1
|
Carrel M, Keino BC, Novak NL, Ryckman KK, Radke S. Bypassing of nearest labor & delivery unit is contingent on rurality, wealth, and race. Birth 2023; 50:5-10. [PMID: 36752116 DOI: 10.1111/birt.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/02/2023] [Accepted: 01/13/2023] [Indexed: 02/09/2023]
Abstract
Patient decisions to bypass the closest labor & delivery (L&D) facility in favor of other birthing locations can have consequences for the provision of health care in rural and micropolitan areas as patient volumes decline and payer mixes change. Among 220 589 uncomplicated births in Iowa, we document characteristics of birth parents who bypass their closest birthing facility, show how this bypassing behavior results in changed travel times to delivery facilities across the rural/urban divide, and indicate the parts of the state where bypassing behavior is most prevalent. From 2013 to 2019, 55.2% of deliveries occurred in facilities that were further from birthing parents' residences than the closest L&D facility. Bypassing is associated with White, non-Hispanic race/ethnicity, and private insurance status. Although bypassing is least common among micropolitan birth parents, this group has the greatest travel burden to birthing facilities and exhibits increasing rates of bypassing over time. Perinatal quality improvement programs can target locations and populations where low-risk birthing parents can be encouraged to deliver close to home if medically appropriate, particularly in small towns and rural areas. This can potentially alleviate the risk of obstetric deserts by ensuring L&D units maintain patient volumes necessary to continue operations.
Collapse
Affiliation(s)
- Margaret Carrel
- Department of Geographical & Sustainability Sciences, University of Iowa, Iowa City, Iowa, USA.,Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Barbara C Keino
- Department of Geographical & Sustainability Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Nicole L Novak
- Department of Community & Behavioral Health, University of Iowa, Iowa City, Iowa, USA
| | - Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Stephanie Radke
- Department of Obstetrics & Gynecology, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
2
|
Carrel M, Keino BC, Ryckman KK, Radke S. Labor & delivery unit closures most impact travel times to birth locations for micropolitan residents in Iowa. J Rural Health 2023; 39:113-120. [PMID: 34978349 DOI: 10.1111/jrh.12643] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Continued closure of rural hospitals and labor & delivery units can impact timely access to care. Iowa has lost over a quarter of its labor & delivery units in the previous decade. Calculating how travel times to labor & delivery services have changed, and where in the state the largest travel times take place, are important for understanding access to this critical service. METHODS Using parental address and facility location from birth certificate data in Iowa from 2013 to 2019, travel times to birth facility are assessed for rural, micropolitan, and metropolitan parents, as well as for complicated versus noncomplicated births and Medicaid versus non-Medicaid recipients. FINDINGS Parts of the state have travel times that are consistently greater than 30 minutes over the duration of the study. The largest increases in travel times are found among micropolitan residents, particularly those experiencing complicated births. Travel times are consistently the longest for rural residents but increased only slightly over the study time period. CONCLUSIONS These findings suggest that access to hospital-based obstetric care is most changed for residents of small towns rather than rural or larger city residents.
Collapse
Affiliation(s)
- Margaret Carrel
- Department of Geographical & Sustainability Sciences, University of Iowa, Iowa City, Iowa, USA.,Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Barbara C Keino
- Department of Geographical & Sustainability Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Stephanie Radke
- Department of Obstetrics & Gynecology, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
3
|
Munjal A, Wu C, Radke S. 34417 Characterizing nipple skin injuries in postpartum women. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.151] [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: 10/14/2022]
|
4
|
Green S, Ryckman KK, Anderson E, Radke S. All-Cause Severe Maternal Morbidity (SMM) and Transfusion-Only SMM Are Independently Associated with a Lower Likelihood of Exclusive Breastfeeding. Breastfeed Med 2022; 17:758-763. [PMID: 35904948 PMCID: PMC9634985 DOI: 10.1089/bfm.2021.0355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Background: The rates of severe maternal morbidity (SMM) including blood transfusions after delivery are rising, yet little is known about the impact of these experiences on breastfeeding. Materials and Methods: This is a single-institution retrospective cohort study examining breastfeeding rates at three time points for 1,857 first-time parents delivered at term between July 1, 2016 and June 30, 2019. Our exposure of interest was SMM, which was subdivided into SMM where transfusion was the only indicator (transfusion-only SMM) and SMM where another indicator (diagnostic or procedural) was met, which may also include transfusion (all-cause SMM). Association between transfusion-only SMM and all-cause SMM with feeding method was determined using multinomial regression modeling and adjusting for relevant sociodemographic characteristics. Results: The majority of those with uncomplicated deliveries were exclusively breastfeeding at the 2- to 4-week and 2- to 3-month time points (59.6% and 53.6%, respectively), in contrast to 46.3% and 42.0% of those who had experienced transfusion-only SMM, and 40.9% and 30% of those who had experienced all-cause SMM. In adjusted models, receipt of a blood transfusion was found to be associated with greater risk of exclusive formula feeding at all time points. Experience of all-cause SMM was significantly associated with increased likelihood of exclusive formula feeding at hospital discharge and the 2- to 3-month time point. Conclusions: We identified that experience of all-cause SMM and transfusion-only SMM are independently associated with a lower likelihood of exclusive breastfeeding after adjusting for sociodemographic factors. Perinatal clinicians should be aware of these risks and offer increased support to these couplets.
Collapse
Affiliation(s)
- Shelby Green
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Kelli K. Ryckman
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Emily Anderson
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Stephanie Radke
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
5
|
Abstract
Background: Nipple discomfort inhibits breastfeeding goals, particularly between 0 and 8 weeks postpartum (PP), and yet the specific dermatologic entities that contribute to nipple soreness have not been clearly delineated. Moreover, there remains a lack of evidence-based guidelines for nipple symptoms and skin diseases. Methods: A survey was distributed to 6-8-week PP women, 18-50 years of age, with an intent to exclusively or partially breastfeed ("at the breast" or "pump"). The study aimed to characterize nipple skin symptoms (pain and itching) and lesions (eczema, redness, cuts, or wounds) and any association between these nipple problems and past dermatologic history, breastfeeding outcomes, and the ability to meet her breastfeeding goals. Results: Findings paralleled Centers for Disease Control and Prevention (CDC) statistics with a 25% decline in breastfeeding rates between birth, 86.3% (189), and 6-8 weeks PP, 64.5% (145). By 6-8 weeks PP, exclusive "formula" and "exclusive feeding at the breast" showed the largest increase (+16.4%) and decrease (-22.9%), respectively. Although no significant difference was found in comparison of nipple problems to feeding methods or skin history, women who reported pumping or PP redness/eczema had higher odds ratios of a change in feeding practice, history of eczema, and sensitive skin. Strong pumping intentions were also associated with the highest risk of unmet breastfeeding goals. Conclusion: Regardless of feeding method, product, or provider use, PP nipple problems predominantly arose between 1 and 3 weeks PP. Clinical Trial Registration number 201901737.
Collapse
Affiliation(s)
- Leah Laageide
- Department of Internal Medicine, University of Iowa - Des Moines, Des Moines, Iowa, USA
| | - Stephanie Radke
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Donna Santillan
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Patrick Ten Eyck
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa, USA
| | - Jennifer Powers
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- VA Medical Center, Iowa City, Iowa, USA
| |
Collapse
|
6
|
Laageide L, Radke S, Santillan D, Powers J. 12812 Understanding the causes and treatments of nipple pain secondary to breastfeeding. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
7
|
Griesinger F, Radke S, Lüers A, Deschler-Baier B, Kimmich M, Sebastian M, Schulz C, Brugger W, Wiewrodt R, Pirker R, Früh M, Gautschi O, Wolf J. [Strategies to Overcome Acquired Resistance to EGFR-TKI Therapy Based on T790M Specific Substances using Osimertinib as an Example]. Pneumologie 2018; 72:774-781. [PMID: 30408830 DOI: 10.1055/a-0647-9835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) are widely used in non-small cell lung cancer patients harboring activating EGFR mutations. However, resistance mechanisms, particularly the T790 M mutation, hamper longer-term therapeutic success of first and second generation EGFR-TKIs. To address this unmet medical need, EGFR-TKIs of the third generation are under clinical development. Relevant clinical efficacy with mainly mild to moderate class-specific side effects has been shown for third-generation EGFR-TKIs. Molecular testing is of major importance in deciding for treatment with third generation EGFR-TKIs. This article elucidates the developmental state of third generation EGFR-TKIs with its focus on Osimertinib, the first and currently the only compound in this class which is approved in Germany. Additionally, the medical importance of molecular diagnosis using tumor tissue and circulating tumor DNA is discussed.
Collapse
Affiliation(s)
- F Griesinger
- Klinik für Hämatologie und Onkologie, Pius-Hospital Oldenburg, Universitätsmedizin Oldenburg, Universitätsklinik Innere Medizin - Onkologie, Oldenburg
| | - S Radke
- AstraZeneca, Medical Affairs, Wedel
| | - A Lüers
- Klinik für Hämatologie und Onkologie, Pius-Hospital Oldenburg, Universitätsmedizin Oldenburg, Universitätsklinik Innere Medizin - Onkologie, Oldenburg
| | - B Deschler-Baier
- Comprehensive Cancer Center Mainfranken, Universitätsklinikum Würzburg, Würzburg
| | - M Kimmich
- Abteilung für Pneumologie und Pneumologische Onkologie, Robert-Bosch-Krankenhaus Klinik Schillerhöhe, Gerlingen
| | - M Sebastian
- Abteilung für Hämatologie und Onkologie, Universitätsklinikum Frankfurt, Frankfurt/Main
| | - C Schulz
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg
| | - W Brugger
- Medizinische Klinik II, Hämatologie/Onkologie, Schwarzwald-Baar Klinikum, Akad. Lehrkrankenhaus der Univ. Freiburg, Villingen-Schwenningen
| | - R Wiewrodt
- Medizinische Klinik A, Universitätsklinikum Münster, Münster
| | - R Pirker
- Klinische Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken Wien
| | - M Früh
- Klinik für Hämatologie/Onkologie, Kantonsspital St. Gallen, St. Gallen
| | - O Gautschi
- Abteilung für Medizinische Onkologie, Kantonsspital Luzern, Luzern
| | - J Wolf
- Klinik I für Innere Medizin, Centrum für Integrierte Onkologie, Uniklinik Köln, Köln
| |
Collapse
|
8
|
Shah A, Coyle T, Lalezari S, Fischer K, Kohlstaedde B, Delesen H, Radke S, Michaels LA. BAY 94-9027, a PEGylated recombinant factor VIII, exhibits a prolonged half-life and higher area under the curve in patients with severe haemophilia A: Comprehensive pharmacokinetic assessment from clinical studies. Haemophilia 2018; 24:733-740. [DOI: 10.1111/hae.13561] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - T. Coyle
- TriHealth Cancer Institute; Cincinnati OH USA
| | - S. Lalezari
- Israel National Hemophilia Center; Chaim Sheba Medical Center; Tel-Hashomer, and Sackler School of Medicine; Tel-Aviv University; Israel
| | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; Utrecht The Netherlands
| | | | | | | | | |
Collapse
|
9
|
Radke S, Seidel EM, Boubela RN, Thaler H, Metzler H, Kryspin-Exner I, Moser E, Habel U, Derntl B. Immediate and delayed neuroendocrine responses to social exclusion in males and females. Psychoneuroendocrinology 2018; 93:56-64. [PMID: 29702443 DOI: 10.1016/j.psyneuen.2018.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 10/19/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 01/22/2023]
Abstract
Social exclusion is a complex phenomenon, with wide-ranging immediate and delayed effects on well-being, hormone levels, brain activation and motivational behavior. Building upon previous work, the current fMRI study investigated affective, endocrine and neural responses to social exclusion in a more naturalistic Cyberball task in 40 males and 40 females. As expected, social exclusion elicited well-documented affective and neural responses, i.e., increased anger and distress, as well as increased exclusion-related activation of the anterior insula, the posterior-medial frontal cortex and the orbitofrontal cortex. Cortisol and testosterone decreased over the course of the experiment, whereas progesterone showed no changes. Hormone levels were not correlated with subjective affect, but they were related to exclusion-induced neural responses. Exclusion-related activation in frontal areas was associated with decreases in cortisol and increases in testosterone until recovery. Given that results were largely independent of sex, the current findings have important implications regarding between-sex vs. within-sex variations and the conceptualization of state vs. trait neuroendocrine functions in social neuroscience.
Collapse
Affiliation(s)
- S Radke
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany; Jülich Aachen Research Alliance (JARA) - BRAIN Institute 1, Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Pauwelsstr. 30, 52074 Aachen, Germany.
| | - E M Seidel
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria
| | - R N Boubela
- MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria; Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - H Thaler
- Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany
| | - H Metzler
- Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Laboratoire de neurosciences cognitives, Département d'études cognitives, École normale supérieure, INSERM, PSL Research University, 29 rue d'Ulm, 75005 Paris, France
| | - I Kryspin-Exner
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria
| | - E Moser
- MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria; Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany; Jülich Aachen Research Alliance (JARA) - BRAIN Institute 1, Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Pauwelsstr. 30, 52074 Aachen, Germany
| | - B Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; Werner Reichardt Center for Integrative Neuroscience, University of Tübingen, Otfried-Müller-Str. 25, 72076 Tübingen, Germany; LEAD Graduate School, University of Tübingen, Gartenstr. 29, 72074 Tübingen,Germany
| |
Collapse
|
10
|
Kettenbach S, Müller T, Radke S, Habel U, Dreher M. Charakterisierung und Visualisierung des Chronic Fatigue Syndrom bei Sarkoidosepatienten. Pneumologie 2018. [DOI: 10.1055/s-0037-1619167] [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]
Affiliation(s)
- S Kettenbach
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| | - T Müller
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| | - S Radke
- Klinik für Pyschiatrie, Psychotherapie, und Psychosomatik, Medizinische Fakultät der RWTH Aachen
| | - U Habel
- Klinik für Pyschiatrie, Psychotherapie, und Psychosomatik, Medizinische Fakultät der RWTH Aachen
| | - M Dreher
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| |
Collapse
|
11
|
Schuette W, Eberhardt WEE, Waller C, Schirmacher P, Dietel M, Zirrgiebel U, Radke S, Thomas M. [Subgroup Analysis of the Non-interventional REASON Study: PFS and OS According to Age, Smoking History, Gender, and Histology in NSCLC Patients Treated with Gefitinib or Chemotherapy]. Pneumologie 2016; 70:579-88. [PMID: 27603946 DOI: 10.1055/s-0042-109760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Assessment of several clinical factors on progression-free (PFS) and overall survival (OS) in NSCLC patients (pts.) (stage IV) with mutated epidermal growth factor receptor (EGFRm+) treated with gefitinib (gef) or with chemotherapy (CT) under real-world conditions. METHODS 285 EGFRm+ pts. of the non-interventional REASON study treated with gef (n = 206) or CT (n = 79) as first-line therapy or with gef (n = 213) or CT (n = 61) in any line throughout the course of therapy were analyzed according to age, gender, smoking history and histology. RESULTS Compared with CT, patients treated with gef showed prolongation of PFS and OS in all subgroups. PFS was significantly increased in women and non-smokers. OS was significantly increased in women, non-smokers, (ex)-smokers, patients with adenocarcinoma and elderly patients when treated with gef compared to CT. Female gender turned out to be an independent positive predictive factor for OS in patients treated with gef (HRmale: 1.74, p = 0.0009). CONCLUSION A clinical benefit of gef was shown for all analyzed clinical subgroups of EGFRm+ pts. This was confirmed for the female gender in a multivariate analysis.
Collapse
Affiliation(s)
- W Schuette
- Krankenhaus Martha-Maria Halle-Doelau, Klinik für Innere Medizin II, Halle
| | - W E E Eberhardt
- Innere Klinik (Tumorforschung), Ruhrlandklinik, Westdeutsches Tumorzentrum (WTZ), Essen, Universitätsklinikum Essen, Universität Duisburg-Essen
| | - C Waller
- Klinik für Innere Medizin I, Universitätsklinikum Freiburg
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinik Heidelberg
| | - M Dietel
- Pathologisches Institut, Humboldt Universität Berlin
| | | | - S Radke
- Medical Affairs, AstraZeneca, Wedel
| | - M Thomas
- Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg
| |
Collapse
|
12
|
Radke S, Safari N, Schulze J. Toxicity of phosphono compounds – A contested but unknown group of chemicals. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
13
|
Schuette W, Dietel M, Thomas M, Eberhardt W, Griesinger F, Zirrgiebel U, Radke S, Schirmacher P. [Exon-dependent Subgroup-analysis of the Non-interventional REASON-Study: PFS and OS in EGFR-mutated NSCLC Patients Treated with Gefitinib or Chemotherapy]. Pneumologie 2016; 70:514-21. [PMID: 27512931 DOI: 10.1055/s-0042-109749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To analyze the influence of the localization of mutations in the epidermal growth factor receptor (EGFR) gene on progression-free (PFS) and overall survival (OS) in patients (pts) with locally advanced or metastatic non-small cell lung cancer (NSCLC) treated with gefitinib (gef) or chemotherapy (CT) under real world conditions within the REASON study. METHODS Subgroups of pts with mutations in exon 19 (n = 141), 18/20 (n = 43), and 21 (n = 104) were analyzed for PFS and OS according to gef or CT treatment and compared using the log-rank test. RESULTS Pts with mutations in exon 19 and 18/20 treated with gef as first line therapy showed increased PFS and OS compared to CT. This increase was statistically significant in pts with exon 19 mutation (11.3 vs. 6.5 months), but was not found in pts with exon 21 mutation (9.1 vs. 9.3 months). Also, OS was significantly increased in patients with mutation in exon 19 treated with gef ever over all treatment lines compared to CT (21.8 vs. 10.6 months), whereas this was not found in pts with mutation in exon 21 (14.1 vs. 13.9 months). CONCLUSION Localization and nature of EGFR mutations influences gefitinib treatment outcomes under routine conditions and should therefore be analyzed in detail.
Collapse
Affiliation(s)
- W Schuette
- Krankenhaus Martha-Maria Halle-Doelau, Klinik für Innere Medizin II, Halle
| | - M Dietel
- Pathologisches Institut Humboldt Universität Berlin
| | - M Thomas
- Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg
| | - W Eberhardt
- Innere Klinik (Tumorforschung), Ruhrlandklinik, Westdeutsches Tumorzentrum (WTZ), Essen, Universitätsklinikum Essen, Universität Duisburg-Essen
| | | | | | - S Radke
- Medical Affairs, AstraZeneca, Wedel
| | - P Schirmacher
- Pathologisches Institut Universitätsklinik Heidelberg
| |
Collapse
|
14
|
Schütte W, Eberhardt W, Schirmacher P, Dietel M, Zirrgiebel U, Radke S, Thomas M. REASON: Klinisch-pathologische Faktoren relevant für die klinische Wirksamkeit von Gefitinib bei Patienten mit NSCLC Stadium IIIb/IV und mutiertem EGF Rezeptor (EGFR-M+). Pneumologie 2016. [DOI: 10.1055/s-0036-1572235] [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]
|
15
|
Griesinger F, Sebastian M, Serke M, Grohé C, Hillejan L, Passlick B, Reinmuth N, Graeven U, Radke S, Karatas A, Tiemann M, Overbeck T. Induction therapy with intercalated TKI and chemotherapy in NSCLC with activating EGFR mutation in stages II-IIIB: NeoIntercal. Pneumologie 2016. [DOI: 10.1055/s-0036-1572237] [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]
|
16
|
Schütte W, Thomas M, Eberhardt W, Zirrgiebel U, Radke S, Dietel M. Zielgerichtete Therapie des NSCLC mit Gefitinib in Abhängigkeit von der Art der EGFR-Mutation: Auswertung der klinischen Wirksamkeit in REASON Exon-Subgruppen. Pneumologie 2016. [DOI: 10.1055/s-0036-1572234] [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]
|
17
|
Ostermann H, Ukena D, Radke S, Freitag A, Hörnig S. German Country-Wide Surveys from 2012 and 2014 About EGFR Mutational Testing Algorithms Adopted by Medical Doctors in Patients with Nsclc. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.21] [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: 11/13/2022] Open
|
18
|
Gane E, Kershenobich D, Seguin-Devaux C, Kristian P, Aho I, Dalgard O, Shestakova I, Nymadawa P, Blach S, Acharya S, Anand AC, Andersson MI, Arendt V, Arkkila P, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Gadano AC, Gower E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kostrzewska K, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Norris S, Nurmukhametova E, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Schréter I, Shah SR, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Prabdial-Sing N, Flisiak R, Estes C. Strategies to manage hepatitis C virus (HCV) infection disease burden - volume 2. J Viral Hepat 2015; 22 Suppl 1:46-73. [PMID: 25560841 DOI: 10.1111/jvh.12352] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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] [Indexed: 02/06/2023]
Abstract
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries, and the relative impact of two scenarios was considered: (i) increased treatment efficacy while holding the treated population constant and (ii) increased treatment efficacy and increased annual treated population. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. In most countries, the annual treated population had to increase several fold to achieve the largest reductions in HCV-related morbidity and mortality. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. In most of the studied countries, the majority of patients were born between 1945 and 1985.
Collapse
Affiliation(s)
- E Gane
- Auckland Hospital Clinical Studies Unit, Auckland, New Zealand
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hatzakis A, Chulanov V, Gadano AC, Bergin C, Ben-Ari Z, Mossong J, Schréter I, Baatarkhuu O, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Arkkila P, Barclay K, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Estes C, Flisiak R, Gane E, Gower E, Halota W, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Norris S, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Radke S, Rakhmanova A, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Puri P, Razavi H. The present and future disease burden of hepatitis C virus (HCV) infections with today's treatment paradigm - volume 2. J Viral Hepat 2015; 22 Suppl 1:26-45. [PMID: 25560840 DOI: 10.1111/jvh.12351] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [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] [Indexed: 12/12/2022]
Abstract
Morbidity and mortality attributable to chronic hepatitis C virus (HCV) infection are increasing in many countries as the infected population ages. Models were developed for 15 countries to quantify and characterize the viremic population, as well as estimate the number of new infections and HCV related deaths from 2013 to 2030. Expert consensus was used to determine current treatment levels and outcomes in each country. In most countries, viremic prevalence has already peaked. In every country studied, prevalence begins to decline before 2030, when current treatment levels were held constant. In contrast, cases of advanced liver disease and liver related deaths will continue to increase through 2030 in most countries. The current treatment paradigm is inadequate if large reductions in HCV related morbidity and mortality are to be achieved.
Collapse
Affiliation(s)
- A Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Saraswat V, Norris S, de Knegt RJ, Sanchez Avila JF, Sonderup M, Zuckerman E, Arkkila P, Stedman C, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Vree M, Estes C, Flisiak R, Gadano AC, Gane E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanduijav R, Schréter I, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Sokolov S, Souliotis K, Spearman CW, Staub T, Strebkova EA, Struck D, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuure FR, Silva MO, Sypsa V, Gower E. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 2. J Viral Hepat 2015; 22 Suppl 1:6-25. [PMID: 25560839 DOI: 10.1111/jvh.12350] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic hepatitis C virus (HCV) infection is a leading cause of liver related morbidity and mortality. In many countries, there is a lack of comprehensive epidemiological data that are crucial in implementing disease control measures as new treatment options become available. Published literature, unpublished data and expert consensus were used to determine key parameters, including prevalence, viremia, genotype and the number of patients diagnosed and treated. In this study of 15 countries, viremic prevalence ranged from 0.13% in the Netherlands to 2.91% in Russia. The largest viremic populations were in India (8 666 000 cases) and Russia (4 162 000 cases). In most countries, males had a higher rate of infections, likely due to higher rates of injection drug use (IDU). Estimates characterizing the infected population are critical to focus screening and treatment efforts as new therapeutic options become available.
Collapse
Affiliation(s)
- V Saraswat
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014; 19:20934. [PMID: 25358042] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
Collapse
Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | | | | | | | | | | | | |
Collapse
|
22
|
Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H, on behalf of the SHIVERS investigation team C. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.42.20934] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
Collapse
Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Thompson
- Influenza Division, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
| | | |
Collapse
|
23
|
Turner N, Pierse N, Bissielo A, Huang QS, Radke S, Baker MG, Widdowson MA, Kelly H, on behalf of the SHIVERS investigation team C. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.34.20884] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
Collapse
Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Baker
- University of Otago, Wellington, New Zealand
| | - M A Widdowson
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
| | | |
Collapse
|
24
|
Gellhaus A, Liu H, Wu Y, Horsch L, Radke S, Giebel B, Köninger A, Kimmig R, Winterhager E. Der angiogene Faktor CCN3 ist an der endothelialen Dysfunktion in der Präeklampsie beteiligt. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347727] [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: 10/26/2022] Open
|
25
|
Abu-Khalaf MM, Kim T, Chung GG, DiGiovanna M, Radke S, Cornfeld D, Harris L. A phase I study of biweekly capecitabine and the histone deacetylase inhibitors (HDACi) vorinostat in for advanced breast cancer (BC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13609] [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: 11/20/2022] Open
|
26
|
Sexton K, McNicholas A, Galloway Y, Radke S, Kieft C, Stehr-Green P, Reid S, Neutze J, Drake R. Henoch-Schönlein purpura and meningococcal B vaccination. Arch Dis Child 2009; 94:224-6. [PMID: 18650242 DOI: 10.1136/adc.2007.125195] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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: 11/04/2022]
Abstract
The risk of Henoch-Schönlein purpura (HSP) following vaccination with a group B meningococcal vaccine was assessed through active hospital safety monitoring. There was no increase in the relative incidence of HSP within 30 days after vaccination nor recurrence in HSP cases who received one or more further vaccine doses (re-challenge).
Collapse
Affiliation(s)
- K Sexton
- Meningococcal Vaccine Strategy, Ministry of Health, Wellington, New Zealand
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Radke S, Kumar A, Jones L, Tuck DP, Harris LN. Activity and mechanism of action of histone deacetylase inhibitors in trastuzumab resistant breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3060] [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
Abstract #3060
Introduction: The Her2 antibody trastuzumab (T) is the first biological therapy that has proven the value of Her2 blockade in breast cancer. However, not all patients respond to trastuzumab and relapses occur after this treatment. Several studies suggest that histone deacetylase inhibitors (HDACis) are active in Her2-amplified breast cancer but none of them have addressed the role of HDACis in trastuzumab-resistant breast cancer. HDACis act by inhibiting the deacetylation of histones and other non-histone proteins such as Hsp90. Our goal is to study the activity, optimal sequencing and mechanism of action of HDACis in Her2-amplified cell lines, which demonstrate either de novo or acquired resistance to trastuzumab.
 Methods: T-sensitive and Her2-overexpressing BT474 & SkBr3, T-resistant BT474 and de novo T-resistant cell lines MDA-MB361, MDA-MB453, UACC812 and UACC893 were used for all experiments. The HDACi TSA (0-1uM) and trastuzumab at 100ug/mL were used for proliferation assays applying WST1 reagent (Roche). Western-immunoblotting was performed using cell lysates from untreated and treated cells. Proteolytic cleavage of caspase-3 and PARP was analyzed as indicator for apoptosis, Akt expression and phosphorylation for survival, Her2 and Erk1/2 expression and phosphorylation for proliferation and Hsp90 and Hsp70 were analyzed as key enzymes for chaperone activity.
 Results: TSA inhibited proliferation in all cell lines [IC50 100-300 nM]. The addition of trastuzumab was antagonistic in de novo T-resistant cell lines MDA MB 453, UACC 812 and 893 but did not change the effect induced by TSA in acquired T-resistant cells (BT474_H100). Her2 expression decreased in TSA and TSA+T treated cells but not in cells treated with trastuzumab alone. Erk1/2 phosphorylation decreased in TSA and TSA+T treated cells but was not affected by trastuzumab alone. Similar phosphorylation patterns were observed regarding Akt. Of note, Akt, Erk1/2, Hsp90 and Hsp70 levels did not change. Finally, TSA induced caspase-3 and PARP cleavage when given as single agent or in combination with trastuzumab.
 Discussion: This study suggests that HDACis are active in both trastuzumab-sensitive and de novo or acquired trastuzumab-resistant cell lines. However, use of trastuzumab together with TSA may be antagonistic in tumors that are resistant against trastuzumab. Further studies are required in these cell lines in order to elucidate the mechanism of resistance against trastuzumab and the mechanism of the here observed antagonistic effect between trastuzumab and TSA.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3060.
Collapse
Affiliation(s)
- S Radke
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - A Kumar
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - L Jones
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - DP Tuck
- 2 Pathology, Yale University School of Medicine, New Haven, CT
| | - LN Harris
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| |
Collapse
|
28
|
Tabe Y, Jin L, Contractor R, Gold D, Ruvolo P, Radke S, Xu Y, Tsutusmi-Ishii Y, Miyake K, Miyake N, Kondo S, Ohsaka A, Nagaoka I, Andreeff M, Konopleva M. Novel role of HDAC inhibitors in AML1/ETO AML cells: activation of apoptosis and phagocytosis through induction of annexin A1. Cell Death Differ 2007; 14:1443-56. [PMID: 17464329 DOI: 10.1038/sj.cdd.4402139] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The chimeric fusion protein AML1-ETO, created by the t(8;21) translocation, recruits histone deacetylase (HDAC) to AML1-dependent promoters, resulting in transcriptional repression of the target genes. We analyzed the transcriptional changes in t(8;21) Kasumi-1 AML cells in response to the HDAC inhibitors, depsipeptide (FK228) and suberoylanilide hydroxamic acid (SAHA), which induced marked growth inhibition and apoptosis. Using cDNA array, annexin A1 (ANXA1) was identified as one of the FK228-induced genes. Induction of ANXA1 mRNA was associated with histone acetylation in ANXA1 promoter and reversal of the HDAC-dependent suppression of C/EBPalpha by AML1-ETO with direct recruitment of C/EBPalpha to ANXA1 promoter. This led to increase in the N-terminal cleaved isoform of ANXA1 protein and accumulation of ANXA1 on cell membrane. Neutralization with anti-ANXA1 antibody or gene silencing with ANXA1 siRNA inhibited FK228-induced apoptosis, suggesting that the upregulation of endogenous ANXA1 promotes cell death. FK228-induced ANXA1 expression was associated with massive increase in cell attachment and engulfment of Kasumi-1 cells by human THP-1-derived macrophages, which was completely abrogated with ANXA1 knockdown via siRNA transfection or ANXA1 neutralization. These findings identify a novel mechanism of action of HDAC inhibitors, which induce the expression and externalization of ANXA1 in leukemic cells, which in turn mediates the phagocytic clearance of apoptotic cells by macrophages.
Collapse
MESH Headings
- Acetylation
- Annexin A1/biosynthesis
- Annexin A1/genetics
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Base Sequence
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Core Binding Factor Alpha 2 Subunit/metabolism
- DNA, Complementary/genetics
- Depsipeptides/pharmacology
- Enzyme Inhibitors/pharmacology
- Histone Deacetylase Inhibitors
- Histones/metabolism
- Humans
- Hydroxamic Acids/pharmacology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Macrophages/physiology
- Oncogene Proteins, Fusion/metabolism
- Phagocytosis/drug effects
- RUNX1 Translocation Partner 1 Protein
- Up-Regulation/drug effects
- Vorinostat
Collapse
Affiliation(s)
- Y Tabe
- Section of Molecular Hematology and Therapy, Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Radke S, Battmann A, Jatzke S, Eulert J, Jakob F, Schütze N. Expression of the angiomatrix and angiogenic proteins CYR61, CTGF, and VEGF in osteonecrosis of the femoral head. J Orthop Res 2006; 24:945-52. [PMID: 16609965 DOI: 10.1002/jor.20097] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Angiogenesis and bone repair are closely linked processes. VEGF, CYR61, and CTGF have been identified as signaling factors that control angiogenesis and could be important in fracture healing. The purpose of this study was to investigate the expression of these signaling factors in osteonecrosis of the femoral head. Twenty-one bone cylinders were retrieved from hips of patients with osteonecrosis of the femoral head at different ARCO stages. Immunohistochemistry for CD34, CYR61, CTGF, and VEGF expression was done on each bone cylinder representing the different regions of osteonecrosis (necrosis, fibrosis, transition zone, and edematous area). VEGF, CYR61, and CTGF were expressed in samples with osteonecrosis. Particularly VEGF and CYR61 were highly expressed in the edematous area. CYR61 was also highly expressed in the transition zone. CTGF was expressed mainly in the area of marrow fibrosis and edema. CYR61, CTGF, and VEGF are expressed to different degrees in the different repair zones of osteonecrosis. Particularly, the high expression of VEGF and CYR61 in the edematous area may represent a consequence of hypoxia and indicate a role of these proteins in the repair processes ongoing in osteonecrosis.
Collapse
Affiliation(s)
- S Radke
- Orthopaedic Center for Musculoskeletal Research, Molecular Orthopaedics, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany
| | | | | | | | | | | |
Collapse
|
30
|
Radke S, Wollmerstedt N, Bischoff A, Eulert J. Knee arthroplasty for spontaneous osteonecrosis of the knee: unicompartimental vs bicompartimental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2005; 13:158-62. [PMID: 15448886 DOI: 10.1007/s00167-004-0551-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 05/17/2004] [Indexed: 10/26/2022]
Abstract
Spontaneous osteonecrosis of the knee (SON) is an osteonecrosis that mainly affects the medial femoral condyle. In endstage SON, knee arthroplasty is the therapy of choice. Because of the unicompartimental nature of the knee, unicondylar knee arthroplasty is considered an ideal implant for treatment of this condition. The purpose of this study was to prove that the long-term results of unicondylar implants are better than the results of bicondylar implants for the treatment of SON. All patients treated for SON between 1984 and 2000 have been recorded. Two groups were formed according to the implant used. In all patients the preoperative radiograph was analyzed according to stage and size of the osteonecrotic lesion and the osteoarthritic changes. Postoperatively, the Knee Society Score and the radiograph were recorded. Thirty-nine patients were included in this study, of which 23 patients were treated by a unicondylar implant and 16 by a bicondylar implant. On a short-term basis, unicondylar implants had better clinical results; however, on a long-term basis bicondylar implants were better. In comparison, only unicondylar implants had to be revised. Radiolucency lines were mainly observed in patients with unicondylar impants and large areas of osteonecrosis. Our long-term results suggest that patients with SON are better treated by bicondylar implants. The reasons for the higher failure rate for unicondylar implants are poor bone stock and secondary arthritic changes.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, König-Ludwig Haus, Julius-Maximilians University Würzburg, Brettreichstr. 11, 97074, Würzburg, Germany,
| | | | | | | |
Collapse
|
31
|
Radke S, Vispo-Seara J, Walther M, Kenn W, Kirschner S, Ettl V, Eulert J. [Osteochondral lesions of the talus -- indications for MRI with a contrast agent]. ACTA ACUST UNITED AC 2004; 142:618-24. [PMID: 15472774 DOI: 10.1055/s-2004-820417] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM This study aims to establish the indication for a pre- and postoperative MRI examination with an intravenous contrast agent in patients with an osteochondral lesion of the talus. METHODS 20 patients with an osteochondral lesion of the talus in the different stages according to DiPaola were prospectively examined preoperatively and 6 months postoperatively by an MRI investigation with an i. v. contrast agent. The Weber ankle score was determined pre- and postoperatively. A correlation was calculated between MRI and arthroscopic findings of an osteochondral lesion (Spearman-rho). RESULTS There was a significant correlation among the radiological, the MRI and the arthroscopically determined locations. With regard to staging only 12 out of 20 lesions were staged correctly by MRI using arthroscopy as a gold standard. Due to metal artifacts and morphological changes the postoperative MRI could not be used for staging. CONCLUSION A preoperative MRI investigation is indicated in patients with ankle pain of unknown origin, a normal radiograph and a suspected osteochondral lesion of the talus. MRI is not indicated to determine the localization and the stage of an osteochondral lesion. A postoperative MRI is only necessary for the exclusion of a secondary pathology.
Collapse
Affiliation(s)
- S Radke
- Orthopädische Klinik, Ludwig-Maximilians-Universität, Würzburg.
| | | | | | | | | | | | | |
Collapse
|
32
|
Radke S, Kirschner S, Seipel V, Rader C, Eulert J. Magnetic resonance imaging criteria of successful core decompression in avascular necrosis of the hip. Skeletal Radiol 2004; 33:519-23. [PMID: 15221216 DOI: 10.1007/s00256-004-0811-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 08/15/2003] [Accepted: 04/28/2004] [Indexed: 02/02/2023]
Abstract
To identify imaging criteria that determine the outcome of core decompression (CD) in femoral-head avascular necrosis (AVN). Radiographs and magnetic resonance imaging (MRI) of 65 hips with early stage AVN treated by core decompression between January 1990 and December 2000 for AVN were reviewed. All hips were categorized into two groups according to the result of CD using total hip arthroplasty (THA) as an end point. Hips that had no THA at follow-up were allocated to group I; those treated with a THA were allocated to group II. CD results were calculated for each group using THA as an end point. The parameters analyzed were the presence or absence of edema associated with the double-line sign on the preoperative MRI, the type of epiphyseal scar (ES) according to Jing, and the type of necrosis according to Mitchell. On follow-up, 45 hips had no THA (group I); 20 patients had a THA (group II). Patients with a radiographic crescent sign and those with edema associated with the double-line sign progressed to THA significantly more frequently. The extent of the necrosis had less discriminatory effect between the two groups. ES and necrotic tissue types had no prognostic value. In regard to the success of CD, it is important to differentiate on MRI between a double line sign plus bone marrow edema and a double-line sign only.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius-Maximilians University, Würzburg, Brettreichstr.11, 97074 Würzburg, Germany.
| | | | | | | | | |
Collapse
|
33
|
Radke S, Kenn W, Eulert J. Transient bone marrow edema syndrome progressing to avascular necrosis of the hip ? a case report and review of the literature. Clin Rheumatol 2004; 23:83-8. [PMID: 14749994 DOI: 10.1007/s10067-003-0820-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2003] [Accepted: 09/29/2003] [Indexed: 10/26/2022]
Abstract
Transient bone marrow edema syndrome (TMES) is a rare disease of unknown etiology. Diagnosis is made by exclusion. There is still controversy as to whether TMES is considered to be a reversible form of avascular necrosis (AVN), a disease entity of its own or a form of non-traumatic algodystrophy. We here describe the extremely rare occurrence of three cases of TMES that progressed to AVN.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopedic Surgery, König Ludwig Haus, Julius-Maximilians-Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
| | | | | |
Collapse
|
34
|
Radke S, Walther M, Ettl V, König A. Epidermoid cyst mimicking monoarticular arthritis of the great toe. Rheumatol Int 2003; 24:117-9. [PMID: 14600783 DOI: 10.1007/s00296-003-0345-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2003] [Accepted: 04/25/2003] [Indexed: 10/26/2022]
Abstract
Local swellings of the foot are a common presentation in rheumatological practice. In the following case report, an epidermoid cyst presenting with the typical features of monoarticular arthritis is described in a 27-year-old woman. The differential diagnosis of forefoot swelling is discussed, with particular emphasis on epidermoid cysts and monoarticular arthritis.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius Maximilian University, Brettreichstrasse 11, 97074, Würzburg, Germany
| | | | | | | |
Collapse
|
35
|
Abstract
We reviewed 34 patients (38 joints) with hallux rigidus treated from 1989 to 1999 with arthrodesis of the first metatarsophalangeal joint. Average patient age at time of surgery was 52 (24-71) years, and the mean follow-up was 54 (18-116) months. There were six superficial infections, and all arthrodeses united. There was a good functional result with a significant pain reduction. The mean postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 53 (5-84) points.
Collapse
Affiliation(s)
- V. Ettl
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - S. Radke
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - M. Gaertner
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - M. Walther
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| |
Collapse
|
36
|
Debret R, El Btaouri H, Duca L, Rahman I, Radke S, Haye B, Sallenave JM, Antonicelli F. Annexin A1 processing is associated with caspase-dependent apoptosis in BZR cells. FEBS Lett 2003; 546:195-202. [PMID: 12832039 DOI: 10.1016/s0014-5793(03)00570-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [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: 11/22/2022]
Abstract
Annexins are widely distributed and have been described in lung as well as in other cells and tissues. Annexin I (ANX AI) is a member of the calcium-dependent phospholipid binding protein family. Besides its anti-inflammatory function, ANX AI has been involved in several mechanisms such as the Erk repression pathway or apoptosis. To investigate the role of ANX AI on apoptosis in broncho-alveolar cells, we have constructed a plasmid containing the ANX AI full length cDNA. Transfected BZR cells displayed a higher level of both forms of ANX AI (37 and 33 kDa) as well as a decrease in cell viability (two-fold versus cells transfected with an empty vector). In order to analyse the endogenous ANX AI processing during stimulus-induced apoptosis, BZR cells were treated with a commonly used inducer, i.e. C2 ceramides. In these conditions, microscopic analysis revealed chromatin condensation in dying cells and the Bcl-2, Bcl-x(L)/Bax mRNA balance was altered. Caspase-3 is one of the key executioners of apoptosis, being responsible for the cleavage of many proteins such as the nuclear enzyme poly(ADP-ribose) polymerase (PARP). We demonstrate that caspase-3 was activated after 4 h treatment in the presence of ceramide leading to the cleavage of PARP. Dose-response experiments revealed that cell morphology and viability modifications following ceramide treatment were accompanied by an increase in endogenous ANX AI processing. Interestingly, in both ceramide and transfection experiments, the ANX AI cleaved form was enhanced whereas pre-treatment with the caspase inhibitor Z-VAD-fmk abolished ANX AI cleavage. In conclusion, this study demonstrates a complex regulatory role of caspase-dependent apoptosis where ANX AI is processed at the N-terminal region which could give susceptibility to apoptosis upon ceramide treatment.
Collapse
Affiliation(s)
- R Debret
- Laboratoire de Biochimie, CNRS FRE 2534, Université de Reims Champagne-Ardenne, UFR Sciences, Moulin de la Housse, PO Box 1039, 51687 Reims Cedex 2, France
| | | | | | | | | | | | | | | |
Collapse
|
37
|
König A, Radke S, Molzen H, Haase M, Müller C, Drexler D, Natalis M, Krauss M, Behrens N, Irnich D. [Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain - range of motion analysis]. Z Orthop Ihre Grenzgeb 2003; 141:395-400. [PMID: 12928995 DOI: 10.1055/s-2003-41566] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM The aim of this study was to compare the effects of acupuncture on active motion of the cervical spine in patients with chronic neck pain with those of "sham" laser acupuncture and massage. MATERIAL AND METHODS 177 patients with chronic neck pain were included in this prospective, randomized, placebo-controlled study. The patients were allocated by external randomization to five treatments over three weeks with acupuncture, massage and "sham" laser acupuncture. The range of active motion was measured by means of a 3D ultrasound real time motion analyzer. RESULTS The analysis of cervical motion in three directions showed the largest increase in range of motion 14 days after acupuncture. Compared to massage, a significant improvement in total range of motion was seen in those patients treated by acupuncture immediately (p = 0,03) and one week (p = 0,03) weeks after therapy. There was no significant difference in those patients treated by sham laser acupuncture. CONCLUSION The results of the study indicate that acupuncture is superior to conventional massage for improving active range of motion in patients with chronic neck pain. Because of its positive effects, its acceptance among patients and the lack of severe side effects, acupuncture can be recommended for the treatment of chronic neck pain, although there was no significant difference in results between "sham" laser acupuncture and acupuncture.
Collapse
Affiliation(s)
- A König
- Orthopädische Klinik, Klinik am Eichert, Göppingen, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Radke S, Rader C, Kenn W, Kirschner S, Walther M, Eulert J. Transient marrow edema syndrome of the hip: results after core decompression. A prospective MRI-controlled study in 22 patients. Arch Orthop Trauma Surg 2003; 123:223-7. [PMID: 12739033 DOI: 10.1007/s00402-003-0506-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2002] [Indexed: 10/19/2022]
Abstract
BACKGROUND Transient marrow edema syndrome (TMES) of the hip is a disease of acute onset and severe functional disability. There is histological evidence for an ischemic etiology of TMES of the hip. Core decompression as applied for avascular necrosis (AVN) of the hip is therefore a therapeutic alternative to conservative therapy, the latter leading only to a reduction of symptoms but never a shortening of the course of the disease. METHODS Between January 1998 and June 2000, 22 hips with TMES were treated with core decompression in our department. TMES was diagnosed by exclusion. MRI was done preoperatively and at 6 months postoperatively. The postoperative MRI result was classified into three categories. RESULTS After an average of 7.2 (range 1-30) days, all patients were pain-free after core decompression. In 2 patients, TMES progressed to AVN despite core decompression. All others had no signal alterations of the head of the femur on MRI after 6 months. The postoperative Harris Hip Score (HHS) in patients with TMES was on average 93.7 (range 77-95); in patients with AVN, the postoperative HHS was 47 (range 45-49). CONCLUSION Our results demonstrate that core decompression of the hip significantly shortens the natural course of disease of TMES of the hip.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig Ludwig Haus, University of Würzburg, Brettreichstr.11, 97074 Würzburg, Germany.
| | | | | | | | | | | |
Collapse
|
39
|
Radke S, Kirschner S, Seipel V, Rader C, Eulert J. Treatment of transient bone marrow oedema of the hip--a comparative study. Int Orthop 2003; 27:149-52. [PMID: 12799758 PMCID: PMC3458445 DOI: 10.1007/s00264-003-0452-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2003] [Indexed: 11/26/2022]
Abstract
Between 1990 and 2000, we treated 43 patients with transient bone marrow oedema of the hip. Five were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and limited weight bearing, and 38 by core decompression followed by limited weight bearing. At follow-up 2-10 years later, all patients were assessed by a structured interview as well as the Harris hip score (HHS) and the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC). Both groups reached the same clinical outcome (HHS and WOMAC). Core decompression enabled a significantly faster recovery. There were no complications, but progression to avascular necrosis was seen in both groups. Core decompression induced fast pain relief, making it the preferable treatment.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig Haus, Julius-Maximilians University Würzburg, Brettreichstr. 11, 97070 Wuerzburg, Germany.
| | | | | | | | | |
Collapse
|
40
|
Abstract
A juxtaarticular ganglion (JAG) is a rare tumor-like lesion of the acetabulum, causing chronic hip disability. Due to its location, a JAG is a special form of an intraosseous ganglion. There is a lack of histological criteria to differentiate a JAG from an osteoarthritic cyst. The clinical findings of a JAG are determined by its proximity to the joint gap and its extraarticular extension. In a case report the necessary diagnostics as well as the therapeutic consequences are discussed.
Collapse
Affiliation(s)
- S Radke
- König-Ludwig-Haus, Universität Würzburg, Brettreichstr. 11, 97074 Würzburg
| | | | | |
Collapse
|
41
|
Rader CP, Baumann B, Rolf O, Radke S, Hendrich C, Schütze N, Seufert J, Jakob F. Detection of differentially expressed genes in particle disease using array-filter analysis. BIOMED ENG-BIOMED TE 2002; 47:111-6. [PMID: 12090138 DOI: 10.1515/bmte.2002.47.5.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The precise cellular mechanism of osteolysis in particle disease is still unknown. The aim of the study was to screen for new gene products in macrophages during particle contact. METHOD In an established macrophage model THP1-cells (human monocytic cells) were differentiated under the influence of vitamin D3 and GM-CSF into macrophage-like cells (MLC). MLCs were incubated each with different concentrations of polyethylene particles, Lipopolysaccharids (LPS) and controls. Isolated RNA was transcribed into complementary radioactive 32P labeled cDNA. This probe was hybridised on an human cDNA expression array and analysed by autoradiography. To obtain a more reliable method quantifying mRNA, the reverse transcriptase polymerase chain reaction (RT-PCR) was used. RESULTS The arrays showed an upregulation of the following genes by particles: TNF-Rezeptor 2, IL-1 Receptor Antagonist, Bone Morphogenic Protein 4 and HM 145. This was proven three times using RT-PCR and statistically significant in comparison to the controls. LPS induced the same upregulation except for HM145 whereas particles caused downregulation of this mRNA expression. CONCLUSION Our results prove that the model of differentiated THP-1 cells treated with PE particles is a suitable system to analyse differential gene expression patterns, since the induction of the major positive control genes TNF alpha and IL1 beta were detected by this approach. BMP 4 is known as signal protein which mediates ectopic bone formation and can also be interpreted as a contra regulatory gene. HM 145 belongs to the leukocyte chemotactic peptide receptor family. HM 145 seems to be one of the first genes that is enhanced along the septical pathway but less expressed by contact with particles. Analysis of HM 145 expression might help to diagnose septic versus aseptic loosening of prosthesis.
Collapse
Affiliation(s)
- Ch P Rader
- Department of Orthopadics, University of Wuerzburg
| | | | | | | | | | | | | | | |
Collapse
|
42
|
|
43
|
Abstract
MRI currently offers the best imaging information for the diagnosis of subacromial pain syndrome, rotator cuff tears and osteoarthritis of the shoulder. The excellent anatomical and tissue specific imaging allows a detailed evaluation of the rotator cuff as well as the adjacent bony structures. If the cause of subacromial pain can not be determined despite extensive clinical, sonographical and radiological examination, MRI is indicated if there is a suspected pathology of the bony structures or the glenohumeral joint that could influence the further therapeutic procedures. In addition, MRI evaluation of muscular atrophy has become an important factor for determining appropriate therapy, particularly in cases of massive rotator cuff tears.
Collapse
Affiliation(s)
- S Radke
- Orthopädische Klinik, König Ludwig Haus, Universität Würzburg, Brettreichstrasse 11, 97070 Würzburg
| | | | | |
Collapse
|
44
|
Abstract
We treated ten patients who on the basis of MRI were suspected to have transient bone marrow oedema. In eight cases the talus was affected, in one the cuboid and in one the navicular bone. All patients had acute onset pain at the ankle. Four were treated with core decompression and had an immediate pain relief. Six were treated conservatively and became also pain-free but with considerable delay.
Collapse
Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig Haus, University of Würzburg, Würzburg, Germany.
| | | | | | | | | |
Collapse
|
45
|
Walther M, Harms H, Krenn V, Radke S, Faehndrich TP, Gohlke F. Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 2001. [PMID: 11229463 DOI: 10.1002/1529-0131(200102)44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane vascularity. METHODS The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. RESULTS The correlation between the qualitative PDS results and the qualitative grading of the vascularity by the pathologist was 0.89 by Spearman's rho (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's p (P < 0.01) for the PDS images. The correlation between the qualitative estimation of vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's rho (P < 0.01). CONCLUSION In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
Collapse
|
46
|
Ettl V, Kenn W, Radke S, Kirschner S, Goerttler-Krauspe I, Vispo-Seara JL. [The role of MRI in therapy and follow-up after surgical treatment of osteochondrosis dissecans of the talus]. Z Orthop Ihre Grenzgeb 2001; 139:157-62. [PMID: 11386107 DOI: 10.1055/s-2001-15049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM Our study was designed to evaluate the use of magnetic resonance imaging (MRI) in the follow-up of surgically treated osteochondrosis dissecans (OCD) of the talus. METHOD We investigated 16 patients (18 joints) with OCD of the talus, surgically treated in our department between 1990 and 1997. All of them had preoperative MRI scans of the affected ankle. The mean follow-up was 40 months (8-82). All patients were evaluated by clinical examination, plain radiography and MRI using a standard protocol. RESULTS The clinical Bray score improved significantly from 58 preoperative to 82 postoperative. Using a visual analogue scale we saw a significant reduction of the patients pain level post-op. In 72% of the patients the preoperative MRI was able to predict the accurate stage of the cartilage. Postoperative MRI showed no more lesion in 3, intact articular cartilage in 11, and disrupted cartilage in 4 joints. There was no correlation between clinical, plain radiographical, and MRI findings postoperative. CONCLUSION Arthroscopy remains the golden standard in evaluating articular cartilage. Using our data, MRI is not the method of choice in the follow-up of surgically treated OCD lesions of the talus. Postoperative use of intravenous contrast media gave no additional information. Postoperative MRI should be reserved only for symptomatic patients to gather additional information about the actual state of the OCD. Afterwards a prompt arthroscopy of the symptomatic ankle should be performed.
Collapse
Affiliation(s)
- V Ettl
- Kliniken Dr. Erler, Abt. für Unfallchirurgie, Nürnberg
| | | | | | | | | | | |
Collapse
|
47
|
Walther M, Harms H, Krenn V, Radke S, Faehndrich TP, Gohlke F. Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 2001; 44:331-8. [PMID: 11229463 DOI: 10.1002/1529-0131(200102)44:2<331::aid-anr50>3.0.co;2-0] [Citation(s) in RCA: 343] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane vascularity. METHODS The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. RESULTS The correlation between the qualitative PDS results and the qualitative grading of the vascularity by the pathologist was 0.89 by Spearman's rho (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's p (P < 0.01) for the PDS images. The correlation between the qualitative estimation of vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's rho (P < 0.01). CONCLUSION In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
Collapse
|
48
|
Stempka L, Schnölzer M, Radke S, Rincke G, Marks F, Gschwendt M. Requirements of protein kinase cdelta for catalytic function. Role of glutamic acid 500 and autophosphorylation on serine 643. J Biol Chem 1999; 274:8886-92. [PMID: 10085132 DOI: 10.1074/jbc.274.13.8886] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Recently, we reported that, in contrast to protein kinase C (PKC)alpha and betaII, PKCdelta does not require phosphorylation of a specific threonine (Thr505) in the activation loop for catalytic competence (Stempka et al. (1997) J. Biol. Chem. 272, 6805-6811). Here, we show that the acidic residue glutamic acid 500 (Glu500) in the activation loop is important for the catalytic function of PKCdelta. A Glu500 to valine mutant shows 76 and 73% reduced kinase activity toward autophosphorylation and substrate phosphorylation, respectively. With regard to thermal stability and inhibition by the inhibitors Gö6976 and Gö6983 the mutant does not differ from the wild type, indicating that the general conformation of the molecule is not altered by the site-directed mutagenesis. Thus, Glu500 in the activation loop of PKCdelta might take over at least part of the role of the phosphate groups on Thr497 and Thr500 of PKCalpha and betaII, respectively. Accordingly, PKCdelta exhibits kinase activity and is able to autophosphorylate probably without posttranslational modification. Autophosphorylation of PKCdelta in vitro occurs on Ser643, as demonstrated by matrix-assisted laser desorption ionization mass spectrometry of tryptic peptides of autophosphorylated PKCdelta wild type and mutants. A peptide containing this site is phosphorylated also in vivo, i.e. in recombinant PKCdelta purified from baculovirus-infected insect cells. A Ser643 to alanine mutation indicates that autophosphorylation of Ser643 is not essential for the kinase activity of PKCdelta. Probably additional (auto)phosphorylation site(s) exist that have not yet been identified.
Collapse
Affiliation(s)
- L Stempka
- German Cancer Research Center, D-69120 Heidelberg, Germany
| | | | | | | | | | | |
Collapse
|
49
|
Radke S, Schwaberg M, Storm G, Wambach W, Bauer H. [The white clot syndrome]. Zentralbl Chir 1998; 123:573-578. [PMID: 22462226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The white clot syndrome is a serious ideosyncratic side effect of routine anticoagulation with low dose heparin. Two different courses of the white clot syndrome are illustrated. The different ways of diagnosis and therapy as well as means of prophylaxis are discussed.
Collapse
Affiliation(s)
- S Radke
- Chirurgische Abteilung KH Altötting, Akademisches Lehrkrankenhaus der TU München
| | | | | | | | | |
Collapse
|
50
|
Ciardiello F, Kim N, Saeki T, Dono R, Persico MG, Plowman GD, Garrigues J, Radke S, Todaro GJ, Salomon DS. Differential expression of epidermal growth factor-related proteins in human colorectal tumors. Proc Natl Acad Sci U S A 1991; 88:7792-6. [PMID: 1715580 PMCID: PMC52389 DOI: 10.1073/pnas.88.17.7792] [Citation(s) in RCA: 171] [Impact Index Per Article: 5.2] [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: 12/28/2022] Open
Abstract
Amphiregulin (AR) and cripto are proteins that are structurally related to epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha). AR is also functionally related to this family of growth regulatory molecules and is able to bind and activate the 170-kDa EGF receptor (EGFR). Human EGFR-3 (HER3)/ERBB3 is a recently identified protein related to the EGFR that is widely expressed in breast carcinomas and is a candidate receptor for EGF-like growth factors. Differential expression of these putative ligands and receptors in transformed cells suggests that they may function in an autocrine manner to regulate tumor cell growth. Specific mRNA transcripts for TGF-alpha [4.8 kilobases (kb)], AR (1.4 kb), cripto (2.2 kb), and HER3 (6.2 kb) were expressed in a majority of human colon cancer cell lines. HER3 mRNA was detected in 55% of primary or metastatic human colorectal carcinomas but in only 22% of normal colon mucosa and 32% of normal liver samples. In contrast, cripto and AR mRNA were expressed in 60-70% of primary or metastatic human colorectal cancers but in only 2-7% of normal human colonic mucosa. Immunostaining also detected AR protein in primary and metastatic colorectal tumors but not in normal colon or uninvolved liver. These findings suggest that cripto and AR may be useful markers to discriminate between normal and malignant colonic epithelium and may provide a selective growth advantage for colorectal carcinomas.
Collapse
Affiliation(s)
- F Ciardiello
- Laboratory of Tumor Immunology and Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | | | | | | | | | | | | | | | | | | |
Collapse
|