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Bady P, Marosi C, Weller M, Grønberg BH, Schultz H, Taphoorn MJB, Gijtenbeek JMM, van den Bent MJ, von Deimling A, Stupp R, Malmström A, Hegi ME. DNA methylation-based age acceleration observed in IDH wild-type glioblastoma is associated with better outcome-including in elderly patients. Acta Neuropathol Commun 2022; 10:39. [PMID: 35331339 PMCID: PMC8944086 DOI: 10.1186/s40478-022-01344-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/05/2022] [Indexed: 12/24/2022] Open
Abstract
Elderly patients represent a growing proportion of individuals with glioblastoma, who however, are often excluded from clinical trials owing to poor expected prognosis. We aimed at identifying age-related molecular differences that would justify and guide distinct treatment decisions in elderly glioblastoma patients. The combined DNA methylome (450 k) of four IDH wild-type glioblastoma datasets, comprising two clinical trial cohorts, was interrogated for differences based on the patients' age, DNA methylation (DNAm) age acceleration (DNAm age "Horvath-clock" minus patient age), DNA methylation-based tumor classification (Heidelberg), entropy, and functional methylation of DNA damage response (DDR) genes. Age dependent methylation included 19 CpGs (p-value ≤ 0.1, Bonferroni corrected), comprising a CpG located in the ELOVL2 gene that is part of a 13-gene forensic age predictor. Most of the age related CpGs (n = 16) were also associated with age acceleration that itself was associated with a large number of CpGs (n = 50,551). Over 70% age acceleration-associated CpGs (n = 36,348) overlapped with those associated with the DNA methylation based tumor classification (n = 170,759). Gene set enrichment analysis identified associated pathways, providing insights into the biology of DNAm age acceleration and respective commonalities with glioblastoma classification. Functional methylation of several DDR genes, defined as correlation of methylation with gene expression (r ≤ -0.3), was associated with age acceleration (n = 8), tumor classification (n = 12), or both (n = 4), the latter including MGMT. DNAm age acceleration was significantly associated with better outcome in both clinical trial cohorts, whereof one comprised only elderly patients. Multivariate analysis included treatment (RT, RT/TMZ→TMZ; TMZ, RT), MGMT promoter methylation status, and interaction with treatment. In conclusion, DNA methylation features of age acceleration are an integrative part of the methylation-based tumor classification (RTK I, RTK II, MES), while patient age seems hardly reflected in the glioblastoma DNA methylome. We found no molecular evidence justifying other treatments in elderly patients, not owing to frailty or co-morbidities.
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Svensberg K, Kalleberg BG, Rosvold EO, Mathiesen L, Wøien H, Hove LH, Andersen R, Waaktaar T, Schultz H, Sveaass N, Hellesö R. Interprofessional education on complex patients in nursing homes: a focus group study. BMC Med Educ 2021; 21:504. [PMID: 34560852 PMCID: PMC8464088 DOI: 10.1186/s12909-021-02867-6] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND An ageing population leads up to increasing multi-morbidity and polypharmacy. This demands a comprehensive and interprofessional approach in meeting patients' complex needs. This study describes graduate students' experiences of working practice based in interprofessional teams with complex patients' care needs in nursing homes. METHOD Students from advanced geriatric nursing, clinical nutrition, dentistry, medicine and pharmacy at the University of Oslo in Norway were assigned to groups to examine and develop a care plan for a nursing home patient during a course. Focus groups were used, 21 graduate students participating in four groups. Data were collected during spring 2018, were inductively analysed according to a thematic analysis method (Systematic Text Condensation). An analytical framework of co-ordination practices was applied to get an in-depth understanding of the data. RESULTS Three themes were identified: 1) Complex patients as learning opportunities- an eye-opener for future interprofessional collaboration 2) A cobweb of relations, and 3) Structural facilitators for new collective knowledge. Graduate university students experienced interprofessional education (IPE) on complex patients in nursing homes as a comprehensive learning arena. Overall, different co-ordination practices for work organization among the students were identified. CONCLUSIONS IPE in nursing homes facilitated the students' scope from a fragmented approach of the patients towards a relational and collaborative practice that can improve patient care and strengthen understanding of IPE. The study also demonstrated the need for preparatory teamwork training to gain maximum benefit from the experience. Something that can be organized by the education institutions in the form of a stepwise learning module and as an online pre-training course in interprofessional teamwork. Further, focusing on the need for well thought through processes of the activity by the institutions and the timing the practice component in students' curricula. This could ensure that IPE is experienced more efficient by the students.
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Affiliation(s)
- K. Svensberg
- Section for Pharmaceutics and Social Pharmacy, Department of Pharmacy, University of Oslo, Oslo, Norway
- Department of Pharmacy, Faculty of Pharmacy, University of Uppsala, P.O. Box 580, 751 23 Uppsala, Sweden
| | - B. G. Kalleberg
- Faculty of Medicine, University of Oslo, P.O. 1078, 0316 Blindern, Oslo Norway
| | - E. O. Rosvold
- Faculty of Medicine, University of Oslo, P.O. 1078, 0316 Blindern, Oslo Norway
| | - L. Mathiesen
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, P.O. 1068, 0316 Blindern, Oslo Norway
| | - H. Wøien
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. 1130, 0318 Blindern, Oslo Norway
| | - L. H. Hove
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, P.O 1109, 0317 Blindern, Oslo Norway
| | - R. Andersen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. 1130, 0318 Blindern, Oslo Norway
| | - T. Waaktaar
- Department of Psychology, University of Oslo, P.O. 1094, 0317 Blindern, Oslo Norway
| | - H. Schultz
- Department of Pharmacy, University of Oslo, P.O. 1068, 0316 Blindern, Oslo Norway
| | - N. Sveaass
- Department of Psychology, University of Oslo, P.O. 1094, 0317 Blindern, Oslo Norway
| | - R. Hellesö
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. 1130, 0318 Blindern, Oslo Norway
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Mueller C, Ahrman E, Eriksson L, Wassilew K, Schultz H, Brunnstroem H, Perch M, Iversen M, Malmstroem J, Westergren-Thorsson G. Laser-capture microdissection, mass spectrometry and immunohistochemistry reveal pathologic alterations in the extracellular matrix of transplanted lungs. Transplantation 2018. [DOI: 10.1183/13993003.congress-2018.lsc-1108] [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: 11/05/2022]
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Hansen S, Rasmussen BK, Laursen RJ, Kosteljanetz M, Schultz H, Nørgård BM, Guldberg R, Gradel KO. Treatment and survival of glioblastoma patients in Denmark: The Danish Neuro-Oncology Registry 2009-2014. J Neurooncol 2018; 139:479-489. [PMID: 29754199 DOI: 10.1007/s11060-018-2892-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 02/06/2018] [Accepted: 05/03/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND As many glioblastoma patients are in a poor condition they are unable to undergo the full treatment documented in clinical trials. We aimed to examine the survival and its relationship to clinical characteristics and treatment in a nationwide population of glioblastoma patients in Denmark. METHODS We included prospectively recorded clinical data from 1364 adult patients with histologically verified glioblastoma from the Danish Neuro-Oncology Registry, 2009-2014. RESULTS The age standardized incidence rate was 6.3/100,000 person-years for males and 3.9 for females and the median age was 66 years. The median overall survival was 11.2 months. There was an independently significant prognostic effect of age, performance status, cognitive symptoms, tumor diameter, multifocality, crossing midline, and contrast enhancement. For partial and total resection compared to biopsy only, the adjusted risk of dying was reduced by 43% (HR [CI] 0.57 [0.48-0.68]) and 51% (0.49 [0.40-0.60]), respectively. For patients receiving a partial and full radiochemotherapy regimen compared to no postsurgical treatment, the risk reduction was 56% (HR [CI] 0.44 [0.37-0.53]) and 70% (0.30 [0.25-0.35]), respectively. The full radiochemotherapy regimen was only allocated to 50% of the patients, 29% among the oldest (70+ years) and 60% among the younger (18-69 years). CONCLUSIONS Glioblastoma patients had a poor overall survival but with several specific independent prognostic factors. Extensive cancer treatment was associated with an increasing survival in all age groups, but only half of the patients were sufficiently fit for a full regimen of postoperative combined radiochemotherapy.
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Affiliation(s)
- Steinbjørn Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark. .,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | | | | | | | - Henrik Schultz
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Mertz Nørgård
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Rikke Guldberg
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Kim Oren Gradel
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
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Rasmussen BK, Hansen S, Laursen RJ, Kosteljanetz M, Schultz H, Nørgård BM, Guldberg R, Gradel KO. Epidemiology of glioma: clinical characteristics, symptoms, and predictors of glioma patients grade I-IV in the the Danish Neuro-Oncology Registry. J Neurooncol 2017; 135:571-579. [PMID: 28861666 DOI: 10.1007/s11060-017-2607-5] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [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: 02/19/2017] [Accepted: 08/20/2017] [Indexed: 01/18/2023]
Abstract
In this national population-based study of glioma, we present epidemiologic data on incidence, demographics, survival, clinical characteristics and symptoms, and evaluate the association of specific indicators with the grade of glioma. We included 1930 patients registered in the Danish Neuro-Oncology Registry (DNOR) from 2009 to 2014. DNOR is a large-scale national population-based database including all adult glioma patients in Denmark. The age-adjusted annual incidence of histologic verified glioma was 7.3 cases pr. 100,000 person-years. High-grade gliomas were present in 85% and low-grade glioma in 15%. The overall male:female ratio was 3:2 and the mean age at onset was 60 years. Data for WHO grade I, II, III and IV glioma showed several important differences regarding age and sex distribution and symptomatology at presentation. The mean age increased with the grade of glioma and males predominated in all grades. Focal deficits were the most frequent presenting symptom, but among patients with glioma, grade II epileptic seizures were the most frequent symptom. Headache was a rare mono-symptomatic onset symptom. At presentation, higher age, focal deficits and cognitive change for <3 months duration, and headache <1 month were significant independent indicators of high-grade gliomas. Younger age and epileptic seizures for more than 3 months were indicative for low-grade gliomas. Survival rates for glioma grade I-IV showed decreasing survival with increasing grade. Glioma grade I-IV showed high diversity regarding several demographic and clinical characteristics emphasizing the importance of individually tailored disease treatments and support.
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Affiliation(s)
- Birthe Krogh Rasmussen
- Department of Neurology, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark
| | - Steinbjørn Hansen
- Department of Oncology, Odense University Hospital, 5000, Odense C, Denmark. .,Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.
| | - René J Laursen
- Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
| | | | - Henrik Schultz
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Mertz Nørgård
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense C, Denmark
| | - Rikke Guldberg
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense C, Denmark
| | - Kim Oren Gradel
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense C, Denmark
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Forkmann K, Schmidt K, Schultz H, Sommer T, Bingel U. Experimental pain impairs recognition memory irrespective of pain predictability. Eur J Pain 2015; 20:977-88. [PMID: 26685005 DOI: 10.1002/ejp.822] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pain is hardwired to signal threat and tissue damage and therefore automatically attracts attention to initiate withdrawal or defensive behaviour. This well-known interruptive function of pain interferes with cognitive functioning and is modulated by bottom-up and top-down variables. Here, we applied predictable or unpredictable painful heat stimuli simultaneously to the presentation of neutral images to investigate (I) whether the predictability of pain modulated its effect on the encoding of images (episodic memory) and (II) whether subjects remember that certain images have been previously presented with pain (source memory). METHODS Twenty-four healthy subjects performed a categorization task in which 80 images had to be categorized into living or non-living objects. We compared the processing and encoding of these images during cued and non-cued pain trials as well as cued and non-cued pain-free trials. Effects on recognition performance and source memory for pain were immediately tested using a surprise recognition task. RESULTS Painful thermal stimulation impaired recognition accuracy (d', recollection, familiarity). This negative effect of pain was positively correlated with the individual expectation of pain interference and the attentional avoidance of pain-related words. However, the interruptive effect of pain was not modulated by the predictability of pain. Source memory for painful stimulation was at chance level, indicating that subjects did not explicitly remember that images had been paired with pain. CONCLUSIONS Targeting negative expectations and a maladaptive attentional bias for pain-related material might help reducing frequently reported pain-induced cognitive impairments.
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Affiliation(s)
- K Forkmann
- Clinic for Neurology, Essen University Hospital, Germany
| | - K Schmidt
- Clinic for Neurology, Essen University Hospital, Germany
| | - H Schultz
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - T Sommer
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - U Bingel
- Clinic for Neurology, Essen University Hospital, Germany
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Taibah KM, Mahasin Z, Kanaan I, McArthur PD, Abuzeld MO, Al Otieschan AT, Schultz H, El-Akkad S. Our Experience in the Treatment of Sarcomas of the Paranasal Sinuses with Skull Base Invasion. Skull Base Surg 2015. [DOI: 10.1159/000429836] [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: 11/19/2022]
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Nyholm B, Schultz H, Andersen K, Iversen M, Gustafsson F, Carlsen J. Postcapillary Pulmonary Hypertension as a Risk Factor for Post-Transplant Survival in Lung Transplantation - A 22 Year Single Centre Experience. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.436] [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: 11/16/2022] Open
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Schultz H, Møller C, Zemtsovski M, Perch M, Carlsen J, Iversen M. Impact of Age and Smoking History on the Selection of Donors for Lung Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.790] [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: 11/29/2022] Open
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Abstract
A small wire specimen can be heated to high temperatures in liquid Helium II by electric current, and quenched by switching off the current. Experimental details about quenching experiments on tungsten wires (0.030 mm Ø) are given. The quenching speed at 2500 °K amounts to about 3·104°K/sec. The temperature, as function of time, was recorded oscillographically during cooling down. This technique is particularly qualified for refractory metals.
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Hansen S, Green A, Nielsen J, Haugaard M, Laursen R, Schultz H, Rasmussen B, Broholm H, Andersen P, Kosteljanetz M. [Danish Neuro-Oncology Registry]. Ugeskr Laeger 2012; 174:2558. [PMID: 23079461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Steinbjørn Hansen
- Onkologisk Afdeling, Odense Universitetshospital, Sdr. Boulevard 29, Odense.
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Malmström A, Grønberg BH, Marosi C, Stupp R, Frappaz D, Schultz H, Abacioglu U, Tavelin B, Lhermitte B, Hegi ME, Rosell J, Henriksson R. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 2012; 13:916-26. [PMID: 22877848 DOI: 10.1016/s1470-2045(12)70265-6] [Citation(s) in RCA: 839] [Impact Index Per Article: 69.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Most patients with glioblastoma are older than 60 years, but treatment guidelines are based on trials in patients aged only up to 70 years. We did a randomised trial to assess the optimum palliative treatment in patients aged 60 years and older with glioblastoma. METHODS Patients with newly diagnosed glioblastoma were recruited from Austria, Denmark, France, Norway, Sweden, Switzerland, and Turkey. They were assigned by a computer-generated randomisation schedule, stratified by centre, to receive temozolomide (200 mg/m(2) on days 1-5 of every 28 days for up to six cycles), hypofractionated radiotherapy (34·0 Gy administered in 3·4 Gy fractions over 2 weeks), or standard radiotherapy (60·0 Gy administered in 2·0 Gy fractions over 6 weeks). Patients and study staff were aware of treatment assignment. The primary endpoint was overall survival. Analyses were done by intention to treat. This trial is registered, number ISRCTN81470623. FINDINGS 342 patients were enrolled, of whom 291 were randomised across three treatment groups (temozolomide n=93, hypofractionated radiotherapy n=98, standard radiotherapy n=100) and 51 of whom were randomised across only two groups (temozolomide n=26, hypofractionated radiotherapy n=25). In the three-group randomisation, in comparison with standard radiotherapy, median overall survival was significantly longer with temozolomide (8·3 months [95% CI 7·1-9·5; n=93] vs 6·0 months [95% CI 5·1-6·8; n=100], hazard ratio [HR] 0·70; 95% CI 0·52-0·93, p=0·01), but not with hypofractionated radiotherapy (7·5 months [6·5-8·6; n=98], HR 0·85 [0·64-1·12], p=0·24). For all patients who received temozolomide or hypofractionated radiotherapy (n=242) overall survival was similar (8·4 months [7·3-9·4; n=119] vs 7·4 months [6·4-8·4; n=123]; HR 0·82, 95% CI 0·63-1·06; p=0·12). For age older than 70 years, survival was better with temozolomide and with hypofractionated radiotherapy than with standard radiotherapy (HR for temozolomide vs standard radiotherapy 0·35 [0·21-0·56], p<0·0001; HR for hypofractionated vs standard radiotherapy 0·59 [95% CI 0·37-0·93], p=0·02). Patients treated with temozolomide who had tumour MGMT promoter methylation had significantly longer survival than those without MGMT promoter methylation (9·7 months [95% CI 8·0-11·4] vs 6·8 months [5·9-7·7]; HR 0·56 [95% CI 0·34-0·93], p=0·02), but no difference was noted between those with methylated and unmethylated MGMT promoter treated with radiotherapy (HR 0·97 [95% CI 0·69-1·38]; p=0·81). As expected, the most common grade 3-4 adverse events in the temozolomide group were neutropenia (n=12) and thrombocytopenia (n=18). Grade 3-5 infections in all randomisation groups were reported in 18 patients. Two patients had fatal infections (one in the temozolomide group and one in the standard radiotherapy group) and one in the temozolomide group with grade 2 thrombocytopenia died from complications after surgery for a gastrointestinal bleed. INTERPRETATION Standard radiotherapy was associated with poor outcomes, especially in patients older than 70 years. Both temozolomide and hypofractionated radiotherapy should be considered as standard treatment options in elderly patients with glioblastoma. MGMT promoter methylation status might be a useful predictive marker for benefit from temozolomide. FUNDING Merck, Lion's Cancer Research Foundation, University of Umeå, and the Swedish Cancer Society.
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Affiliation(s)
- Annika Malmström
- Division of Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Unit of Advanced Palliative Home Care, County Council of Östergötland, Linköping, Sweden.
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Møller S, Grunnet K, Hansen S, Schultz H, Holmberg M, Sorensen M, Poulsen HS, Lassen U. A phase II trial with bevacizumab and irinotecan for patients with primary brain tumors and progression after standard therapy. Acta Oncol 2012; 51:797-804. [PMID: 22548369 DOI: 10.3109/0284186x.2012.681063] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED The combination of irinotecan and bevacizumab has shown efficacy in the treatment of recurrent glioblastoma multiforme (GBM). A prospective, phase II study of 85 patients with various recurrent brain tumors was carried out. Primary endpoints were progression free survival (PFS) and response rate. MATERIAL AND METHODS Patients with recurrent primary brain tumors with performance status 0-2 were eligible. Intravenous bevacizumab 10 mg/kg and irinotecan 125/340 mg/m(2) were administered every 14 days. Evaluation was carried out every eight weeks using MRI and Macdonald response criteria. Treatment was continued until progression. RESULTS In total 85 patients were included with the following histologies: GBM (n = 32), glioma WHO gr. III (n = 33), glioma WHO gr. II (n = 12) and others (n = 8). Patients received a median of four cycles. ORR (overall response rate) for glioblastoma was 25% and 59% achieved stable disease (SD). Median PFS was 5.2 months. For grade III gliomas ORR was 21% and 45% had SD. Median PFS was 3.7 months. No objective responses occurred in grade II gliomas. In the non-glioma population, one PR as well as several long PFS times were observed. DISCUSSION AND CONCLUSION The combination of bevacizumab and irinotecan is well tolerated and moderately efficacious in glioblastoma and glioma WHO gr. III. A majority of patients achieve at least disease stabilization. Prolonged progression-free survival in non-glioma patients warrants further research.
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Lassen KS, Schultz H, Heegaard NHH, He M. A novel DNAseq program for enhanced analysis of Illumina GAII data: a case study on antibody complementarity-determining regions. N Biotechnol 2012; 29:271-8. [PMID: 22155428 DOI: 10.1016/j.nbt.2011.11.014] [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] [Received: 08/24/2011] [Revised: 11/09/2011] [Accepted: 11/25/2011] [Indexed: 11/16/2022]
Abstract
High-throughput DNA sequencing technologies are increasingly becoming powerful systems for the comprehensive analysis of variations in whole genomes or various DNA libraries. As they are capable of producing massive collections of short sequences with varying lengths, a major challenge is how to turn these reads into biologically meaningful information. The first stage is to assemble the short reads into longer sequences through an in silico process. However, currently available software/programs allow only the assembly of abundant sequences, which apparently results in the loss of highly variable (or rare) sequences or creates artefact assemblies. In this paper, we describe a novel program (DNAseq) that is capable of assembling highly variable sequences and displaying them directly for phylogenetic analysis. In addition, this program is Microsoft Windows-based and runs by a normal PC with 700MB RAM for a general use. We have applied it to analyse a human naive single-chain antibody (scFv) library, comprehensively revealing the diversity of antibody variable complementarity-determining regions (CDRs) and their families. Although only a scFv library was exemplified here, we envisage that this program could be applicable to other genome libraries.
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Affiliation(s)
- Klaus S Lassen
- Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
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15
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Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [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: 11/14/2022] Open
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Abstract
Introduction and purpose. Primary Ewing's sarcoma arising from the
bones of the head and neck region is extremely rare representing only 1– 4% of all Ewing's
sarcoma cases. Previous reports suggest a better prognosis for that particular anatomic site.
The purpose of this study was to analyze the clinico-epidemiologic characteristics of that rare clinical presentation, as
well as its patterns of failure and prognosis following treatment. Materials and methods. This study included a retrospective review of the medical records
of patients with the diagnosis of Ewing's sarcoma of the head and neck region treated at King
Faisal Specialist Hospital and Research Center between 1975 and 1996. Results. Out of a total number of 24 cases analyzed, there were 17 males and
7 females with a ratio of 2.4:1. The median age at diagnosis was 16.5 years. A painful swelling was
the most common clinical presentation.The maxilla was the most common site of presentation
(9/24 cases). There were 3/24 cases who presented with metastatic disease at diagnosis.The
majority of patients (16/24 cases) had a tumor size >10 cm. Most patients were treated with systemic
chemotherapy plus localized irradiation following an initial biopsy.With a mean follow
up of 3.4 years, the 5-year actual overall survival (OS) for the whole group was 53%, while
the 5-year actuarial disease-free survival (DFS) was 30%. These figures were higher than those
repor ted from our institution for young patients (≤ 14 years treated for Ewing' s sarcoma in other
anatomic locations (30% v 15%). The response to chemotherapy was the only prognostic factor
that affected both the OS and DFS. Conclusion. The prognosis of Ewing's sarcoma of the head and neck
region is slightly better than that of other anatomic sites.The response to systemic chemotherapy
is one of the most important prognostic factors affecting both DFS and OS of Ewing's sarcoma of
the head and neck. Multimodality therapy consisting of an initial biopsy, aggressive combination
chemotherapy and localized radiotherapy is the treatment of choice for Ewing's sarcoma of
the head and neck region and may result in long-term survival.
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Affiliation(s)
- A Allam
- Department of Radiation Oncology King Faisal Specialist Hospital and Research Center PO Box 3354 Riyadh 11211 Saudi Arabia
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Hermes A, Gatzemeier U, Schultz H, Reck M. [Non-small-cell carcinoma of the lung with invasive Aspergillus infection after chemotherapy]. Dtsch Med Wochenschr 2011; 136:582-5. [PMID: 21412676 DOI: 10.1055/s-0031-1274542] [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: 10/18/2022]
Abstract
HISTORY A 56-year-old woman had two years previously undergone a neck dissection and subsequent adjuvant radiotherapy for an adenocarcinoma at the base of the tongue (pT2NOMOG2) when a percutaneous endoscopic gastrostomy (PEG) catheter had been placed. She was now admitted for chemotherapy, recent onset of severe pain in the left hip and knee having been caused by metastasis of a non-small-cell lung carcinoma (NSCLC). She was cachectic and in a reduced general condition (Karnofsky index 80), but had recently only occasionally used the PEG catheter. There were no inflammatory changes of the skin at the site of the PEG. TREATMENT, COURSE AND OUTCOME The first chemotherapy cycle was initially without complication, but after a week the patient's general condition deteriorated and she developed nausea, fever and pain around the markedly inflamed site of the PEG catheter insertion. Laboratory tests indicated severe neutropenia. Intensive antibiotic and antimycotic treatment at first brought about some improvement, but she died 11 days after admission. Necropsy revealed invasive aspergillosis, with the PEG as the portal of entry and spreading to the stomach and intestines, where numerous hyphae were identified. There had also been a disseminated intravascular coagulopathy. CONCLUSION Bacterial infections (and occasionally, but difficult to diagnose, fungal infection) are quite common as a result of neutropenia during chemotherapy of solid tumors. Various risk factors, including reduced general condition and weight loss, must be individually assessed in the prevention or treatment of associated infectious complications in such cases.
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Affiliation(s)
- A Hermes
- Onkologischer Schwerpunkt, Krankenhaus Grosshansdorf, Germany.
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Clarke JL, Ennis MM, Lamborn KR, Prados MD, Puduvalli VK, Penas-Prado M, Gilbert MR, Groves MD, Hess KR, Levin VA, de Groot J, Colman H, Conrad CA, Loghin ME, Hunter K, Yung WK, Chen C, Damek D, Liu A, Gaspar LE, Waziri A, Lillehei K, Kavanagh B, Finlay JL, Haley K, Dhall G, Gardner S, Allen J, Cornelius A, Olshefski R, Garvin J, Pradhan K, Etzl M, Goldman S, Atlas M, Thompson S, Hirt A, Hukin J, Comito M, Bertolone S, Torkildson J, Joyce M, Moertel C, Letterio J, Kennedy G, Walter A, Ji L, Sposto R, Dorris K, Wagner L, Hummel T, Drissi R, Miles L, Leach J, Chow L, Turner R, Gragert MN, Pruitt D, Sutton M, Breneman J, Crone K, Fouladi M, Friday BB, Buckner J, Anderson SK, Giannini C, Kugler J, Mazurczac M, Flynn P, Gross H, Pajon E, Jaeckle K, Galanis E, Badruddoja MA, Pazzi MA, Stea B, Lefferts P, Contreras N, Bishop M, Seeger J, Carmody R, Rance N, Marsella M, Schroeder K, Sanan A, Swinnen LJ, Rankin C, Rushing EJ, Hutchins LF, Damek DM, Barger GR, Norden AD, Lesser G, Hammond SN, Drappatz J, Fadul CE, Batchelor TT, Quant EC, Beroukhim R, Ciampa A, Doherty L, LaFrankie D, Ruland S, Bochacki C, Phan P, Faroh E, McNamara B, David K, Rosenfeld MR, Wen PY, Hammond SN, Norden AD, Drappatz J, Phuphanich S, Reardon D, Wong ET, Plotkin SR, Lesser G, Mintz A, Raizer JJ, Batchelor TT, Quant EC, Beroukhim R, Kaley TJ, Ciampa A, Doherty L, LaFrankie D, Ruland S, Smith KH, Wen PY, Chamberlain MC, Graham C, Mrugala M, Johnston S, Kreisl TN, Smith P, Iwamoto F, Sul J, Butman JA, Fine HA, Westphal M, Heese O, Warmuth-Metz M, Pietsch T, Schlegel U, Tonn JC, Schramm J, Schackert G, Melms A, Mehdorn HM, Seifert V, Geletneky K, Reuter D, Bach F, Khasraw M, Abrey LE, Lassman AB, Hormigo A, Nolan C, Gavrilovic IT, Mellinghoff IK, Reiner AS, DeAngelis L, Omuro AM, Burzynski SR, Weaver RA, Janicki TJ, Burzynski GS, Szymkowski B, Acelar SS, Mechtler LL, O'Connor PC, Kroon HA, Vora T, Kurkure P, Arora B, Gupta T, Dhamankar V, Banavali S, Moiyadi A, Epari S, Merchant N, Jalali R, Moller S, Grunnet K, Hansen S, Schultz H, Holmberg M, Sorensen MM, Poulsen HS, Lassen U, Reardon DA, Vredenburgh JJ, Desjardins A, Janney DE, Peters K, Sampson J, Gururangan S, Friedman HS, Jeyapalan S, Constantinou M, Evans D, Elinzano H, O'Connor B, Puthawala MY, Goldman M, Oyelese A, Cielo D, Dipetrillo T, Safran H, Anan M, Seyed Sadr M, Alshami J, Sabau C, Seyed Sadr E, Siu V, Guiot MC, Samani A, Del Maestro R, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine VE, Parfenov VE, Poverennova IE, Hau P, Jachimczak P, Heinrichs H, Schlingensiepen KH, Shibui S, Kayama T, Wakabayashi T, Nishikawa R, de Groot M, Aronica E, Vecht CJ, Toering ST, Heimans JJ, Reijneveld JC, Batchelor T, Mulholland P, Neyns B, Nabors LB, Campone M, Wick A, Mason W, Mikkelsen T, Phuphanich S, Ashby LS, DeGroot JF, Gattamaneni HR, Cher LM, Rosenthal MA, Payer F, Xu J, Liu Q, van den Bent M, Nabors B, Fink K, Mikkelsen T, Chan M, Trusheim J, Raval S, Hicking C, Henslee-Downey J, Picard M, Reardon D, Kaley TJ, Wen PY, Schiff D, Karimi S, DeAngelis LM, Nolan CP, Omuro A, Gavrilovic I, Norden A, Drappatz J, Purow BW, Lieberman FS, Hariharan S, Abrey LE, Lassman AB, Perez-Larraya JG, Honnorat J, Chinot O, Catry-Thomas I, Taillandier L, Guillamo JS, Campello C, Monjour A, Tanguy ML, Delattre JY, Franz DN, Krueger DA, Care MM, Holland-Bouley K, Agricola K, Tudor C, Mangeshkar P, Byars AW, Sahmoud T, Alonso-Basanta M, Lustig RA, Dorsey JF, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Meech S, Davis T, Pavlov D, Marshall MA, Sampson J, Slot M, Peerdeman SM, Beauchesne PD, Faure G, Noel G, Schmitt T, Kerr C, Jadaud E, Martin L, Taillandier L, Carnin C, Desjardins A, Reardon DA, Peters KB, Herndon JE, Kirkpatrick JP, Friedman HS, Vredenburgh JJ, Nayak L, Panageas KS, Deangelis LM, Abrey LE, Lassman AB. Ongoing Clinical Trials. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rupp J, Kramme E, Schultz H, Schaaf B. [Diagnostics for fungal infections of the lungs]. Pneumologie 2010; 64:300-10. [PMID: 20455177 DOI: 10.1055/s-0029-1244004] [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: 10/19/2022]
Abstract
Recognition of and therapy for fungal infections of the lungs still presents problems even for the experienced clinician. The distinction between invasive mycoses of the lungs and fungal colonisations that do not require therapy is cinically difficult and can often not be made satisfactorily even with advanced microbiological diagnostics. One must differentiate between a primary, often locally limited, endemic pulmonary mycosis and a pulmonary mycosis against the background of a locally or systemically compromised immune system. Patients at risk include those with advanced HIV infections, patients under long-term antibiotic therapy as well as oncological and multimorbid patients. The pulmonary manifestation of a mycosis may not only be the starting point for a systemic dissemination but can also arise in the course of hematogenous spread of the infection. The latter can appear, for example, as an invasive pulmonary aspergillosis in immunesuppressed patients. Thus, early clinical, radiological and biological confirmation of the diagnosis is essential in order to avoid the possible complications of pulmonary mycosis.
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Affiliation(s)
- J Rupp
- Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein/Campus Lübeck, Universität zu Lübeck
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Vollmer E, Schultz H, Stellmacher F, Kähler D, Abdullah M, Galle J, Lang DS, Goldmann T. Tumors in the lung--morphologic features and the challenge of integrating biomarker signatures into diagnostics. Rom J Morphol Embryol 2010; 51:607-614. [PMID: 21103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In the last decade, pathologic approaches concerning diagnosis and treatment of lung carcinomas have increasingly moved towards the implementation of molecular methods into the process of decision. In this study, an overview is given referring to the variety of tumors in the lung including common primary lung neoplasms and secondary tumors, and a modus operandi is presented which integrates immunology as well as molecular pathology within the process of finding correct diagnoses. Besides the conventional and approved methods and techniques leading to appropriate treatment including so-called targeted therapies, pathologist's work meanwhile depends on both histologic and molecular results. Since molecular techniques have increasingly entered the field of routine diagnostics, challenges and possibilities have changed and are still rapidly developing. The proceeding integration of molecular-biologic investigations into the process of diagnosing has changed the nature of diagnostics and will continuously grow in the near future. Only by obtaining a proper diagnosis, the optimal treatment of a patient can be assured, whereupon the knowledge of gene mutations and/or altered protein expression is crucial. By identifying those novel molecular target structures, the therapeutic spectrum is tremendously enlarged and will finally improve the patient's prognosis by personalized targeted therapies.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Large Cell/diagnosis
- Carcinoma, Large Cell/metabolism
- Carcinoma, Large Cell/pathology
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/metabolism
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Humans
- Immunohistochemistry
- Lung Neoplasms/diagnosis
- Lung Neoplasms/genetics
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
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Affiliation(s)
- E Vollmer
- Clinical and Experimental Pathology, Research Center Borstel, Germany.
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Abdullah M, Schultz H, Kähler D, Branscheid D, Dalhoff K, Zabel P, Vollmer E, Goldmann T. On the expression of haptoglobin in the human lungs. Pneumologie 2010. [DOI: 10.1055/s-0029-1247898] [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: 10/19/2022]
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Kähler D, Alexander C, Schultz H, Branscheid D, Lindner B, Abdullah M, Zabel P, Vollmer E, Goldmann T. Proteomuntersuchungen und massenspektrometrische Proteinidentifikation unter Verwendung HOPE-fixierter, paraffin-eingebetteter Lungengewebe. Pneumologie 2010. [DOI: 10.1055/s-0029-1247923] [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: 10/19/2022]
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Radtke J, Rezaie SG, Kugler C, Zabel P, Schultz H, Vollmer E, Goldmann T, Lang DS. Expression analysis of EML4 in normal lung tissue and non-small cell lung cancer (NSCLC) in the absence and presence of chemotherapeutics. Rom J Morphol Embryol 2010; 51:647-653. [PMID: 21103621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Despite considerable progress in the development of individualized targeted therapies of tumor diseases, identification of additional reliable target molecules is still mandatory. One of the most recent targets is microtubule-associated human EML4 generating a fusion-type oncogene with ALK demonstrating marked transforming activity in lung cancer. Since EML4 is a poorly characterized protein with regard to expression, function and regulation in human tissue, specimens of human tumor and tumor-free tissues obtained from patients with NSCLC were analyzed to determine the cellular localization. All tissue samples have been previously fixed with the novel HOPE-technique and paraffin embedded. Determination of both gene expression and protein levels of EML4 were performed using RT-PCR, in situ hybridization as well as immunohistochemistry, respectively. In human NSCLC tissue samples, possible regulation of EML4 transcription upon chemotherapy with combinations of most established cytotoxic drugs for NSCLC treatment was also studied employing the recently established ex vivo tissue culture model STST. In normal lung, both marked mRNA and protein levels of EML4 were localized in alveolar macrophages. In contrast, lung tumor tissues always showed consistent transcriptional expression in situ and by RT-PCR. Stimulation of NSCLC tissues with chemotherapeutics revealed heterogeneous effects on EML4 mRNA levels. Based on its expression patterns in both tumor-free lung and NSCLC tissues, human EML4 is likely to be closely associated with processes involved in local inflammation of the lung as well as with tumor behavior. Thus, our results suggest that EML4 may have the potential as a therapeutic target molecule in NSCLC chemotherapy.
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Affiliation(s)
- J Radtke
- Clinical and Experimental Pathology, Research Center Borstel, Germany
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Reardon DA, Dresemann G, Taillibert S, Campone M, van den Bent M, Clement P, Blomquist E, Gordower L, Schultz H, Raizer J, Hau P, Easaw J, Gil M, Tonn J, Gijtenbeek A, Schlegel U, Bergstrom P, Green S, Weir A, Nikolova Z. Multicentre phase II studies evaluating imatinib plus hydroxyurea in patients with progressive glioblastoma. Br J Cancer 2009; 101:1995-2004. [PMID: 19904263 PMCID: PMC2795431 DOI: 10.1038/sj.bjc.6605411] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: We evaluated the efficacy of imatinib mesylate in addition to hydroxyurea in patients with recurrent glioblastoma (GBM) who were either on or not on enzyme-inducing anti-epileptic drugs (EIAEDs). Methods: A total of 231 patients with GBM at first recurrence from 21 institutions in 10 countries were enrolled. All patients received 500 mg of hydroxyurea twice a day. Imatinib was administered at 600 mg per day for patients not on EIAEDs and at 500 mg twice a day if on EIAEDs. The primary end point was radiographic response rate and secondary end points were safety, progression-free survival at 6 months (PFS-6), and overall survival (OS). Results: The radiographic response rate after centralised review was 3.4%. Progression-free survival at 6 months and median OS were 10.6% and 26.0 weeks, respectively. Outcome did not appear to differ based on EIAED status. The most common grade 3 or greater adverse events were fatigue (7%), neutropaenia (7%), and thrombocytopaenia (7%). Conclusions: Imatinib in addition to hydroxyurea was well tolerated among patients with recurrent GBM but did not show clinically meaningful anti-tumour activity.
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Affiliation(s)
- D A Reardon
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Box 3624, Durham, NC 27710, USA.
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Lang D, Drömann D, Branscheid D, Schultz H, Zabel P, Gerdes J, Vollmer E, Goldmann T. Ex vivo Kultur humaner Gewebe: Ein neuartiges Modell zur Untersuchung Chemotherapie-induzierter Effekte auf Proliferation und Apoptose bei NSCLC. Pneumologie 2008. [DOI: 10.1055/s-2008-1074246] [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: 10/21/2022]
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Memon MA, Allam AA, El-Enbaby AM, El-Sebaie M, Khafaga YM, Schultz H, El-Weshi A. Synovial sarcoma: Retrospective analysis of treatment outcome and prognostic factors. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.20517] [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
20517 Introduction and Objectives: Synovial Sarcoma (SS) account for approximately 10 % of soft tissue sarcoma. Despite numerous case reports and several relatively large series, debate still exists about the prognostic factors for this disease, the biologic behavior and role of adjuvant chemotherapy. The purpose of this study is to analyze the variable prognostic factors that may affect the treatment outcome in patients with SS. Patient and Methods: Sixty-six patients with SS (36 males and 30 females) were seen in institution between January 1985 and December 2000. Median age at diagnosis was 29 years. Site of involvement include, lower extremities 43/66 cases; (65%), upper extremity 16/66 (24%), trunk 3/66 (5%), others 4/66 (include larynx, thyroid, neck, and hypopharynx).Tumor size: = 10 cm 42/66 (64%), = 10 cm 24/66 (36%). Patients with stage III and IV disease represented 58% of all patients (38/66), stage I and II 42%(28/66). All patients underwent surgery and adequate resection margins(= 2 cm) were achieved in 52% of cases. Histopathology: Biphasic 36/66, Monophasic 16/66, spindle cell 12/66 and not otherwise specified 2/66. Radiation therapy was given 44/66 cases (67%). Chemotherapy was delivered to 11/66 patients (17%). Results: With a median follow up of 50 months, the 5-year overall survival (OS) for all patients was 45%, while the 5- year relapse free survival (RFS) for patients treated with radical intent was 32%. Prognostic factors that significantly affected OS on univariate analysis were tumor size (≤ 10 cm vs > 10cm), tumor stage (stages I and II vs stage III), adequacy of surgical resection and local control. On multivariate analysis, tumor size and local control were the only independent factors that did affect OS. For RFS, sex, tumor size, tumor grade, tumor stage, and adequacy of surgical resection were the prognostic factors of significance on univariate. Tumor stage and sex were the only independent prognostic factors of significance on multivariate analysis for RFS. Conclusion: Tumor size, stage, grade, and adequacy of surgical resection are the main prognostic factors affecting OS and RFS. These parameters can help to identify the high risk patient who may qualify for aggressive treatment. No significant financial relationships to disclose.
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Affiliation(s)
- M. A. Memon
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - A. A. Allam
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - A. M. El-Enbaby
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - M. El-Sebaie
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - Y. M. Khafaga
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - H. Schultz
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
| | - A. El-Weshi
- King faisal specialist Hospital and Research Cente, Riyadh, Saudi Arabia
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Akkan R, Welker L, Heigener D, Magnussen H, Schultz H, Vollmer E. Imitierung eines Bronchialkarzinoms beim Erwachsenen durch zurückliegende, okkulte Fremdkörperaspiration. Pneumologie 2007. [DOI: 10.1055/s-2007-973340] [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: 10/21/2022]
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Affiliation(s)
- J. E. Eibnee
- Max-Planck-Institut für Eisenforschung, Düsseldorf, Germany
| | - H.-J. Engell
- Max-Planck-Institut für Eisenforschung, Düsseldorf, Germany
| | - H. Schultz
- Max-Planck-Institut für Eisenforschung, Düsseldorf, Germany
- Max-Planck-Institut für Metallforschung, Institut für Physik, Stuttgart, Germany
| | - H. Jacobi
- Max-Planck-Institut für Eisenforschung, Düsseldorf, Germany
| | - G. Schlatte
- Max-Planck-Institut für Eisenforschung, Düsseldorf, Germany
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Takaki S, Fuss J, Kuglers H, Dedek U, Schultz H. The resistivity recovery of high purity and carbon doped iron following low temperature electron irradiation. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/00337578308207398] [Citation(s) in RCA: 213] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vollmer E, Galle J, Lang DS, Loeschke S, Schultz H, Goldmann T. The HOPE technique opens up a multitude of new possibilities in pathology. Rom J Morphol Embryol 2006; 47:15-9. [PMID: 16838052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Fixation of tissues with formalin results in well-preserved morphology but to a high degree leads to degradation of nucleic acids, which substantially constricts the spectrum of applicable molecular techniques. The novel HOPE-fixative with subsequent paraffin embedding, as an alternative to formalin, has been shown to result in a morphological preservation comparable to formalin-fixed, paraffin-embedded specimens. Due to a similar workflow like in formalin-fixation and paraffin embedding, the HOPE technique can be successfully established within any pathological institute. We have shown that DNA, RNA and proteins are protected in HOPE-fixed, paraffin-embedded tissues for at least eight years. Moreover, we described procedures which permit successful application of all common molecular techniques such as in situ hybridization targeting either DNA or RNA, immunohistochemistry without antigen retrieval and for formalin-refractory antigens, PCR, RT-PCR, Western blot, Northern blot, and transcription microarrays to HOPE-fixed, paraffin-embedded tissues. Furthermore, HOPE-fixed tissues can be used for the construction of tissue microarrays for enhanced high-throughput analyses on the molecular level. Using the HOPE technique as its crucial methodological base, ex vivo model systems could be established, e.g. for the simulation of early events in human infections and detection of chemotherapy resistances in human cancer. In addition to tissues, cell-culture preparations have been prepared utilizing the HOPE technique, which were then successfully applied to in situ hybridization targeting mRNA or immunocytochemistry with excellent preservation of morphological details. Taken together, the HOPE technique to date represents an alternative fixation that is, in contrary to other procedures, scientifically broadly analyzed. Therefore new possibilities are opened up especially within the rapidly growing field of molecular pathology.
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Affiliation(s)
- E Vollmer
- Clinical & Experimental Pathology, Research Center Borstel, Germany.
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Sonnenschein M, Brosig G, Eckert A, Engelke K, Jung M, Vogt C, Schlegel M, Polt A, Schultz H. Anforderungen an Werkzeuge und Methoden zum verbesserten Design von Wertschöpfungsketten in der chemischen Industrie. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200590132] [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: 11/12/2022]
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Polt A, Schultz H. VIP@GI™: „Value Improving Practices” als Schlüsselelemente der Konzept-Planung. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200580038] [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: 11/06/2022]
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Vogt C, Allers T, Brosig G, Eckert A, Engelke K, Jung M, Polt A, Schultz H, Sonnenschein M. Paradigm Shift and Requirements in Enhanced Value Chain Design in the Chemical Industry. Chem Eng Res Des 2005. [DOI: 10.1205/cherd.04373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Schreiber T, Schultz H, Schmidt O, Röser F, Limpert J, Tünnermann A. Stress-induced birefringence in large-mode-area micro-structured optical fibers. Opt Express 2005; 13:3637-3646. [PMID: 19495270 DOI: 10.1364/opex.13.003637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report on detailed numerical investigation of stress-induced birefringence in micro-structured solid-core optical fibers. The stress is induced either by external forces or stress applying parts inside the fiber. Both methods lead to different stress distributions where screening as well as enhancement effects due to the air-hole micro-structuring could be observed. Furthermore, we discuss the potential of the realization of polarization-maintaining low-nonlinearity micro-structured fibers that are suitable for applications in ultrafast optics.
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Jagiello P, Klein W, Schultz H, Csernok E, Gross WL, Epplen JT. Association study of Wegener granulomatosis and the functionally relevant A645G polymorphism in the bactericidal/permeability increasing protein (BPI) gene. Int J Immunogenet 2005; 32:3-6. [PMID: 15686586 DOI: 10.1111/j.1744-313x.2005.00495.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In antineutrophil cytoplasmatic antibody (ANCA)-associated vasculitides (AAV), bactericidal/permeability increasing protein (BPI) ANCAs are detected. Recent observations suggest that BPI-ANCAs can potentially contribute to a proinflammatory setting in the absence of proteinase 3 (PRTN3) ANCAs during the development of a pulmonary relapse by impeding the elimination of Gram-negative bacteria (GNB). However, it is as yet not clear whether the genetic background contributes to the generation of BPI-ANCAs in Wegener granulomatosis (WG) or if BPI polymorphisms are associated with WG. In this study we genotyped the functionally relevant single nucleotide polymorphism (SNP) A645 (Glu216Lys) of the BPI gene in 201 WG patients and 608 healthy controls. To investigate whether further SNPs might be associated with WG, we also examined an intragenic microsatellite marker. No significant differences were found between patients and controls. Thus BPI polymorphisms do not appear to contribute to genetic predisposition to WG. Moreover, our data do not suggest a genetic background for the generation of BPI-ANCAs in WG.
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Affiliation(s)
- P Jagiello
- Department of Human Genetics, Ruhr University, Bochum, Germany.
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Abstract
Different individuals with the same kind of primary immunodeficiency may start having symptoms from early childhood on, or alternatively much later in adult life, or never. The differences in phenotype can only partly be deduced from genotype-analysis or--in case of female patients with X-linked diseases--from age-related skewing of lyonisation. The role of compensatory immune mechanisms is less clear. The microbial spectrum of infections is usually the same for both adult and infantile forms of a special primary immunodeficiency syndrome. Yet, many of the adult forms are associated with non-infectious complications, such as granuloma formation, autoimmunity or tumors. Besides standard antibiotic treatment and IgG replacement therapy, there are now different cytokine- or enzyme-replacement regimens available for some of the primary immunodeficiencies. However, exact diagnostic classification of the immunodeficiency should be obtained before such treatment modalities are used. Adult primary immunodeficiency syndromes therefore represent a challenge to both clinicians and molecular biologists.
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Affiliation(s)
- S Gadola
- Klinik für Rheumatologie und Klinische Immunologie/Allergologie, Universitätsspital INSEL, Bern, Schweiz.
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Chovanec A, Waringer J, Straif M, Graf W, Reckendorfer W, Waringer-Löschenkohl A, Waidbacher H, Schultz H. The Floodplain Index - a new approach for assessing the ecological status of river/floodplain-systems according to the EU Water Framework Directive. ACTA ACUST UNITED AC 2003. [DOI: 10.1127/lr/15/2003/169] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Schultz H, Csernok E, Herlyn K, Reichel PH, Moosig F, Cornely OA, Fagerhol MK, Gross WL. ANCA against bactericidal/permeability-increasing protein, azurocidin, calprotectin and defensins in rheumatic and infectious diseases: prevalence and clinical associations. Clin Exp Rheumatol 2003; 21:S117-20. [PMID: 14740437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVE To determine the prevalence and clinical associations of ANCA against the antibiotic proteins and peptides: Bactericidal/permeability-increasing protein (BPI), Azurocidin (AZ), Calprotectin (CP) and beta-Defensin-1 and -2 (DF). METHODS Patients with ANCA-associated vasculitides (n = 99), other vasculitides and rheumatic connective tissue diseases (n = 303), HIV-infection (n = 66), other infectious diseases (n = 134) Crohn's disease (n = 12) and ulcerative colitis (n = 12) were tested for BPI-, AZ-, CP-, DF-, PR3-, and MPO-ANCA in indirect immunofluorescence technique (IFT) and ELISA. RESULTS In ANCA associated vasculitides BPI-ANCA were detected in 6% of patients. In HIV infection, BPI was the main target antigen of ANCA-IFT positive sera (74%). BPI-ANCA was associated with higher inflammatory activity. In Crohn's disease and ulcerative colitis BPI-ANCA was prominent (34% of patients). AZ-ANCA were found in 5% of patients. No ANCA were detected against defensin and calprotectin. CONCLUSION BPI-ANCA is the main autoantibody in HIV and is associated with higher inflammatory activity. In inflammatory bowel diseases BPI-ANCA is predominant, AZ-ANCA are also present to a lesser extend. Both were not useful characterize clinical subgroups. No ANCA were detected against calprotectin or defensins.
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Affiliation(s)
- H Schultz
- Department of Rheumatology, University of Lübeck, Lübeck, Germany
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Schultz H, Heintz H, van Zandbergen G, Ullrich S, Reinhold-Keller E, Gross WL. ANCA against the bactericidal/permeability increasing protein (BPI-ANCA) can compromise the antibiotic function of BPI in a Wegener's granulomatosis patient. Clin Exp Rheumatol 2003; 21:763-6. [PMID: 14740457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
A 54-year old Wegener's granulomatosis patient with PR3-ANCA at diagnosis 2 years ago was admitted with a pulmonary relapse and new subglottic stenosis preceded by pulmonary infections. The patient presented with bactericidal/permeability increasing protein (BPI)-ANCA in ELISA whereas at the same time PR3-ANCA had disappeared. Bronchoalveolar lavage revealed pulmonary infection with Gram-negative bacteria. After antibiotic treatment, immunosuppression was started with cyclophosphamide and infliximab due to refractory disease. Remission was induced and BPI-ANCA disappeared. A bacterial growth inhibition assay with BPI and the patient's IgG purified during the actual pulmonary relapse showed inhibition of the antimicrobial activity of BPI in vitro, in contrast to IgG from sera taken 2 years before and after remission was induced. The patient's BPI-ANCA recognised the bioactive N-terminal portion of BPI. Thus a possible mechanism is demonstrated for how BPI-ANCA may contribute to a pro-inflammatory setting during the development of a pulmonary relapse in the absence of PR3-ANCA by impeding bacterial clearance.
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Affiliation(s)
- H Schultz
- Poliklinik für Rheumatologie, Universitaetsklinikum Luebeck, Luebeck, Germany
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Drögemüller A, Schultz H, Senges J, Seidl K. Kathetertechnische Bergung der Innenwendel einer separierten Schrittmacher-Elektrode in der Arteria pulmonalis. ACTA ACUST UNITED AC 2003; 92:884-8. [PMID: 14579054 DOI: 10.1007/s00392-003-0980-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2003] [Accepted: 06/11/2003] [Indexed: 11/25/2022]
Abstract
This case report describes a successful catheter-based rescue of a split pacemaker lead in the pulmonary artery-as an unusual reason for pleural effusion. Hemorrhagic pleural effusion was diagnosed 7 months after pacemaker exchange due to battery depletion and lead replacement due to an increase of the stimulation threshold. The reason for the pleural effusion was a splitting of the inactive electrode lead into shaft and inner fragment which was dislocated into the pulmonary artery and micro-perforated. The dislocated lead was retrieved using biopsy forceps and a gooseneck snare. Finally it was capped and fixed. Even in an anatomically difficult position, catheter-based rescue is feasible. Not in all pacemaker lead types is cutting the adapter of the inactive pacemaker leads recommendable.
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Affiliation(s)
- A Drögemüller
- Herzzentrum Ludwigshafen, Kardiologie, Bremserstr. 79, 67063 Ludwigshafen, Germany.
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Schultz H, Schinke S, Weiss J, Cerundolo V, Gross WL, Gadola S. BPI-ANCA in transporter associated with antigen presentation (TAP) deficiency: possible role in susceptibility to Gram-negative bacterial infections. Clin Exp Immunol 2003; 133:252-9. [PMID: 12869032 PMCID: PMC1808774 DOI: 10.1046/j.1365-2249.2003.02197.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [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] [Indexed: 01/10/2023] Open
Abstract
Although HLA class I expression is diminished in patients with defects in the transporter associated with antigen presentation (TAP), recurrent Gram-negative bacterial lung infections are found from childhood onwards. As MHC class II-mediated responses are normal, other mechanisms that contribute to susceptibility to infections are presumed. The bactericidal/permeability-increasing protein (BPI) is a potent neutrophil antibiotic that neutralizes endotoxin efficiently. As antineutrophil cytoplasmic autoantibodies (ANCA) against BPI were found in the majority of cystic fibrosis patients and correlate with disease severity we examined the prevalence of BPI-ANCA and their contribution to susceptibility to bacterial infections in six TAP-deficient patients. Although only two patients showed ANCA in indirect immunofluorescence, BPI-ANCA occurred in five of six patients in ELISA. Purified IgG from BPI-ANCA-positive sera (five of six) inhibited the antimicrobial function of BPI in vitro. Epitope mapping revealed binding sites not only on the C-terminal but also on the antibiotic N-terminal portion of BPI, indicating that short linear BPI peptide fragments may be long-lived enough to become immunogens. In conclusion, BPI-ANCA are associated strongly with TAP deficiency. Inhibition of the antimicrobial BPI function by BPI-ANCA demonstrates a possible mechanism of how autoantibodies may contribute to increased susceptibility for pulmonary Gram-negative bacterial infections by diminished bacterial clearance.
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Affiliation(s)
- H Schultz
- Department of Rheumatology, University Hospital Luebeck and Rheumaklinik Bad Bramstedt, Germany.
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Khafaga Y, Hassounah M, Kandil A, Kanaan I, Allam A, El Husseiny G, Kofide A, Belal A, Al Shabanah M, Schultz H, Jenkin D. Optic gliomas: a retrospective analysis of 50 cases. Int J Radiat Oncol Biol Phys 2003; 56:807-12. [PMID: 12788189 DOI: 10.1016/s0360-3016(02)04512-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Gliomas of the optic pathways are rare childhood central nervous system tumors. The treatment approach is controversial because of its rarity and the slow and unpredictable growth rates of these lesions. METHODS AND MATERIALS We reviewed 50 patients with the diagnosis of optic pathway low-grade gliomas treated between January 1980 and December 1995 at King Faisal Specialist Hospital and Research Center, Saudi Arabia. Thirty-five patients presented with chiasmatic/hypothalamic (posterior tumors), and 15 with optic nerve gliomas with or without chiasmal involvement (anterior tumors). Evidence of neurofibromatosis was present in 18 patients. Twenty-nine patients underwent surgery (total or partial resection), and 12 of these received postoperative radiotherapy (RT). Sixteen patients were treated with primary RT. The radiation dose varied between 42 and 54 Gy (median dose 50). RESULTS The overall actuarial survival rate was 87.5% at 5 years and 75% at 10 years, and the corresponding progression-free survival (PFS) rates were 69% and 62%. Patients with anterior tumors fared better than those with posterior tumors, with a 10-year PFS rate of 72% and 58%, respectively; the difference, however, was not statistically significant (p = 0.58). A PFS advantage was found in favor of patients with posterior tumors treated with RT (primary or postoperative) compared with no RT, with 5-year PFS rates of 68% vs. 42% (p = 0.03). This, however, did not translate into a survival advantage because of the success of salvage treatment. CONCLUSION In multivariate analysis, age (<3 vs. >3 years) emerged as the only significant determinant for PFS with patients <3 years old faring worse (p = 0.03). Neurologic and endocrine dysfunction are significant problems that need to be addressed.
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Affiliation(s)
- Yasser Khafaga
- Department of Oncology, Section of Radiation Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Jenkin RD, Al-Fawaz I, Al-Shabanah M, Allam A, Ayas M, Khafaga Y, Memon M, Rifai S, Schultz H, Younge D. Localised Ewing sarcoma/PNET of bone--prognostic factors and international data comparison. Med Pediatr Oncol 2002; 39:586-93. [PMID: 12376982 DOI: 10.1002/mpo.10212] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND To determine if the distribution of prognostic factors accounted for the differences when the outcome for localised Ewing Sarcoma/PNET bone in Saudi Arabia was compared with results from countries with well developed health care systems. PROCEDURE Retrospective analysis was undertaken of 163 consecutive patients of all ages, treated with radical intent at KFSHRC from 1975 to 1998. Standard chemotherapy was commenced in all patients. The local treatment modality was resection +/- radiation in 30% and radiation treatment alone in 67%. Size data were available for 51 patients treated from 1994 to 1998, inclusive. One third of these patients had tumors with volume >500 ml. RESULTS Three year survival significantly increased with the year of diagnosis, 1975-1988 45%; 1989-1993 55%; and 1993-1998 63% (P = 0.006). Favorable prognostic factors were age < or =14 (P = 0.07); site, distal extremity, and skull (P = 0.08); and volume < or = 200 ml (P = 0.06). Secondary prognostic factors were response to induction chemotherapy, both histological, 100% necrosis, (P = 0.04) and clinical CR+PR, (P = 0.02). From 1994 to 1998, 3 year survival for tumors in the distal extremity and skull was 80% and for small tumors, < 200 ml, at any site was 82%. In comparison, the 3 year survival for patients with tumors at any other sites was 60%, and for tumors >200 ml, 55%. CONCLUSIONS Overall survival progressively improved. From 1994 to 1998 the survival of patients with small tumors and/or favorable sites was similar to the best reported results. It was not possible to compare results by tumor size for large tumors, > 500 ml, due to the absence of data from elsewhere. A better staging system is required for the international comparison of results.
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Affiliation(s)
- R Derek Jenkin
- Department of Oncology, Section of Radiation Oncology, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, Saudi Arabia 11211.
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Affiliation(s)
- T J Doherty
- Department Of Large Animal Clinical Sciences, The University Of Tennessee, College Of Veterinary Medicine, Knoxville 37901-1071, USA.
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Belal A, Kandil A, Allam A, Khafaga Y, El-Husseiny G, El-Enbaby A, Memon M, Younge D, Moreau P, Gray A, Schultz H. Malignant fibrous histiocytoma: a retrospective study of 109 cases. Am J Clin Oncol 2002; 25:16-22. [PMID: 11823689 DOI: 10.1097/00000421-200202000-00003] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this report is to assess the prognostic factors that could influence management and clinical outcome of malignant fibrous histiocytoma (MFH) of soft tissues. Between 1975 and 1998, 109 patients diagnosed with MFH of the soft tissues, seen at King Faisal Specialist Hospital and Research Center, have been reviewed. Of the 109 patients, 75 were men and 34 were women. The median age at presentation was 48 years (range: 3-94). Seven patients (6%) had regional nodal disease and 10 other patients (9%) with distant metastases were excluded from survival analysis. The remaining 92 patients had localized disease and had surgery as the primary treatment modality with or without radiotherapy and/or chemotherapy. Extremities were the most common location (58%). Tumors less than 5 cm represented 32%, whereas 68% had tumors 5 cm or more. Low-grade tumors constituted 46%, and the remaining 54% were high grade. Thirty-seven percent of patients had positive surgical margins histologically after complete gross resection. The 5- and 10-year relapse-free survival (RFS) rates were 39% and 36%, respectively. Isolated local recurrence occurred in 20 patients (22%), isolated metastatic disease without local recurrence in 9 patients (10%), and combined local and metastatic disease occurred in 20 patients (22%). The overall 5- and 10-year overall survival (OS) rates were 50% and 43%, respectively. On multivariate analysis, tumor size and radiation dose were significant factors for RFS (p = 0.04 and 0.0005, respectively). In terms of OS, size, histologic grade, and surgical margins were significant factors on multivariate analysis (p = 0.001. 0.006, and 0.0001, respectively). Complete surgical resection at the time of primary tumor presentation is likely to afford the best chance for RFS and OS. Radiation therapy plays an important role, in combination with surgery for better local control, particularly in high-grade lesions, and in cases with positive surgical margins after wide complete gross excision. The role of adjuvant chemotherapy remains investigational.
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Affiliation(s)
- Abdelaziz Belal
- Section of Radiation Oncology, Department of Oncology, King Faisal Specialist Hospital & Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia
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