Dresden, Germany; (J.A.); (U.S.); (A.M.)
| | - Alexander Michaelis
- Fraunhofer Institut für Keramische Technologien und Systeme (IKTS), Winterbergstraße 28, 01277 Dresden, Germany; (J.A.); (U.S.); (A.M.)
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Kolaitis N, Chen H, Calabrese D, Kumar K, Obata J, Bach C, Golden J, Simon M, Kukreja J, Hays S, Leard L, Singer J, De Marco T. The Lung Allocation Score Remains Inequitable for Patients with PAH, Even After the 2015 Revision. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.339] [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: 11/27/2022] Open
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Drasch T, Bach C, Luber M, Spriewald B, Utpatel K, Büttner-Herold M, Banas B, Zecher D. Increased Levels of sCD30 Have No Impact on the Incidence of Early ABMR and Long-Term Outcome in Intermediate-Risk Renal Transplant Patients With Preformed DSA. Front Med (Lausanne) 2021; 8:778864. [PMID: 34820407 PMCID: PMC8606593 DOI: 10.3389/fmed.2021.778864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/14/2021] [Indexed: 11/21/2022] Open
Abstract
Background: It is still incompletely understood why some patients with preformed donor-specific anti-HLA antibodies (DSA) have reduced kidney allograft survival secondary to antibody-mediated rejection (ABMR), whereas many DSA-positive patients have favorable long-term outcomes. Elevated levels of soluble CD30 (sCD30) have emerged as a promising biomarker indicating deleterious T-cell help in conjunction with DSA in immunologically high-risk patients. We hypothesized that this would also be true in intermediate-risk patients. Methods: We retrospectively analyzed pre-transplant sera from 287 CDC-crossmatch negative patients treated with basiliximab induction and tacrolimus-based maintenance therapy for the presence of DSA and sCD30. The incidence of ABMR according to the Banff 2019 classification and death-censored allograft survival were determined. Results: During a median follow-up of 7.4 years, allograft survival was significantly lower in DSA-positive as compared to DSA-negative patients (p < 0.001). In DSA-positive patients, most pronounced in those with strong DSA (MFI > 5,000), increased levels of sCD30 were associated with accelerated graft loss compared to patients with low sCD30 (3-year allograft survival 75 vs. 95%). Long-term survival, however, was comparable in DSA-positive patients irrespective of sCD30 status. Likewise, the incidence of early ABMR and lesion score characteristics were comparable between sCD30-positive and sCD30-negative patients with DSA. Finally, increased sCD30 levels were not predictive for early persistence of DSA. Conclusion: Preformed DSA are associated with an increased risk for ABMR and long-term graft loss independent of sCD30 levels in intermediate-risk kidney transplant patients.
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Affiliation(s)
- Thomas Drasch
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Christian Bach
- Department of Internal Medicine 5-Hematology and Oncology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Luber
- Department of Internal Medicine 5-Hematology and Oncology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Bernd Spriewald
- Department of Internal Medicine 5-Hematology and Oncology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Kirsten Utpatel
- Institute of Pathology, Regensburg University, Regensburg, Germany
| | | | - Bernhard Banas
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Daniel Zecher
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
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O'Keefe R, LaRiviere M, Vachani C, Hampshire M, Bach C, Arnold-Korzeniowski K, Healy M, Metz J, Hill-Kayser C. Contribution of Family History of Head and Neck Cancer and Associated Risk Factors: Analysis of an Internet Based Risk Assessment Tool. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Marand AJB, Bach C, Janssen D, Heesakkers J, Ghojazadeh M, Vögeli TA, Salehi-Pourmehr H, Mostafae H, Hajebrahimi S, Rahnama'i MS. Lower urinary tract signs and symptoms in patients with COVID-19. BMC Infect Dis 2021; 21:706. [PMID: 34311703 PMCID: PMC8312200 DOI: 10.1186/s12879-021-06394-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022] Open
Abstract
Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread across the world in a pandemic. It is not clear if COVID-19 patients have any lower urinary tract signs or symptoms. Methods The effect of COVID-19 on lower urinary tract function was studied in a prospective multi-centre, observational study including 238 patients who were admitted with symptoms caused by COVID-19 to the university hospital of Aachen in Germany and Tabriz in Iran. Results None of the patients reported to have any lower urinary tract symptoms. SARS-CoV-2 was found in the urine of 19% of the tested patients. The mortality rate in COVID-19 infected patients with microscopic haematuria together with white blood cells in their urine, was significantly increased from 48 to 61% in the Tabriz cohort (p-value = 0.03) and from 30 to 35% in the Aachen cohort (p-value =0.045). Furthermore, in the group of patients with SARS-CoV-2 urine PCR, the mortality rate rose from 30 to 58%. (p-value =0.039). Conclusion Patients admitted with COVID-19 did not report to have any lower urinary tract symptoms, even those patient who had a positive Urine SARS-CoV-2 PCR. In addition, hematuria, WBC in urine as well as SARS- CoV-2 presence in urine, were found to be strong negative prognostic factors in admitted COVID-19 patients.
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Affiliation(s)
- Aida Javan Balegh Marand
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.,Radboud University, Nijmegen, The Netherlands.,Society of Urological Research and Education (SURE), Heerlen, The Netherlands
| | - Christian Bach
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | | | | | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hanieh Salehi-Pourmehr
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sakineh Hajebrahimi
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Sajjad Rahnama'i
- Uniklinik RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. .,Radboud University, Nijmegen, The Netherlands.
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Hofbauer D, Mougiakakos D, Broggini L, Zaiss M, Büttner-Herold M, Bach C, Spriewald B, Neumann F, Bisht S, Nolting J, Zeiser R, Hamarsheh S, Eberhardt M, Vera J, Visentin C, De Luca CMG, Moda F, Haskamp S, Flamann C, Böttcher M, Bitterer K, Völkl S, Mackensen A, Ricagno S, Bruns H. β 2-microglobulin triggers NLRP3 inflammasome activation in tumor-associated macrophages to promote multiple myeloma progression. Immunity 2021; 54:1772-1787.e9. [PMID: 34289378 DOI: 10.1016/j.immuni.2021.07.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/28/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022]
Abstract
As substantial constituents of the multiple myeloma (MM) microenvironment, pro-inflammatory macrophages have emerged as key promoters of disease progression, bone destruction, and immune impairment. We identify beta-2-microglobulin (β2m) as a driver in initiating inflammation in myeloma-associated macrophages (MAMs). Lysosomal accumulation of phagocytosed β2m promotes β2m amyloid aggregation in MAMs, resulting in lysosomal rupture and ultimately production of active interleukin-1β (IL-1β) and IL-18. This process depends on activation of the NLRP3 inflammasome after β2m accumulation, as macrophages from NLRP3-deficient mice lack efficient β2m-induced IL-1β production. Moreover, depletion or silencing of β2m in MM cells abrogates inflammasome activation in a murine MM model. Finally, we demonstrate that disruption of NLRP3 or IL-18 diminishes tumor growth and osteolytic bone destruction normally promoted by β2m-induced inflammasome signaling. Our results provide mechanistic evidence for β2m's role as an NLRP3 inflammasome activator during MM pathogenesis. Moreover, inhibition of NLRP3 represents a potential therapeutic approach in MM.
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Affiliation(s)
- Daniel Hofbauer
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | | | - Luca Broggini
- Department of Biosciences, University of Milan, Milan, Italy; Institute of Molecular and Translational Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Mario Zaiss
- Department of Internal Medicine 3, University Hospital Erlangen, Erlangen, Germany
| | | | - Christian Bach
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Bernd Spriewald
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Frank Neumann
- Department of Internal Medicine 1, Saarland University Medical School, Homburg, Germany
| | - Savita Bisht
- Department of Oncology/Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | - Jens Nolting
- Department of Oncology/Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | - Robert Zeiser
- Department of Medicine 1, University of Freiburg, Freiburg, Germany
| | | | - Martin Eberhardt
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Julio Vera
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | | | - Chiara Maria Giulia De Luca
- Divisione di Neurologia 5 - Neuropatologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Fabio Moda
- Divisione di Neurologia 5 - Neuropatologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Stefan Haskamp
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Cindy Flamann
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Martin Böttcher
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Katrin Bitterer
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
| | - Stefano Ricagno
- Department of Biosciences, University of Milan, Milan, Italy
| | - Heiko Bruns
- Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany.
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10
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Bach C, Knaup KX, Herrmann M, Krumbiegel M, Pfister F, Büttner-Herold M, Steffen M, Zecher D, Lopau K, Schneider K, Dieterle A, Amann K, Reis A, Schiffer M, Spriewald BM, Wiesener MS. A noninvasive diagnostic approach to retrospective donor HLA typing in kidney transplant patients using urine. Transpl Int 2021; 34:1226-1238. [PMID: 33904183 DOI: 10.1111/tri.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/24/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
Antibody-mediated rejection (AMR) is a major obstacle to long-term kidney transplantation. AMR is mostly caused by donor specific HLA antibodies, which can arise before or any time after transplantation. Incomplete donor HLA typing and unavailability of donor DNA regularly preclude the assessment of donor-specificity of circulating anti-HLA antibodies. In our centre, this problem arises in approximately 20% of all post-transplant HLA-antibody assessments. We demonstrate that this diagnostic challenge can be resolved by establishing donor renal tubular cell cultures from recipient´s urine as a source of high-quality donor DNA. DNA was then verified for genetic origin and purity by fluorescence in situ hybridization and short tandem repeat analysis. Two representative cases highlight the diagnostic value of this approach which is corroborated by analysis of ten additional patients. The latter were randomly sampled from routine clinical care patients with available donor DNA as controls. In all 12 cases, we were able to perform full HLA typing of the respective donors confirmed by cross-comparison to results from the stored 10 donor DNAs. We propose that this noninvasive diagnostic approach for HLA typing in kidney transplant patients is valuable to determine donor specificity of HLA antibodies, which is important in clinical assessment of suspected AMR.
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Affiliation(s)
- Christian Bach
- Department of Internal Medicine 5 - Haematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Karl X Knaup
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Markus Herrmann
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Mandy Krumbiegel
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Frederick Pfister
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Martin Steffen
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Daniel Zecher
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Kai Lopau
- Department of Internal Medicine, University of Würzburg, Würzburg, Germany
| | - Karen Schneider
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Anne Dieterle
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Kerstin Amann
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Mario Schiffer
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Bernd M Spriewald
- Department of Internal Medicine 5 - Haematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Michael S Wiesener
- Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
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11
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Ataei J, Bach C, Javan A, Vögeli TA, Grafe C, Rahnama'i MS. The Scientific Value of Abstracts on Prostate Cancer Presented at the European Association of Urology Congresses. Front Surg 2021; 8:683359. [PMID: 34212000 PMCID: PMC8239171 DOI: 10.3389/fsurg.2021.683359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Scientific congresses are an important medium for presenting recent clinical findings. Publication of abstracts allows wider dissemination. Objectives: To determine the publication rates of prostate cancer abstracts presented at the annual congress of the European Association of Urology (EAU). Design, Setting, and Participants: All abstracts with the term prostate cancer or carcinoma presented at the congress of the European Association of Urology from 2015 to 2018 were analyzed. We captured their publication rate, journal impact factor and time to publication. Moreover, we formulated a scoring system to determine the grade of discrepancy between the conclusions mentioned in the congress abstract and published abstract. Results: A total of 834 abstracts presented at EAU annual meeting included prostate cancer or carcinoma in their title. We recorded a publication rate of 56.8% with 474 of the 834 abstracts being published with a mean time of 12.5 months. Conclusion: Approximately, 57% of the prostate cancer abstracts presented at the EAU congress are published in peer reviewed journals. This acceptance rate indicates the high distribution and dissemination of these abstracts.
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Affiliation(s)
- Jasmin Ataei
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Christian Bach
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Aida Javan
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Thomas-Alexander Vögeli
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Christina Grafe
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Mohammad Sajjad Rahnama'i
- Department of Urology, Uniklinik Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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Rahnama'i MS, Bach C, Schulze-Hagen M, Kuhl CK, Vögeli TA. Can the predictive value of multiparametric MRI for prostate cancer be improved by a liquid biopsy with SelectMDx? Cancer Rep (Hoboken) 2021; 4:e1396. [PMID: 33931984 PMCID: PMC8714534 DOI: 10.1002/cnr2.1396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND SelectMDx is a urinary biomarker test for determining prostate cancer risk. AIM In a group of patients with a biopsy proven prostate cancer (PCa) who had undergone a multi parametric Magnetic Resonance Imaging (mpMRI) and urinary biomarker test with SelectMDx, we studied the additive value of SelectMDx to mpMRI and correlated that to the radical prostatectomy histology. METHODS AND RESULTS Thirty-nine consecutive patients with a positive prostate biopsy were included in the study. They all had mpMRI and SelectMDx and underwent a radical prostatectomy. Overall, the mpMRI showed a PIRADS ≤3 lesion in seven cases out of the 39 patients. Significant lesions (PIRADS ≥4) were found in 32 cases (82%), that is, in 17 cases a PIRADS 5 lesion and in 15 cases a PIRADS 4 lesion. The mpMRI missed significant PCa in seven cases (18%) who had a PIRADS ≤3 lesion but had a significant PCa on final histology after RP. In our study, the positive predictive values of mpMRI were 97% and that of the SelectMDx was 100%. CONCLUSION In this real-life selected group of consecutive patients with a confirmed positive PCa biopsy and available mpMRI, the liquid biopsy test with SelectMDx, did not provide an additional information about the PCa clinical significance. The addition of SelectMDx was only found valuable in those patients who had a very high-risk PCa (ie, GS ≥8) who had a positive SelectMDx test outcome despite of a negative mpMRI outcome.
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Hutchinson JA, Kronenberg K, Riquelme P, Wenzel JJ, Glehr G, Schilling HL, Zeman F, Evert K, Schmiedel M, Mickler M, Drexler K, Bitterer F, Cordero L, Beyer L, Bach C, Koestler J, Burkhardt R, Schlitt HJ, Hellwig D, Werner JM, Spang R, Schmidt B, Geissler EK, Haferkamp S. Virus-specific memory T cell responses unmasked by immune checkpoint blockade cause hepatitis. Nat Commun 2021; 12:1439. [PMID: 33664251 PMCID: PMC7933278 DOI: 10.1038/s41467-021-21572-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/29/2021] [Indexed: 02/08/2023] Open
Abstract
Treatment of advanced melanoma with combined PD-1/CTLA-4 blockade commonly causes serious immune-mediated complications. Here, we identify a subset of patients predisposed to immune checkpoint blockade-related hepatitis who are distinguished by chronic expansion of effector memory CD4+ T cells (TEM cells). Pre-therapy CD4+ TEM cell expansion occurs primarily during autumn or winter in patients with metastatic disease and high cytomegalovirus (CMV)-specific serum antibody titres. These clinical features implicate metastasis-dependent, compartmentalised CMV reactivation as the cause of CD4+ TEM expansion. Pre-therapy CD4+ TEM expansion predicts hepatitis in CMV-seropositive patients, opening possibilities for avoidance or prevention. 3 of 4 patients with pre-treatment CD4+ TEM expansion who received αPD-1 monotherapy instead of αPD-1/αCTLA-4 therapy remained hepatitis-free. 4 of 4 patients with baseline CD4+ TEM expansion given prophylactic valganciclovir and αPD-1/αCTLA-4 therapy remained hepatitis-free. Our findings exemplify how pathogen exposure can shape clinical reactions after cancer therapy and how this insight leads to therapeutic innovations.
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Affiliation(s)
- James A. Hutchinson
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Katharina Kronenberg
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Paloma Riquelme
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Jürgen J. Wenzel
- grid.411941.80000 0000 9194 7179Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Gunther Glehr
- grid.7727.50000 0001 2190 5763Institute of Functional Genomics and Statistical Bioinformatics, University of Regensburg, Regensburg, Germany
| | - Hannah-Lou Schilling
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- grid.411941.80000 0000 9194 7179Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Katja Evert
- grid.411941.80000 0000 9194 7179Institute of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Martin Schmiedel
- grid.411941.80000 0000 9194 7179Department of Nuclear Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Marion Mickler
- grid.411941.80000 0000 9194 7179Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Konstantin Drexler
- grid.411941.80000 0000 9194 7179Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Florian Bitterer
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Laura Cordero
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Lukas Beyer
- grid.411941.80000 0000 9194 7179Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Christian Bach
- grid.411668.c0000 0000 9935 6525Department of Medicine V, University Hospital Erlangen, Erlangen, Germany
| | - Josef Koestler
- grid.411941.80000 0000 9194 7179Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Ralph Burkhardt
- grid.411941.80000 0000 9194 7179Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Hans J. Schlitt
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Dirk Hellwig
- grid.411941.80000 0000 9194 7179Department of Nuclear Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Jens M. Werner
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Rainer Spang
- grid.7727.50000 0001 2190 5763Institute of Functional Genomics and Statistical Bioinformatics, University of Regensburg, Regensburg, Germany
| | - Barbara Schmidt
- grid.411941.80000 0000 9194 7179Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Edward K. Geissler
- grid.411941.80000 0000 9194 7179Department of Surgery, University Hospital Regensburg, Regensburg, Germany ,Personalised Tumour Therapy, Fraunhofer Institute for Experimental Medicine and Toxicology, Regensburg, Germany
| | - Sebastian Haferkamp
- grid.411941.80000 0000 9194 7179Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
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O'Keefe R, Lariviere M, Vachani C, Hampshire M, Bach C, Arnold-Korzeniowski K, Healy M, Metz J, Hill-Kayser C. FP09.04 Association Between Family History and Other Risk Factors for Lung Cancer: Analysis of an Internet-Based Risk Assessment. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.121] [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: 11/15/2022]
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Mougiakakos D, Bach C, Böttcher M, Beier F, Röhner L, Stoll A, Rehli M, Gebhard C, Lischer C, Eberhardt M, Vera J, Büttner-Herold M, Bitterer K, Balzer H, Leffler M, Jitschin S, Hundemer M, Awwad MHS, Busch M, Stenger S, Völkl S, Schütz C, Krönke J, Mackensen A, Bruns H. The IKZF1-IRF4/IRF5 Axis Controls Polarization of Myeloma-Associated Macrophages. Cancer Immunol Res 2021; 9:265-278. [PMID: 33563611 DOI: 10.1158/2326-6066.cir-20-0555] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/03/2020] [Accepted: 01/20/2021] [Indexed: 11/16/2022]
Abstract
The bone marrow niche has a pivotal role in progression, survival, and drug resistance of multiple myeloma cells. Therefore, it is important to develop means for targeting the multiple myeloma bone marrow microenvironment. Myeloma-associated macrophages (MAM) in the bone marrow niche are M2 like. They provide nurturing signals to multiple myeloma cells and promote immune escape. Reprogramming M2-like macrophages toward a tumoricidal M1 phenotype represents an intriguing therapeutic strategy. This is especially interesting in view of the successful use of mAbs against multiple myeloma cells, as these therapies hold the potential to trigger macrophage-mediated phagocytosis and cytotoxicity. In this study, we observed that MAMs derived from patients treated with the immunomodulatory drug (IMiD) lenalidomide skewed phenotypically and functionally toward an M1 phenotype. Lenalidomide is known to exert its beneficial effects by modulating the CRBN-CRL4 E3 ligase to ubiquitinate and degrade the transcription factor IKAROS family zinc finger 1 (IKZF1). In M2-like MAMs, we observed enhanced IKZF1 levels that vanished through treatment with lenalidomide, yielding MAMs with a bioenergetic profile, T-cell stimulatory properties, and loss of tumor-promoting capabilities that resemble M1 cells. We also provide evidence that IMiDs interfere epigenetically, via degradation of IKZF1, with IFN regulatory factors 4 and 5, which in turn alters the balance of M1/M2 polarization. We validated our observations in vivo using the CrbnI391V mouse model that recapitulates the IMiD-triggered IKZF1 degradation. These data show a role for IKZF1 in macrophage polarization and can provide explanations for the clinical benefits observed when combining IMiDs with therapeutic antibodies.See related Spotlight on p. 254.
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Affiliation(s)
- Dimitrios Mougiakakos
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian Bach
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Böttcher
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Fabian Beier
- Department of Oncology, Hematology and Stem Cell Transplantation, RWTH Medical School, Aachen, Germany
| | - Linda Röhner
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
| | - Andrej Stoll
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Rehli
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Claudia Gebhard
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Christopher Lischer
- Department of Dermatology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Eberhardt
- Department of Dermatology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Julio Vera
- Department of Dermatology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Katrin Bitterer
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heidi Balzer
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Magdalena Leffler
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Simon Jitschin
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Hundemer
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Mohamed H S Awwad
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Martin Busch
- Institute for Medical Microbiology and Hygiene, University Hospital Ulm, Ulm, Germany
| | - Steffen Stenger
- Institute for Medical Microbiology and Hygiene, University Hospital Ulm, Ulm, Germany
| | - Simon Völkl
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Jan Krönke
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.,Charite Berlin Hematology Department at Campus Benjamin Franklin, Berlin, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heiko Bruns
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Harke NN, Radtke JP, Hadaschik BA, Bach C, Berger FP, Blana A, Borgmann H, Distler FA, Edeling S, Egner T, Engels CL, Farzat M, Haese A, Hein R, Kuczyk MA, Manseck A, Moritz R, Musch M, Peters I, Pokupic S, Rocco B, Schneider A, Schumann A, Schwentner C, Sighinolfi CM, Buse S, Stolzenburg JU, Truß MC, Waldner M, Wülfing C, Zimmermanns V, Witt JH, Wagner C. To defer or not to defer? A German longitudinal multicentric assessment of clinical practice in urology during the COVID-19 pandemic. PLoS One 2020; 15:e0239027. [PMID: 32931510 PMCID: PMC7491711 DOI: 10.1371/journal.pone.0239027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/30/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction After the outbreak of COVID-19 unprecedented changes in the healthcare systems worldwide were necessary resulting in a reduction of urological capacities with postponements of consultations and surgeries. Material and methods An email was sent to 66 urological hospitals with focus on robotic surgery (RS) including a link to a questionnaire (e.g. bed/staff capacity, surgical caseload, protection measures during RS) that covered three time points: a representative baseline week prior to COVID-19, the week of March 16th-22nd and April 20th-26th 2020. The results were evaluated using descriptive analyses. Results 27 out of 66 questionnaires were analyzed (response rate: 41%). We found a decrease of 11% in hospital beds and 25% in OR capacity with equal reductions for endourological, open and robotic procedures. Primary surgical treatment of urolithiasis and benign prostate syndrome (BPS) but also of testicular and penile cancer dropped by at least 50% while the decrease of surgeries for prostate, renal and urothelial cancer (TUR-B and cystectomies) ranged from 15 to 37%. The use of personal protection equipment (PPE), screening of staff and patients and protection during RS was unevenly distributed in the different centers–however, the number of COVID-19 patients and urologists did not reach double digits. Conclusion The German urological landscape has changed since the outbreak of COVID-19 with a significant shift of high priority surgeries but also continuation of elective surgical treatments. While screening and staff protection is employed heterogeneously, the number of infected German urologists stays low.
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Affiliation(s)
- Nina N Harke
- Department of Urology and Urologic Oncology, Hanover Medical School, Hanover, Germany
| | - Jan P Radtke
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | | | - Christian Bach
- Department of Urology, RWTH Aachen University, Aachen, Germany
| | - Frank P Berger
- Department of Urology, University of Jena, Jena, Germany
| | - Andreas Blana
- Department of Urology, Fürth Hospital, Fürth, Germany
| | - Hendrik Borgmann
- Department of Urology, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Florian A Distler
- Department of Urology, Paracelsus Medical University, Nuremberg, Germany
| | | | - Tobias Egner
- Department of Urology, Klinikum Würzburg Mitte, Würzburg, Germany
| | | | - Mahmoud Farzat
- Department of Urology, Diakonie Klinikum, Siegen, Germany
| | - Alexander Haese
- Martini-Klinik Prostate Cancer Center, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Hein
- Department of Urology, Klinikum Magdeburg, Magdeburg, Germany
| | - Markus A Kuczyk
- Department of Urology and Urologic Oncology, Hanover Medical School, Hanover, Germany
| | - Andreas Manseck
- Department of Urology, Klinikum Ingolstadt, Ingolstadt, Germany
| | - Rudolf Moritz
- Department of Urology, Marien Hospital, Ruhr-University Bochum, Herne, Germany
| | - Michael Musch
- Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Inga Peters
- Department of Urology and Urologic Oncology, Hanover Medical School, Hanover, Germany
| | - Sasa Pokupic
- Department of Urology, Asklepios Klinikum Harburg, Hamburg, Germany
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Andreas Schneider
- Department of Urology, Main-Kinzig-Kliniken Standort Gelnhausen, Gelnhausen, Germany
| | - André Schumann
- Department of Urology and Kidney Transplantation, Martin Luther University, Halle (Saale), Germany
| | | | - Chiara M Sighinolfi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephan Buse
- Department of Urology and Urologic Oncology, Alfried Krupp Krankenhaus, Essen, Germany
| | | | - Michael C Truß
- Department of Urology, Klinikum Dortmund, Dortmund, Germany
| | - Michael Waldner
- Department of Urology, St. Elisabeth Krankenhaus Köln-Hohenlind, Köln, Germany
| | | | | | - Jörn H Witt
- Department of Urology, Pediatric Urology and Urologic Oncology, Prostate Center Northwest, St. Antonius Hospital Gronau, Gronau, Germany
| | - Christian Wagner
- Department of Urology, Pediatric Urology and Urologic Oncology, Prostate Center Northwest, St. Antonius Hospital Gronau, Gronau, Germany
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Wollenhaupt J, Strothmeyer H, Fiene M, Morys S, Bach C, Roemmler-Zehrer J. FRI0365 REAL-WORLD EFFECTIVENESS AND SAFETY OF APREMILAST IN A LARGE COHORT OF GERMAN PATIENTS WITH PSORIATIC ARTHRITIS: 1-YEAR ANALYSIS OF AN ONGOING MULTICENTER, PROSPECTIVE, NON-INTERVENTIONAL STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Apremilast (APR) has been studied extensively in phase III randomized, controlled trials. However, real-world information is limited on the effectiveness and safety of APR in patients with psoriatic arthritis (PsA).Objectives:To assess the effectiveness and safety of APR in a large cohort of patients with active PsA from routine clinical practice settings in Germany.Methods:In this multicenter, prospective, non-interventional study, the primary endpoint was the proportion of patients reaching ≥1 point (≥20%) improvement from baseline (BL) in the Physician’s Global Assessment of Disease Activity (PhGA) score. Other endpoints included effects on swollen and tender joint counts (SJC/TJC), psoriasis-involved body surface area (BSA), enthesitis, dactylitis, Patient’s Global Assessment of Disease Activity score (PtGA), Psoriatic Arthritis Impact of Disease (PsAID) tool, pain, and pruritus. The current analysis is based on observed data through 1 year of study duration.Results:A total of 545 German patients were enrolled and followed up to 12 months of APR treatment; 488 patients were included in the safety analysis and 418 in the full analysis set. The mean age was 55 years, mean body mass index was 29.5 kg/m2, and 60% were female. The mean duration of psoriasis and PsA was 26 years and 18 years, respectively. At BL, 46.7% of patients had enthesitis based on the Leeds Enthesitis Index (LEI; mean [SD]: 2.9 [1.72]) and 23% had dactylitis (mean [SD]: 2.2±2.03); 74% of patients were biologic-naive. Effectiveness is shown after ~1 month (Visit 1 [V1]) and ~4 months (Visit 2 [V2]) and for up to 225 patients after 12 months (Visit 5 [V5]) of treatment (Table).Improvements were also seen in PtGA, overall pain, and pruritus. A subanalysis suggests APR was associated with greater benefits in biologic-naive patients compared with patients who previously received biologic therapy. Observed safety and tolerability through V5 were consistent with the known overall safety profile of APR. Common adverse events in clinical trials were similar, with a lower incidence of diarrhea (11.1%), nausea (7.0%), headache (3.9%), and respiratory tract infection (0.8%).Conclusion:Data from this large, real-world cohort of patients with PsA show the effectiveness of APR. In patients with up to 12 months of follow-up, APR was associated with rapid and maintained improvements in physician-assessed and patient-reported outcomes. Safety and tolerability were consistent with the known profile of APR.Table.Effectiveness of APR TreatmentBL n=418*V1 n=326*V2 n=360*V5 n=214*≥1-point PhGA improvement, %NA56.277.286.4PhGA score, mean (95% CI)2.5 (2.4, 2.5)1.8 (1.7, 1.9)1.4 (1.3, 1.5)1.1 (1.0, 1.2)PhGA score=0-1, %NA34.360.877.0SJC mean improvement, % (95% CI)NA42.1 (34.7, 49.5)54.7 (45.4, 64.1)75.7 (65.5, 86.0)TJC mean improvement, % (95% CI)NA38.3 (27.2, 40.4)36.0 (23.8, 48.3)57.1 (41.1, 73.1)Psoriasis-involved BSA (%), mean (95% CI)10.0 (8.6, 11.4)7.7 (6.3, 9.1)4.7 (3.8, 5.7)2.4 (1.8, 2.9)Achievement of LEI=0†, %NA385058Achievement of dactylitis count=0†, %NA487188PsAID score, mean (95% CI)5.33 (5.12, 5.53)4.65 (4.41, 4.89)3.97 (3.73, 4.20)3.22 (2.94, 3.50)*Based on the number of patients with data available at the given visit; the n may vary for individual parameters at a given visit. †In patients affected at BL. CI=confidence interval; NA=not applicable.Disclosure of Interests:Jürgen Wollenhaupt Grant/research support from: Abbott, BMS, MSD, Pfizer, UCB – grant/research support, Consultant of: Abbott, BMS, MSD, Pfizer, UCB – consultant, Harald Strothmeyer: None declared, Michael Fiene: None declared, Stephan Morys Employee of: Amgen Inc. – employment; Celgene GmbH – employment at the time of study conduct, Christian Bach Employee of: Amgen Inc. – employment; Celgene GmbH – employment at the time of study conduct, Josefine Roemmler-Zehrer Employee of: Amgen Inc. – employment; Celgene GmbH – employment at the time of study conduct
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Bacquaert G, Bach C, Draper D, Peldschus S, Duddeck F. Positioning human body models for crashworthiness using model order reduction. Comput Methods Biomech Biomed Engin 2020; 23:734-743. [PMID: 32401046 DOI: 10.1080/10255842.2020.1763321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A new technique to accelerate the positioning of human body models (HBMs) by means of a dimensionality reduction of a database of precomputed simulations is presented. First, a set of important subspace deformation modes which are used to approximate the model's movements observed in the training simulations are computed. In the second step, a convex optimization problem is solved in order to obtain an optimal position of the human body model as described by the user. We apply the proposed method to a new reclined seating position of the Total Human Model for Safety (THUMS, v5).
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Affiliation(s)
- G Bacquaert
- BMW AG, Research and Innovation Centre, Munich, Germany.,École des Ponts ParisTech, Champs-sur-Marne, France
| | - C Bach
- BMW AG, Research and Innovation Centre, Munich, Germany.,Technical University of Munich, Munich, Germany
| | - D Draper
- BMW AG, Research and Innovation Centre, Munich, Germany.,Ludwig Maximilian University of Munich, Munich, Germany
| | - S Peldschus
- Ludwig Maximilian University of Munich, Munich, Germany
| | - F Duddeck
- Technical University of Munich, Munich, Germany.,Queen Mary University of London, London, UK
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20
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Voegeli TA, Frank E, Bach C, Nzeh C. Results after two years of follow up after intravesical thermochemotherapy with heated mitomycin 40 in patients with high-risk superficial bladder cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
512 Background: Standard management of high risk TCC is either BCG or radical cystectomy, alternative treatment options are limited. It is known that the anti-tumor effect of heated mitomycin is 10 fold higher than at room temperature, which is the standard of intravesical therapy. We herein report the first 2 year follow up (FU) after intravesical therapy with heated mitomycin in a cohort of patients with high risk superficial bladder cancer (TCC). Methods: Treatment was performed for 1 hour with machine bladder irrigation (COMBAT) which maintaines temperature of mitomycin (40 mg) exactly at 43 C. Patients underwent therapy with a 6 week course of weekly treatment and were than followed by cystoscopy every 3 month and if necessary biopsy. Results: We identified 62 patients out of a total group of 108 patients who met the inclusion criteria for high risk TCC according to the EAU Guidelines and who got the complete 6 courses of treatment. 2 were lost of follow up, 1 died due to cardiac problems and 1 from metastatic prostate carcinoma. The remaining 58 patients had a mean FU of 26 month (16-54 m) and included 20 non-responders to BCG. 48/58 patients had CIS or pT1 Tumors or both, 10 patients had pTa+CIS. There were 5 recurrences, all superficial stage pTa, one in the rigth ureter, all could be managed without cystectomy. 8 patients had progressive or recurrent CIS/pT1 or were progressive to pT2 after therapy and underwent cystectomy. Conclusions: In this high risk cohort of 58 patients with a high rate of BCG non-responders only 8 patients had to undergo cystectomy during a 2 year follow up. Intravesical therapy with heated mitomycin is safe and well tolerated and may be an additional alternative treatment before cystectomy is performed in high risk patients with high risk TCC or BCG non responders.
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Affiliation(s)
| | - Eric Frank
- Uniclinic RWTH Aachen, 52074 Aachen, Germany
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21
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Rose M, Bringezu S, Godfrey L, Fiedler D, Gaisa NT, Koch M, Bach C, Füssel S, Herr A, Hübner D, Ellinger J, Pfister D, Knüchel R, Wirth MP, Böhme M, Dahl E. ITIH5 and ECRG4 DNA Methylation Biomarker Test (EI-BLA) for Urine-Based Non-Invasive Detection of Bladder Cancer. Int J Mol Sci 2020; 21:ijms21031117. [PMID: 32046186 PMCID: PMC7036997 DOI: 10.3390/ijms21031117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 02/07/2023] Open
Abstract
Bladder cancer is one of the more common malignancies in humans and the most expensive tumor for treating in the Unites States (US) and Europe due to the need for lifelong surveillance. Non-invasive tests approved by the FDA have not been widely adopted in routine diagnosis so far. Therefore, we aimed to characterize the two putative tumor suppressor genes ECRG4 and ITIH5 as novel urinary DNA methylation biomarkers that are suitable for non-invasive detection of bladder cancer. While assessing the analytical performance, a spiking experiment was performed by determining the limit of RT112 tumor cell detection (range: 100-10,000 cells) in the urine of healthy donors in dependency of the processing protocols of the RWTH cBMB. Clinically, urine sediments of 474 patients were analyzed by using quantitative methylation-specific PCR (qMSP) and Methylation Sensitive Restriction Enzyme (MSRE) qPCR techniques. Overall, ECRG4-ITIH5 showed a sensitivity of 64% to 70% with a specificity ranging between 80% and 92%, i.e., discriminating healthy, benign lesions, and/or inflammatory diseases from bladder tumors. When comparing single biomarkers, ECRG4 achieved a sensitivity of 73%, which was increased by combination with the known biomarker candidate NID2 up to 76% at a specificity of 97%. Hence, ITIH5 and, in particular, ECRG4 might be promising candidates for further optimizing current bladder cancer biomarker panels and platforms.
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Affiliation(s)
- Michael Rose
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
- RWTH Centralized Biomaterial Bank (RWTH cBMB), Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
- Correspondence: (M.R.); (E.D.); Tel.: +49-241-808-9715 (M.R.); +49-241-808-8431 (E.D.); Fax: +49-241-808-2439 (M.R.); +49-241-808-2439 (E.D.)
| | - Sarah Bringezu
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - Laura Godfrey
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - David Fiedler
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - Nadine T. Gaisa
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - Maximilian Koch
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - Christian Bach
- Department of Urology, RWTH Aachen University, 52074 Aachen, Germany; (C.B.); (D.P.)
| | - Susanne Füssel
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (S.F.); (D.H.); (M.P.W.)
| | | | - Doreen Hübner
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (S.F.); (D.H.); (M.P.W.)
| | - Jörg Ellinger
- Department of Urology, University Hospital Bonn, 53105 Bonn, Germany;
| | - David Pfister
- Department of Urology, RWTH Aachen University, 52074 Aachen, Germany; (C.B.); (D.P.)
- Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Ruth Knüchel
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
| | - Manfred P. Wirth
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (S.F.); (D.H.); (M.P.W.)
| | - Manja Böhme
- Biotype GmbH, 01109 Dresden, Germany; (A.H.); (M.B.)
| | - Edgar Dahl
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.B.); (L.G.); (D.F.); (N.T.G.); (M.K.); (R.K.)
- RWTH Centralized Biomaterial Bank (RWTH cBMB), Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
- Correspondence: (M.R.); (E.D.); Tel.: +49-241-808-9715 (M.R.); +49-241-808-8431 (E.D.); Fax: +49-241-808-2439 (M.R.); +49-241-808-2439 (E.D.)
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Askar M, Madbouly A, Zhrebker L, Willis A, Kennedy S, Padros K, Rodriguez MB, Bach C, Spriewald B, Ameen R, Shemmari SA, Tarassi K, Tsirogianni A, Hamdy N, Mossallam G, Hönger G, Spinnler R, Fischer G, Fae I, Charlton R, Dunk A, Vayntrub TA, Halagan M, Osoegawa K, Fernández-Viña M. HLA Haplotypes In 250 Families: The Baylor Laboratory Results And A Perspective On A Core NGS Testing Model For The 17 th International HLA And Immunogenetics Workshop. Hum Immunol 2019; 80:897-905. [PMID: 31558329 DOI: 10.1016/j.humimm.2019.07.298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 01/05/2023]
Abstract
Since their inception, the International HLA & Immunogenetics Workshops (IHIW) served as a collaborative platform for exchange of specimens, reference materials, experiences and best practices. In this report we present a subset of the results of human leukocyte antigen (HLA) haplotypes in families tested by next generation sequencing (NGS) under the 17th IHIW. We characterized 961 haplotypes in 921 subjects belonging to 250 families from 8 countries (Argentina, Austria, Egypt, Jamaica, Germany, Greece, Kuwait, and Switzerland). These samples were tested in a single core laboratory in a high throughput fashion using 6 different reagents/software platforms. Families tested included patients evaluated clinically as transplant recipients (kidney and hematopoietic cell transplant) and their respective family members. We identified 486 HLA alleles at the following loci HLA-A, -B, -C, -DRB1, -DRB3, -DRB4, -DRB5, -DQA1, -DQB1, -DPA1, -DPB1 (77, 115, 68, 69, 10, 6, 4, 44, 31, 20 and 42 alleles, respectively). We also identified nine novel alleles with polymorphisms in coding regions. This approach of testing samples from multiple laboratories across the world in different stages of technology implementation in a single core laboratory may be useful for future international workshops. Although data presented may not be reflective of allele and haplotype frequencies in the countries to which the families belong, they represent an extensive collection of 3rd and 4th field resolution level 11-locus haplotype associations of 486 alleles identified in families from 8 countries.
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Affiliation(s)
- Medhat Askar
- Baylor University Medical Center, Dallas, TX, USA; Texas A&M Health Science Center College of Medicine, Bryan, TX, USA.
| | - Abeer Madbouly
- Bioinformatics Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | | | | | | | - Karin Padros
- Primer Centro Argentino de Immunogenetica (PRICAI), Fundacion Favaloro, CABA, Argentina
| | | | - Christian Bach
- Departments of Internal Medicine & Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Bernd Spriewald
- Departments of Internal Medicine & Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Reem Ameen
- Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | | | | | | | - Nayera Hamdy
- National Cancer Institute, Cairo University, Cairo, Egypt
| | | | - Gideon Hönger
- Transplantation Immunology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland; HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Regina Spinnler
- HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | | | - Ingrid Fae
- Medical University of Vienna, Vienna, Austria
| | - Ronald Charlton
- Caribbean Bone Marrow Registry, Plantation, FL, USA; Laboratory Consultants of Florida, Jacksonville, FL, USA
| | - Arthur Dunk
- Caribbean Bone Marrow Registry, Plantation, FL, USA
| | | | - Michael Halagan
- Bioinformatics Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | | | - Marcelo Fernández-Viña
- Stanford Blood Center, Palo Alto, CA, USA; Stanford University School of Medicine, Palo Alto, CA, USA
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Abstract
Pyeloplasty is one of the most common urological reconstructive interventions. Since the presentation of the first open pyeloplasty by Anderson and Hynes in 1949, the management of ureteropelvic junction obstruction has dramatically developed. The most immense progress was made in the 1990s with the introduction of laparoscopy. A multitude of new minimal surgical techniques have been introduced since then. In the last few years, the innovations were based on refinement of already-existing techniques and technology. With this aim, single-port surgery, three-dimensional vision for laparoscopy, robotic technology, and alternative techniques for creating the anastomosis-like fibrin glue have been introduced. This unsystematic review is timely, and the scientific interest is to present and discuss some of the latest advances in surgical techniques and different approaches for the intra- and post-operative management in pyeloplasty. To the best of our knowledge, this is the only review looking at the recent advances in urological surgical techniques for pyeloplasty during the last few years with a focus on new technology and surgical techniques.
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Affiliation(s)
- Mikolaj Mendrek
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
| | | | - Christian Bach
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
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Boscheinen JB, Thomann S, Knipe DM, DeLuca N, Schuler-Thurner B, Gross S, Dörrie J, Schaft N, Bach C, Rohrhofer A, Werner-Klein M, Schmidt B, Schuster P. Generation of an Oncolytic Herpes Simplex Virus 1 Expressing Human MelanA. Front Immunol 2019; 10:2. [PMID: 30723467 PMCID: PMC6349778 DOI: 10.3389/fimmu.2019.00002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/02/2019] [Indexed: 12/30/2022] Open
Abstract
Robust anti-tumor immunity requires innate as well as adaptive immune responses. We have shown that plasmacytoid dendritic cells develop killer cell-like activity in melanoma cell cocultures after exposure to the infectious but replication-deficient herpes simplex virus 1 (HSV-1) d106S. To combine this innate effect with an enhanced adaptive immune response, the gene encoding human MelanA/MART-1 was inserted into HSV-1 d106S via homologous recombination to increase direct expression of this tumor antigen. Infection of Vero cells using this recombinant virus confirmed MelanA expression by Western blotting, flow cytometry, and immunofluorescence. HSV-1 d106S-MelanA induced expression of the transgene in fibroblast and melanoma cell lines not naturally expressing MelanA. Infection of a melanoma cell line with CRISPR-Cas9-mediated knockout of MelanA confirmed de novo expression of the transgene in the viral context. Dependent on MelanA expression, infected fibroblast and melanoma cell lines induced degranulation of HLA-matched MelanA-specific CD8+ T cells, followed by killing of infected cells. To study infection of immune cells, we exposed peripheral blood mononuclear cells and in vitro-differentiated macrophages to the parental HSV-1 d106S, resulting in expression of the transgene GFP in CD11c+ cells and macrophages. These data provide evidence that the application of MelanA-encoding HSV-1 d106S could enhance adaptive immune responses and re-direct MelanA-specific CD8+ T cells to tumor lesions, which have escaped adaptive immune responses via downregulation of their tumor antigen. Hence, HSV-1 d106S-MelanA harbors the potential to induce innate immune responses in conjunction with adaptive anti-tumor responses by CD8+ T cells, which should be evaluated in further studies.
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Affiliation(s)
- Jan B Boscheinen
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sabrina Thomann
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - David M Knipe
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, United States
| | - Neal DeLuca
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Beatrice Schuler-Thurner
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stefanie Gross
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jan Dörrie
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Niels Schaft
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bach
- Lab for Immunogenetics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anette Rohrhofer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Melanie Werner-Klein
- Chair of Immunology, Regensburg Center for Interventional Immunology (RCI), University of Regensburg, Regensburg, Germany
| | - Barbara Schmidt
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Philipp Schuster
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
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Nazim SM, Fawzy M, Bach C, Ather MH. Multi-disciplinary and shared decision-making approach in the management of organ-confined prostate cancer. Arab J Urol 2018; 16:367-377. [PMID: 30534434 PMCID: PMC6277278 DOI: 10.1016/j.aju.2018.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/12/2018] [Accepted: 06/18/2018] [Indexed: 01/24/2023] Open
Abstract
Decision-making in the management of organ-confined prostate cancer is complex as it is based on multi-factorial considerations. It is complicated by a multitude of issues, which are related to the patient, treatment, disease, availability of equipment(s), expertise, and physicians. Combination of all these factors play a major role in the decision-making process and provide for an interactive decision-making preferably in the multi-disciplinary team (MDT) meeting. MDT decisions are comprehensive and are often based on all factors including patients' biological status, disease and its aggressiveness, and physician and centres' expertise. However, one important and often under rated factor is patient-related factors. There is considerable evidence that patients and physicians have different goals for treatment and physicians' understanding of their own patients' preferences is not accurate. Several patient-related key factors have been identified such as age, religious beliefs, sexual health, educational background, and cognitive impairment. We have focused on these areas and highlight some key factors that need to be taken considered whilst counselling a patient and understanding his choice of treatment, which might not always be match with the clinicians' recommendation.
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Key Words
- (EB)RT, (external beam) radiotherapy
- ADT, androgen-deprivation therapy
- AS, active surveillance
- CCI, Charlson Comorbidity Index
- Decision-making
- ECE, extracapsular extension
- MDT, multi-disciplinary team
- Multi-disciplinary team (MDT)
- NCCN, National Comprehensive Cancer Network
- Patients’ preferences
- Prostate cancer
- QoL, quality of life
- RCT, randomised controlled trial
- RP, radical prostatectomy
- mpMRI, multiparametric MRI
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Affiliation(s)
- Syed M. Nazim
- Department of Urology, Aga Khan University, Karachi, Pakistan
| | - Mohamed Fawzy
- Department of Urology, University Hospital Aachen, Aachen, Germany
| | - Christian Bach
- Department of Urology, University Hospital Aachen, Aachen, Germany
| | - M. Hammad Ather
- Department of Urology, Aga Khan University, Karachi, Pakistan
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Wright MR, Bach C, Gernaey KV, Krühne U. Investigation of the effect of uncertain growth kinetics on a CFD based model for the growth of S. cerevisiae in an industrial bioreactor. Chem Eng Res Des 2018. [DOI: 10.1016/j.cherd.2018.09.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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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Morinière S, Gorphe P, Espitalier F, Blanchard D, Fakhry N, Saroul N, Bach C, Dufour X, Fuchsmann C, Vergez S, Albert S. Assessment of swallowing function after circumferential pharyngolaryngectomy. A multicenter study by the GETTEC group. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:3-5. [PMID: 30482707 DOI: 10.1016/j.anorl.2018.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/28/2022]
Abstract
OBJECTIVE Circumferential pharyngolaryngectomy is performed for advanced pharyngeal tumor or in a context of postradiation recurrence. Several free or pedicle flaps have been described for pharyngeal defect reconstruction, with choice at the surgeon's discretion. The aim of this study was to evaluate long-term swallowing function according to the type of flap used for reconstruction. MATERIAL AND METHOD A multicenter retrospective study was conducted from January to September 2016 within the French GETTEC head and neck tumor study group. All patients in remission after circumferential pharyngolaryngectomy were included and filled out the Deglutition Handicap Index (DHI) questionnaire and underwent swallowing function fiberoptic endoscopy assessment. 46 patients (39 men, 7 women) were included. Reconstruction used a tubularized forearm free flap (FFF group) in 19 cases, pectoralis major myocutaneous flap (PMMF group) in 15 cases and free jejunum flap (FJF group) in 12 cases. RESULTS Mean DHI was 24: 20 in the FFF group, 23 in the FJF group and 25 in the PMMF group, without significant differences. 27 patients had normal swallowing, 9 mixed diet, 8 liquid diet and 3 were fed by gastrostomy. On endoscopy, free flaps (FJF and FFF) were associated with significantly greater rates of normal swallowing of saliva and yogurt than in the PMMF group (P=0.04). CONCLUSION Type of flap reconstruction after circumferential pharyngolaryngectomy had no significant impact on postoperative swallowing function assessed on the self-administered DHI questionnaire.
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Affiliation(s)
- S Morinière
- Service d'ORL et de CCF, CHU Bretonneau, 2 Bd Tonnellé, 37000 Tours, France.
| | - P Gorphe
- Service d'ORL et de CCF, IGR, 94800 Villejuif, France
| | - F Espitalier
- Service d'ORL et de CCF, CHU de Nantes, Nantes, France
| | - D Blanchard
- Service d'ORL et de CCF,CHU de Caen, Caen, France
| | - N Fakhry
- Service d'ORL et de CCF, CHU de Marseille, Marseille, France
| | - N Saroul
- Service d'ORL et de CCF, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Bach
- Service d'ORL et de CCF, Hôpital Foch, Paris, France
| | - X Dufour
- Service d'ORL et de CCF, CHU Poitiers, Poitiers, France
| | - C Fuchsmann
- Service d'ORL et de CCF, CHU Lyon, Lyon, France
| | - S Vergez
- Service d'ORL et de CCF, CHU Toulouse, Toulouse, France
| | - S Albert
- Service d'ORL et de CCF, CHU Bichat, 75877 Paris, France
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Arnold ML, Bach C, Spriewald B. Immunglobulin-A-Isotyp bei Anti-HLA-Antikörpern und Organüberleben von Patienten nach Nierentransplantation. Transfusionsmedizin 2018. [DOI: 10.1055/a-0637-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
ZusammenfassungAnti-Human-Leukocyte-Antigen-Antikörper (HLA-Ak) des Isotyps Immunglobulin A (IgA) erkennen ihr Zielantigen mit einer sehr hohen Affinität und Avidität. Eine systematische Erforschung des Einflusses von Anti-HLA-IgA-Antikörpern auf die Organabstoßung und den Organfunktionsverlust nach Organtransplantation hat gerade erst begonnen. Anhand der hier vorgestellten Arbeit soll gezeigt werden, dass neben der bekannten Beteiligung von Anti-HLA-Immunglobulin G (IgG) auch Anti-HLA-IgA eine Rolle bei der Organabstoßung spielen könnte. Im Rahmen der Studie wurden Seren von 276 Patienten untersucht. Alle Patienten hatten bereits mindestens eine Nierentransplantation bekommen und wurden aufgrund eines Funktionsverlusts des transplantierten Organs wieder dialysepflichtig. Als Messparameter für das Organüberleben wurde die in Monaten gemessene Dauer zwischen erfolgter Nierentransplantation und erneuter Dialyse nach Transplantation („Time to Dialysis“, TtD, Median) herangezogen. Die Testung des Ak-Profils der Patientenseren für die Isotpyen IgG und IgA wurde mittels Luminex-basierter Methode durchgeführt. Von den 276 getesteten Seren waren 89 Ak-positiv für Anti-HLA-IgA und 243 positiv für Anti-HLA-IgG. Es wurde eine starke Korrelation der beiden untersuchten Isotypen beobachtet (p < 0,0001). 86 von 89 der Anti-HLA-IgA-positiven Seren waren ebenfalls IgG-positiv. Wie erwartet hatten Patienten ohne Anti-HLA-Ak das längste Organüberleben (TtD 127 Monate). Patienten mit ausschließlich Anti-HLA-IgG zeigten im Vergleich dazu ein verringertes mittleres Organüberleben (TtD 116 Monate). Interessanterweise wurde ein signifikant verringertes Organüberleben bei IgA- und IgG-Ak doppelt positiven Patienten (TtD 88 Monate, p < 0,001) beobachtet. Nur 3 Patienten zeigten ausschließlich IgA-Ak, eine statistische Auswertung der TtD-Zeit ist hier nicht möglich. In einer früheren Studie mit 694 Patienten konnte bereits gezeigt werden, dass bei Patienten mit Anti-HLA-IgA-Ak, die spezifisch gegen das Spenderorgan gerichtet waren, das Organüberleben deutlich auf 76 Monate verringert war – wogegen Patienten mit nicht spenderspezifischen Anti-HLA-IgA-Ak im Median erst nach 82 Monaten wieder dialysepflichtig wurden. Die gleichzeitige Anwesenheit von Anti-HLA-IgA- und Anti-HLA-IgG-Ak im Serum von Patienten nach Nierentransplantation stellt eine hohe Risikoprognose für ein mögliches Organversagen dar. Dies zeigte sich in einer signifikant kürzeren Organüberlebenszeit verglichen mit transplantierten Patienten, bei denen lediglich Anti-HLA-IgG-Ak nachgewiesen wurden. Diese Daten deuten darauf hin, dass die – momentan nicht routinemäßig durchgeführte – Testung von Anti-HLA-IgA als neuer Parameter für eine bessere Risikostratifizierung sowohl vor als auch nach Nierentransplantation dienen könnte.
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Affiliation(s)
- Marie-Luise Arnold
- Klinik für Innere Medizin 3 – Rheumatologie und Immunologie, Universitätsklinik Erlangen, Erlangen-Nürnberg
| | - Christian Bach
- Klinik für Innere Medizin 5 – Hämatologie and Onkologie, Universitätsklinik Erlangen, Erlangen-Nürnberg
| | - Bernd Spriewald
- Klinik für Innere Medizin 5 – Hämatologie and Onkologie, Universitätsklinik Erlangen, Erlangen-Nürnberg
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Mendrek M, Bach C, Gaisa NT, Vögeli TA. Leiomyoma arising from the right seminal duct/seminal vesicle-Report of a rare case and review of the literature. Andrologia 2018; 51:e13174. [PMID: 30318835 DOI: 10.1111/and.13174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/21/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022] Open
Abstract
We present a case of a patient with a large, symptomatic abdominal tumour, which finally could be classified as a leiomyoma arising from the right seminal duct/seminal vesicle. In computed tomography (CT) scan, it appeared as a 7.5 × 6.5 cm solid, supravesical mass. A cystoscopy as well as bilateral retrograde studies was normal, a transrectal ultrasound-guided biopsy and an ultrasound-guided transabdominal biopsy of the mass were inconclusive. Subsequently, we performed a tumour extirpation through a lower midline laparotomy. Histological examination showed a leiomyoma arising from the right seminal duct or seminal vesicle. In this article, we discuss clinical presentation, findings on imaging and management of this rare benign tumour and review the relevant literature where only 13 similar cases could be identified.
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Affiliation(s)
- Mikolaj Mendrek
- Department of Urology, Medical University of Aachen, Aachen, Germany
| | - Christian Bach
- Department of Urology, Medical University of Aachen, Aachen, Germany
| | - Nadine T Gaisa
- Department of Pathology, Medical University of Aachen, Aachen, Germany
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Reinhardt N, Dietz-Laursonn K, Janzen M, Radermacher K, Bach C, Radermacher K, Fuente MDL. Experimental setup for evaluation of cavitation effects in ESWL. Current Directions in Biomedical Engineering 2018. [DOI: 10.1515/cdbme-2018-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractCavitation is a major fracture mechanism in extracorporeal shock wave lithotripsy (ESWL). However, it can cause tissue trauma and its effects on kidney stones and surrounding tissue are not fully understood. Therefore experimental setups enabling systematic parameter studies are crucial. We developed and evaluated a testing rig comprising three measuring methods in order to examine this mechanism. Our initial evaluation of this setup based on standard components showed promising results. Primary cavitation was displayed by high-speed photography 195 μs after the shock front had passed the focal zone. The effect of different pulse repetition rates (30, 60, 90, 120 SW/min) on the extension of the cavitation area was determined. The lifetime of secondary cavitation was analysed by B-mode ultrasound imaging. In a post processing progress the images showing bubbles were compared to a reference picture for both types of cavitation and the number of pixels that changed colour was counted. Furthermore stone comminution at different pulse repetition rates (30, 60, 90, 120 SW/min) was investigated by fixed-dose fragmentation. We observed an inverse correlation of cavitation and fragmentation. As the pulse repetition rate increases, the area of primary cavitation grows whereas the fragmentation efficiency decreases. B-mode imaging showed that secondary cavitation bubbles persisted between the shocks and can serve as nuclei. The higher the pulse repetition rate is, the more of these nuclei remain and thus facilitate formation of primary cavitation. The experimental setup provides reproducible results regarding the development of primary and secondary cavitation on the one hand and the fragmentation of phantom stones on the other hand. Therefore it can be utilized to further investigate the effect of different boundary conditions and shock wave parameters on cavitation and stone comminution. The impact of different focal sound fields is subject of ongoing research.
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Affiliation(s)
- Nina Reinhardt
- 1Chair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, Pauwelsstr. 20,Aachen, Germany
| | - Kristin Dietz-Laursonn
- 2Chair of Medical Engineering, Helmholtz- Institute for Biomedical Engineering,Aachen, Germany
| | - Marc Janzen
- 2Chair of Medical Engineering, Helmholtz- Institute for Biomedical Engineering,Aachen, Germany
| | - Klaus Radermacher
- 2Chair of Medical Engineering, Helmholtz- Institute for Biomedical Engineering,Aachen, Germany
| | - Christian Bach
- 3University Hospital Aachen, Department of Urology,Aachen, Germany
| | - Klaus Radermacher
- 2Chair of Medical Engineering, Helmholtz- Institute for Biomedical Engineering,Aachen, Germany
| | - Matias de la Fuente
- 2Chair of Medical Engineering, Helmholtz- Institute for Biomedical Engineering,Aachen, Germany
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31
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Geelvink M, Babmorad A, Maurer A, Stöhr R, Grimm T, Bach C, Knuechel R, Rose M, Gaisa NT. Diagnostic and Prognostic Implications of FGFR3 high/Ki67 high Papillary Bladder Cancers. Int J Mol Sci 2018; 19:E2548. [PMID: 30154342 PMCID: PMC6163244 DOI: 10.3390/ijms19092548] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/19/2018] [Accepted: 08/24/2018] [Indexed: 01/22/2023] Open
Abstract
Prognostic/therapeutic stratification of papillary urothelial cancers is solely based upon histology, despite activated FGFR3-signaling was found to be associated with low grade tumors and favorable outcome. However, there are FGFR3-overexpressing tumors showing high proliferation-a paradox of coexisting favorable and adverse features. Therefore, our study aimed to decipher the relevance of FGFR3-overexpression/proliferation for histopathological grading and risk stratification. N = 142 (n = 82 pTa, n = 42 pT1, n = 18 pT2-4) morphologically G1⁻G3 tumors were analyzed for immunohistochemical expression of FGFR3 and Ki67. Mutation analysis of FGFR3 and TP53 and FISH for FGFR3 amplification and rearrangement was performed. SPSS 23.0 was used for statistical analysis. Overall FGFR3high/Ki67high status (n = 58) resulted in a reduced ∆mean progression-free survival (PFS) (p < 0.01) of 63.92 months, and shorter progression-free survival (p < 0.01; mean PFS: 55.89 months) in pTa tumors (n = 50). FGFR3mut/TP53mut double mutations led to a reduced ∆mean PFS (p < 0.01) of 80.30 months in all tumors, and FGFR3mut/TP53mut pTa tumors presented a dramatically reduced PFS (p < 0.001; mean PFS: 5.00 months). Our results identified FGFR3high/Ki67high papillary pTa tumors as a subgroup with poor prognosis and encourage histological grading as high grade tumors. Tumor grading should possibly be augmented by immunohistochemical stainings and suitable clinical surveillance by endoscopy should be performed.
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MESH Headings
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/metabolism
- Carcinoma, Papillary/mortality
- Female
- Humans
- Immunohistochemistry
- Ki-67 Antigen/genetics
- Ki-67 Antigen/metabolism
- Male
- Middle Aged
- Mutation
- Neoplasm Grading
- Neoplasm Staging
- Prognosis
- Proportional Hazards Models
- Receptor, Fibroblast Growth Factor, Type 3/genetics
- Receptor, Fibroblast Growth Factor, Type 3/metabolism
- Signal Transduction
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
- Urinary Bladder Neoplasms/diagnosis
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/metabolism
- Urinary Bladder Neoplasms/mortality
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Affiliation(s)
- Mirja Geelvink
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Armin Babmorad
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Angela Maurer
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Robert Stöhr
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Tobias Grimm
- Department of Urology, Ludwig Maximilian University Munich, 81377 Munich, Germany.
| | - Christian Bach
- Department of Urology, RWTH Aachen University, 52074 Aachen, Germany.
| | - Ruth Knuechel
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Michael Rose
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
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Affiliation(s)
- Noor N P Buchholz
- Sobeh's Vascular and Medical Center (SVMC), DHCC Building 73, Dubai 505008, United Arab Emirates.,University Hospital RWTH Aachen, Aachen, Germany
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Spriewald BM, Bach C, Zingsem J, Strobel J, Winkler J, Mackensen A, Roesler W. Depletion of donor-specific anti-HLA A2 alloantibodies in a hematopoietic cell transplant recipient using directed mismatched platelet transfusions. Bone Marrow Transplant 2018; 53:791-794. [PMID: 29795430 PMCID: PMC6006140 DOI: 10.1038/s41409-018-0220-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/23/2018] [Accepted: 03/23/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Bernd M Spriewald
- Department of Internal Medicine 5, Hematology/Oncology, University Hospital Erlangen, Erlangen, Germany.
| | - Christian Bach
- Department of Internal Medicine 5, Hematology/Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Juergen Zingsem
- Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Erlangen, Germany
| | - Julian Strobel
- Department of Transfusion Medicine and Hemostaseology, University Hospital Erlangen, Erlangen, Germany
| | - Julia Winkler
- Department of Internal Medicine 5, Hematology/Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, Hematology/Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Wolf Roesler
- Department of Internal Medicine 5, Hematology/Oncology, University Hospital Erlangen, Erlangen, Germany
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Arnold ML, Bach C, Heinemann FM, Horn PA, Ziemann M, Lachmann N, Mühlbacher A, Dick A, Ender A, Thammanichanond D, Schaub S, Hönger G, Fischer GF, Mytilineos J, Hallensleben M, Hitzler WE, Seidl C, Spriewald BM. Anti-HLA alloantibodies of the IgA isotype in re-transplant candidates part II: Correlation with graft survival. Int J Immunogenet 2018; 45:95-101. [PMID: 29575597 DOI: 10.1111/iji.12363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/29/2018] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
We reported previously on the widespread occurrence of anti-HLA alloantibodies of the IgA isotype (anti-HLA IgA) in the sera of solid-organ re-transplantation (re-tx) candidates (Arnold et al., ). Specifically focussing on kidney re-tx patients, we now extended our earlier findings by examining the impact of the presence and donor specificity of anti-HLA IgA on graft survival. We observed frequent concurrence of anti-HLA IgA and anti-HLA IgG in 27% of our multicenter collective of 694 kidney re-tx patients. This subgroup displayed significantly reduced graft survival as evidenced by the median time to first dialysis after transplantation (TTD 77 months) compared to patients carrying either anti-HLA IgG or IgA (TTD 102 and 94 months, respectively). In addition, donor specificity of anti-HLA IgA had a significant negative impact on graft survival (TTD 74 months) in our study. Taken together, our data strongly indicate that presence of anti-HLA IgA, in particular in conjunction with anti-HLA-IgG, in sera of kidney re-tx patients is associated with negative transplantation outcome.
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Affiliation(s)
- M-L Arnold
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - C Bach
- Department of Internal Medicine 5 - Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - F M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - P A Horn
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - M Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck- Kiel, Germany
| | - N Lachmann
- HLA Laboratory, Center for Tumor Medicine, Charité, Berlin, Germany
| | - A Mühlbacher
- Central Institute for Blood Transfusion and Immunology, General Hospital and University Clinics, Innsbruck, Austria
| | - A Dick
- Laboratory for Immunogenetics, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - A Ender
- Central Institute for Transfusion Medicine and Blood Donation, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - D Thammanichanond
- Histocompatibility and Immunogenetics Laboratory, Department of Pathology, Mahidol University Bangkok, Bangkok, Thailand
| | - S Schaub
- HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, Transplantation Immunology & Nephrology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - G Hönger
- Transplantation Immunology and Nephrology, Department of Biomedicine, University Basel, Basel, Switzerland
| | - G F Fischer
- Department for Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria
| | - J Mytilineos
- Institute of Clinical Transfusion Medicine and Immunogenetics, University Hospital of Ulm, Ulm, Germany
| | - M Hallensleben
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - W E Hitzler
- Transfusion Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - C Seidl
- German Red Cross Blood Donor Service, Institute for Transfusion Medicine and Immunohaematology, Frankfurt, Germany
| | - B M Spriewald
- Department of Internal Medicine 5 - Hematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
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Voegeli TA, Frank E, Bach C, Nzeh C. Heat targeted drug delivery (COMBAT) in superficial TCC : First midterm results in a cohort of high-risk patients scheduled for cystectomy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
442 Background: Due to the suboptimal outcomes in recurrent superficial TCC over the last 30 years the search for new treatments continues. We report the first mid term results of a high risk cohort of heavily pretreated patients by a circulating device for intravesical thermochemotherapy.It is known that the effect of mitomycin increases at a temperature over 40 C. Methods: 58 patients with different failed methods of former intravesical therapy and recurrent TCC (21 intermediate risk and 37 high risk patients) were treated with the COMBAT device which facilitates irrigation of the bladder with mitomycin 40 mg at exactly 43 degree Celsius for 1 hour/6 courses weekly.Side effects were monitored prospectively and success of the treatment was controlled by ReTUR whenever possible and afterwards by 3 monthly cystoscopy and cytology. Results: 22 patients had dysuria during treatment and 9/58 suffered from hematuria but without intervention. In 6 cases urinary tract infection occured and 3 patients had allergic reaction. In one patient thermochemotherapy must be terminated due to pain and discomfort, no long term morbidity was recorded over the whole period. The FU was 14 month (3-29) for the entire cohort, 17 patients had a FU of over 2 years. One Patient had recurrent pTaGIII Tumor managed successfully by TUR. 2 patients underwent cystectomy because of invasive recurrence early after intravesical therapy, one patient developed bone metastasis 2 years after therapy without intravesical tumor. Conclusions: Thermochemotherapy with heated mitomycin is a well tolerated new option for patients with superficial TCC who are at high risk of recurrence or progression.The toxicity is acceptable and no long term morbidity was obeserved. The rate of cystectomies in this heavily pretreated group of patients including 18 BCG failures was very low with N= 2 respective 1,9%. Intravesical thermochemotherapy seems to be a new therapeutic bladder preserving option in high risk patients with superficial TCC. It is of note that thermochemotherapy has now been included in the European Guidelines.
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Affiliation(s)
| | - Eric Frank
- Uniclinic RWTH Aachen, 52074 Aachen, Germany
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Hutchinson JA, Riquelme P, Bach C, Kekarainen T, Fändrich F, Geissler EK, Ahrens N. Donor-specific Anti-HLA Antibodies Present in Pooled Human Serum Do Not Prevent Development of Human Mreg_UKR From Monocytes in Culture. Transplantation 2018; 101:e188-e190. [PMID: 28114172 DOI: 10.1097/tp.0000000000001652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- James A Hutchinson
- 1 Department of Experimental Surgery, University Hospital Regensburg, Regensburg, Germany. 2 Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Department of Internal Medicine 5-Laboratory for Immunogenetics, University Hospital Erlangen, Erlangen, Germany. 3 Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland. 4 FinVector Vision Therapies Oy, Microkatu 1S, Kuopio, Finland. 5 Clinic for Applied Cell Therapy, University Hospital of Schleswig-Holstein, Kiel, Germany. 6 Department of Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany
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Müller PF, Schlager D, Hein S, Bach C, Miernik A, Schoeb DS. Robotic stone surgery - Current state and future prospects: A systematic review. Arab J Urol 2017; 16:357-364. [PMID: 30140470 PMCID: PMC6104666 DOI: 10.1016/j.aju.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/19/2017] [Accepted: 09/27/2017] [Indexed: 12/23/2022] Open
Abstract
Objective To provide a comprehensive review of robot-assisted surgery in urolithiasis and to consider the future prospects of robotic approaches in stone surgery. Materials and methods We performed a systematic PubMed© literature search using predefined Medical Subject Headings search terms to identify PubMed-listed clinical research studies on robotic stone surgery. All authors screened the results for eligibility and two independent reviewers performed the data extraction. Results The most common approach in robotic stone surgery is a robot-assisted pyelolithotomy using the da Vinci™ system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Several studies show this technique to be comparable to classic laparoscopic and open surgical interventions. One study that focused on ureteric stones showed a similar result. In recent years, promising data on robotic intrarenal surgery have been reported (Roboflex Avicenna™; Elmed Medical Systems, Ankara, Turkey). Initial studies have shown its feasibility and high stone-free rates and prove that this novel endoscopic approach is safe for the patient and comfortable for the surgeon. Conclusions The benefits of robotic devices in stone surgery in existing endourological, laparoscopic, and open treatment strategies still need elucidation. Although recent data are promising, more prospective randomised controlled studies are necessary to clarify the impact of this technique on patient safety and stone-free rates.
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Affiliation(s)
- Philippe F Müller
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Daniel Schlager
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Simon Hein
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Christian Bach
- Department of Urology, University Hospital Aachen, Aachen, Germany
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
| | - Dominik S Schoeb
- Department of Urology, Faculty of Medicine, University of Freiburg, Medical Centre, Freiburg, Germany
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Bach C, Yang J, Larsson H, Stocks SM, Gernaey KV, Albaek MO, Krühne U. Evaluation of mixing and mass transfer in a stirred pilot scale bioreactor utilizing CFD. Chem Eng Sci 2017. [DOI: 10.1016/j.ces.2017.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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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Frick M, Vachani C, Hampshire M, Bach C, Arnold-Korzeniowski K, Metz J, Hill-Kayser C. Survivorship after Treatment of Pancreatic Cancer: Insights Via an Internet-Based Survivorship Care Plan Tool. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cip J, Widemschek M, Bach C, Ruckenstuhl P, Benesch T, Studer K, Martin A. Encouraging treatment algorithm for computer-assisted navigated total knee arthroplasty (TKA): A retrospective cohort analysis. J Orthop 2017; 14:377-383. [PMID: 28701852 DOI: 10.1016/j.jor.2017.06.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/22/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Navigated computer-assisted total knee arthroplasty (TKA) shows inconclusive mid- to long-term outcome results and is limited by increased costs, surgery-time and an additional learning curve. We introduced a treatment algorithm preserving computer-assisted TKA for patients with adipositas-per-magna, posttraumatic leg-deformities, osteosynthetic material in-situ or reduced preoperative X-ray quality. METHODS 237 primary unilateral TKA were allocated based on the treatment concept described above. A retrospective pre- and postoperative radiological analysis was performed. RESULTS 222 TKA (93.7%) were within 3° varus/valgus of mechanical-lower-limb axis (mean absolute deviation: 1.8° ± 1.3°). CONCLUSION This algorithm showed an excellent postoperative implantation-accuracy based on an accurate preoperative surgery-planning.
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Affiliation(s)
- J Cip
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Graz, Carinagasse 47, A-6800 Feldkirch, Austria
| | - M Widemschek
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Graz, Carinagasse 47, A-6800 Feldkirch, Austria
| | - C Bach
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Graz, Carinagasse 47, A-6800 Feldkirch, Austria
| | - P Ruckenstuhl
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036 Graz, Austria
| | | | - K Studer
- Department of Pediatric Orthopedic Surgery, Children's Hospital St. Gallen, Claudiusstrasse 6, CH-9006 St. Gallen, Switzerland
| | - A Martin
- Department of Traumatology, Academic Teaching Hospital Bregenz, Carl-Pedenz-Straße 2, A-6900 Bregenz, Austria
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Veeratterapillay R, Goonewardene SS, Barclay J, Persad R, Bach C. Radical prostatectomy for locally advanced and metastatic prostate cancer. Ann R Coll Surg Engl 2017; 99:259-264. [PMID: 28349755 DOI: 10.1308/rcsann.2017.0031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 12/28/2022] Open
Abstract
The management of advanced prostate cancer remains challenging. Traditionally, radical prostatectomy was discouraged in patients with locally advanced or node positive disease owing to the increased complication rate and treatment related morbidity. However, technical advances and refinements in surgical techniques have enabled the outcomes for patients with high risk prostate cancer to be improved. More recently, the concept of cytoreductive prostatectomy has been described where surgery (often Combined with an extended lymph node dissection) is performed in the setting of metastatic disease. Indirect evidence suggests an advantage using the cytoreductive approach. Hypothetical explanations for this observed benefit include decreased tumour burden, immune modulation, improved response to secondary treatment and avoidance of secondary complications attributable to local tumour growth. Nevertheless, prospective trials are required to investigate this further.
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Affiliation(s)
| | | | - J Barclay
- Newcastle upon Tyne Hospitals NHS Foundation Trust , UK
| | | | - C Bach
- Newcastle upon Tyne Hospitals NHS Foundation Trust , UK
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Zecher D, Bach C, Staudner C, Böger CA, Bergler T, Banas B, Spriewald BM. Characteristics of donor-specific anti-HLA antibodies and outcome in renal transplant patients treated with a standardized induction regimen. Nephrol Dial Transplant 2017; 32:730-737. [DOI: 10.1093/ndt/gfw445] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/28/2016] [Indexed: 11/13/2022] Open
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Abstract
Bladder cancer is the second commonest urinary tract malignancy with 70–80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80–90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.
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Affiliation(s)
- Rajan Veeratterapillay
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE77DN, UK
| | - Rakesh Heer
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE77DN, UK.
| | - Mark I Johnson
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE77DN, UK
| | - Raj Persad
- Bristol Urology Institute, Southmead Hospital, Bristol, UK
| | - Christian Bach
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE77DN, UK
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Chanu T, Neuzillet Y, Butreau M, Bach C, Rouanne M, Lebret T. [Predictive factors and prognostic consequences of perioperative complications of radical cystectomies for urothelial carcinoma in patients of 80 years or more]. Prog Urol 2016; 26:331-8. [PMID: 27209221 DOI: 10.1016/j.purol.2016.04.006] [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] [Received: 12/14/2015] [Revised: 03/18/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To define the predictive factors and the prognostic consequences of perioperative complications occurrence while radical cystectomies for urothelial carcinoma treatment in patients older than 80 years. MATERIAL AND METHOD Retrospective analysis of clinical and biological preoperative data and outcome of eighty patients of 80 years or more, treated with radical cystectomy between 1990 and 2010 in one centre. Perioperative complications were graded according to the classification from Clavien-Dindo. RESULTS Twenty-eight patients (35%) had a single perioperative complication and nineteen (24%) had multiple (≥2) perioperative complications. Overall survival of patients with multiple perioperative complications was significantly lower than that of patients who had no complications (Log-rank P=0.0004). The occurrence of multiple perioperative complications was associated with Charlson and ASA scores, with pelvic irradiation and induction chemotherapy histories. However, in multivariate analysis, only the existence of respiratory comorbidity was an independent risk factor for the occurrence of multiple perioperative complications. CONCLUSIONS The occurrence of multiple perioperative complications was associated with reduced overall survival in elderly patients after radical cystectomy. The existence of respiratory comorbidity was the only independent risk factor for the occurrence of multiple perioperative complications. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- T Chanu
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France
| | - Y Neuzillet
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
| | - M Butreau
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France
| | - C Bach
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France
| | - M Rouanne
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France
| | - T Lebret
- Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France
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Affiliation(s)
- Christian Bach
- a Department of Biomedical Engineering , University of Bridgeport , CT , USA
| | - Prabir Patra
- a Department of Biomedical Engineering , University of Bridgeport , CT , USA
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Jeanbille M, Buée M, Bach C, Cébron A, Frey-Klett P, Turpault MP, Uroz S. Soil Parameters Drive the Structure, Diversity and Metabolic Potentials of the Bacterial Communities Across Temperate Beech Forest Soil Sequences. Microb Ecol 2016; 71:482-93. [PMID: 26370112 DOI: 10.1007/s00248-015-0669-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/28/2015] [Indexed: 05/20/2023]
Abstract
Soil and climatic conditions as well as land cover and land management have been shown to strongly impact the structure and diversity of the soil bacterial communities. Here, we addressed under a same land cover the potential effect of the edaphic parameters on the soil bacterial communities, excluding potential confounding factors as climate. To do this, we characterized two natural soil sequences occurring in the Montiers experimental site. Spatially distant soil samples were collected below Fagus sylvatica tree stands to assess the effect of soil sequences on the edaphic parameters, as well as the structure and diversity of the bacterial communities. Soil analyses revealed that the two soil sequences were characterized by higher pH and calcium and magnesium contents in the lower plots. Metabolic assays based on Biolog Ecoplates highlighted higher intensity and richness in usable carbon substrates in the lower plots than in the middle and upper plots, although no significant differences occurred in the abundance of bacterial and fungal communities along the soil sequences as assessed using quantitative PCR. Pyrosequencing analysis of 16S ribosomal RNA (rRNA) gene amplicons revealed that Proteobacteria, Acidobacteria and Bacteroidetes were the most abundantly represented phyla. Acidobacteria, Proteobacteria and Chlamydiae were significantly enriched in the most acidic and nutrient-poor soils compared to the Bacteroidetes, which were significantly enriched in the soils presenting the higher pH and nutrient contents. Interestingly, aluminium, nitrogen, calcium, nutrient availability and pH appeared to be the best predictors of the bacterial community structures along the soil sequences.
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Affiliation(s)
- M Jeanbille
- INRA, UMR1136 Interactions Arbres-Microorganismes, Champenoux, 54280, France
- Université de Lorraine, UMR1136 Interactions Arbres-Microorganismes, Vandoeuvre-lès-Nancy, 54500, France
| | - M Buée
- INRA, UMR1136 Interactions Arbres-Microorganismes, Champenoux, 54280, France
- Université de Lorraine, UMR1136 Interactions Arbres-Microorganismes, Vandoeuvre-lès-Nancy, 54500, France
| | - C Bach
- INRA, UMR1136 Interactions Arbres-Microorganismes, Champenoux, 54280, France
| | - A Cébron
- INRA UR 1138 "Biogéochimie des Ecosystèmes Forestiers", Centre INRA de Nancy, Champenoux, France
- CNRS, LIEC UMR7360 Faculté des Sciences et Technologies, Vandoeuvre-les-Nancy, France
| | - P Frey-Klett
- INRA, UMR1136 Interactions Arbres-Microorganismes, Champenoux, 54280, France
- Université de Lorraine, UMR1136 Interactions Arbres-Microorganismes, Vandoeuvre-lès-Nancy, 54500, France
| | - M P Turpault
- Université de Lorraine, UMR1136 Interactions Arbres-Microorganismes, Vandoeuvre-lès-Nancy, 54500, France
| | - S Uroz
- INRA, UMR1136 Interactions Arbres-Microorganismes, Champenoux, 54280, France.
- Université de Lorraine, UMR1136 Interactions Arbres-Microorganismes, Vandoeuvre-lès-Nancy, 54500, France.
- Université de Lorraine, LIEC UMR7360 Faculté des Sciences et Technologies, Vandoeuvre-les-Nancy, France.
- UMR 1136 INRA-Université de Lorraine, Interactions Arbres Micro-organismes, Champenoux, 54280, France.
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Durner L, Bach C, El Howairis MEF, Hakenberg OW, Buchholz N. Current Trends in Urolithiasis Treatment in Various European Health Systems. Urol Int 2015; 96:125-31. [DOI: 10.1159/000441041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/10/2015] [Indexed: 11/19/2022]
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Neußer C, Bach C, Doeringer J, Jockenhoevel S. Processing of membranes for oxygenation using the Bellhouse-effect. Current Directions in Biomedical Engineering 2015. [DOI: 10.1515/cdbme-2015-0028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractState-of-the-art lung support systems are limited to short time application because of a lack of long term hemocompatibility and protein absorption on the membrane surfaces. In a highly interdisciplinary project at RWTH Aachen University a biohybrid lung assist system with endothelialised gas exchange flat membranes is developed to improve long term compatibility of oxygenators. To increase the gas exchange performance of flat membranes hollows are imprinted in the membrane surfaces. This approach is based on the research of B. J. Bell-house et al. [1], who discovered this effect, now known as Bellhouse-effect, around 1960. In this paper a processes to manufacture membrane assemblies for oxygenation with imprinted hollows on the flat membrane surfaces is reviewed.
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Affiliation(s)
- C. Neußer
- 1Department of Tissue Engineering and Textile Implants, Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany
| | - C. Bach
- 1Department of Tissue Engineering and Textile Implants, Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany
| | - J. Doeringer
- 1Department of Tissue Engineering and Textile Implants, Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany
| | - S. Jockenhoevel
- 1Department of Tissue Engineering and Textile Implants, Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany
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Cip J, Bach C, Widemschek M, Luegmair M, Martin A. Revision of Articular Surface Replacement (ASR) Total Hip Arthroplasty: Correlation of Perioperative Data and Early Post-Revision Outcome Results. J Arthroplasty 2015; 30:1607-17. [PMID: 25956526 DOI: 10.1016/j.arth.2015.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/24/2015] [Accepted: 04/06/2015] [Indexed: 02/01/2023] Open
Abstract
The articular surface replacement (ASR) total hip arthroplasty (THA) showed accelerated failure rates due to adverse-reaction to metal debris (ARMD). Literature correlating preoperative with intraoperative revision findings respectively post-revision outcome results are rare. 30 of 99 available ASR THA were revised due to ARMD. Mean post-revision follow-up term was 2.3 years. In part, preoperative data did not correlate with intraoperative revision findings. ARMD was even found in asymptomatic patients with non-elevated ion levels. Postoperative pain and metal ions decreased significantly (P ≤ 0.016). Cobalt decreased faster than chrome. Patients with intraoperative pseudotumors, osteolysis or bilateral THA did not have higher pre- or postoperative ion values (P ≥ 0.053). Females showed higher postoperative chrome levels (P=0.031). One major post-revision complication (femoral nerve palsy) and one re-revision (late onset infection) occurred.
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Affiliation(s)
- Johannes Cip
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria
| | - Christian Bach
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria
| | - Mark Widemschek
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria
| | - Matthias Luegmair
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria
| | - Arno Martin
- Department of Orthopedic Surgery, Academic Teaching Hospital Feldkirch, Medical University of Innsbruck, Feldkirch, Austria
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Toniolo PA, Pilarski PM, Bach C, Griffin JD, Adamia S. Abstract 3972: MicroRNAs as potential therapeutic agents for AML: Targeting the AML1-ETO Oncogene by pre-miR-520 and -373. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-3972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Acute myeloid leukemia (AML) is a heterogeneous neoplasm characterized by the accumulation of poorly differentiated myeloid cells in the bone marrow and blood of patients. Differentiation therapy is an attractive therapeutic approach for treating patients with AML. All-Trans Retionic Acid, induces differentiation of patients with the PML/RARa oncogene, but is ineffective in treating other more frequent types of AML. Here we describe the use of microRNAs to target the oncogene formed as a result of the (8;21) translocation, The goals was to identify miRNAs that could target the breakpoint region of the fusion protein, and determine if this would reduce expression of AML1-ETO and promote differentiation and/or apoptosis. Bioinformatics analysis was used to identify 28 different miRNAs that could potentially target AML1-ETO transcripts. Among those, miRNA-520 and -373 showed the highest degree of complimentary to AML1-ETO transcripts at the braikpoint. To look for miR-520 and -373 efficacy, we transfected two AML cell lines, Kasumi 1 and SKNO1, which have AML1-ETO translocation, with pre-miR-520 and -373 LNA probes, as well as HL60 cells which lack AML1-ETO. Expression of the LNA pre-miR-520/373 in Kasumi-1 and SKNO-1 cell lines decreased AML1-ETO transcripts and led to a significant reduction of AML1-ETO protein levels. The inhibition of AML1-ETO fusion protein also induced apoptosis of leukemic cells in vitro, but had no effect on HL60 cells. Moreover, the administration of LNA pre-miR-520 in an AML xenografts murine model increased apoptosis of leukemic cells and reduced tumor burden without obvious toxicity. We are currently testing the effects of miR-520 and -373 on differentiation and proliferation of primary blasts from patients with the AML1-ETO translocation.
Our results suggest that small molecules such as miRNAs can be identified that directly target a frequent AML oncogene. miRNAs are naturally accruing molecules and have the potential advantage of producing modest side effects, with highly significant specificity. The approaches we developed in this study can be used to evaluate and optimize other pre-miRs and anti-miRs as therapeutic agents to target other types oncogenes not currently amenable to small molecule drugs.
Citation Format: Patricia A. Toniolo, Patrick M. Pilarski, Christian Bach, James D. Griffin, Sophia Adamia. MicroRNAs as potential therapeutic agents for AML: Targeting the AML1-ETO Oncogene by pre-miR-520 and -373. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3972. doi:10.1158/1538-7445.AM2015-3972
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