1
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Abuter R, Allouche F, Amorim A, Bailet C, Berdeu A, Berger JP, Berio P, Bigioli A, Boebion O, Bolzer ML, Bonnet H, Bourdarot G, Bourget P, Brandner W, Cao Y, Conzelmann R, Comin M, Clénet Y, Courtney-Barrer B, Davies R, Defrère D, Delboulbé A, Delplancke-Ströbele F, Dembet R, Dexter J, de Zeeuw PT, Drescher A, Eckart A, Édouard C, Eisenhauer F, Fabricius M, Feuchtgruber H, Finger G, Förster Schreiber NM, Garcia P, Garcia Lopez R, Gao F, Gendron E, Genzel R, Gil JP, Gillessen S, Gomes T, Gonté F, Gouvret C, Guajardo P, Guieu S, Hackenberg W, Haddad N, Hartl M, Haubois X, Haußmann F, Heißel G, Henning T, Hippler S, Hönig SF, Horrobin M, Hubin N, Jacqmart E, Jocou L, Kaufer A, Kervella P, Kolb J, Korhonen H, Lacour S, Lagarde S, Lai O, Lapeyrère V, Laugier R, Le Bouquin JB, Leftley J, Léna P, Lewis S, Liu D, Lopez B, Lutz D, Magnard Y, Mang F, Marcotto A, Maurel D, Mérand A, Millour F, More N, Netzer H, Nowacki H, Nowak M, Oberti S, Ott T, Pallanca L, Paumard T, Perraut K, Perrin G, Petrov R, Pfuhl O, Pourré N, Rabien S, Rau C, Riquelme M, Robbe-Dubois S, Rochat S, Salman M, Sanchez-Bermudez J, Santos DJD, Scheithauer S, Schöller M, Schubert J, Schuhler N, Shangguan J, Shchekaturov P, Shimizu TT, Sevin A, Soulez F, Spang A, Stadler E, Sternberg A, Straubmeier C, Sturm E, Sykes C, Tacconi LJ, Tristram KRW, Vincent F, von Fellenberg S, Uysal S, Widmann F, Wieprecht E, Wiezorrek E, Woillez J, Zins G. A dynamical measure of the black hole mass in a quasar 11 billion years ago. Nature 2024; 627:281-285. [PMID: 38286342 DOI: 10.1038/s41586-024-07053-4] [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] [Received: 08/07/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024]
Abstract
Tight relationships exist in the local Universe between the central stellar properties of galaxies and the mass of their supermassive black hole (SMBH)1-3. These suggest that galaxies and black holes co-evolve, with the main regulation mechanism being energetic feedback from accretion onto the black hole during its quasar phase4-6. A crucial question is how the relationship between black holes and galaxies evolves with time; a key epoch to examine this relationship is at the peaks of star formation and black hole growth 8-12 billion years ago (redshifts 1-3)7. Here we report a dynamical measurement of the mass of the black hole in a luminous quasar at a redshift of 2, with a look back in time of 11 billion years, by spatially resolving the broad-line region (BLR). We detect a 40-μas (0.31-pc) spatial offset between the red and blue photocentres of the Hα line that traces the velocity gradient of a rotating BLR. The flux and differential phase spectra are well reproduced by a thick, moderately inclined disk of gas clouds within the sphere of influence of a central black hole with a mass of 3.2 × 108 solar masses. Molecular gas data reveal a dynamical mass for the host galaxy of 6 × 1011 solar masses, which indicates an undermassive black hole accreting at a super-Eddington rate. This suggests a host galaxy that grew faster than the SMBH, indicating a delay between galaxy and black hole formation for some systems.
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Affiliation(s)
- R Abuter
- European Southern Observatory, Garching, Germany
| | - F Allouche
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - A Amorim
- Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
- CENTRA - Centro de Astrofísica e Gravitação, Instituto Superior Técnico (IST), Universidade de Lisboa, Lisboa, Portugal
| | - C Bailet
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - A Berdeu
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - J-P Berger
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - P Berio
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - A Bigioli
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - O Boebion
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - M-L Bolzer
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
- Department of Physics, Technical University Munich, Garching, Germany
- Univ. Lyon, Univ. Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon UMR5574, Saint-Genis-Laval, France
| | - H Bonnet
- European Southern Observatory, Garching, Germany
| | - G Bourdarot
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - P Bourget
- European Southern Observatory, Santiago, Chile
| | - W Brandner
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - Y Cao
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - R Conzelmann
- European Southern Observatory, Garching, Germany
| | - M Comin
- European Southern Observatory, Garching, Germany
| | - Y Clénet
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - B Courtney-Barrer
- European Southern Observatory, Santiago, Chile
- Research School of Astronomy and Astrophysics, College of Science, Australian National University, Canberra, Australian Capital Territory, Australia
| | - R Davies
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - D Defrère
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - A Delboulbé
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | | | - R Dembet
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - J Dexter
- Department of Astrophysical & Planetary Sciences, JILA, University of Colorado Boulder, Boulder, CO, USA
| | | | - A Drescher
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - A Eckart
- Max Planck Institute for Radio Astronomy, Bonn, Germany
- 1st Institute of Physics, University of Cologne, Cologne, Germany
| | - C Édouard
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - F Eisenhauer
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - M Fabricius
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - H Feuchtgruber
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - G Finger
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | | | - P Garcia
- CENTRA - Centro de Astrofísica e Gravitação, Instituto Superior Técnico (IST), Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - R Garcia Lopez
- School of Physics, University College Dublin, Belfield, Dublin 4, Ireland
| | - F Gao
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - E Gendron
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - R Genzel
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
- Departments of Physics, University of California, Berkeley, Berkeley, CA, USA
- Department of Astronomy, University of California, Berkeley, Berkeley, CA, USA
| | - J P Gil
- European Southern Observatory, Santiago, Chile
| | - S Gillessen
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - T Gomes
- CENTRA - Centro de Astrofísica e Gravitação, Instituto Superior Técnico (IST), Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - F Gonté
- European Southern Observatory, Garching, Germany
| | - C Gouvret
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - P Guajardo
- European Southern Observatory, Santiago, Chile
| | - S Guieu
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - W Hackenberg
- European Southern Observatory, Garching, Germany
| | - N Haddad
- European Southern Observatory, Santiago, Chile
| | - M Hartl
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - X Haubois
- European Southern Observatory, Santiago, Chile
| | - F Haußmann
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - G Heißel
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
- Advanced Concepts Team, European Space Agency, TEC-SF, ESTEC, Noordwijk, The Netherlands
| | - Th Henning
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - S Hippler
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - S F Hönig
- School of Physics and Astronomy, University of Southampton, Southampton, UK
| | - M Horrobin
- 1st Institute of Physics, University of Cologne, Cologne, Germany
| | - N Hubin
- European Southern Observatory, Garching, Germany
| | - E Jacqmart
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - L Jocou
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - A Kaufer
- European Southern Observatory, Santiago, Chile
| | - P Kervella
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - J Kolb
- European Southern Observatory, Garching, Germany
| | - H Korhonen
- European Southern Observatory, Santiago, Chile
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - S Lacour
- European Southern Observatory, Garching, Germany
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - S Lagarde
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - O Lai
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - V Lapeyrère
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - R Laugier
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | | | - J Leftley
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - P Léna
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - S Lewis
- European Southern Observatory, Garching, Germany
| | - D Liu
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - B Lopez
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - D Lutz
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - Y Magnard
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - F Mang
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
- Department of Physics, Technical University Munich, Garching, Germany
| | - A Marcotto
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - D Maurel
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - A Mérand
- European Southern Observatory, Garching, Germany
| | - F Millour
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - N More
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - H Netzer
- School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel
| | - H Nowacki
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - M Nowak
- Institute of Astronomy, University of Cambridge, Cambridge, UK
| | - S Oberti
- European Southern Observatory, Garching, Germany
| | - T Ott
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - L Pallanca
- European Southern Observatory, Santiago, Chile
| | - T Paumard
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - K Perraut
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - G Perrin
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - R Petrov
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - O Pfuhl
- European Southern Observatory, Garching, Germany
| | - N Pourré
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - S Rabien
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - C Rau
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - M Riquelme
- European Southern Observatory, Garching, Germany
| | - S Robbe-Dubois
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - S Rochat
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - M Salman
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - J Sanchez-Bermudez
- Max Planck Institute for Astronomy, Heidelberg, Germany
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - D J D Santos
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - S Scheithauer
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - M Schöller
- European Southern Observatory, Garching, Germany
| | - J Schubert
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - N Schuhler
- European Southern Observatory, Santiago, Chile
| | - J Shangguan
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | | | - T T Shimizu
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany.
| | - A Sevin
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | - F Soulez
- Univ. Lyon, Univ. Lyon 1, ENS de Lyon, CNRS, Centre de Recherche Astrophysique de Lyon UMR5574, Saint-Genis-Laval, France
| | - A Spang
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | - E Stadler
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - A Sternberg
- School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel
- Center for Computational Astrophysics, Flatiron Institute, New York, NY, USA
| | - C Straubmeier
- 1st Institute of Physics, University of Cologne, Cologne, Germany
| | - E Sturm
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - C Sykes
- School of Physics and Astronomy, University of Southampton, Southampton, UK
| | - L J Tacconi
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | | | - F Vincent
- LESIA - Observatoire de Paris, Université PSL, Sorbonne Université, Université Paris Cité, CNRS, Meudon, France
| | | | - S Uysal
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - F Widmann
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - E Wieprecht
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - E Wiezorrek
- Max Planck Institute for Extraterrestrial Physics, Garching, Germany
| | - J Woillez
- European Southern Observatory, Garching, Germany
| | - G Zins
- European Southern Observatory, Garching, Germany
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2
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Lin F, Cao K, Chang F, Oved JH, Luo M, Fan Z, Schubert J, Wu J, Zhong Y, Gallo DJ, Denenberg EH, Chen J, Fanning EA, Lambert MP, Paessler ME, Surrey LF, Zelley K, MacFarland S, Kurre P, Olson TS, Li MM. Uncovering the Genetic Etiology of Inherited Bone Marrow Failure Syndromes Using a Custom-Designed Next-Generation Sequencing Panel. J Mol Diagn 2024; 26:191-201. [PMID: 38103590 DOI: 10.1016/j.jmoldx.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/13/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Inherited bone marrow failure syndromes (IBMFS) are a group of heterogeneous disorders that account for ∼30% of pediatric cases of bone marrow failure and are often associated with developmental abnormalities and cancer predisposition. This article reports the laboratory validation and clinical utility of a large-scale, custom-designed next-generation sequencing panel, Children's Hospital of Philadelphia (CHOP) IBMFS panel, for the diagnosis of IBMFS in a cohort of pediatric patients. This panel demonstrated excellent analytic accuracy, with 100% sensitivity, ≥99.99% specificity, and 100% reproducibility on validation samples. In 269 patients with suspected IBMFS, this next-generation sequencing panel was used for identifying single-nucleotide variants, small insertions/deletions, and copy number variations in mosaic or nonmosaic status. Sixty-one pathogenic/likely pathogenic variants (54 single-nucleotide variants/insertions/deletions and 7 copy number variations) and 24 hypomorphic variants were identified, resulting in the molecular diagnosis of IBMFS in 21 cases (7.8%) and exclusion of IBMFS with a diagnosis of a blood disorder in 10 cases (3.7%). Secondary findings, including evidence of early hematologic malignancies and other hereditary cancer-predisposition syndromes, were observed in 9 cases (3.3%). The CHOP IBMFS panel was highly sensitive and specific, with a significant increase in the diagnostic yield of IBMFS. These findings suggest that next-generation sequencing-based panel testing should be a part of routine diagnostics in patients with suspected IBMFS.
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Affiliation(s)
- Fumin Lin
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kajia Cao
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Fengqi Chang
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joseph H Oved
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Minjie Luo
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zhiqian Fan
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey Schubert
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jinhua Wu
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Yiming Zhong
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel J Gallo
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elizabeth H Denenberg
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jiani Chen
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elizabeth A Fanning
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michele P Lambert
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Pediatric Comprehensive Bone Marrow Failure Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michele E Paessler
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lea F Surrey
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kristin Zelley
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Suzanne MacFarland
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Peter Kurre
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Pediatric Comprehensive Bone Marrow Failure Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Timothy S Olson
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Pediatric Comprehensive Bone Marrow Failure Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Marilyn M Li
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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3
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Newman H, Clark ME, Wong D, Wu J, Brodeur GM, Hunger SP, Tasian SK, Olson T, Warren JT, Teachey DT, Bona K, Schubert J, Golenberg N, Patel M, Denenberg EH, Fanning EA, Chen J, Luke T, Charles S, Gallo D, Cao K, Fu W, Fan Z, Surrey LF, Wertheim G, Luo M, MacFarland SP, Li MM, Zhong Y. Genomic profiling of pediatric hematologic malignancies and diagnosis of cancer predisposition syndromes: tumor-only versus paired tumor-normal sequencing. Haematologica 2024. [PMID: 38385299 DOI: 10.3324/haematol.2023.284855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Indexed: 02/23/2024] Open
Abstract
Not available.
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Affiliation(s)
- Haley Newman
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mary Egan Clark
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Derek Wong
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jinhua Wu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Garrett M Brodeur
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Stephen P Hunger
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sarah K Tasian
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Timothy Olson
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Julia T Warren
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - David T Teachey
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kira Bona
- Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Jeffrey Schubert
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Netta Golenberg
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Maha Patel
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Elizabeth H Denenberg
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Elizabeth A Fanning
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jiani Chen
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Tamara Luke
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sarah Charles
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Daniel Gallo
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kajia Cao
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Weixuan Fu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Zhiqian Fan
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Lea F Surrey
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Gerald Wertheim
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Minjie Luo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Suzanne P MacFarland
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Marilyn M Li
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Yiming Zhong
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
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Schubert J, Svensson M, Denstedt G, Johnston N, Cars T, Gustafsson S, Schalin L, Hagstrom E. Long-term assessment and target achievement of LDL-C and systolic blood pressure in primary care after acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1410] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hospital-based cardiac rehabilitation and risk factor control decreases the risk of recurrent events after acute coronary syndrome (ACS). Little is known on long-term assessment and target achievement after referral to primary care. Patients with diabetes, regardless of ACS, have yearly follow-up visits in primary care, whereas there is no structured follow-up after ACS for patients without diabetes.
Purpose
To describe long-term assessment and target achievement of LDL-C and systolic blood pressure (SBP) in ACS patients after referral to primary care. Further, to compare patients with and without diabetes at the time of index ACS.
Methods
A non-interventional population-based observational study of patients with first ever ACS in a Swedish region with 390,000 inhabitants. Data on clinical measurements after ACS were collected from the electronic medical records between 2012 and 2020. Patients were followed until new ACS event, death, moving out of the county, or end of study. Target levels studied were LDL-C <1.8 mmol/L and SBP <140 mmHg. The same assessments with the addition of target levels of HbA1c ≤70 mmol/mol were evaluated in patients with diabetes.
Results
Median follow-up was 2.9 years (inter quartile range [IQR]: 1.0–5.4) and 4,733 patients were detected. Median age was 72 years (IQR 63–80) and 34% were female. Follow-up data were available for 3,579 (76%) patients any time during the first, 2,891 (61%) during the second, and 2,308 (49%) during the third year after the index ACS event. The number of patients with diabetes was 1311 (28%), and of these 921, 723, and 562 could be followed for the first, second, and third year. During the first three years, 898 (19%) of all patients with available follow-up died.
The proportion of patients with assessments of LDL-C and SBP declined for each year of follow-up and target achievement was low (Table). Among patients with diabetes a larger proportion had measurements for LDL-C and SBP, while the target achievement was similar to that of the whole study population. HbA1c was measured equally frequently as SBP and was at target in 81% of patients with diabetes during the three years of follow-up (Table).
Conclusion
The proportion of patients with follow-up assessment and measurements in primary care declined each year after the index ACS event. Patients with diabetes had more frequent LDL-C and SBP measurements but the same low target achievement after an ACS compared with patients without diabetes. This could potentially be due to an increased focus on glycaemic control at these visits. A structured long-term follow-up for ACS patients in primary care might improve both assessment and target achievement and prevent recurrent ACS events.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): AmgenSwedish Heart Lung Foundation
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Affiliation(s)
- J Schubert
- Uppsala University, Medical Sciences, Cardiology , Uppsala , Sweden
| | - M Svensson
- Uppsala University, Medical Sciences, Renal Medicine , Uppsala , Sweden
| | | | - N Johnston
- Uppsala University, Medical Sciences, Cardiology , Uppsala , Sweden
| | - T Cars
- Sence Research , Uppsala , Sweden
| | | | | | - E Hagstrom
- Uppsala University, Medical Sciences, Cardiology , Uppsala , Sweden
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5
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Schubert J, Wu J, Li MM, Cao K. Best Practice for Clinical Somatic Variant Interpretation and Reporting. Clin Lab Med 2022; 42:423-434. [DOI: 10.1016/j.cll.2022.04.006] [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: 11/03/2022]
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6
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Xu F, Viaene AN, Ruiz J, Schubert J, Wu J, Chen J, Cao K, Fu W, Bagatell R, Fan Z, Long A, Pagliaroli L, Zhong Y, Luo M, Kreiger PA, Surrey LF, Wertheim GB, Cole KA, Li MM, Santi M, Storm PB. Novel ATXN1/ATXN1L::NUTM2A fusions identified in aggressive infant sarcomas with gene expression and methylation patterns similar to CIC-rearranged sarcoma. Acta Neuropathol Commun 2022; 10:102. [PMID: 35836290 PMCID: PMC9281131 DOI: 10.1186/s40478-022-01401-z] [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: 05/24/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
CIC-rearranged sarcomas are newly defined undifferentiated soft tissue tumors with CIC-associated fusions, and dismal prognosis. CIC fusions activate PEA3 family genes, ETV1/4/5, leading to tumorigenesis and progression. We report two high-grade CNS sarcomas of unclear histological diagnosis and one disseminated tumor of unknown origin with novel fusions and similar gene-expression/methylation patterns without CIC rearrangement. All three patients were infants with aggressive diseases, and two experienced rapid disease deterioration and death. Whole-transcriptome sequencing identified an ATXN1-NUTM2A fusion in the two CNS tumors and an ATXN1L-NUTM2A fusion in case 3. ETV1/4/5 and WT1 overexpression were observed in all three cases. Methylation analyses predicted CIC-rearranged sarcoma for all cases. Retrospective IHC staining on case 2 demonstrated ETV4 and WT1 overexpression. ATXN1 and ATXN1L interact with CIC forming a transcription repressor complex. We propose that ATXN1/ATXN1L-associated fusions disrupt their interaction with CIC and decrease the transcription repressor complex, leading to downstream PEA3 family gene overexpression. These three cases with novel ATXN1/ATXN1L-associated fusions and features of CIC-rearranged sarcomas may further expand the scope of "CIC-rearranged" sarcomas to include non-CIC rearrangements. Additional cases are needed to demonstrate if ATXN1/ATXN1L-NUTM2A fusions are associated with younger age and more aggressive diseases.
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Affiliation(s)
- Feng Xu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Angela N Viaene
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jenny Ruiz
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jeffrey Schubert
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jinhua Wu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jiani Chen
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kajia Cao
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Weixuan Fu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rochelle Bagatell
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhiqian Fan
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ariel Long
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Luca Pagliaroli
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Yiming Zhong
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Minjie Luo
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Portia A Kreiger
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lea F Surrey
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gerald B Wertheim
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristina A Cole
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marilyn M Li
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Mariarita Santi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Phillip B Storm
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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7
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Wu J, Schubert J, Xu F, Long A, Patel M, Golenberg N, Fu W, Cao K, Chen J, Denenberg EH, Fanning EA, Bagatell R, Laetsch TW, Resnick A, Santi M, Storm PJB, Luo M, Surrey LF, Zhong Y, Li MM. Abstract 5268: The spectrum of FGFR mutations in pediatric and young adult solid tumor. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5268] [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
Fibroblast growth factor receptors (FGFRs) are a family of receptor tyrosine kinases expressed on the cell membrane that play crucial roles in cellular lineage commitment, differentiation, proliferation, and apoptosis. Deregulated FGFR signaling is observed in a subset of tumors across various histologies, making FGFRs ideal therapeutic targets. We sought to determine the genetic landscape of FGFR-family variations in a cohort of pediatric and young adult patients with solid tumors. The CHOP Comprehensive Solid Tumor Panel was performed on 1,420 patients. The panel covers 238 cancer genes and screens for single nucleotide variants (SNVs), indels, copy number alterations, and 117 fusion gene partners interrogating over 700 exons for known and novel fusions. Identified variants were categorized and reported according to the AMP/ASCO/CAP guidelines. Fifty-six patients (4.1%), including 47 children and 9 young adults, were found to carry at least one FGFR alteration in their tumors. CNS tumors accounted for most of the cases (51 total, 87.9%), with pilomyxoid astrocytoma/pilocytic astrocytoma and dysembryoplastic neuroepithelial tumor the most common (13 and 12 patients, respectively). Non-CNS solid tumors included rhabdomyosarcoma (4 patients), neuroblastoma/ganglioneuroblastoma (2), and follicular thyroid carcinoma (1). FGFR somatic alterations were found in 56 tumors including 41 SNVs and small indels, 6 internal tandem duplications (ITDs), and 15 fusions genes. The most common SNVs observed were hotspot mutations p.K656E and p.N546K of FGFR1. Sequence alterations in FGFR1 contained 35 SNVs and small indels, mostly gain of function mutations located in the kinase domain, and 6 kinase domain ITDs. One SNV was identified in FGFR2 in the immunoglobulin domain. Two SNVs were reported in FGFR3, both of which were in the fibroblast growth factor receptor family domain, and 3 SNVs were identified in FGFR4, all occurring at the p.V550 codon located on the kinase domain. Companion mutations in non-FGFR genes were detected in 27 tumors, predominantly involving RAS signaling pathway genes including NF1 (14 variants), PIK3CA (8), PTPN11 (6) and PIK3R1 (4). Among fusion variants, FGFR1-TACC1 fusions were found in 5 patients, mostly in pediatric patients. One FGFR3-TACC3 fusion was identified in one young adult patient. Seven pediatric patients tested positive for FGFR2 fusions; all with different 3’ partners. The detection of an FGFR alteration defined or changed the histologic diagnosis for 22 patients. Our results reveal that FGFR alterations account for 4.1% (56/1420) of the patients with solid tumors tested in our laboratory. The majority of the FGFR-positive tumors are low-grade CNS tumors. Further, the identification of FGFR alterations can significantly improve the tumor diagnosis and provide genomic evidence for potential targeted treatment with FGFR inhibitors.
Citation Format: Jinhua Wu, Jeffrey Schubert, Feng Xu, Ariel Long, Maha Patel, Netta Golenberg, Weixuan Fu, Kajia Cao, Jiani Chen, Elizabeth H. Denenberg, Elizabeth A. Fanning, Rochelle Bagatell, Theodore W. Laetsch, Adam Resnick, Mariarita Santi, Phillip Jay B. Storm, Minjie Luo, Lea F. Surrey, Yiming Zhong, Marilyn M. Li. The spectrum of FGFR mutations in pediatric and young adult solid tumor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5268.
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Affiliation(s)
- Jinhua Wu
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Feng Xu
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Ariel Long
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Maha Patel
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Weixuan Fu
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kajia Cao
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Jiani Chen
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | | | | | | | - Adam Resnick
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | | | - Minjie Luo
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Lea F. Surrey
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Yiming Zhong
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Marilyn M. Li
- 1Children’s Hospital of Philadelphia, Philadelphia, PA
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8
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Linschoten M, Uijl A, Schut A, Jakob CEM, Romão LR, Bell RM, McFarlane E, Stecher M, Zondag AGM, van Iperen EPA, Hermans-van Ast W, Lea NC, Schaap J, Jewbali LS, Smits PC, Patel RS, Aujayeb A, van der Harst P, Siebelink HJ, van Smeden M, Williams S, Pilgram L, van Gilst WH, Tieleman RG, Williams B, Asselbergs FW, Al-Ali AK, Al-Muhanna FA, Al-Rubaish AM, Al-Windy NYY, Alkhalil M, Almubarak YA, Alnafie AN, Alshahrani M, Alshehri AM, Anning C, Anthonio RL, Badings EA, Ball C, van Beek EA, ten Berg JM, von Bergwelt-Baildon M, Bianco M, Blagova OV, Bleijendaal H, Bor WL, Borgmann S, van Boxem AJM, van den Brink FS, Bucciarelli-Ducci C, van Bussel BCT, Byrom-Goulthorp R, Captur G, Caputo M, Charlotte N, vom Dahl J, Dark P, De Sutter J, Degenhardt C, Delsing CE, Dolff S, Dorman HGR, Drost JT, Eberwein L, Emans ME, Er AG, Ferreira JB, Forner MJ, Friedrichs A, Gabriel L, Groenemeijer BE, Groenendijk AL, Grüner B, Guggemos W, Haerkens-Arends HE, Hanses F, Hedayat B, Heigener D, van der Heijden DJ, Hellou E, Hellwig K, Henkens MTHM, Hermanides RS, Hermans WRM, van Hessen MWJ, Heymans SRB, Hilt AD, van der Horst ICC, Hower M, van Ierssel SH, Isberner N, Jensen B, Kearney MT, van Kesteren HAM, Kielstein JT, Kietselaer BLJH, Kochanek M, Kolk MZH, Koning AMH, Kopylov PY, Kuijper AFM, Kwakkel-van Erp JM, Lanznaster J, van der Linden MMJM, van der Lingen ACJ, Linssen GCM, Lomas D, Maarse M, Macías Ruiz R, Magdelijns FJH, Magro M, Markart P, Martens FMAC, Mazzilli SG, McCann GP, van der Meer P, Meijs MFL, Merle U, Messiaen P, Milovanovic M, Monraats PS, Montagna L, Moriarty A, Moss AJ, Mosterd A, Nadalin S, Nattermann J, Neufang M, Nierop PR, Offerhaus JA, van Ofwegen-Hanekamp CEE, Parker E, Persoon AM, Piepel C, Pinto YM, Poorhosseini H, Prasad S, Raafs AG, Raichle C, Rauschning D, Redón J, Reidinga AC, Ribeiro MIA, Riedel C, Rieg S, Ripley DP, Römmele C, Rothfuss K, Rüddel J, Rüthrich MM, Salah R, Saneei E, Saxena M, Schellings DAAM, Scholte NTB, Schubert J, Seelig J, Shafiee A, Shore AC, Spinner C, Stieglitz S, Strauss R, Sturkenboom NH, Tessitore E, Thomson RJ, Timmermans P, Tio RA, Tjong FVY, Tometten L, Trauth J, den Uil CA, Van Craenenbroeck EM, van Veen HPAA, Vehreschild MJGT, Veldhuis LI, Veneman T, Verschure DO, Voigt I, de Vries JK, van de Wal RMA, Walter L, van de Watering DJ, Westendorp ICD, Westendorp PHM, Westhoff T, Weytjens C, Wierda E, Wille K, de With K, Worm M, Woudstra P, Wu KW, Zaal R, Zaman AG, van der Zee PM, Zijlstra LE, Alling TE, Ahmed R, van Aken K, Bayraktar-Verver ECE, Bermúdez Jiménes FJ, Biolé CA, den Boer-Penning P, Bontje M, Bos M, Bosch L, Broekman M, Broeyer FJF, de Bruijn EAW, Bruinsma S, Cardoso NM, Cosyns B, van Dalen DH, Dekimpe E, Domange J, van Doorn JL, van Doorn P, Dormal F, Drost IMJ, Dunnink A, van Eck JWM, Elshinawy K, Gevers RMM, Gognieva DG, van der Graaf M, Grangeon S, Guclu A, Habib A, Haenen NA, Hamilton K, Handgraaf S, Heidbuchel H, Hendriks-van Woerden M, Hessels-Linnemeijer BM, Hosseini K, Huisman J, Jacobs TC, Jansen SE, Janssen A, Jourdan K, ten Kate GL, van Kempen MJ, Kievit CM, Kleikers P, Knufman N, van der Kooi SE, Koole BAS, Koole MAC, Kui KK, Kuipers-Elferink L, Lemoine I, Lensink E, van Marrewijk V, van Meerbeeck JP, Meijer EJ, Melein AJ, Mesitskaya DF, van Nes CPM, Paris FMA, Perrelli MG, Pieterse-Rots A, Pisters R, Pölkerman BC, van Poppel A, Reinders S, Reitsma MJ, Ruiter AH, Selder JL, van der Sluis A, Sousa AIC, Tajdini M, Tercedor Sánchez L, Van De Heyning CM, Vial H, Vlieghe E, Vonkeman HE, Vreugdenhil P, de Vries TAC, Willems AM, Wils AM, Zoet-Nugteren SK. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries. Eur Heart J 2022; 43:1104-1120. [PMID: 34734634 DOI: 10.1093/eurheartj/ehab656] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. METHODS AND RESULTS We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. CONCLUSION Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
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9
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Xu F, Aref-Eshghi E, Wu J, Schubert J, Wertheim G, Bhatti T, Pogoriler J, Patel M, Cao K, Long A, Fan Z, Denenberg E, Fanning E, Wilmoth D, Luo M, Conlin L, Dain AS, Baldino S, Zelley K, Balamuth NJ, Macfarland S, Li MM, Zhong Y. A Novel TP53 Tandem Duplication in a Child with Li-Fraumeni Syndrome. Cold Spring Harb Mol Case Stud 2022; 8:mcs.a006181. [PMID: 35232817 PMCID: PMC9059784 DOI: 10.1101/mcs.a006181] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022] Open
Abstract
Li–Fraumeni syndrome (LFS) is one of the most common cancer predisposition syndromes that affects both children and adults. Individuals with LFS are at an increased risk of developing various types of cancer over their lifetime including soft tissue sarcomas, osteosarcomas, breast cancer, leukemia, brain tumors, and adrenocortical carcinoma. Heterozygous germline pathogenic variants in the tumor suppressor gene TP53 are the known causal genetic defect for LFS. Single-nucleotide variants (SNVs) including missense substitutions that occur in the highly conserved DNA binding domain of the protein are the most common alterations, followed by nonsense and splice site variants. Gross copy-number changes in TP53 are rare and account for <1% of all variants. Using next-generation sequencing (NGS) panels, we identified a paternally inherited germline intragenic duplication of TP53 in a child with metastatic osteosarcoma who later developed acute myeloid leukemia (AML). Transcriptome sequencing (RNA-seq) demonstrated the duplication was tandem, encompassing exons 2–6 and 28 nt of the untranslated region (UTR) upstream of the start codon in exon 2. The inclusion of the 28 nt is expected to result in a frameshift with a stop codon 18 codons downstream from the exon 6, leading to a loss-of-function allele. This case highlights the significance of simultaneous identification of both significant copy-number variants as well as SNVs/indels using NGS panels.
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Affiliation(s)
- Feng Xu
- Children's Hospital of Philadelphia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marilyn M Li
- Children's Hospital of Philadelphia; University of Pennsylvania
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10
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Meisenheimer PB, Steinhardt RA, Sung SH, Williams LD, Zhuang S, Nowakowski ME, Novakov S, Torunbalci MM, Prasad B, Zollner CJ, Wang Z, Dawley NM, Schubert J, Hunter AH, Manipatruni S, Nikonov DE, Young IA, Chen LQ, Bokor J, Bhave SA, Ramesh R, Hu JM, Kioupakis E, Hovden R, Schlom DG, Heron JT. Engineering new limits to magnetostriction through metastability in iron-gallium alloys. Nat Commun 2021; 12:2757. [PMID: 33980848 PMCID: PMC8115637 DOI: 10.1038/s41467-021-22793-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Received: 09/21/2020] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
Magnetostrictive materials transduce magnetic and mechanical energies and when combined with piezoelectric elements, evoke magnetoelectric transduction for high-sensitivity magnetic field sensors and energy-efficient beyond-CMOS technologies. The dearth of ductile, rare-earth-free materials with high magnetostrictive coefficients motivates the discovery of superior materials. Fe1-xGax alloys are amongst the highest performing rare-earth-free magnetostrictive materials; however, magnetostriction becomes sharply suppressed beyond x = 19% due to the formation of a parasitic ordered intermetallic phase. Here, we harness epitaxy to extend the stability of the BCC Fe1-xGax alloy to gallium compositions as high as x = 30% and in so doing dramatically boost the magnetostriction by as much as 10x relative to the bulk and 2x larger than canonical rare-earth based magnetostrictors. A Fe1-xGax - [Pb(Mg1/3Nb2/3)O3]0.7-[PbTiO3]0.3 (PMN-PT) composite magnetoelectric shows robust 90° electrical switching of magnetic anisotropy and a converse magnetoelectric coefficient of 2.0 × 10-5 s m-1. When optimally scaled, this high coefficient implies stable switching at ~80 aJ per bit.
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Affiliation(s)
- P B Meisenheimer
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - R A Steinhardt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - S H Sung
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - L D Williams
- Department of Materials Design and Innovation, University at Buffalo - The State University of New York, Buffalo, NY, USA
| | - S Zhuang
- Department of Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - M E Nowakowski
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - S Novakov
- Department of Physics, University of Michigan, Ann Arbor, MI, USA
| | - M M Torunbalci
- OxideMEMS Lab, Purdue University, West Lafayette, IN, USA
| | - B Prasad
- Department of Materials Science and Engineering, University of California, Berkeley, CA, USA
| | - C J Zollner
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
| | - Z Wang
- School of Applied and Engineering Physics, Cornell University, Ithaca, NY, USA
| | - N M Dawley
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - J Schubert
- Peter Grünberg Institute (PGI-9) and JARA Fundamentals of Future Information Technology, Forschungszentrum Jülich GmbH, Jülich, Germany
| | - A H Hunter
- Michigan Center for Materials Characterization, University of Michigan, Ann Arbor, MI, USA
| | - S Manipatruni
- Components Research, Intel Corporation, Hillsboro, OR, USA
| | - D E Nikonov
- Components Research, Intel Corporation, Hillsboro, OR, USA
| | - I A Young
- Components Research, Intel Corporation, Hillsboro, OR, USA
| | - L Q Chen
- Department of Materials Science and Engineering, Penn State University, State College, PA, USA
| | - J Bokor
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - S A Bhave
- OxideMEMS Lab, Purdue University, West Lafayette, IN, USA
| | - R Ramesh
- Department of Materials Science and Engineering, University of California, Berkeley, CA, USA.,Materials Sciences Division, Lawrence Berkeley National Laboratory, CA, USA.,Department of Physics, University of California, Berkeley, CA, USA
| | - J-M Hu
- Department of Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - E Kioupakis
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - R Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Kavli Institute at Cornell for Nanoscale Science, Ithaca, NY, USA.,Leibniz-Institut für Kristallzüchtung, Max-Born-Str. 2, Berlin, Germany
| | - J T Heron
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
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11
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Zhong Y, Xu F, Wu J, Schubert J, Li MM. Application of Next Generation Sequencing in Laboratory Medicine. Ann Lab Med 2021; 41:25-43. [PMID: 32829577 PMCID: PMC7443516 DOI: 10.3343/alm.2021.41.1.25] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [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: 02/27/2020] [Revised: 03/24/2020] [Accepted: 08/07/2020] [Indexed: 12/12/2022] Open
Abstract
The rapid development of next-generation sequencing (NGS) technology, including advances in sequencing chemistry, sequencing technologies, bioinformatics, and data interpretation, has facilitated its wide clinical application in precision medicine. This review describes current sequencing technologies, including short- and long-read sequencing technologies, and highlights the clinical application of NGS in inherited diseases, oncology, and infectious diseases. We review NGS approaches and clinical diagnosis for constitutional disorders; summarize the application of U.S. Food and Drug Administration-approved NGS panels, cancer biomarkers, minimal residual disease, and liquid biopsy in clinical oncology; and consider epidemiological surveillance, identification of pathogens, and the importance of host microbiome in infectious diseases. Finally, we discuss the challenges and future perspectives of clinical NGS tests.
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Affiliation(s)
- Yiming Zhong
- Department of Pathology & Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,
USA
| | - Feng Xu
- Department of Pathology & Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
| | - Jinhua Wu
- Department of Pathology & Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
| | - Jeffrey Schubert
- Department of Pathology & Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
| | - Marilyn M. Li
- Department of Pathology & Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,
USA
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA,
USA
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12
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Siepmann T, Sedghi A, Simon E, Winzer S, Barlinn J, de With K, Mirow L, Wolz M, Gruenewald T, Schroettner P, von Bonin S, Pallesen LP, Rosengarten B, Schubert J, Lohmann T, Machetanz J, Spieth P, Koch T, Bornstein S, Reichmann H, Puetz V, Barlinn K. Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis. Eur J Neurol 2021; 28:238-247. [PMID: 32920964 DOI: 10.1111/ene.14535] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [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: 06/01/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Recent observations linked coronavirus disease 2019 (COVID-19) to thromboembolic complications possibly mediated by increased blood coagulability and inflammatory endothelial impairment. We aimed to define the risk of acute stroke in patients with severe and non-severe COVID-19. METHODS We performed an observational, multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we conducted a systematic review using PubMed/MEDLINE, Embase, Cochrane Library and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including data from observational studies of acute stroke in COVID-19 patients. Data were extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RRs) and 95% confidence intervals (95% CIs) for acute stroke related to COVID-19 severity using a random-effects model. Between-study heterogeneity was assessed using Cochran's Q and I2 statistics. International Prospective Register of Systematic Reviews registration number: CRD42020187194. RESULTS Of 165 patients hospitalized for COVID-19 (49.1% males, median age = 67 years [57-79 years], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95% CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were eligible for meta-analysis. Amongst 741 pooled COVID-19 patients, overall stroke rate was 2.9% (95% CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR = 4.18, 95% CI: 1.7-10.25; P = 0.002) with no evidence of heterogeneity (I2 = 0%, P = 0.82). CONCLUSIONS Synthesized analysis of data from our multicenter study and previously published cohorts indicates that severity of COVID-19 is associated with an increased risk of acute stroke.
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Affiliation(s)
- T Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - A Sedghi
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - E Simon
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - S Winzer
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - J Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - K de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - L Mirow
- Department of General and Visceral Surgery, Klinikum Chemnitz gGmbH, Chemnitz
| | - M Wolz
- Department of Neurology, Elblandklinikum Meissen, Meissen
| | - T Gruenewald
- Department of Infectious Diseases/Tropical Medicine, Klinikum Chemnitz gGmbH, Chemnitz
| | - P Schroettner
- Department of Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - S von Bonin
- Department of Internal Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - L-P Pallesen
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - B Rosengarten
- Department of Neurology, Klinikum Chemnitz gGmbH, Chemnitz
| | - J Schubert
- Department of Hematology and Oncology, Elblandklinikum Riesa, Riesa
| | - T Lohmann
- Department of Internal Medicine, Städtisches Klinikum Dresden, Dresden
| | - J Machetanz
- Department of Neurology, Städtisches Klinikum Dresden, Dresden
| | - P Spieth
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Koch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Bornstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - H Reichmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - V Puetz
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - K Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
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13
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Fritsche V, Siol AF, Schnabel KP, Bauer D, Schubert J, Stoevesandt D. Use of simulation patients in the third section of the medical examination. GMS J Med Educ 2020; 37:Doc90. [PMID: 33364369 PMCID: PMC7740027 DOI: 10.3205/zma001383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/22/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
In order to protect patients and students during the Covid 19 pandemic, the third section of the medical examination (M3) in Halle (Saale) was conducted in a modified form in accordance with the "Verordnung zur Abweichung von der Approbationsordnung für Ärzte bei einer epidemischen Lage von nationaler Tragweite" [1]. The one-day examination took place at the Dorothea Erxleben Learning Center (DELH) of the Martin Luther University Halle-Wittenberg on standardized simulation subjects. In contrast to previous years, all examiners were examined individually in internal medicine, surgery and their elective subject of the practical year. In the evaluations carried out, the standardized cases were assessed as consistent and fair by examiners and exam takers. Approximately 90% of the examiners could imagine to test a state examination with simulated patients again. After successful pilot testing, a study will be conducted in the coming exam to determine whether the substitution of real patients with simulated patients in the M3 exam can contribute to better standardization and objectivity while maintaining the same high level of acceptance in the exam. Whether the high acceptance will remain constant can only be checked in the course of the study.
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Affiliation(s)
- Vivien Fritsche
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - A. F. Siol
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - Kai P. Schnabel
- Universität Bern, Medizinische Fakultät, Institut für Medizinische Lehre, Bern, Switzerland
| | - Daniel Bauer
- Universität Bern, Medizinische Fakultät, Institut für Medizinische Lehre, Bern, Switzerland
| | - J. Schubert
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
| | - D. Stoevesandt
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Dorothea Erxleben Lernzentrum, Halle (Saale), Germany
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Zhong Y, Schubert J, Wu J, Xu F, Lin F, Cao K, Zelley K, Luo M, Foster JB, Cole KA, MacFarland SP, Resnick AC, Storm PB, Li MM. A germline PALB2 pathogenic variant identified in a pediatric high-grade glioma. Cold Spring Harb Mol Case Stud 2020; 6:mcs.a005397. [PMID: 32554798 PMCID: PMC7476410 DOI: 10.1101/mcs.a005397] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
PALB2 (partner and localizer of BRCA2) gene encodes a protein that colocalizes with BRCA2 in nuclear foci and likely permits the stable intranuclear localization and accumulation of BRCA2. PALB2 plays a critical role in maintaining genome integrity through its role in the Fanconi anemia and homologous recombination DNA repair pathways. It has a known loss-of-function disease mechanism. Biallelic PALB2 pathogenic variants have been described in autosomal recessive Fanconi anemia. Heterozygous pathogenic variants in PALB2 are associated with increased risk for female and male breast cancer and pancreatic cancer (Science 324: 217; Cancer Res 71: 2222–2229; N Engl J Med 371: 497–506). Heterozygous germline PALB2 mutations have also been observed in patients with medulloblastoma (Lancet Oncol 19: 785–798). However, PALB2-related cancer predisposition to high-grade gliomas has not been reported. Here we report a germline PALB2 pathogenic variant (c.509_510delGA, p.Arg170Ilefs*14, NM_024675.3) found in a pediatric patient with high-grade glioma. This variant was first identified by tumor sequencing using the Children's Hospital of Philadelphia (CHOP) Comprehensive Solid Tumor Panel and then confirmed to be a germline change using the CHOP Comprehensive Hereditary Cancer Panel on DNA from a blood sample of this patient. Parental studies showed that this variant was paternally inherited. Further studies are needed to illustrate if pathogenic variants in PALB2 convey increased risk to developing brain tumor. This case also highlights the potential of identifying germline mutation through tumor sequencing.
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Affiliation(s)
- Yiming Zhong
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Jeffrey Schubert
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Jinhua Wu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Feng Xu
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Fumin Lin
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Kajia Cao
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Kristin Zelley
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Minjie Luo
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Jessica B Foster
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Kristina A Cole
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Suzanne P MacFarland
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Adam C Resnick
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Neurosurgery, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Phillip B Storm
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Neurosurgery, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
| | - Marilyn M Li
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA
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15
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Waschk M, Sarkar A, Barthel J, Voigt J, Schröder S, Zakalek P, Schmitz M, Kirby BJ, Pütter S, Schubert J, Brückel T. Impact of growth kinetics on the interface morphology and magnetization in La 1/3Sr 2/3FeO 3/La 2/3Sr 1/3MnO 3 heterostructures. J Phys Condens Matter 2020; 32:165801. [PMID: 31899900 DOI: 10.1088/1361-648x/ab678c] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ability to create atomically perfect, epitaxial heterostructures of correlated complex perovskite oxides using state-of-art thin film deposition techniques has generated new physical phenomena at engineered interfaces. Here we report on the impact of growth kinetics on the magnetic structure and exchange coupling at the interface in heterostructures combining layers of antiferromagnetic La1/3Sr2/3FeO3 (LSFO) and ferromagnetic La2/3Sr1/3MnO3 (LSMO) on (0 0 1)-oriented SrTiO3 (STO) substrates. Two growth orders are investigated, (a) LSMO/LSFO/STO(0 0 1) and (b) LSFO/LSMO/STO(0 0 1), where the LSFO layer is grown by molecular beam epitaxy and the LSMO layer by high oxygen pressure sputtering. The interface has been investigated using electron microscopy and polarized neutron reflectometry. Interdiffusion over seven monolayers is observed in LSMO/LSFO (a) with an almost 50% reduction in magnetization at the interface and showing no exchange coupling. However, the exchange bias effect ([Formula: see text] mT at 10 K) could be realized when the interface is atomically sharp, as in LSFO/LSMO (b). Our study therefore reveals that, even for well ordered and lattice-matched structures, the kinetics involved in the growth processes drastically influences the interface quality with a strong correlation to the magnetic properties.
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Affiliation(s)
- M Waschk
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS-2) and Peter Grünberg Institut (PGI-4), JARA-FIT, 52425 Jülich, Germany
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16
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Storm Van's Gravesande K, Calabrese P, Blaschek A, Rostásy K, Huppke P, Rothe L, Mall V, Kessler J, Kalbe E, Dornfeld E, Elpers C, Lohmann H, Weddige A, Hagspiel S, Kirschner J, Brehm M, Blank C, Schubert J, Schimmel M, Pacheè S, Mohrbach M, Karenfort M, Kamp G, Lücke T, Neumann H, Lutz S, Gierse A, Sievers S, Schiffmann H, de Soye I, Trollmann R, Candova A, Rosner M, Neu A, Romer G, Seidel U, John R, Hofmann C, Schulz, Kinder S, Bertolatus A, Scheidtmann K, Lasogga R, Leiz S, Alber M, Kranz J, Bajer-Kornek B, Seidl R, Novak A. The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
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Affiliation(s)
- K Storm Van's Gravesande
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
| | - P Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland
| | - A Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
| | - K Rostásy
- Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Dr. Friedrich Steiner Str. 5, 5711 Datteln, Germany
| | - P Huppke
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany
| | - L Rothe
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - V Mall
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany
| | - J Kessler
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - E Kalbe
- Department of Medical Psychology ǀ, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
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Schubert J, Lindahl B, Melhus H, Renlund H, Leosdottir M, Allahyari A, Ueda P, Jernberg T, Hagstrom E. P5325A possible paradoxical association between LDL-cholesterol in myocardial infarction patients and relation to major adverse outcomes - a 10-year nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0294] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiovascular disease (CVD) risk increases with the level of LDL-cholesterol (LDL-C), and LDL-C lowering treatment improves prognosis. Less is known about LDL-C levels at myocardial infarction (MI) admission and long-term prognosis.
Purpose
To investigate admission LDL-C levels in relation to mortality, recurrent MI and baseline characteristics.
Methods
Patients admitted with an MI in Sweden and recorded in the MI-registry (SWEDEHEART) 2006–2016 were included and followed until 2018. Associations between baseline LDL-C, mortality and MI were assessed with Cox regression analysis, adjusting for risk factors (eg. age, diabetes, prior CV events) and lipid lowering therapy.
Results
Of 126,669 patients (median age: 70) admitted with MI, 26.2% (n=32,883) had ongoing statin therapy, and the median LDL-C was 2.96 (interquartile range 2.23, 3.74) mmol/L. During median follow-up of 4.2 years, 31,024 died and 17,896 had an MI (table). Patients with higher LDL-C were younger, had substantially fewer comorbidities such as diabetes and prior CVD (p<0.001). In this analysis there was an interaction with ongoing statin-use (p=0.0025). When dividing patients by LDL-C into quartiles, statin naive in the highest LDL-C quartile (3.95 mmol/L) had a lower risk of death compared to patients in the lowest quartile (2.62 mmol/L) HR 0.86 (95% CI 0.83–0.90). For patients with ongoing statin, the risk was also lower with higher LDL-C (2.84 mmol/L) compared to lower LDL-C (1.72 mmol/L) HR 0.88 (95% CI 0.81–0.96). No association was observed between LDL-C and recurrent MI.
Table 1. Event rate for mortality and myocardial infarction (MI) by LDL quartile groups Q1 Q2 Q3 Q4 LDL-C (mmol/L) Statin naive <2.62 2.62–3.26 3.26–3.95 >3.95 Ongoing <1.72 1.72–2.21 2.21–2.84 >2.84 Mortality Statin naive 0.074 (6553) 0.049 (4596) 0.037 (3706) 0.030 (2949) Ongoing 0.10 (3297) 0.075 (2769) 0.062 (2462) 0.055 (2157) MI Statin naive 0.034 (2808) 0.026 (2292) 0.024 (2269) 0.023 (2094) Ongoing 0.064 (1796) 0.055 (1792) 0.048 (1694) 0.044 (1557) Event/year (n of events) stratified by statin treatment at index event.
Conclusions
In this real-world population with over 126,000 patients and 10 years of follow-up, higher LDL-C at the time of the MI was associated with a markedly better prognosis in patients with and without prior statin therapy. This paradox may, despite adjustment, be caused by a substantially lower CVD baseline risk in patients with higher LDL-C pertaining to a lower burden of risk factors, younger age, and fewer prior CVD events as well as a highly treatable risk factor.
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Affiliation(s)
- J Schubert
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - B Lindahl
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - H Melhus
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - H Renlund
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - M Leosdottir
- Skane University Hospital, Department of Cardiology, Lund, Sweden
| | - A Allahyari
- Danderyd University Hospital, Department of Clinical Sciences, Stockholm, Sweden
| | - P Ueda
- Karolinska Institute, Clinical Epidemiology Division, Department of Medicine, Stockholm, Sweden
| | - T Jernberg
- Danderyd University Hospital, Department of Clinical Sciences, Stockholm, Sweden
| | - E Hagstrom
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
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Schubert J, Lindahl B, Melhus H, Renlund H, Leosdottir M, Allahyari A, Ueda P, Jernberg T, Hagstrom E. 5130Association between degree of LDL-cholesterol decrease after a myocardial infarction and mortality - a nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0044] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In clinical trials, patients with myocardial infarction (MI) and elevated LDL-cholesterol (LDL-C) benefit the most from lipid lowering therapy, and more intensive LDL-C lowering therapy is associated with better prognosis.
Purpose
To investigate the association between degree of LDL-C lowering and prognosis in MI patients from a large real-world setting.
Methods
Patients admitted with an MI between 2006 and 2016 and registered in the Swedish MI-registry (SWEDEHEART) were followed until 2018. The difference in LDL-C between the MI hospitalization and a 6–10 week follow-up was measured. In multivariable Cox regression analysis adjusting for clinical risk factors (eg. age, diabetes, prior cardiovascular disease), the association between LDL-C change, mortality and recurrent MI was assessed using restricted cubic splines. Further, the patients were stratified according to quartile decrease in LDL-C from MI hospitalization to the follow-up.
Results
A total of 44,148 patients (median age: 64) had an LDL-C measured during the MI hospitalization and at follow-up. Of these, 9,905 (22.4%) had ongoing statin treatment prior to admission. The median LDL-C at the MI hospitalization was 2.96 (interquartile range 2.23, 3.74) mmol/L and the median decrease in LDL-C was 1.17 (0.37, 1.86) mmol/L. During a median follow-up of 3.9 years, 3,342 patients died and 3,210 had an MI. Patients with the highest quartile of LDL-C decrease (1.86 mmol/L) from index event to follow-up, had a lower risk of mortality, hazard ratio (HR) 0.59 (95% confidence interval [CI] 0.44–0.80) compared to those with the lowest quartile of LDL-C decrease (0.37 mmol/L) (figure). For MI, the corresponding HR was 0.83 (95% CI 0.68–1.02). Ongoing statin-use prior to admission did not alter the effect of LDL-C decrease and outcome in the analysis.
Conclusions
In this large nationwide cohort of MI patients, a gradually lower risk of death was observed in patients with larger decrease in LDL-C from index event to follow-up, regardless of statin use prior to admission. The same trend was observed for recurrent MI, although not reaching statistical significance. This confirms previous findings that efforts should be made to lower LDL-C after MI.
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Affiliation(s)
- J Schubert
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - B Lindahl
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - H Melhus
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
| | - H Renlund
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - M Leosdottir
- Skane University Hospital, Department of Cardiology, Lund, Sweden
| | - A Allahyari
- Danderyd University Hospital, Department of Clinical Sciences, Stockholm, Sweden
| | - P Ueda
- Karolinska Institute, Clinical Epidemiology Division, Department of Medicine, Stockholm, Sweden
| | - T Jernberg
- Danderyd University Hospital, Department of Clinical Sciences, Stockholm, Sweden
| | - E Hagstrom
- Uppsala University, Department of Medical Sciences, Uppsala, Sweden
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19
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Kobak KA, Schubert J, Kasztura M, Franczuk P, Dziegala M, Drozd M, Tkaczyszyn M, Kulej-Lyko K, Bania J, Banasiak W, Ponikowski P, Jankowska EA. P6353Iron depletion in human cardiomyocytes cultured with sera from myocarditis patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0949] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac myocytes, which are particularly sensitive to disordered iron homeostasis, are the main cells affected in the course of myocarditis. Iron is essential for the proper maintenance of energy metabolism but also plays key role in inflammation and ROS production. We hypothesize that iron homeostasis might be involved in the pathophysiology of myocarditis.
Purpose
The aim of the study was to assess differences in the expression of key genes and proteins involved in iron homeostasis, cardiac malfunctioning, and protection against ROS in human cardiomyocytes (HCMs) cultured in the indirect model of myocarditis.
Methods
HCMs were cultured for 48 hours with 10% of sera from patients with acute myocarditis (n=11) and after 6 weeks of recovery, and also with sera from healthy controls (n=7). We analyzed expression of light and heavy ferritin chains [FTL, FTH], transferrin receptor 1 [TfR1], galectin 3 [LGALs3], TGFβ signaling [TGFβ1, TGFβ2, TGFβ3], glutathione peroxidase [GPX] and superoxide dismutase [SOD1] at the mRNA level using RTqPCR and at the protein level using Western bloting. We compared obtained data with the clinical characteristics of patients.
Results
In HCMs exposed to sera from myocarditis patients, in comparison to those treated with sera from healthy controls, we found a significant increase in an expression of TfR1 both at mRNA and protein level (p<0,01). We also observed that elevated expression of TfR1 in cells correlated with serum levels of total iron (R=-0,52; p<0,05), CRP (R=0,67; p<0,05), and NT-proBNP (R=0,55; p<0,05), suggesting increased iron demand in HCMs and its possible relation to inflammation and hemodynamic dysfunction in patients.
Moreover, we observed elevated expression of FTH and FTL at the mRNA level (both p<0,01) and its strong correlation with expression of TfR1 as well as with increased levels of CRP in sera. It could be explained by the double role of ferritin in iron storage and in inflammation.
Interestingly, we noticed detrimental effects of myocarditis sera on HCMs reflected by augmented expression of galectin 3 (p<0,01) and disturbances in TGFβ genes, in comparison to those treated with sera from healthy controls. Augmented expression of galectin 3 was strongly related to disturbed iron homeostasis, manifesting itself by correlations with TfR1 (R=0,77; p<0,05), FTH (R=0,92; p<0,05) and FTL (R=0,76; p<0,05).
In addition, HCMs treated with sera from myocarditis patients showed an increase in expression of ROS protective genes such as SOD1 and GPX (both p<0,01), indicating higher oxidative stress in these cells.
We noticed that gene expression profile was similar in HCMs treated with sera collected after 6 weeks of clinical recovery, suggesting that the negative impact of sera was preserved.
Conclusions
Malfunctioning of cardiomyocytes in course of myocarditis might be related to disturbances in the iron homeostasis.
Acknowledgement/Funding
The present study was financially supported by the National Science Centre (Krakow, Poland; grant no. 2014/13/B/NZ5/03146)
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Affiliation(s)
- K A Kobak
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
| | - J Schubert
- Wroclaw University of Environmental and Life Sciences, Department of Food Hygiene and Consumer Health Protection, Wroclaw, Poland
| | - M Kasztura
- Wroclaw University of Environmental and Life Sciences, Department of Food Hygiene and Consumer Health Protection, Wroclaw, Poland
| | - P Franczuk
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
| | - M Dziegala
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
| | - M Drozd
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
| | - M Tkaczyszyn
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
| | - K Kulej-Lyko
- Military Hospital of Wroclaw, Centre for Heart Diseases, Wroclaw, Poland
| | - J Bania
- Wroclaw University of Environmental and Life Sciences, Department of Food Hygiene and Consumer Health Protection, Wroclaw, Poland
| | - W Banasiak
- Military Hospital of Wroclaw, Centre for Heart Diseases, Wroclaw, Poland
| | - P Ponikowski
- Wroclaw Medical University, Department of Heart Diseases, Wroclaw, Poland
| | - E A Jankowska
- Wroclaw Medical University, Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw, Poland
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20
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Allahyari A, Jernberg T, Lautsch D, Lundman P, Hagstrom E, Schubert J, Boggs R, Salomonsson S, Ueda P. P828Low-density lipoprotein cholesterol lowering therapy and target level attainment after a recent myocardial infarction - nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0427] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of cardiovascular disease after a myocardial infarction (MI). The European Society of Cardiology (ESC) guidelines recommend lipid lowering therapy to reach LDL-C treatment targets after an MI.
Purpose
To assess LDL-C target level attainment according to the ESC guidelines among patients with a recent MI in Sweden.
Methods
We used data from nationwide registers in Sweden and included patients aged 18–74 years admitted to a hospital with MI (1 January 2013–1 October 2016). Among patients who were alive and had LDL-C data available, we assessed LDL-C target achievement at 6–10 weeks (n=21,505) and 12–14 months (n=17,957) after the MI by category of lipid lowering therapy (no statin; low/moderate-intensity statins; high-intensity statins; any statin plus ezetimibe). The target was defined as an LDL-C of <1.8 mmol/L and a ≥50% reduction from the baseline if LDL-C was 1.8–3.5 mmol/L and the patient was not already receiving statins.
Results
Most patients were treated with high-intensity statin monotherapy (84.2% and 72.0%) or any statin with ezetimibe (2.1% and 10.4%) at 6–10 weeks and 12–14 months after the MI, respectively. In total, 37.7% (6–10 weeks) and 38.3% (12–14 months) had attained their LDL-C target. The proportion of patients attaining their LDL-C target at 6–10 weeks was 12% (no statin), 30% (low/moderate-intensity statins), 39% (high-intensity statins), and 49% (any statin plus ezetimibe). The corresponding numbers at 12–14 months were 16% (no statin), 29% (low/moderate-intensity statins), 39% (high-intensity statins), and 58% (any statin plus ezetimibe). A total of 11.8% at 6–10 weeks and 12.3% at 12–14 months reached an LDL-C level of <1.8 mmol/L, but did not reach their LDL-C target level due to the ≥50% reduction criteria. (Figure 1)
Figure 1
Conclusions
In this large population-based study using nationwide data, more than half of patients with a recent MI did not achieve the ESC guidelines LDL-C target levels, despite a large proportion with high-intensity statin therapy. In patients treated with statins and ezetimibe, four out of ten did not reach the ESC LDL-C target level. Our findings indicate that there may be a need for additional LDL-C lowering therapy if the target level is to be attained in all patients.
Acknowledgement/Funding
This project was supported by funding from Merck Sharp & Dohme.
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Affiliation(s)
- A Allahyari
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - T Jernberg
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - D Lautsch
- Merck & Co., Inc., Kenilworth, New Jersey, United States of America
| | - P Lundman
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - E Hagstrom
- Uppsala University, Department of Medical Sciences, Cardiology, Uppsala, Sweden
| | - J Schubert
- Uppsala University, Department of Medical Sciences, Cardiology, Uppsala, Sweden
| | - R Boggs
- Merck & Co., Inc., Kenilworth, New Jersey, United States of America
| | | | - P Ueda
- Karolinska Institute, Division of Clinical Epidemiology, Department of Medicine, Solna, Stockholm, Sweden
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21
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Günther A, Schubert J, Witte OW, Brämer D. [Intensive care aspects of autoimmune encephalitis]. Med Klin Intensivmed Notfmed 2019; 114:620-627. [PMID: 31456008 DOI: 10.1007/s00063-019-0604-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/08/2019] [Revised: 02/27/2019] [Accepted: 03/03/2019] [Indexed: 01/15/2023]
Abstract
Autoimmune encephalitis is a rare, rapidly progressive and potentially severe inflammatory brain disease, usually mediated by autoantibodies. Frequently, the affected patients go through various phases of the disease with prodromi, neuropsychological abnormalities, severe neurological and autonomic disorders and usually long reconvalescence. In up to 85% of patients intensive care treatment is necessary, especially in the group of anti-NMDA receptor encephalitis (NMDA-RE). Typical problems during ICU stay include: severe qualitative and quantitative disturbances of consciousness, autonomic dysfunction, epileptic seizures/epileptic status, treatment-refractory movement disorders, as well as ventilation and weaning problems requiring tracheotomy. But also ethical conflicts and general ICU complications such as sepsis, the need for resuscitation, as well as surgical and psychiatric complications occur. The outcome is highly heterogeneous with a range from complete recovery to the most severe, persistent disorders of consciousness with extensive care and death. Mortality data also vary at between 12% and 40%. Patients requiring mechanical ventilation and tracheostomy and with sepsis and autonomic dysfunction are prone to worse outcomes. A large part of the presented data refers to a recently published multicenter, Germany-wide retrospective cohort study and brought into the context of existing literature.
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Affiliation(s)
- A Günther
- Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
| | - J Schubert
- Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - O W Witte
- Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - D Brämer
- Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
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22
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Schubert J, Tariq M, Geddes G, Kindel S, Miller EM, Ware SM. Back Cover, Volume 39, Issue 12. Hum Mutat 2018. [DOI: 10.1002/humu.23685] [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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23
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Schubert J, Tariq M, Geddes G, Kindel S, Miller EM, Ware SM. Novel pathogenic variants in filamin C identified in pediatric restrictive cardiomyopathy. Hum Mutat 2018; 39:2083-2096. [DOI: 10.1002/humu.23661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/29/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Jeffrey Schubert
- Department of Molecular Genetics, Microbiology, and Biochemistry; University of Cincinnati College of Medicine; Cincinnati Ohio
- Departments of Pediatrics and Medical and Molecular Genetics; Indiana University School of Medicine; Indianapolis Indiana
| | - Muhammad Tariq
- Faculty of Applied Medical Science; University of Tabuk; Tabuk Kingdom of Saudi Arabia
| | - Gabrielle Geddes
- Department of Pediatrics; Medical College of Wisconsin; Milwaukee Wisconsin
| | - Steven Kindel
- Department of Pediatrics; Medical College of Wisconsin; Milwaukee Wisconsin
| | - Erin M. Miller
- Cincinnati Children's Hospital Medical Center; Cincinnati Ohio
| | - Stephanie M. Ware
- Departments of Pediatrics and Medical and Molecular Genetics; Indiana University School of Medicine; Indianapolis Indiana
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24
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Schönherr C, Götze T, zur Hausen G, Reichart A, Pauligk C, Schlag R, Siegler G, Dörfel S, Aldaoud A, Hahn L, Schubert J, Zahn MO, Höffkes HG, Reiser M, Koenigsmann M, Blau W, Waidmann O, Homann N, Trojan J, Al-Batran SE. Quality of life (QoL) in patients with metastatic pancreatic cancer receiving first-line Nab-paclitaxel/gemcitabine chemotherapy: Results of the large QoL study AIO-QoliXane/PARAGON. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Schubert J, Timmesfeld N, Noever K, Arabin B. Standardisierung maternaler Gewichtzunahme bei Geminischwangerschaft. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Schubert
- Mutter-Kind Zentrum und Abteilung für medizinische Biometrie der Philipps Universität Marburg, Clara Angela Foundation Witten-Berlin
| | - N Timmesfeld
- Mutter-Kind Zentrum und Abteilung für medizinische Biometrie der Philipps Universität Marburg, Clara Angela Foundation Witten-Berlin
| | - K Noever
- Mutter-Kind Zentrum und Abteilung für medizinische Biometrie der Philipps Universität Marburg, Clara Angela Foundation Witten-Berlin
| | - B Arabin
- Mutter-Kind Zentrum und Abteilung für medizinische Biometrie der Philipps Universität Marburg, Clara Angela Foundation Witten-Berlin
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26
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Keppner J, Schubert J, Ziegner M, Mogwitz B, Janek J, Korte C. Influence of texture and grain misorientation on the ionic conduction in multilayered solid electrolytes – interface strain effects in competition with blocking grain boundaries. Phys Chem Chem Phys 2018; 20:9269-9280. [DOI: 10.1039/c7cp06951k] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We investigate the relaxation of mismatch induced interface strain as a function of the texture and its influence on the ionic conductivity in YSZ/Er2O3 multilayer thin films.
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Affiliation(s)
- J. Keppner
- Institut für Energie- und Klimaforschung
- Elektrochemische Verfahrenstechnik (IEK-3)
- Forschungszentrum Jülich GmbH
- D-52425 Jülich
- Germany
| | - J. Schubert
- Peter-Grünberg-Institut
- Halbleiter-Nanoelektronik (PGI-9)
- Forschungszentrum Jülich GmbH
- 52425 Jülich
- Germany
| | - M. Ziegner
- Institut für Energie- und Klimaforschung
- Werkstoffstruktur/-eigenschaften (IEK-2)
- Forschungszentrum Jülich GmbH
- 52425 Jülich
- Germany
| | - B. Mogwitz
- Physikalisch-Chemisches Institut
- Justus-Liebig-Universität Gießen
- 35392 Gießen
- Germany
| | - J. Janek
- Physikalisch-Chemisches Institut
- Justus-Liebig-Universität Gießen
- 35392 Gießen
- Germany
| | - C. Korte
- Institut für Energie- und Klimaforschung
- Elektrochemische Verfahrenstechnik (IEK-3)
- Forschungszentrum Jülich GmbH
- D-52425 Jülich
- Germany
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27
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Al-Batran SE, Reichart A, Schoenherr C, zur Hausen G, Pauligk C, Schöttger B, Siegler G, Doerfel S, Aldaoud A, Hahn L, Schubert J, Waidmann O, Trojan J, Hoeffkes HG, Schnell R, Koenigsmann M, Blau W, Uhlig J, Homann N, Götze T. Metastatic pancreatic cancer: Real Life data from the german quality of life and translational research on pancreatic cancer study (QoliXane). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.133] [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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28
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Weyrich C, Drögeler M, Kampmeier J, Eschbach M, Mussler G, Merzenich T, Stoica T, Batov IE, Schubert J, Plucinski L, Beschoten B, Schneider CM, Stampfer C, Grützmacher D, Schäpers T. Growth, characterization, and transport properties of ternary (Bi 1-x Sb x ) 2Te 3 topological insulator layers. J Phys Condens Matter 2016; 28:495501. [PMID: 27749271 DOI: 10.1088/0953-8984/28/49/495501] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Ternary (Bi1-x Sb x )2Te3 films with an Sb content between 0 and 100% were deposited on a Si(1 1 1) substrate by means of molecular beam epitaxy. X-ray diffraction measurements confirm single crystal growth in all cases. The Sb content is determined by x-ray photoelectron spectroscopy. Consistent values of the Sb content are obtained from Raman spectroscopy. Scanning Raman spectroscopy reveals that the (Bi1-x Sb x )2Te3 layers with an intermediate Sb content show spatial composition inhomogeneities. The observed spectra broadening in angular-resolved photoemission spectroscopy (ARPES) is also attributed to this phenomena. Upon increasing the Sb content from x = 0 to 1 the ARPES measurements show a shift of the Fermi level from the conduction band to the valence band. This shift is also confirmed by corresponding magnetotransport measurements where the conductance changes from n- to p-type. In this transition region, an increase of the resistivity is found, indicating a location of the Fermi level within the band gap region. More detailed measurements in the transition region reveals that the transport takes place in two independent channels. By means of a gate electrode the transport can be changed from n- to p-type, thus allowing a tuning of the Fermi level within the topologically protected surface states.
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Affiliation(s)
- C Weyrich
- Peter Grünberg Institute (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany. Helmholtz Virtual Institute for Topological Insulators (VITI), Forschungszentrum Jülich, 52425 Jülich, Germany
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29
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Heedt S, Manolescu A, Nemnes GA, Prost W, Schubert J, Grützmacher D, Schäpers T. Adiabatic Edge Channel Transport in a Nanowire Quantum Point Contact Register. Nano Lett 2016; 16:4569-4575. [PMID: 27347816 DOI: 10.1021/acs.nanolett.6b01840] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report on a prototype device geometry where a number of quantum point contacts are connected in series in a single quasi-ballistic InAs nanowire. At finite magnetic field the backscattering length is increased up to the micron-scale and the quantum point contacts are connected adiabatically. Hence, several input gates can control the outcome of a ballistic logic operation. The absence of backscattering is explained in terms of selective population of spatially separated edge channels. Evidence is provided by regular Aharonov-Bohm-type conductance oscillations in transverse magnetic fields, in agreement with magnetoconductance calculations. The observation of the Shubnikov-de Haas effect at large magnetic fields corroborates the existence of spatially separated edge channels and provides a new means for nanowire characterization.
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Affiliation(s)
- S Heedt
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - A Manolescu
- School of Science and Engineering, Reykjavik University , IS-101 Reykjavik, Iceland
| | - G A Nemnes
- Faculty of Physics, MDEO Research Center, University of Bucharest , 077125 Magurele-Ilfov, Romania
- Horia Hulubei National Institute of Physics and Nuclear Engineering , 077126 Magurele-Ilfov, Romania
| | - W Prost
- Solid State Electronics Department, University of Duisburg-Essen , 47057 Duisburg, Germany
| | - J Schubert
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - D Grützmacher
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - Th Schäpers
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
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30
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Heedt S, Prost W, Schubert J, Grützmacher D, Schäpers T. Ballistic Transport and Exchange Interaction in InAs Nanowire Quantum Point Contacts. Nano Lett 2016; 16:3116-3123. [PMID: 27104768 DOI: 10.1021/acs.nanolett.6b00414] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
One-dimensional ballistic transport is demonstrated for a high-mobility InAs nanowire device. Unlike conventional quantum point contacts (QPCs) created in a two-dimensional electron gas, the nanowire QPCs represent one-dimensional constrictions formed inside a quasi-one-dimensional conductor. For each QPC, the local subband occupation can be controlled individually between zero and up to six degenerate modes. At large out-of-plane magnetic fields Landau quantization and Zeeman splitting emerge and comprehensive voltage bias spectroscopy is performed. Confinement-induced quenching of the orbital motion gives rise to significantly modified subband-dependent Landé g factors. A pronounced g factor enhancement related to Coulomb exchange interaction is reported. Many-body effects of that kind also manifest in the observation of the 0.7·2e(2)/h conductance anomaly, commonly found in planar devices.
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Affiliation(s)
- S Heedt
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - W Prost
- Solid State Electronics Department, University of Duisburg-Essen , 47057 Duisburg, Germany
| | - J Schubert
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - D Grützmacher
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
| | - Th Schäpers
- Peter Grünberg Institut (PGI-9) and JARA-Fundamentals of Future Information Technology, Forschungszentrum Jülich , 52425 Jülich, Germany
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31
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Pietrini S, Durst M, Schubert J, List J, Wong G, Fullner J. Do one, do one, do one: a model for an inexpensive, build-it-yourself IR simulation laboratory. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.600] [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: 10/22/2022] Open
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32
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Bloch W, Baumann F, Zimmer P, Grischke EM, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Tesch H, Schütz F, Lüftner D, Jackisch C. Abstract P4-13-07: Impact of physical activity/exercise on adverse events and quality of life during treatment with everolimus and exemestane for ER+ women - Results of the 3rd interim analysis of BRAWO. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-07] [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
Introduction
BRAWO is a non-interventional study collecting data of 3000 breast cancer patients treated with everolimus and exemestane (advanced or metastatic, hormone-receptor-positive, HER2-negative breast cancer). We introduce results of the 3rd preplanned interim analysis with data cut-off 08/01/ 2015, including 1300 patients. Since physical activity/exercise was reported to influence side effects as well as quality of life (QoL) of various cancer types and therapies, this analysis focuses on the impact of the physical activity/exercise history, development on adverse effects (AE) of the medical treatment and QoL.
Methods
Patients were asked to complete the EORTC QLQ-C30 QoL questionnaire and visual analogue scales (VAS-KAS) measuring their present-, past ten year- and lifetime physical activity/exercise level. To differentiate between activity/exercise levels, VAS were divided in three equal components (inactive, somewhat active, very active). Questionnaires and information about AE (e. g. stomatitis, fatigue, nausea, diarrhea, etc.) were collected before starting the medical treatment and were repeated each three months. Logistic regression model was used to estimate the impact of baseline physical activity/exercise on AE at any time point of the therapy. ANOVA models were used to calculate the impact of the baseline activity/exercise level on QoL at the last completed data set of each patient.
Results
Median age of patients was 66 years, median weight was 70 kg, median BMI was 25.9, median time since primary diagnosis was 6.2 years, and 54.4% had visceral metastases at baseline. The median PFS for the first 1300 patients was 7.1 months (95% CI, 6.5-8.0). Patients who reported to be very active (exercise) at the week prior to baseline (4.4%) showed significant lower numbers of AE compared to patients who indicate to be somewhat (14.8%) or inactive (80.8%). In contrast to the exercise level, physical activity in everyday life did not affect the AE incidence. Neither lifetime nor past ten year activity/exercise level is associated with the occurrence of AE. Regarding QoL, very active as well as somewhat active women (measured at baseline for almost each time period) showed significant higher QoL values compared to inactive women during the last assessment before death/progress.
Conclusion
Exercise prior to medical treatment with Everolimus and Exemestane may impact AE during therapy. Since physical activity did not show such a relation, this analysis highlights the importance of specific guidelines for preventive/rehabilitative exercise programs. More knowledge about dose-response relationships is needed. Furthermore a livelong healthy, "active" lifestyle may increase QoL, even in patients with advanced and terminal breast cancer disease.
Citation Format: Bloch W, Baumann F, Zimmer P, Grischke E-M, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Tesch H, Schütz F, Lüftner D, Jackisch C. Impact of physical activity/exercise on adverse events and quality of life during treatment with everolimus and exemestane for ER+ women - Results of the 3rd interim analysis of BRAWO. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-07.
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Affiliation(s)
- W Bloch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Baumann
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - P Zimmer
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - E-M Grischke
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - PA Fasching
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - T Decker
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Uleer
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - A Schneeweiss
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Salat
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - P Wimberger
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Mundhenke
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Förster
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - B Kluth-Pepper
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - J Schubert
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - H Tesch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Schütz
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - D Lüftner
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Jackisch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
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Tesch H, Grischke EM, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Bloch W, Jackisch C, Schütz F, Lüftner D. Abstract P4-13-06: Results of the 3rd interim analysis of the non-interventional trial BRAWO – Subanalysis of patients <70 years and ≥ 70 years. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
BRAWO is a German non-interventional study of 3000 patients (pts) with advanced/metastatic, hormone-receptor-positive and HER2-negative breast cancer treated with everolimus and exemestane (EVE+EXE). The pivotal BOLERO-2 trial demonstrated that adding EVE to EXE improved PFS over EXE and was generally well tolerated in elderly patients with HR+ advanced breast cancer (>65 years as well as >70 years). Here we describe data of elderly patients treated with EVE+EXE in daily clinical routine.
Methods
We report data of the 3rd preplanned interim analysis (IA) of the first 1300 pts documented in BRAWO. Patient and disease characteristics in elderly patients (≥ 70 years, n=485) and patients <70 years (n=813) are described. Furthermore, safety and efficacy data for both subgroups are described.
Results
At time of data cut-off, 71% pts had discontinued the study, 29% were still ongoing. Patient and disease characteristics were comparable in both groups except for: median age (60y (range: 20-69y) vs. 75y (range 70-93y)), median time since 1st diagnosis (6.4y <70y vs. 8.8y ≥70 y), ECOG performance status 0 (56.6% <70y vs. 37.0% ≥70 y), and younger pts seemed to have less comorbidities (charlson comorbidity index (CCI)=0: 80.9% vs. 67.4%). The distribution of patients by therapy line was similar as well as tumor grading, hormone receptor status, Ki67-status and metastasis localization.
More patients in the older group received fulvestrant (20.6% vs. 16.2%), in the younger group more patients received chemotherapy (20.3% vs. 14.2%) as last antineoplastic therapy. In general, more patients in the older subgroup did not receive any chemotherapy as pretreatment (53.6% vs 40.2%).
More patients in the subgroup ≥70y received 5mg EVE as starting dose (30.3% vs. 20.8%) and had 5mg as end dose (37.9% vs. 26.9%). Median PFS was 7.1 months in the overall population, 7.0 months (6.5, 8.0; 95%CI) for pts <70y and 7.3 months (6.3, 8.6; 95%CI) for pts ≥70y. Kaplan Meier estimates for median treatment duration were longer for younger pts (167.0 days (155.0, 191.0; 95%CI vs. 128.0 days (112.0, 152.0; 95%CI)). Incidence and severity of stomatitis were comparable across subgroups (Table 1). Quality of life analysis revealed no significant differences between older and younger pts.
Table 1: Incidence and severity of stomatitis
Patient Characteristics< 70 years (n=813)≥ 70 years (n=485)Stomatitis Number of patients with at least one Stomatitis Event (based on stomatitis questionnaires)339 (41.7%)200 (41.2%)Grade 1181 (22.3%)95 (19.6%)Grade 2119 (14.6%)79 (16.3%)Grade 319 (2.3%)11 (2.3%)unknown20 (2.5%)15 (3.1%)Number of Stomatitis Events431 (100.0%)252 (100%)Grade 1237 (55.0%)125 (49.6%)Grade 2136 (31.6%)87 (34.5%)Grade 319 (4.4%)13 (5.2%)
Discussion
The data described here show that EVE+EXE treatment is effective and safe for elderly patients in daily clinical routine. This is consistent with data from an exploratory analysis of the pivotal BOLERO-2 trial, where the same differences in baseline characteristics were observed for elderly pts compared to younger pts as in BRAWO. Efficacy was also comparable to elderly pts in BOLERO-2 (mPFS 6.8 months for EVE+EXE in pts ≥70 years).
Citation Format: Tesch H, Grischke E-M, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Bloch W, Jackisch C, Schütz F, Lüftner D. Results of the 3rd interim analysis of the non-interventional trial BRAWO – Subanalysis of patients <70 years and ≥ 70 years. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-06.
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Affiliation(s)
- H Tesch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - E-M Grischke
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - PA Fasching
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - T Decker
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Uleer
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - A Schneeweiss
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Salat
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - P Wimberger
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Mundhenke
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - F Förster
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - B Kluth-Pepper
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - J Schubert
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - W Bloch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Jackisch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - F Schütz
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - D Lüftner
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
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Lüftner D, Grischke E, Fasching P, Decker T, Schneeweiss A, Uleer C, Foerster F, Wimberger P, Kluth-Pepper B, Schubert J, Bloch W, Tesch H, Schuetz F, Jackisch C. 1869 Disease characteristics of subgroup patients treated with everolimus + exemestane for <12 months, ≥12 to <18months, and ≥18 months - Results of the 3rd interim analysis of the non-interventional trial BRAWO. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schubert J, Siekierska A, Esguerra C, Weber Y, Lerche H. V23. Mutations in STX1B encoding a presynaptic protein cause fever-associated epilepsy syndromes. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schubert J, Heller M. Imaging in advanced laryngeal cancer before laser surgery. A critical review. Adv Otorhinolaryngol 2015; 49:207-11. [PMID: 7653366 DOI: 10.1159/000424374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- J Schubert
- Klinik für Radiologische Diagnostik, Christian-Albrecht-Universität Kiel, Deutschland
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Hanfstein B, Shlyakhto V, Lauseker M, Hehlmann R, Saussele S, Dietz C, Erben P, Fabarius A, Proetel U, Schnittger S, Krause SW, Schubert J, Einsele H, Hänel M, Dengler J, Falge C, Kanz L, Neubauer A, Kneba M, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Baerlocher GM, Pfirrmann M, Hasford J, Hofmann WK, Hochhaus A, Müller MC. Velocity of early BCR-ABL transcript elimination as an optimized predictor of outcome in chronic myeloid leukemia (CML) patients in chronic phase on treatment with imatinib. Leukemia 2014; 28:1988-92. [DOI: 10.1038/leu.2014.153] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 03/30/2014] [Accepted: 04/21/2014] [Indexed: 11/09/2022]
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Wunderlich H, Schlichter A, Werner W, Reichelt O, Kosmehl H, Schubert J. Nebennierenmetastasen Konsequenzen hinsichtlich konservativer und operativer Maßnahmen. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s001310050149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Steppert C, Alhanna J, Schubert J, Krugmann J, Vieth M. Verrucous carcinoma of the tracheobronchial tree: an underdiagnosed entity? Eur Respir J 2014; 43:1198-200. [DOI: 10.1183/09031936.00129913] [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: 11/05/2022]
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Kucinski T, Schubert J. FOAR: Facet Joint Osteoarthritis with Radiculopathy: a case series and a hypothesis explaining spinal nerve irritation in the absence of osteodiskal compression. Clin Neuroradiol 2014; 25:83-7. [PMID: 24522453 DOI: 10.1007/s00062-013-0275-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 12/02/2013] [Indexed: 11/24/2022]
Affiliation(s)
- T Kucinski
- Radiologie am Rathausmarkt,, Radiologische Allianz Hamburg, Mönckebergstrasse 31, 20095, Hamburg, Germany,
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Alozie A, Westphal B, Kische S, Kaminski A, Paranskaya L, Bozdag-Turan I, Ortak J, Schubert J, Steinhoff G, Ince H. Surgical revision after percutaneous mitral valve repair by edge-to-edge device: when the strategy fails in the highest risk surgical population. Eur J Cardiothorac Surg 2013; 46:55-60. [DOI: 10.1093/ejcts/ezt535] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schubert J, Mullins C, van Gool S, Vandenberk L, Linnebacher M, Classen CF. In-vitro and in-vivo effects of Cilengitide in Glioblastoma models. Klin Padiatr 2013. [DOI: 10.1055/s-0033-1353452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bolz J, Dosá E, Schubert J, Eckert AW. Bacterial colonization of microbial biofilms in oral squamous cell carcinoma. Clin Oral Investig 2013; 18:409-14. [DOI: 10.1007/s00784-013-1007-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/24/2013] [Indexed: 12/01/2022]
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Schubert J. [Local flaps for the closure of facial defects]. HNO 2013; 61:433-46. [PMID: 23649526 DOI: 10.1007/s00106-013-2706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Local flaps for the closure of facial defects after trauma, tumor resection or due to malformations have been well known since ancient times and allow good to satisfying functional and aesthetic results. Based on the characteristics of skin and soft tissue nearly all clinical situations can be resolved by stretching, rotating and transposing flaps depending on the localization. A good surgical technique is essential for the success. The basic principles are briefly described and suggestions for the application of flaps to different localizations are given. For analgesia local anesthesia is sufficient. As could be demonstrated multitudinously the method is ideal for closure of small to large defects in the face; therefore, microvascular surgery can be extremely restricted in treating defects of the face.
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Affiliation(s)
- J Schubert
- Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Klinikum der Martin-Luther-Universität Halle, Ernst-Grube-Str. 40, 06120, Halle, Deutschland.
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Nichau A, Schnee M, Schubert J, Besmehn A, Rubio-Zuazo J, Breuer U, Bernardy P, Holländer B, Mücklich A, Castro GR, von Borany J, Buca D, Mantl S. Photoemission spectroscopy study of the lanthanum lutetium oxide/silicon interface. J Chem Phys 2013; 138:154709. [DOI: 10.1063/1.4801324] [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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Bord E, Farrell Z, Heur W, Keslin W, Laughlin R, Leedom H, LeMense A, Lucre S, Marable C, Mielke S, Olk S, Orozco C, Rosio C, Schubert J, Smith S, Wade G, Weeden M, Sampe D, Frank DW. Feel the Burn, then Feel the Death. ExoU as a Phospholipase. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.lb180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- E. Bord
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - W. Heur
- Brown Deer HIgh SchoolBrown DeerWI
| | | | | | | | | | - S. Lucre
- Brown Deer HIgh SchoolBrown DeerWI
| | | | | | - S. Olk
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - C. Rosio
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - S. Smith
- Brown Deer HIgh SchoolBrown DeerWI
| | - G. Wade
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - D. Sampe
- Brown Deer HIgh SchoolBrown DeerWI
| | - D. W. Frank
- Microbiology and Molecular GeneticsMedical College of WisconsinMilwaukeeWI
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Schubert J, Mullins C, Piek J, Classen CF. Sensitivity of primary Glioblastoma cell lines towards Cilengitide alone and in combination with Temozolomide. Klin Padiatr 2012. [DOI: 10.1055/s-0032-1320182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fiedler W, Dahse R, Schlichter A, Junker K, Kosmehl H, Ernst G, Schubert J, Claussen U. Telomerase activity and telomere length in different areas of renal cell carcinoma. Int J Oncol 2012; 9:1227-32. [PMID: 21541632 DOI: 10.3892/ijo.9.6.1227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Telomerase activity and telomere length were analyzed in a total of 59 surgically removed primary renal cell carcinoma (RCC). The study includes tissue from the centre of the tumor, several different peripheral tumor areas, metastases and secondary tumors. None of the normal renal cortex tissues used as control exhibited telomerase activity. In contrast, telomerase activity was detected in 55 out df 59 (=93%) tested primary RCC. There was no case with intratumoral heterogeneity concerning the telomerase activity status. All metastases and secondary tumors were telomerase-positive. In the four telomerase deficient tumors all measured telomeric repeat fragments were shortened in comparison to the normal tissue. As these patients exhibit no metastases or secondary tumors a less malignant variant of RCC is supposed. There was no correlation between telomerase activity and specific histopathological subtypes of RCC or specific chromosomal aberrations. As telomerase activity is not associated with advanced stages of tumors it may be an important early event in the development of RCC. Thus, telomerase activity may be a prevalent marker for early and late stages of all subtypes of RCC.
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Affiliation(s)
- W Fiedler
- UROL CLIN,D-07740 JENA,GERMANY. INST PATHOL,D-07740 JENA,GERMANY
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Korfel A, Weller M, Martus P, Roth P, Klasen HA, Roeth A, Rauch M, Hertenstein B, Fischer T, Hundsberger T, Leithäuser M, Birnbaum T, Kirchen H, Mergenthaler HG, Schubert J, Berdel W, Birkmann J, Hummel M, Thiel E, Fischer L. Prognostic impact of meningeal dissemination in primary CNS lymphoma (PCNSL): experience from the G-PCNSL-SG1 trial. Ann Oncol 2012; 23:2374-2380. [PMID: 22396446 DOI: 10.1093/annonc/mdr627] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We evaluated the frequency and prognostic impact of meningeal dissemination (MD) in immunocompetent adult patients with primary central nervous system lymphoma treated in a randomized phase III trial. PATIENTS AND METHODS MD was evaluated at study entry and defined by lymphoma proof in the meningeal compartment detected by at least one of the following methods: cerebrospinal fluid (CSF) cytomorphology, detection of clonal B cells by IgH PCR in CSF or contrast enhancement of the leptomeninges on magnetic resonance imaging (MRI). RESULTS Data on MD were available in 415 patients, of those, MD was detected in 65 (15.7%): in 44/361 (12.2%) by CSF cytomorphology, in 16/152 (10.5%) by PCR and in 17/415 (4.1%) by MRI. Major patients' characteristics and therapy did not significantly differ between patients with MD (MD+) versus those without MD (MD-). There was a significant correlation of MD with CSF pleocytosis (>5/μl; P < 0.0001), but no correlation with CSF protein elevation (>45 mg/dl). Median progression-free survival was 6.7 months [95% confidence interval (CI) 0-14.5] in MD+ and 8.3 months (5.7-10.8) in MD- patients (P = 0.95); median overall survival was 21.5 months (95% CI 16.8-26.1) and 24.9 months (17.5-32.3), respectively (P = 0.98). CONCLUSION MD was detected infrequently and had no impact on outcome in this trial.
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Affiliation(s)
- A Korfel
- Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany.
| | - M Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Tuebingen, Tuebingen
| | - P Martus
- Institute of Biostatistics, University Tuebingen, Tuebingen; Institute of Biostatistics, University Hospital Tuebingen, Tuebingen
| | - P Roth
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Tuebingen, Tuebingen
| | - H A Klasen
- Department of Hematology & Oncology, Pius Hospital, Oldenburg
| | - A Roeth
- Department of Hematology, West German Cancer Center, University Hospital Essen, Essen
| | - M Rauch
- Department of Hematology & Oncology, Evangelisches Krankenhaus Bielefeld, Bielefeld
| | - B Hertenstein
- Department of Hematology & Oncology, Klinikum Bremen Mitte, Bremen
| | - T Fischer
- Department of Hematology & Oncology, University of Magdeburg, Magdeburg
| | - T Hundsberger
- Department of Hematology & Oncology, University Hospital Mainz, Mainz, Germany; Department of Neurology, Cantonal Hospital, St Gallen, Switzerland
| | - M Leithäuser
- Department of Hematology & Oncology, University Hospital Rostock, Rostock
| | - T Birnbaum
- Department of Neurology, University Hospital Grosshadern, Munich
| | - H Kirchen
- Department of Hematology & Oncology, Hospital Trier, Trier
| | - H-G Mergenthaler
- Department of Oncology & Hematology, Klinikum Stuttgart, Stuttgart
| | - J Schubert
- Department of Neurology, Hospital Minden, Minden
| | - W Berdel
- Department of Medicine A, University Hospital Muenster, Muenster
| | - J Birkmann
- Department of Hematology & Oncology, Hospital Nürnberg, Nürnberg
| | - M Hummel
- Department of Pathology, Campus Benjamin Franklin, Charite Berlin, Germany
| | - E Thiel
- Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany
| | - L Fischer
- Department of Hematology & Oncology, Campus Benjamin Franklin, Charite Berlin, Berlin, Germany
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Eckert AW, Kappler M, Schubert J, Taubert H. Correlation of expression of hypoxia-related proteins with prognosis in oral squamous cell carcinoma patients. Oral Maxillofac Surg 2012; 16:189-96. [PMID: 22592457 DOI: 10.1007/s10006-012-0335-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 05/07/2012] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Hypoxia plays a major role in tumor progression, therapy resistance and for prognosis of oral squamous cell carcinoma (OSCC). The crucial step as a response to hypoxia is the activation and stabilization of the alpha subunit of hypoxia inducible factor 1 (HIF-1α). HIF-1: HIF-1 regulates the expression of different genes to adapt the tumor cells to reduced oxygenation. The HIF-1 system is intrinsic regulated by von Hippel-Lindau protein (pVHL). Main downstream proteins are the glucose transporter 1 (GLUT-1), carbonic anhydrase IX (CAIX), and vascular endothelial growth factor (VEGF). For therapeutical stratification in OSCC, it is important to understand the mechanism caused by hypoxic stress and to comprehend the resulting adaptive process in cancer cells. Therefore, an overview of HIF-1α-depending protein expression, focussed on the expression of GLUT-1, CAIX, and VEGF and their prognostic significance in OSCC is given. CONCLUSION Several unique roles of hypoxic pathway in the context of tumor progression are described in this review. As a consequence, a marker panel is proposed to allow a more individualized prognosis in OSCC patients. This marker panel should include beside HIF-1α, pVHL, and GLUT-1.
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Affiliation(s)
- A W Eckert
- Department of Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, E.-Grube-Str. 40, 06120, Halle, Saale, Germany.
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