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Tully K, Schulmeyer M, Reike M, Hanske J, Von Landenberg N, Moritz R, Brock M, Hendrik J, Von Bodman C, Noldus J, Palisaar R, Roghmann F. Impact of residual microscopial evidence of prostate cancer at second tumor resection on biochemical recurrence after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33793-9] [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: 11/28/2022] Open
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Wernicke CM, Grunewald TG, Hendrik J, Kuci S, Kuci Z, Koehl U, Mueller I, Doering M, Peters C, Lawitschka A, Kolb HJ, Bader P, Burdach S, von Luettichau I. Mesenchymal stromal cells for treatment of steroid-refractory GvHD: a review of the literature and two pediatric cases. Int Arch Med 2011; 4:27. [PMID: 21843360 PMCID: PMC3169455 DOI: 10.1186/1755-7682-4-27] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 08/15/2011] [Indexed: 12/11/2022] Open
Abstract
Severe acute graft versus host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. Human mesenchymal stromal cells (MSCs) play an important role in endogenous tissue repair and possess strong immune-modulatory properties making them a promising tool for the treatment of steroid-refractory GvHD. To date, a few reports exist on the use of MSCs in treatment of GvHD in children indicating that children tend to respond better than adults, albeit with heterogeneous results. We here present a review of the literature and the clinical course of two instructive pediatric patients with acute steroid-refractory GvHD after haploidentical stem cell transplantation, which exemplify the beneficial effects of third-party transplanted MSCs in treatment of acute steroid-refractory GvHD. Moreover, we provide a meta-analysis of clinical studies addressing the outcome of patients with steroid-refractory GvHD and treatment with MSCs in adults and in children (n = 183; 122 adults, 61 children). Our meta-analysis demonstrates that the overall response-rate is high (73.8%) and confirms, for the first time, that children indeed respond better to treatment of GvHD with MSCs than adults (complete response 57.4% vs. 45.1%, respectively). These data emphasize the significance of this therapeutic approach especially in children and indicate that future prospective studies are needed to assess the reasons for the observed differential response-rates in pediatric and adult patients.
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Affiliation(s)
- Caroline M Wernicke
- Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Kölner Platz 1, 80804 Munich, Germany
| | - Thomas Gp Grunewald
- Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Kölner Platz 1, 80804 Munich, Germany.,Medical Life Science and Technology Center, TUM Graduate School, Technische Universität München, Boltzmannstrasse 17, 85748 Garching, Germany
| | - Juenger Hendrik
- Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Kölner Platz 1, 80804 Munich, Germany
| | - Selim Kuci
- Division for Stem Cell Transplantation, Department of Hematology, Oncology and Hemostasis, Hospital for Children and Adolescents, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Zyrafete Kuci
- Division for Stem Cell Transplantation, Department of Hematology, Oncology and Hemostasis, Hospital for Children and Adolescents, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ulrike Koehl
- Division for Stem Cell Transplantation, Department of Hematology, Oncology and Hemostasis, Hospital for Children and Adolescents, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ingo Mueller
- University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Michaela Doering
- University Children's Hospital, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany
| | - Christina Peters
- St. Anna Children's Hospital, Kinderspitalgasse 6, 1090 Vienna, Austria
| | - Anita Lawitschka
- St. Anna Children's Hospital, Kinderspitalgasse 6, 1090 Vienna, Austria
| | - Hans-Jochem Kolb
- Division for Stem Cell Transplantation, Department of Medicine III, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Peter Bader
- Division for Stem Cell Transplantation, Department of Hematology, Oncology and Hemostasis, Hospital for Children and Adolescents, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Stefan Burdach
- Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Kölner Platz 1, 80804 Munich, Germany
| | - Irene von Luettichau
- Children's Cancer Research and Roman Herzog Comprehensive Cancer Center, Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Kölner Platz 1, 80804 Munich, Germany
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Hanke T, Hendrik J, Anderson I, Schön J, Heinze H, Sievers HH, Heringlake M. High sensitive troponin t is superior to additive Euroscore for predicting 30 and 90 day mortality in non-coronary cardiac surgery. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269386] [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: 10/18/2022]
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Abstract
OBJECTIVE This study aims to determine if nucleated red blood cells are elevated in pregnancies that continue beyond 289 days of gestation. STUDY DESIGN Cord blood was prospectively collected from term and post-term singleton gestations from August 1 to December 31, 1998. Umbilical artery nucleated red blood cells were counted per 100 white blood cells. The comparison was made between pregnancies ending at 261-289 days (37.1-41.2 weeks) of gestation and those ending after 289 days (> or = 41.3 weeks) of gestation. RESULTS Cord blood from 304 cases was obtained and evaluated for nucleated red blood cells per 100 white blood cells. The mean value of nucleated red blood cells per 100 white blood cells in the post-term neonate group was significantly higher than in the term neonate group (median 6.5, range 0-24 vs. median 3.7, range 0-14; p < 0.05). The values did not vary by fetal presentation, mode or duration of delivery. Neonatal outcome was comparable between both study groups. CONCLUSION In post-term gestation after 289 days nucleated red blood cells in cord blood are significantly increased. These results point towards a different fetal oxygenation in post-term pregnancies beyond 289 days of gestation and support the current practice of very close testing of fetal well-being under those circumstances.
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Affiliation(s)
- R Axt
- Department of Obstetrics and Gynecology, University of the Saarland, Homburg/Saar, Germany.
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Abstract
OBJECTIVE To study the maternal and neonatal outcome of twin pregnancies complicated by the intrauterine death of one fetus after 20 weeks of gestation. DESIGN Retrospective, observational study of 7 twin pregnancies out of 185 twin pregnancies with the diagnosis of a single intrauterine death over a 5-years period in a university hospital. RESULTS The incidence of single fetal death in twin gestation after 20 weeks was 3.8% in the study population with a high incidence of intrauterine growth retardation (IUGR) of the remaining fetus and preeclampsia in the further course of pregnancy. The incidence of preterm delivery was 71% with a mean gestational age of 33.0 +/- 1.0 weeks. The median interval from diagnosis of single fetal death to delivery was 10.2 +/- 4.1 days (range 1-28 days). 5 of 7 (71%) cases were delivered by cesarean section for standard obstetrical reasons. Neither perinatal nor neonatal death of the remaining twin were observed. Two cases of neurologic injury were diagnosed after delivery by ultrasound and MRI. No maternal coagulopathy related to single fetal death occurred. CONCLUSION Expectant management of single fetal death in twin pregnancies might be advisible under close surveillance of both, mother and the surviving fetus.
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Affiliation(s)
- R Axt
- Department of Obstetrics and Gynecology, University of the Saarland, Homburg, Germany
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Gnirs J, Boos R, Hendrik J, Hentemann M, Schmidt W. [Discolored amniotic fluid--results of prenatal diagnosis and clinical significance]. Geburtshilfe Frauenheilkd 1991; 51:217-22. [PMID: 1711490 DOI: 10.1055/s-2007-1023707] [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] [Indexed: 12/28/2022] Open
Abstract
7000 pregnancies were analysed after genetic amniocentesis in respect of the further course and results of prenatal diagnosis (observation period 1975-1988). In 3.1% (217 cases) samples of amniotic fluid were discoloured. Vaginal haemorrhages prior to amniocentesis were recorded with significantly higher incidence (18%) in patients with discoloured amniotic fluid than in a control group (n = 217) with normal colour of the amniotic fluid (4.6%) (p less than 0.001). Miscarriages and chromosome anomalies occurred more often in the study group (3.7%/2.8%, control group: 0.9%/1.8%, n.s.). The risk of miscarriages was increased in cases with sanguineous amniotic fluid if the amniotic fluid alpha-fetoprotein values were enhanced at the same time. Significant differences were observed in respect of the incidence of foetal malformations in patients with discoloured amniotic fluid (7.8%) and in the control group (2.3%) (p less than 0.01). Borderline or definitely pathological amniotic fluid AFP concentrations were found often if the amniotic fluid was discoloured (6.9%, control group 3.2%). If discoloured amniotic fluid was sampled, foetal malformations should be excluded sonographically. In 82% of all cases with discoloured amniotic fluid and foetal malformations pathological sonographic findings and/or enhanced MS-AFP values were recorded even prior to amniocentesis.
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Affiliation(s)
- J Gnirs
- Univ.-Frauenklinik und Poliklinik mit Hebammenlehranstalt Homburg/Saar
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Gnirs J, Hendrik J, Heberling D, Schmidt W. [Vascular abnormalities of the umbilical cord--incidence, significance and possibility for prenatal ultrasonic detection]. Geburtshilfe Frauenheilkd 1988; 48:355-60. [PMID: 3294088 DOI: 10.1055/s-2008-1035992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Vascular anomalies of the umbilical cord are amongst the most frequent congenital malformations, their incidence being 0.2% to 1.4%. As a result of the latter the risk of occurrence of other malformations and chromosomal anomalies is markedly elevated. Between January 1977 and July 1987 a total of 78 cases (0.51%) of umbilical cord vascular anomalies were recorded at the Department of Gynaecology of the University of Heidelberg. Malformations occurred in 37% of the foetuses involved. 28% showed retarded growth and 9% had an abnormal set of chromosomes. Anomalies of the urinary tract and malformations of the thoracic organs were very frequent. Total mortality after the 28th pregnancy was about 14%. Currently available high-resolution real-time ultrasound equipment can show up even prenatally pathological variations of the umbilical vascular pedicle (e.g. a single umbilical artery). Because of the manifold risk involved, routine ultrasound control is recommended. If this anomaly is diagnosed, the pregnancy should be classified and treated immediately as a high-risk pregnancy.
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Affiliation(s)
- J Gnirs
- Abt. Allg. Geburtshilfe und Gynäkologie mit Poliklinik, Universitäts-Frauenklinik Heidelberg
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Hendrik J, Van Ouwerkerk J, Tulp JH, Piceni HA, Roufs JA, Blommaert FJ. Instabilities in a continuous medium model for the retina. Biol Cybern 1980; 39:11-14. [PMID: 7459395 DOI: 10.1007/bf00336939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The shape of the spatial response of the retina on a small light stimulus as found by Rodieck (1965) for the cat, and proposed for the human retina among others by Korn and von Seelen (1972), resembles a Mexican hat known as a sombrero. A model presented by Röhler (1976), using a continuous medium as a description of the retina, can lead to such a "Mexican hat" response function for a specific choice of parameters. The spatial Fourier transform of this response function has a general appearance that corresponds to that calculated for stationary signals. However, such an analysis of the model for stationary signals is incomplete. Inspection of the time-dependent equations shows that it is unstable precisely for those parameter values that give the stationary response function its desired shape. Such stationary situations cannot be physically realized since the model is unstable.
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