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Sample records for patienten mit aml

  1. Kompressionstherapie bei Patienten mit Ulcus cruris venosum.

    Science.gov (United States)

    Dissemond, Joachim; Assenheimer, Bernd; Bültemann, Anke; Gerber, Veronika; Gretener, Silvia; Kohler-von Siebenthal, Elisabeth; Koller, Sonja; Kröger, Knut; Kurz, Peter; Läuchli, Severin; Münter, Christian; Panfil, Eva-Maria; Probst, Sebastian; Protz, Kerstin; Riepe, Gunnar; Strohal, Robert; Traber, Jürg; Partsch, Hugo

    2016-11-01

    Wund-D.A.CH. ist der Dachverband deutschsprachiger Fachgesellschaften, die sich mit den Thematiken der Wundbehandlung beschäftigen. Experten verschiedener Fachgesellschaften aus Deutschland, Österreich und der Schweiz haben nun einen aktuellen Konsens der Kompressionstherapie für Patienten mit Ulcus cruris venosum erstellt. In Europa ist das Ulcus cruris venosum eine der häufigsten Ursachen für chronische Wunden. Neben der konservativen und interventionellen Wund- und Venentherapie, ist die Kompressionstherapie die Basis der Behandlungsstrategien. Die Kompressionstherapie kann heute mit sehr unterschiedlichen Materialien und Systemen durchgeführt werden. Während in der Entstauungsphase insbesondere Verbände mit Kurzzugbinden oder Mehrkomponentensysteme zur Anwendung kommen, sind es anschließend überwiegend Ulkus-Strumpfsysteme. Eine weitere, bislang wenig verbreitete Alternative sind adaptive Kompressionsbandagen. Insbesondere für die Rezidivprophylaxe werden medizinische Kompressionsstrümpfe empfohlen. Durch die Vielzahl der heute zur Verfügung stehenden Behandlungsoptionen, kann für nahezu alle Patienten ein Konzept entwickelt werden, dass sich an den individuellen Bedürfnissen und Fähigkeiten orientiert und daher auch akzeptiert und durchgeführt wird. Die Kompressionstherapie ist für die Behandlung von Patienten mit Ulcus cruris venosum essentiell. In den letzten Jahren sind viele verschiedene Therapieoptionen verfügbar, die in den deutschsprachigen Ländern unterschiedlich angewendet oder durchgeführt werden. Daher soll dieser Expertenkonsens dazu beitragen, konkrete Empfehlungen für die praktische Durchführung der Kompressionstherapie von Patienten mit Ulcus cruris venosum darzustellen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  2. Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation; Myeloablative Radioimmuntherapien zur Konditionierung bei Patienten mit AML, MDS und multiplem Myelom vor Stammzelltransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Buchmann, I. [Abt. fuer Nuklearmedizin, Universitaetsklinik Heidelberg (Germany)

    2008-06-15

    Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. {sup 90}Y, {sup 188}Re and {sup 131}I are the most frequently used {beta}{sup -}-particles. Of these, {sup 90}Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate {sup 90}Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The {sup 90}Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow < 25%. The specific doses (Gy/GBq) are 10.2 {+-} 1.8 (bone marrow), 2.7 {+-} 2 (liver) and < 1 (kidneys). In contrast, radiolabeled anti-CD33- and anti-CD45-antibodies bind to both, most of white blood cells and

  3. Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen.

    Science.gov (United States)

    Castellanos-González, Maria; Joven, Beatriz Esther; Sánchez, Julio; Andrés-Esteban, Eva María; Vanaclocha-Sebastián, Francisco; Romero, Pablo Ortiz; Díaz, Raquel Rivera

    2016-11-01

    Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren. Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis-Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen. Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target-NAPSI-Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035). Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis-Patienten sein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. Untersuchungen zum Riechvermögen bei Patienten mit schizophrenen Störungen

    OpenAIRE

    Minovi, A; Dombrowski, T; Brüne, M; Dazert, S; Juckel, G

    2014-01-01

    Einleitung: Riechstörungen werden bei Patienten mit einer Schizophrenie in vielen Studien beschrieben. Im Rahmen einer prospektiv angelegten Studie untersuchten wir das Riechvermögen von 18 Patienten mit einer Schizophrenie im Vergleich zu einer Kontrollgruppe (n=13). Weiterhin erfolgte eine immunhistochemische Untersuchung der Riechschleimhaut bei 8 Patienten mit einer Schizophrenie.Methoden: Die Riechprüfung erfolgte mit Hilfe der erweiterten Sniffin' Sticks-Testbatterie. Nach Biopsie der...

  5. Kompressionstherapie - Versorgungspraxis: Informationsstand von Patienten mit Ulcus cruris venosum.

    Science.gov (United States)

    Protz, Kerstin; Heyer, Kristina; Dissemond, Joachim; Temme, Barbara; Münter, Karl-Christian; Verheyen-Cronau, Ida; Klose, Katharina; Hampel-Kalthoff, Carsten; Augustin, Matthias

    2016-12-01

    Eine Säule der kausalen Therapie bei Patienten mit Ulcus cruris venosum ist die Kompressionstherapie. Sie unterstützt die Abheilung, reduziert Schmerzen und Rezidive und steigert die Lebensqualität. Bislang existieren kaum wissenschaftliche Daten zu dem Versorgungsstand und fachspezifischem Wissen von Patienten mit Ulcus cruris venosum. Standardisierte Fragebögen wurden bundesweit in 55 Pflegediensten, 32 Arztpraxen, vier Wundzentren und -sprechstunden sowie einem Pflegetherapiestützpunkt von Patienten mit Ulcus cruris venosum bei Erstvorstellung anonym ausgefüllt. Insgesamt nahmen 177 Patienten (Durchschnittsalter 69,4 Jahre; 75,1 % Frauen) teil. Ein florides Ulcus cruris venosum bestand im Mittel 17 Monate. 31,1 % hatten keine Kompressionstherapie, 40,1 % Binden und 28,8 % Strümpfe. Bei der Bestrumpfung hatten 13,7 % Kompressionsklasse III, 64,7 % Kompressionsklasse II und 19,6 % Kompressionsklasse I. 70,6 % legten die Strümpfe nach dem Aufstehen an, 21,1 % trugen sie Tag und Nacht. 39,2 % bereiteten die Strümpfe Beschwerden. Lediglich 11,7 % hatten eine An- und Ausziehhilfe. Die Binden wurden im Mittel 40,7 Wochen getragen und bei 69 % nicht unterpolstert. Bei 2,8 % wurde der Knöchel- und Waden-Umfang zur Erfolgskontrolle gemessen. Venensport machten 45,9 %. Ein Drittel hatte keine Kompressionsversorgung, obwohl diese eine Basismaßnahme der Therapie des Ulcus cruris venosum ist. Zudem ist deren korrekte Auswahl und Anwendung angesichts der langen Bestandsdauer der Ulzerationen zu hinterfragen. Weiterführende Fachkenntnisse bei Anwendern und Verordnern sowie Patientenschulungen sind erforderlich. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  6. Behandlung von Herzrhythmusstörungen mit Magnesium bei Patienten mit Herzinsuffizienz

    Directory of Open Access Journals (Sweden)

    Wink K

    2002-01-01

    Full Text Available Die medikamentöse Behandlung von Herzrhythmusstörungen ist unbefriedigend, da bei guter Wirksamkeit durch die Proarrhythmie eine Verbesserung der Prognose gefährdet und nicht gesichert ist. Man kann davon ausgehen, daß Magnesiumsalze keine arrhythmogene Effekte aufweisen. Bei Patienten mit einer Herzinsuffizienz besteht häufig ein Mg-Mangel, der durch gastrointestinale Störungen, neurohormonale Regulationen, aber auch durch die Therapie (Diuretika,Digitalisbedingt ist. An Patienten mit einer Herzinsuffizienz müßte sich demnach zeigen lassen, ob die Mg-Substitution einen antiarrhythmischen Effekt aufweist. In fünf placebokontrollierten Studien konnte gezeigt werden, daß sich teil weise signifikant und mit ausreichen der Aussagekraft (PowerArrhythmien bei Patienten mit Herzinsuffizienz durch orale und parenterale Gabe von Mg-Salzen reduzieren lassen. Trotz Einschränkungen wie z.B. inadäquates Design, fehlende Vermeidung von Bias, ungenügende Vergleichbarkeit der Behandlungsgruppen, inadäquate Auswertung und ungenügende Berücksichtigung der Spontanvariation läßt sich aufgrund der Ergebnisse der Studien die Hypothese aufstellen, daß Magnesiumsalze bei Patienten mit Herzinsuffizienz Herzrhythmusstörungen günstig beeinflussen können. Prospektive, randomisierte,verblindete und kontrollierte konfirmatorische Studien mit ausreichenden Fallzahlen sind jedoch notwendig, um diese Hypothese zu bestätigen.

  7. Pathophysiologie des Kollagenstoffwechsels bei Patienten mit Induratio penis plastica (IPP

    Directory of Open Access Journals (Sweden)

    Lahme S

    2000-01-01

    Full Text Available Die Pathogenese der IPP ist bis heute nicht geklärt. Histopathologische Untersuchungen zeigen, daß der Kollagenstoffwechsel eine Rolle spielt. Dies veranlaßte uns zur genauen Analyse der Kollagenstoffwechselparameter bei IPP. Bei 11 Patienten mit IPP und 11 Kontrollpersonen wurden Kollagenstoffwechselparameter (Prokollagen III [PIIIP], PMN-Elastase [PMN-E], Fibronektin [FN], Fibronektinrezeptor [FN-R] und alpha1-Proteinase-Inhibitor [alpha1-PI] im cavernösen und peripheren Blut bestimmt. PMN-E, PIIIP, FN und FN-R waren in den beiden Untersuchungsgruppen nicht unterschiedlich. Die peripher venösen unterschieden sich nicht von den cavernösen Blutproben. Sowohl im peripher venös (158,55 mg/dl als auch im cavernös entnommenen Blut (168,29 mg/dl war die Konzentration des a1-PI signifikant niedriger als in der Kontrollgruppe (214,82 mg/dl. An einem zweiten Kollektiv von 23 Patienten wurden Analysen des Phänotyps für alpha1-PI im Hinblick auf das Vorliegen von genetisch determinierten Mangelallelen vorgenommen. Hier zeigte sich kein signifikanter Unterschied zu einem Kontrollkollektiv von 19 gesunden Probanden. Die alpha1-PI Erniedrigung der IPP-Patienten ist signifikant und liegt unterhalb des Normalwertbereichs für die gesunde Population. Ein Mangel an alpha1-PI kann zur Aktivitätserhöhung der Proteasen und zum Umbau des Kollagengewebes führen. Möglicherweise kommt es zusammen mit einem lokal wirksamen Einflußfaktor schließlich zur dystrophen Kalzifikation. Die humangenetischen Untersuchungen sprechen nicht für eine genetische Determinierung des alpha1-PI-Mangels, sondern legen eine erworbene hepatische Störung nahe.

  8. Ernährungszustand bei Patienten mit chronisch entzündlichen Darmerkrankungen

    OpenAIRE

    Blunk, Christine

    2009-01-01

    Zahlreiche internationale Studien konnten den negativen Einfluss einer bestehenden Malnutrition auf den Verlauf einer Erkrankung belegen. Dies gilt insbesondere für Patienten mit chronisch entzündlichen Darmerkrankungen wie Morbus Crohn und Colitis ulcerosa, die wie klinische Studien gezeigt haben besonders häufig unter einer Malnutrition leiden. In der vorliegenden Studie wurde der Ernährungszustand von 127 Patienten mit chronisch entzündlichen Darmerkrankungen anhand verschiedener etabli...

  9. Rigiscan®-Monitoring der Erektion unter audiovisueller sexueller Stimulation ohne/mit Viagra™ bei Patienten mit erektiler Dysfunktion

    Directory of Open Access Journals (Sweden)

    Perabo FGE

    2000-01-01

    Full Text Available Die orale Medikation mit Sildenafil (Viagra™ hat sich zur Therapie der erektilen Dysfunktion etabliert und relativiert die Differentialdiagnose zwischen psychogener und organischer Dysfunktion mit den entsprechenden therapeutischen Konsequenzen. Diesem Problem widmet sich diese Studie zur Prüfung der erektilen Antwort unter RigiScan®-Monitoring ohne/mit 50 mg Viagra™. 64 Patienten (mittleres Alter 48 Jahre mit einer erektilen Dysfunktion arteriogener (n = 10, venöser (n = 7, gemischt neurogen/vaskulärer (n = 15 und psychogener (n = 32 Genese von mehr als 6 Monaten Dauer wurden in die Studie aufgenommen. Alle Patienten wurden eingehend diagnostisch abgeklärt, inklusive Hormonlabor, dynamischer Pharmako-Duplexsonographie und, falls indiziert, mit einer Cavernosometrie/ -graphie. Zur Testung der penilen Rigidität und zur Objektivierung der Erektion wurde das "real-time" RigiScan® verwendet. In zwei konsekutiven Messungen wurden sowohl die direkte erektile Antwort auf visuelle Stimulation als auch die nächtlichen Erektionen abgeleitet und die Meßergebnisse mit den Begleiterkrankungen, "lifestyle"-Faktoren und dem Ergebnis der Pharmako-Duplexsonographie korreliert. Es fand sich keine Korrelation zwischen der Ätiologie der erektilen Dysfunktion in bezug auf organische oder psychogene Genese und dem Alter der Patienten, der Dauer der Erektionsstörung, dem Nikotinabusus, den Blutfetten, den Testosteronwerten, dem klinischen Ergebnis der Pharmakotestung (Erektionsgrad und dem duplexsonographisch gemessenen Fluß der penilen Arterien. Hingegen zeigte sich eine positive Korrelation zwischen Genese der erektilen Dysfunktion (organisch bzw. psychogen und dem RigiScan®-Meßergebnis (r = 0,29. Patienten mit psychogen bedingter Erektionsstörung profitierten am meisten von Viagra™, während Patienten mit vaskulärer Genese oder gemischt neurogener/vaskulärer Genese deutlich schlechter auf Viagra™ ansprachen. Es bestand keine Korrelation

  10. Ustekinumab in der Therapie der Pustulosis palmoplantaris - Eine Fallserie mit neun Patienten.

    Science.gov (United States)

    Buder, Valeska; Herberger, Katharina; Jacobi, Arnd; Augustin, Matthias; Radtke, Marc Alexander

    2016-11-01

    Die Pustulosis palmoplantaris ist eine chronisch entzündliche Hauterkrankung, die mit bedeutenden Einschränkungen der Lebensqualität und der Belastbarkeit einhergeht. Aufgrund von Zulassungsbeschränkungen und einem häufig therapierefraktären Verlauf sind die Behandlungsmöglichkeiten limitiert. Nach zuvor frustranen Therapien erhielten 9 Patienten mit Pustulosis palmoplantaris nach Ausschluss einer latenten Tuberkulose Ustekinumab (45 mg Ustekinumab bei  100 kg KG) in Woche 0, 4, 12 und 24. Reguläre Visiten erfolgten nach 4 und 12 Wochen, im weiteren Verlauf alle 12 Wochen. Das Durchschnittsalter bei Therapiebeginn betrug 48 Jahre. Drei Patienten waren männlich. Bei n  =  4 Patienten (44,4 %) wurde eine Verbesserung um 75 % des Palmoplantar-Psoriasis-Area-Severity-Index (PPPASI) erreicht. Insgesamt verbesserte sich der PPPASI nach 24 Wochen durchschnittlich um 71,6 %. Eine komplette Abheilung zeigte sich bei n  =  2 Patienten nach 24 Wochen. Bis auf lokale Injektionsreaktionen und leichte Infekte wurden keine unerwünschten Wirkungen beobachtet. Die Fallserie ist ein weiterer Beleg für die Wirksamkeit und Verträglichkeit von Ustekinumab in der Therapie der Pustulosis palmoplantaris. Zur Beurteilung der Langzeitwirkung und -sicherheit sowie der Wirksamkeit einer intermittierenden Therapie sind kontrollierte Studiendaten sowie Beobachtungen im Rahmen von Patientenregistern notwendig. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  11. Furosemide urogram in patients with neobladder; Das Diureseurogramm bei Patienten mit Harnblasenersatz

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, E.M. [Univ. Ulm (Germany). Abt. Radiologie; Aschoff, A.J. [Univ. Ulm (Germany). Abt. Radiologie; Bachor, R. [Univ. Ulm (Germany). Abt. fuer Urologie; Vogel, J. [Univ. Ulm (Germany). Abt. Radiologie; Merk, J. [Univ. Ulm (Germany). Abt. Radiologie; Brambs, H.J. [Univ. Ulm (Germany). Abt. Radiologie

    1996-11-01

    Purpose: To differentiate between urodynamically relevant obstruction and functionally unimportant dilation of the upper urinary tract in patients with neobladder using a modified furosemide urogram. Method: An excretory urogram with furosemide loading was carried out in 19 patients with neobladder and sonographically and urographically confirmed dilation of the upper urinary tract. Once strong contrasting of the renal pelves and calyces has been achieved, 20 mg of furosemide were applied and late radiographs were obtained at 15 min and 30 min, respectively. An obstruction was defined as increasing dilation of the renal pelves and calices during forced diuresis and lack of washout effect of the contrast medium. Results: In 32 cases, the renoureteral unit (RUU) was dilated on ultrasound. Of these, 25 RUU`s showed good emptyness of contrast medium upon stimulation of diuresis, six RUU`s returned a borderline findings, while one RUU was found to exhibit a decompensated anastomotic stenosis, which was dilated. Two further patients with bordeline findings were later treated surgically due to their pain symptoms. No patient required further preoperative diagnostic procedures. Conclusions: The modified furosemide urogram represents a cost-effective diagnostic orientation strategy in patients with neobladder and dilated renal pelves and calyses and is both well-tolerated by patients and meets with broad acceptance from the urologic staff. (orig.) [Deutsch] Ziel: Differenzierung zwischen urodynamisch relevanter Obstruktion und funktionell bedeutungsloser Dilatation des oberen Harntraktes bei Patienten mit Harnblasenersatz durch ein modifiziertes Diureseurogramm. Methodik: Bei 19 Patienten mit Harnableitung und sonographisch sowie urographisch nachgewiesener Erweiterung des oberen Harntraktes wurde ein Ausscheidungsurogramm mit Furosemidbelastung durchgefuehrt. Bei kraeftiger Kontrastierung des erweiterten Nierenbeckenkelchsystems (NBKS) wurden 20 mg Furosemid appliziert und

  12. Schlafmedizinische Charakterisierung von Parkinson-Patienten mit Schlafattacken unter dopaminerger Therapie

    OpenAIRE

    Rethfeldt, Mira

    2006-01-01

    1999 wurden erstmals sogenannte Schlafattacken bei Parkinson-Patienten unter der Therapie mit Nonergolin-Dopaminagonisten berichtet. Später zeigten Studien, dass diese Schlafattacken unter jeglicher dopaminerger Therapie auftreten können. Bis heute ist jedoch die Pathophysiologie dieses Phänomens nicht hinreichend geklärt. Es wird diskutiert, ob diese Attacken als paroxysmales Symptom überhaupt bestehen oder nicht vielmehr ...

  13. [COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

    Science.gov (United States)

    Hartwig, Bernhard; Schmidt, Stefan; Hartwig, Isabella

    2016-01-01

    Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität» (FEV1) und «inspiratorische Vitalkapazität» (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern. © 2016 S. Karger GmbH, Freiburg.

  14. Gebrauch von Komplementärmedizin bei Patienten mit metastasierendem Melanom unter Therapie mit Ipilimumab innerhalb einer klinischen Studie.

    Science.gov (United States)

    Huebner, Jutta; Mohr, Peter; Simon, Jan-Christoph; Fluck, Michael; Berking, Carola; Zimmer, Lisa; Loquai, Carmen

    2016-05-01

    In Deutschland wenden 40-90 % aller Krebspatienten Methoden der komplementären and alternativen Medizin (KAM) an. Bis dato gibt es kein Datenmaterial zum Einsatz der KAM bei Melanompatienten. Das Ziel unserer Studie war es, Daten über den Gebrauch, die Informationsquellen und Ziele von Patienten mit metastasierendem Melanom zu erfassen. Einhundertsechsundfünfzig Patienten aus 25 Studienzentren nahmen an der DecOG-MM-PAL Multibasket Studie teil. Die beteiligten Personen wurden auch gebeten, an einer Nebenstudie teilzunehmen, die ihren Gebrauch von KAM erfassen sollte. Dazu wurde während der Behandlung ein standardisierter Fragebogen zu genau festgelegten Zeitpunkten ausgeteilt. Insgesamt gingen 55 Fragebögen von 32 (21 %) Melanompatienten ein. Von diesen gaben 17 (53 %) ein Interesse an KAM an, und sieben (22 %) machten von KAM Gebrauch. Die Hauptinformationsquellen (31 %) waren Familienmitglieder und Freunde, gefolgt von Ärzten (19 %). Die Hauptgründe für die Anwendung von KAM waren die Stärkung des Immunsystems (41 %) und des Körpers (34 %). Nahrungsergänzungsmittel (Vitamine und Spurenelemente) wurden am häufigsten angewendet (28 %). Eine relativ hohe Anzahl an Patienten mit metastasierendem Melanom machte trotz Teilnahme an einer klinischen Studie von KAM Gebrauch. Wechselwirkungen könnten durch biologisch basierte KAM auftreten, und hier besonders bei immunmodulierenden KAM- Strategien. Um Risiken zu vermeiden, sollte die Kommunikation zwischen den Ärzten und den Patienten verbessert werden. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  15. Wirksamkeit und Sicherheit von Fumarsäureestern in Kombination mit Phototherapie bei Patienten mit moderater bis schwerer Plaque-Psoriasis (FAST).

    Science.gov (United States)

    Weisenseel, Peter; Reich, Kristian; Griemberg, Wiebke; Merten, Katharina; Gröschel, Christine; Gomez, Natalie Nunez; Taipale, Kirsi; Bräu, Beate; Zschocke, Ina

    2017-02-01

    Die Behandlung von Psoriasis-Patienten mit einer Kombination aus Fumarsäureestern (FSE, Fumaderm ® ) und Phototherapie (UV) ist verbreitet, wurde aber im Rahmen von Studien wenig untersucht. Bisher liegen lediglich Daten aus einer kleinen Pilotstudie vor. Intention dieser Studie war, eine FSE/UV-Kombinationsbehandlung an einem größeren Patientenkollektiv mit mittelschwerer bis schwerer Psoriasis zu untersuchen. In dieser prospektiven, multizentrischen, nichtinterventionellen Studie wurden Daten von Patienten mit FSE/UV-Kombinationstherapie hinsichtlich der Wirksamkeit (PGA' PASI, DLQI, EQ-5D), Sicherheit und Dosierung über einen Zeitraum von zwölf Monaten erfasst und mit Daten einer retrospektiven Studie mit FSE-Monotherapie verglichen. Es wurden Daten von 363 Patienten ausgewertet. Unter der Kombinationstherapie verbesserten sich alle Wirksamkeitsparameter deutlich. Im Vergleich zur Monotherapie mit FSE konnte durch die Kombination mit UV ein schnellerer Wirkeintritt erzielt werden, wobei nach zwölf Monaten kein Unterschied in der Wirksamkeit bestand. Die Dauer und Art der Phototherapie zeigte keinen Einfluss auf die Wirksamkeitsparameter. Allgemein wurde die Kombinationstherapie gut vertragen. Unerwünschte Ereignisse wurden bei 7 % der Patienten berichtet. Die FSE/UV Kombinationstherapie zeigt eine gute Wirksamkeit und Verträglichkeit und kann zu einem schnelleren Wirkeintritt führen. Eine Kombinationstherapie erscheint vor allem in den ersten drei Monaten der FSE Behandlung sinnvoll. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  16. Zeitlicher Verlauf der avaskulären Nekrose des Hüftkopfes bei Patienten mit Pemphigus vulgaris.

    Science.gov (United States)

    Balighi, Kamran; Daneshpazhooh, Maryam; Aghazadeh, Nessa; Saeidi, Vahide; Shahpouri, Farzam; Hejazi, Pardis; Chams-Davatchi, Cheyda

    2016-10-01

    Pemphigus vulgaris (PV) wird in der Regel mit systemischen Corticosteroiden und Immunsuppressiva behandelt. Avaskuläre Nekrose (AVN) des Hüftkopfes ist eine gut bekannte schwerere Komplikation einer Corticosteroid-Therapie. Die Charakteristika dieser schweren Komplikation bei PV sind nach wie vor unbekannt. Nicht kontrollierte, retrospektive Untersuchung aller PV-bedingten AVN-Fälle, die in einer iranischen Klinik für bullöse Autoimmunerkrankungen zwischen 1985 und 2013 diagnostiziert wurden. Anhand der Krankenakten von 2321 untersuchten PV-Patienten wurden 45 Fälle (1,93 %) von femoraler AVN identifiziert. Dreißig davon waren Männer. Das mittlere Alter bei der Diagnose der AVN betrug 47,4 ± 14,2 Jahre. Der mittlere Zeitraum zwischen der Diagnose des PV und dem Einsetzen der AVN lag bei 25,3 ± 18,3 Monaten. Mit Ausnahme von acht Fällen (17,8 %) setzte die AVN bei der Mehrheit der Patienten innerhalb von drei Jahren nach Diagnose des PV ein. Die mittlere kumulative Dosis von Prednisolon bei Patienten mit AVN betrug 13.115,8 ± 7041,1 mg. Zwischen der Prednisolon-Gesamtdosis und dem Zeitraum bis zum Einsetzen der AVN bestand eine starke Korrelation (p = 0,001). Bei Patienten mit Alendronateinnahme in der Vorgeschichte war dieser Zeitraum signifikant kürzer (p = 0,01). Die AVN ist eine schwere Komplikation einer Corticosteroid-Behandlung bei Patienten mit PV. Sie wird bei 2 % der Patienten beobachtet und tritt vor allem in den ersten drei Behandlungsjahren auf. Bei Patienten, die höhere Dosen von Prednisolon erhalten, setzt die AVN tendenziell früher ein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  17. [Cardiodoron® bei Patienten mit Schlafstörungen - Ergebnisse einer prospektiven Beobachtungsstudie].

    Science.gov (United States)

    Rother, Claudia; Schnelle, Martin

    Hintergrund: Schlafstörungen gehören zu den häufigsten gesundheitlichen Problemen der heutigen Zeit. Stress und die dadurch bedingte innere Anspannung sowie eine unrhythmische Lebensführung z.B. durch Schichtarbeit sind bekannte auslösende Faktoren. Weniger bekannt ist, dass auch funktionelle Herz-Kreislauf-Beschwerden zu Störungen des Schlafs führen können und dass deren Behandlung zu einer Verbesserung der Schlafqualität beiträgt. Ganzheitlich betrachtet geht es daher um die Wiederherstellung einer gesunden Rhythmik, insbesondere des Herz-/Atem- sowie des Schlaf-Wach-Rhythmus, die Cardiodoron®, eine Heilpflanzenkomposition aus Primula veris, Hyoscyamus niger und Onopordum acanthium, unterstützt. Patienten und Methoden: Mittels einer prospektiven, multizentrischen Beobachtungsstudie sollte ermittelt werden, wie sich funktionelle Herz-Kreislauf-Beschwerden und/oder Schlafstörungen unter der Behandlung mit Cardiodoron® (Dilution) über 3-6 Monate entwickeln. Im Zeitraum von September 2009 bis März 2012 dokumentierten 92 Ärzte 501 Patienten, von denen 380 über Schlafstörungen klagten und deren Daten in dieser Publikation näher betrachtet werden. Nach einer Aufnahmeuntersuchung erfolgte nach 90 Tagen eine Abschlussuntersuchung und bei Fortführung der Therapie nach nochmals 90 Tagen eine Follow-up-Untersuchung. Neben 30 ärztlicherseits bewerteten Symptomen beurteilten die Patienten ihr Befinden mittels Pittsburgh Sleep Quality Index (PSQI) nach Buysse und der Beschwerden-Liste nach von Zerssen (B-L und B-L'). Ergebnisse: Unter der Cardiodoron®-Therapie gingen bei guter Verträglichkeit sowohl die Ausprägung der Schlafstörungen (um 65% von 2,0 auf 0,7 Punkte) als auch die erfassten 30 Symptome (um 59% von 24,3 auf 9,9 Punkte) deutlich zurück (p mit Schlafstörungen (mit oder ohne funktionelle Herz-Kreislauf-Beschwerden) kann die Ausprägung der Beschwerden mit Cardiodoron® deutlich gesenkt werden. Cardiodoron® ist gut verträglich. © 2016 S

  18. Retrospektive Analyse von Zufallsbefunden, die bei Patienten mit kutanem malignen Malignom durch (18) F-Fluordeoxyglucose-PET/CT erhoben wurden.

    Science.gov (United States)

    Conrad, Franziska; Winkens, Thomas; Kaatz, Martin; Goetze, Steven; Freesmeyer, Martin

    2016-08-01

    Bei der (18) F-Fluordeoxyglucose-Positronenemissionstomographie/Computertomographie (FDG-PET/CT) ergeben sich häufig Zufallsbefunde. In der vorliegenden Studie konzentrierten wir uns auf mittels FDG-PET/CT erhaltene Zufallsbefunde bei Patienten mit kutanem Melanom und überprüften deren Relevanz hinsichtlich weiterer diagnostischer Maßnahmen und Interventionen. Die Krankenakten von 181 konsekutiven Melanom-Patienten wurden retrospektiv ausgewertet, um das Management von Zufallsbefunden zu dokumentieren. Der Schwerpunkt lag dabei auf den histologischen Befunden. Bei 33 von 181 (18 %) Patienten lagen 39 relevante Zufallsbefunde vor, und zwar im Kolorektalbereich (n = 15 Patienten), in der Schilddrüse (n = 8), der Prostata (n = 2), dem Bewegungsapparat (n = 2), in Lymphknoten (n = 2), der Parotis (n = 1), den Mandeln (n = 1), den Nieren (n = 1) und der Gallenblase (n = 1). Bei 25 Patienten schlossen sich weitere diagnostische Verfahren an, wobei in 21 Fällen ein klinisches Korrelat nachgewiesen wurde. Bei 16 von 21 Patienten ergab sich eine Neoplasie, darunter fünf maligne Läsionen (vier Kolonkarzinome und ein Prostatakarzinom). Die Malignome wurden frühzeitig diagnostiziert und in der Mehrzahl der Fälle erfolgreich entfernt. Der Einsatz der FDG-PET/CT als Routine-Diagnostik wird in den Leitlinien empfohlen und ist indiziert bei malignem Melanom ab Stadium IIC. In dieser Studie wurden auf effektive Weise ansonsten nicht erkannte Krebserkrankungen, insbesondere Kolonkarzinome, detektiert. In den meisten Fällen war eine frühe Intervention möglich. Zufallsbefunde durch FDG-PET/CT sollten, unter Berücksichtigung des Zustands und der Wünsche des Patienten, mit den geeigneten diagnostischen Maßnahmen abgeklärt werden. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  19. MRI for therapy planning in patients with atrial septum defects; MRT zur Therapieplanung bei Patienten mit Vorhofseptumdefekt

    Energy Technology Data Exchange (ETDEWEB)

    Huber, A.; Rummeny, E. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institut fuer Radiologie, Muenchen (Germany); Prompona, M.; Reiser, M.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Kozlik-Feldmann, R. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Kinderkardiologie, Muenchen (Germany); Muehling, O. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik I, Muenchen (Germany)

    2011-01-15

    The aim of this study was to determine the value of a combined magnetic resonance imaging (MRI) protocol including steady-state free precession (SSFP) imaging, phase-contrast measurements and contrast-enhanced MR angiography (CE-MRA) for presurgical or preinterventional diagnostic imaging in patients with suspected atrial septum defects. Out of 65 MRI studies of patients with suspected atrial septum defects, 56 patients were included in the study. The atrial septum defects were identified on cine images. Velocity encoded flow measurements were used to determine shunt volumes, which were compared with invasive oxymetry in 24 patients. Contrast-enhanced MRI was used to assess the thoracic vessels in order to detect vascular anomalies. The findings were compared with the intraoperative results. A total of 24 patients with high shunt volumes were treated either surgically (16 patients) or interventionally (8 patients) and 32 patients with low shunt volumes did not require surgical or interventional treatment. The vascular anomaly, which in all cases was anomalous pulmonary venous return, was confirmed by the intraoperative findings. The type and location of atrial septal defects which required treatment, were confirmed intraoperatively or during the intervention. The results of shunt quantification by MRI showed a good correlation with the results of invasive oximetry (r=0.91, p <0.0001). A combined MRI protocol including cine SSFP images, velocity-encoded flow measurements and CE-MRA is an accurate method for preoperative and preinterventional evaluation of atrial septum defects. (orig.) [German] Ziel war es, die Wertigkeit eines kombinierten MRT-Protokolls aus Funktionsuntersuchung, Flussmessung und MR-Angiographie zur praeoperativen oder -interventionellen Abklaerung bei Patienten mit Vorhofseptumdefekt zu evaluieren. Ingesamt wurden 56 Patienten mit Vorhofseptumdefekt aus einem Kollektiv von 65 Patienten mit Verdacht auf Vorhofseptumdefekt, die im MRT untersucht

  20. Der Einfluss von Alitretinoin auf die Lebensqualität bei Patienten mit schwerem chronischen Handekzem: FUGETTA - Beobachtungsstudie unter Praxisbedingungen.

    Science.gov (United States)

    Augustin, Matthias; Thaçi, Diamant; Kamps, Anja

    2016-12-01

    Alitretinoin ist die einzige zugelassene Behandlung für schweres chronisches Handekzem (CHE), das refraktär gegenüber potenten topischen Corticosteroiden ist. Bei dieser Studie (FUGETTA) wurde die Wirksamkeit von leitliniengerecht angewendetem oralem Alitretinoin sowie dessen Einfluss auf die Lebensqualität (LQ) bei Patienten mit schwerem refraktärem CHE beurteilt. Multizentrische, offene, nichtinterventionelle Beobachtungsstudie, durchgeführt in Deutschland. Die Patienten wurden nach Ermessen ihres behandelnden Arztes mit Alitretinoin 10 mg oder 30 mg einmal täglich über maximal 24 Wochen behandelt. Die Wirksamkeit wurde anhand des Physician Global Assessment (PGA) und des Dermatology Life Quality Index (DLQI) bewertet. Zudem wurden unerwünschte Ereignisse (UE) erfasst. Die Studienpopulation bestand aus 658 Patienten (30 mg: n = 581; 10 mg: n = 77). Bei Beobachtungsbeginn litten die meisten Patienten (83 %) gemäß PGA an einem schweren CHE. Bei Beobachtungsende war das Handekzem bei 48 % der Patienten gemäß PGA vollständig oder fast vollständig abgeheilt (30 mg: 49 %; 10 mg: 43 %). Die mittlere Verbesserung des DLQI-Scores in Woche 24 betrug 58 % (30 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,4 [8,04]) und 70 % (10 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,8 [7,29]). Die Gesamtinzidenz von NW war niedrig und in den beiden Gruppen ähnlich. Alitretinoin führte zu einer schnellen, deutlichen Verbesserung der LQ bei Patienten mit schwerem CHE. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  1. Vergleichende Analyse der Expression des Glukokortikoid-Rezeptors und der NF-kappaB Untereinheit p50 in Lymphozyten von Patienten mit rheumatoider Arthritis und Gesunden

    OpenAIRE

    Klüter, Andreas

    2003-01-01

    Zielstellung: Es wurden die Expression des antiinflammatorisch wirkenden Transkriptionsfaktors Glukokortikoid-Rezeptor (GR) und der Untereinheit p50 des proinflammatorischen Transkriptionsfaktor NF-kappaB in peripheren mononuklearen Blutzellen (PBMC) von Patienten mit rheumatoider Arthritis (RA) untersucht. Methode: Es wurden unbehandelte und mit Glukokortikoiden vorbehandelte RA-Patienten sowie gesunde Probanden verglichen. Die Expressionsanalyse von GR und der NF-kappaB Untereinheit p50 ...

  2. Imaging modalities and therapy options in patients with acute flank pain; Bildgebungsmodalitaeten und Therapieoptionen bei Patienten mit akutem Flankenschmerz

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, A.; Grosse, C. [Universitaet Bern, Bern (Switzerland)

    2014-07-15

    The objective of this article is the description of imaging techniques for the evaluation of patients with acute flank pain and suspicion of urolithiasis and the impact of these techniques in the therapy management of patients with calculi. (orig.) [German] Ziel der Arbeit ist die Eroerterung der bildgebenden Verfahren zur Abklaerung von Patienten mit akutem Flankenschmerz und Verdacht auf Urolithiasis und die Rolle dieser Verfahren im Therapiemanagement von Steinpatienten. (orig.)

  3. Analyse der pharmazeutischen Versorgungssituation von Patienten mit Psoriasis-Arthritis auf Basis von Routinedaten der Gesetzlichen Krankenversicherung.

    Science.gov (United States)

    Sondermann, Wiebke; Ventzke, Julia; Matusiewicz, David; Körber, Andreas

    2018-03-01

    Die Psoriasis-Arthritis (PsA) gehört zu den chronisch entzündlichen Gelenkerkrankungen. Trotz zahlreicher versorgungswissenschaftlicher Studien in Deutschland liegen zur pharmazeutischen Versorgungssituation von PsA-Patienten bisher kaum aktuelle Ergebnisse vor. Mit Hilfe einer systematischen Literaturrecherche sowie anhand von Routinedaten der Allgemeinen Ortskrankenkasse (AOK) Rheinland/Hamburg wird ein aktueller Überblick über die pharmazeutische Versorgung von PsA-Patienten in Deutschland gegeben. Selektiert wurden Versicherte aus dem ambulanten und stationären Bereich, die im 1. und 2. Quartal des Jahres 2014 die gesicherte Abrechnungsdiagnose Psoriasis-Arthritis L40.5+ aufwiesen. Anschließend wurden auf Basis dieser "vorab definierten" Kohorte die Arzneimitteldaten für 5 Jahre (01.01.2010-31.12.2014) abgerufen. Es konnten insgesamt n  =  3205 Versicherte (45 % männlich, 55 % weiblich) der AOK Rheinland/Hamburg mit einer gesicherten PsA-Diagnose selektiert werden. Das Durchschnittsalter betrug 58,9 Jahre. 53,7 % der PsA-Patienten wurden mit systemischen PsA-relevanten Arzneimitteln versorgt. Nichtsteroidale Antirheumatika (NSAR) wurden am häufigsten verordnet, gefolgt von systemischen Glucocorticoiden. Von den selektierten PsA-Patienten, die eine Systemtherapie erhielten, wurden 72,1 % mittels einer Disease-modifying-antirheumatic-Drug (DMARD)-Monotherapie behandelt, gefolgt von der Kombinationstherapie aus DMARDs und Biologika (20,9 %). Die pharmakologische Therapie der PsA muss eine Gewährleistung zwischen adäquater Versorgung der PsA mit Verhinderung der Krankheitsprogression und ökonomischer Verantwortung darstellen. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. MRI for therapy control in patients with tetralogy of Fallot; MRT zur Therapiekontrolle bei Patienten mit Fallot-Tetralogie

    Energy Technology Data Exchange (ETDEWEB)

    Theisen, D.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Dalla Pozza, R.D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Abteilung fuer Kinderkardiologie und Paediatrische Intensivmedizin, Kinderherzzentrum, Muenchen (Germany); Malec, E. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Herzchirurgische Klinik, Kinderherzzentrum, Muenchen (Germany)

    2011-01-15

    With prevalences ranging from 0.26 to 0.8 permille of all live births tetralogy of Fallot (TOF) is the most common congenital heart disease with primary cyanosis. Due to improvements in surgical techniques, nearly all patients can nowadays expect to reach adulthood. After surgical repair, pulmonary regurgitation (PR) occurs in almost every child and is an important contributing factor in long-term morbidity and mortality. Cardiac magnetic resonance imaging is well established for functional assessment and flow measurements and is an ideal tool for serial post-surgical follow-up examinations, as it is non-invasive and does not expose patients to ionizing radiation. The timing of pulmonary valve replacement is crucial as right ventricular (RV) volumes have only proven to normalize when preoperative end-diastolic volumes are <170 ml/m{sup 2} and end-systolic volumes are <85 ml/m{sup 2}. After surgical repair up to 15% of patients have residual or recurrent pulmonary artery stenosis. Distal pulmonary branch stenosis can aggravate PR and lead to right heart failure due to combined pressure and volume overload. Therefore, it has to be diagnosed in time and treated by angioplasty with or without stenting. (orig.) [German] Die Fallot-Tetralogie (TOF) ist mit einer Praevalenz zwischen 0,26 und 0,8 permille aller Lebendgeburten der haeufigste Herzfehler mit primaerer Zyanose. Durch verbesserte Operationstechniken erreichen heute nahezu alle Patienten das Erwachsenenalter. Bei fast allen Patienten tritt eine postoperative Pulmonalinsuffizienz (PI) auf, die entscheidenden Einfluss auf die langfristige Morbiditaet und Mortalitaet hat. Die kardiale Magnetresonanztomographie (MRT) ist fuer Quantifizierung von Ventrikelfunktion und Klappeninsuffizienzen etabliert und aufgrund ihrer fehlenden Invasivitaet und Strahlenexposition sehr gut fuer regelmaessige Verlaufskontrollen der heranwachsenden Patienten geeignet. Insbesondere der Zeitpunkt fuer einen Pulmonalklappenersatz darf

  5. Intra- und postoperative Komplikationen bei Patienten mit roboterassistierter laparoskopischer radikaler Prostatektomie (RALP. Eine Analyse von 3000 konsekutiven Fällen

    Directory of Open Access Journals (Sweden)

    Zugor V

    2012-01-01

    Full Text Available Einleitung: Das Ziel dieser Studie ist es, die intra- und postoperativen Komplikationen bei Patienten mit roboterassistierter laparoskopischer radikaler Prostatektomie anhand von 3000 konsekutiven Fällen aufzuzeigen. Material und Methoden:3000 Männer, welche sich einer RALP unterzogen, wurden retrospektiv untersucht. Alle Patienten wurden sowohl hinsichtlich ihrer intra- als auch postoperativen Komplikationen beobachtet. Postoperative Komplikationen und Re-Interventionen wurden bis 30 Tage nach OP erfasst und anhand der Clavien-Klassifikation in „Minor“- (Clavien-Klassifikation I–IIIa und „Major“- Komplikationen (Clavien-Klassifikation IIIb–IVa eingeteilt. Ergebnisse: Die intraoperativen Komplikationen sind ebenso wie die „minor“ und „major“ postoperativen Komplikationen in Tabellen 3 und 4 aufgeführt. Das mediane Alter der Patienten betrug 64,1 Jahre, der mediane BMI 26,7 kg/m2 , das mediane Prostatagewicht 40,1 g und der mediane PSA-Wert 10,1 ng/ml. Der Gleason-Score bei Biopsie war in 65 % kleiner als 7, in 34,4 % gleich 7 und größer als 7 in 9,6 % der Fälle. Die Lymphknotendissektion wurde in 75,9 % durchgeführt. Ein organbeschränktes Stadium zeigte sich in 75 % und eine extraprostatische Ausbreitung in 25 %. Die gesamte intraoperative Komplikationsrate lag bei 5,1 %, die „minor“ postoperative Komplikationsrate bei 16,1 % und die „major“ bei 1,8 %. Zusammenfassung: Die RALP ist nicht komplikationslos. In erfahrenen Händen ist sie jedoch ein sicheres chirurgisches Verfahren mit einer niedrigen Morbidität und Mortalität.

  6. Einfluss physiologischer Faktoren auf die Gehstrecke und prognostische Aussagekraft des 6 Minuten Gehtestes bei Patienten mit dilatativer Kardiomyopathie und ihren Angehörigen

    OpenAIRE

    Temath, Christoph

    2013-01-01

    Ein Vergleich biometrischer Faktoren wie Alter, Geschlecht, BMI, Ejektionsfraktion, SF und linksventrikulärer enddistolischer Durchmesser, sowie dem NYHA Stadium bei Patienten mit dilatativer Kardiomyopathie und gesunden Probanden auf die während des 6-Minuten-Gehtest gelaufene Distanz ergab, dass Frauen mit dilatativer Kardiomyopathie eine kürzere Gehstrecke zurücklegen als Männer gleichen Alters und gleicher Erkrankung. Zudem la...

  7. Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves` disease; Volumenreduktion der Schilddruese nach Radiojodtherapie bei Patienten mit Schilddruesenautonomie und Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Dederichs, B. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Otte, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Klink, J.E. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany)

    1996-10-01

    Aim: It is well known that radioiodine therapy (RITh) leads to a significant thyroid volume reduction (TVR). But until now only little data has been presented due to the course of time and the extent of TVR. Method: Therefore the data of 33 patients with Graves` disease (GD), 36 patients with multifocal (MAG) and 31 with solitary (SAG) autonomous goitre were analyzed retrospectively. Results: All the patients showed a highly significant (p<0.001) TVR, which continued up to 1 year after RITh. Receiving equal effective radiation doses, the extent of TVR was significantly greater for GD than for MAG. This difference developed within six weeks up to 3 months after RITh. Conclusion: This observation suggests that the underlying thyroid disease affects the therapeutic effect of RITh and may be partially explained by the total suppression of non-autonomous thyroid tissue in AG at the time of RITh. In patients with SAG with a 1.7 times higher effective radiation dose than in MAG relative TVR was about 1.6 times stronger in SAG than in MAG. This demonstrates a direct relation between the effective radiation dose and the extent of the TVR after RITh. (orig.) [Deutsch] Ziel: Es ist bekannt, dass die Radiojodtherapie (RJTh) zu einer relvanten Schilddruesenvolumenreduktion (SVR) fuehrt. Bisher wurden jedoch nur vereinzelt systematische Daten zum zeitlichen Verlauf und quantitativen Ausmass der SVR veroeffentlicht. Methode: Daher fuehrten wir eine retrospektive Auswertung der Daten von 33 Patienten mit Morbus Basedow (MB), 36 Patienten mit multifokaler (MFA) und 31 mit unifokaler (UFA) Autonomie der Schilddruese durch. Ergebnisse: Fuer alle Patientengruppen ergab sich eine hochsignifikante (p<0,001) SVR, welche sich bis ein Jahr nach RJTh signifikant fortsetzte. Obwohl die effektive Herddosis nicht signifikant verschieden war, war das Ausmass der SVR fuer Patienten mit MB signifikant groesser als fuer Patienten mit MFA. Dieser Unterschied war bereits innerhalb der ersten 6

  8. Psychologie körperlicher Aktivität bei Patienten mit Rückenschmerzen

    OpenAIRE

    Leonhardt, Corinna

    2008-01-01

    Die vorliegende Arbeit setzt sich mit den psychologischen Determinanten und Fördermöglichkeiten von körperlicher Aktivität bei Rückenschmerzpatienten auseinander, wobei Daten einer multizentrischen cluster-randomisierten Studie (N= 1378) genutzt werden. Der theoretische Hintergrund aller Originalarbeiten gibt einen Überblick zu neuen Erkenntnissen zum Rückenschmerz und zur Aktivitätsförderung in der Gesundheitspsychologie und ...

  9. Problembasiertes kollaboratives Lernen mit virtuellen Patienten in der Kinderheilkunde: ein Beispiel aus der Ausbildungspraxis

    Directory of Open Access Journals (Sweden)

    Sostmann, Kai

    2009-02-01

    Full Text Available Der studentische Unterricht in der Kinderheilkunde an der Charité hat seit 1999 mehrere Umstrukturierungen durchlaufen. Mit der Einführung der neuen ärztlichen Approbationsordnung 2004 im Regelstudiengang (RSG und dem Modellcurriculum Reformstudiengang Medizin (RSM 1999 müssen zwei Curricula parallel neu konzipiert und gepflegt werden. Durch den Schwerpunkt Unterricht am Krankenbett (UaK im RSG ergaben sich neue didaktische, pädagogische und infrastrukturelle Anforderungen. Die technische und inhaltliche Weiterentwicklung der Einsatzmöglichkeiten elektronischer Lernszenarien durch e-Learning im Rahmen des BMBF-geförderten Projektes ELWIS-MED, ermöglichte die Erprobung der curricularen Implementierung von e-Learning-Modulen im Pflichtunterricht. Der UaK wurde durch die Bearbeitung kinderheilkundlicher elektronischer Lernfälle online ergänzt. Die Studierenden sollten tutoriell betreute Diskussionen zu fachlichen Aufgabenstellungen online führen. In der ersten Erprobungsstufe wurde der Einsatz der Diskussionsforen in Verbindung mit den Lernfällen von den Studierenden und Lehrenden als sinnvolle Ergänzung betrachtet. In zukünftigen Einsatzszenarien sollte eine Messung des studentischen Lernerfolgs mit dieser Methode erfolgen.

  10. Krankheitsverlauf, medizinische Versorgung und Lebensqualität von Patienten mit kongenitalen melanozytären Nävi - Auswertung des deutschsprachigen KMN-Registers.

    Science.gov (United States)

    Elisabeth Wramp, Maria; Langenbruch, Anna; Augustin, Matthias; Zillikens, Detlef; Krengel, Sven

    2017-02-01

    Kongenitale melanozytäre Nävi (KMN) bedeuten für Patienten und Familien eine psychologische Belastung und bergen zudem medizinische Risiken. Das 2005 gegründete deutschsprachige KMN-Register wurde nun einer Zwischenauswertung bezüglich des Krankheitsverlaufes, der medizinischen Versorgung und der Lebensqualität unterzogen. 100 Patienten, die sich in den Jahren 2005 bis 2012 mit einem Erstmeldebogen registriert hatten, wurde im Rahmen einer prospektiven Kohortenstudie Anfang 2013 ein Folgemeldebogen zugesandt. Außerdem wurden mithilfe standardisierter Fragebögen Daten zu Lebensqualität (dermatology life quality index, DLQI) und Stigmatisierungserfahrungen (perceived stigmatization questionnaire, PSQ; social comfort questionnaire, SCQ) erhoben. 83 % der Patienten oder deren Eltern antworteten (Altersdurchschnitt 11,2 Jahre, Median 6 Jahre; mittleres Follow-up 4,4 Jahre). Im Gesamtkollektiv wurden vier Melanome diagnostiziert, davon zwei zerebrale Melanome im Kindesalter, ein kutanes Melanom im Erwachsenenalter und eines, das sich als proliferierender Knoten erwies. Bei vier Kindern wurde eine neurokutane Melanozytose festgestellt, drei davon mit neurologischer Symptomatik. Chirurgisch behandelt wurden 88 % (73/83). Achtundsiebzig Prozent der Befragten berichteten eine geringe oder keine Beeinträchtigung der Lebensqualität. Die wahrgenommene Stigmatisierung beziehungsweise Beeinträchtigung des sozialen Wohlbefindens war generell ebenfalls gering. Die Ergebnisse geben einen Überblick über die Situation von Patienten mit KMN in Deutschland, Österreich und der Schweiz. Ein Melanom entwickelte sich in 3 %, eine ZNS-Beteiligung bestand in 4 % der Fälle. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  11. PET-Studies in parkinson's disease; Untersuchungen mit der Positronen-Emissions-Tomographie (PET) bei Patienten mit Morbus Parkinson

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, J. [Klinik fuer Neurologie, Univ. Leipzig (Germany)

    2002-09-01

    Positron-emission-tomography (PET) has enabled to study the metabolism and blood flow in specific brain areas. Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease. (orig.) [German] Die positronen-emissions-tomographie (PET) bietet neben der Messung von Metabolismus und Blutfluss die Moeglichkeit der Darstellung von einzelnen Molekuelen. Bei Patienten mit Morbus Parkinson hat es diese Technik erstmals erlaubt, die Anzahl der dopaminergen Neurone zu quantifizieren, wodurch die Diagnose gesichert, die Progression der Erkrankung beurteilt und auch das Anwachsen von Implantaten beurteilt werden kann. Die PET hat einen wesentlichen Beitrag zu unserem heutigen Wissen ueber die Pathophysiologie dieser Erkrankung beigetragen. (orig.)

  12. Soziale Interaktion, Lebensqualität und Krankheitsverarbeitung bei Akne-Patienten : Fall-Kontroll-Studie mit 32 Akne-Patienten und einer parallelisierten Gruppe Gesunder

    OpenAIRE

    Dittmer, Julia Gesine Erdmute

    2015-01-01

    Hintergrund Acne vulgaris ist mehr als ein vorübergehendes Pubertätsproblem: Sie kann schwere psychische Folgeerscheinungen verursachen. Fragestellung In der vorliegenden zweiarmigen Studie sollten Erkenntnisse zu sozialer Interaktion, Lebensqualität und Krankheitsverarbeitung von Akne-Patienten im Vergleich zu einer gesunden Kontrollgruppe gewonnen werden. Besonderes Interesse galt dabei der sozialen Interaktionsangst und dem Affekt Ekel. Ferner wurde die Entwicklung der genannten P...

  13. MRI for therapy control in patients with aortic isthmus stenosis; MRT zur Therapiekontrolle bei Patienten mit Aortenisthmusstenose

    Energy Technology Data Exchange (ETDEWEB)

    Wintersperger, B.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Toronto General Hospital, University of Toronto, Department of Medical Imaging, University Health Network, Toronto M5G 2N2 (Canada); Theisen, D.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2011-01-15

    Aortic isthmus stenosis is the most common congenital aortic anomaly and is often a problem for therapy surveillance. In addition to possible comorbidities (e.g. bicuspid aortic valve) it is accompanied by various middle and long-term complications depending on the primary choice of the therapeutic procedure. Magnetic resonance imaging (MRI) plays an important role for the mostly young patients in the control of the aortic isthmus stenosis and therapy because it is non-invasive and there is no X-ray exposure. Radiologists should be well-informed on the principles of the therapeutic procedure in order to be competent in the interpretation of MRI findings. Due to the continuous development of MRI technology, techniques for functional evaluation (e.g. dynamic MRA, 4D PC flow measurement) are increasingly becoming available in addition to high-resolution MR angiography (MRA), which could predict the risk of possible complications, such as aneurysms. However, in this aspect further studies are necessary. Interventional therapy with stents and stent grafts is often employed for the therapy of possible complications following an operation (aneurysms, restenosis) but because of massive metal artefacts the use of MRI is often sometimes severely limited. (orig.) [German] Die Aortenisthmusstenose als haeufigste angeborene Aortenanomalie stellt ein haeufiges Problem der Therapieueberwachung dar und ist neben moeglichen begleitenden Anomalien (z. B. bikuspidale Aortenklappe) in Abhaengigkeit vom primaer gewaehlten Therapieverfahren mit verschiedenen Komplikationen im mittel- bis laengerfristigem Verlauf vergesellschaftet. Bei der Kontrolle der Aortenisthmusstenose bzw. deren Therapie spielt die Magnetresonanztomographie (MRT) aufgrund der Nichtinvasivitaet und fehlenden Strahlenexposition bei den meist juengeren Patienten eine wichtige Rolle. Der Radiologe sollte ueber die Grundzuege der Therapieverfahren informiert sein, um die MRT-Befunde kompetent zu befunden. Durch stetige

  14. MR volumetry of the trigeminal nerve in patients with unilateral facial pain; MR-Volumetrie des N. trigeminus bei Patienten mit einseitigen Gesichtsschmerzen

    Energy Technology Data Exchange (ETDEWEB)

    Kress, B.; Fiebach, J.; Sartor, K.; Stippich, C. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Rasche, D.; Tronnier, V. [Neurochirurgische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2004-05-01

    Purpose: to assess whether MRI can detect atrophy of the trigeminal nerve in patients with trigeminal neuralgia. Materials and methods: a prospective MRI study was conducted in 39 patients (trigeminal neuralgia, trigeminal neuropathy, or atypical facial pain) and 25 volunteers. Using a coronal orientation (T1 flash 3D; T2 CISS 3D), regions of interest were delineated in the cisternal part of the trigeminal nerve along the border of the nerve to calculate the volume of the nerve. The volume of the nerve was compared side-by-side in each patient (t-test, p < 0.05) and the volume difference compared between patients and volunteers. Results: the volume of the compromised trigeminal nerve in patients with trigeminal neuralgia was lower than on the contralateral healthy side, with the difference between healthy and compromised side statistically significant (p < 0.05). In all other patients and in all volunteers, no significant difference was found between the volume of the healthy and compromised nerve. The volume difference between the healthy and compromised side in patients with trigeminal neuralgia was significantly higher (p < 0.05) than in all other patients and volunteers. Conclusion: atrophy of the trigeminal nerve caused by a nerve-vessel conflict can be detected by MRI. Only patients with trigeminal neuralgia show this unilateral atrophy. Therefore, it is possible to demonstrate the result of the nerve-vessel conflict and to determine the consequences of such a conflict. (orig.) [German] Ziel: Die Studie wurde mit der Frage durchgefuehrt, ob die bei Patienten mit Trigeminusneuralgie durch einen Gefaess-Nerven-Konflikt bedingte Atrophie des Nervs magnetresonanztomographisch darstellbar ist. Methodik: 39 Patienten (Trigeminusneuralgie, Trigeminusneuropathie, atypischer Gesichtsschmerz) und 25 Probanden wurden prospektiv magnetresonanztomographisch untersucht. In koronaren T1- und T2-Gradientenechosequenzen wurde der zisternale Abschnitt des N. trigeminus mittels

  15. PET in patients with clear-cut multiple chemical sensitivity (MCS); PET bei Patienten mit klar definierter multipler chemischer Sensibilitaet (MCS)

    Energy Technology Data Exchange (ETDEWEB)

    Bornschein, S. [Toxikologische Abt. der II. Medizinischen Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Klinik und Poliklinik fuer Psychiatrie und Psychotherapie der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Hausteiner, C.; Foerstl, H. [Klinik und Poliklinik fuer Psychiatrie und Psychotherapie der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Drzezga, A.; Schwaiger, M. [Nuklearmedizinische Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany); Bartenstein, P. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Mainz (Germany); Zilker, Th. [Toxikologische Abt. der II. Medizinischen Klinik und Poliklinik der Technischen Univ. Muenchen, Klinikum rechts der Isar, Muenchen (Germany)

    2002-12-01

    Aim: Multiple chemical sensitivity (MCS) is a controversially discussed symptom complex. Patients afflicted by MCS react to very low and generally non-toxic concentrations of environmental chemicals. It has been suggested that MCS leads to neurotoxic damage or neuroimmunological alteration in the brain detectable by positron emission tomography (PET) and single photon emission computer tomography (SPECT). These methods are often applied to MCS patients for diagnosis, although they never proved appropriate. Method: We scanned 12 MCS patients with PET, hypothesizing that it would reveal abnormal findings. Results: Mild glucose hypometabolism was present in one patient. In comparison with normal controls, the patient group showed no significant functional brain changes. Conclusion: This first systematic PET study in MCS patients revealed no hint of neurotoxic or neuroimmunological brain changes of functional significance. (orig.) [German] Ziel: Multiple chemische sensibilitaet (MCS) ist ein umstrittenes Krankheitsbild, das durch Reaktionen auf geringe, fueer Normalpersonen unschaedliche Mengen an Umweltchemikalien gekennzeichnet ist. Es wurde postuliert, dass MCS zu neurotoxischer Schaedigung bzw. neuroimmunologischer Veraenderung im Gehirn fuehrt, die mittels funktioneller bildgebender Verfahren, z. B. positronenemissionstomographie (PET), single-photon-emissions-computer-tomographie (SPECT) dargestellt werden koennte. Obwohl hierfuer kein wissenschaftlicher Beleg erbracht wurde, werden diese Methoden vielfach diagnostisch bei MCS-Patienten eingesetzt. Methode: Wir untersuchten 12 MCS-Patienten mit PET, um etwaige funktionelle Hirnveraenderungen nachzuweisen. Ergebnisse: Im Einzelvergleich war bei einem Patienten ein diskreter Glukose-Hypometabolismus in einzelnen Hirnregionen vorhanden. Im Gruppenvergleich konnte keine signifikante Abweichung von der Norm gefunden werden. Schlussfolgerung: Diese erste systematische PET-Studie bei MCS-Patienten erbrachte keinen

  16. Der Einfluss von COMT Val158Met auf neuronale Korrelate von Delay Discounting bei adulten Patienten mit Aufmerksamkeitsdefizit/Hyperaktivitätsstörung (ADHS)

    OpenAIRE

    Gieseke, Heiner Alexander

    2013-01-01

    In dieser Studie führten 37 adulte Patienten mit einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) ein Delay Discounting (DD) - Paradigma aus, während gleichzeitig mittels Funktioneller-Nahinfrarotspektroskopie (fNIRS) die Gehirnaktivität der „Regions of Interest“ (ROIs) des Orbitofrontalen-Kortex (OFC) und des Dorsolateralen-Präfrontalen-Kortex (dlPFC) gemessen wurde. Mittels Fragebögen und eines Delay Discounting Tasks (DDT) wurden zusätzlich Verhaltensparameter erhoben und flosse...

  17. Effectiveness of geriatric rehabilitation among patients with secondary diagnosis dementia [Effektivität der ambulanten und stationären geriatrischen Rehabilitation bei Patienten mit der Nebendiagnose Demenz

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2012-09-01

    Full Text Available [english] Often geriatric patients with secondary diagnosis dementia do not receive a rehabilitation treatment, although it is an obligatory service offered by the statutory health insurance. Scientists have examined the benefit of relevant measures for patients who are slightly or moderately affected with dementia. Thus, also these patients would profit by a rehabilitation.[german] Geriatrische Patienten mit Nebendiagnose Demenz erhalten oft keine Rehabilitation, obwohl diese zu den Pflichtleistungen der gesetzlichen Krankenkasse gehört. Wissenschaftler haben untersucht, ob und wenn ja, welchen Nutzen entsprechende Maßnahmen für leicht bis moderat demenzkranke Patienten haben. Demnach profitieren durchaus auch diese Patienten von einer Rehabilitation.

  18. Supportive treatment with megestrol acetate during radio-(chemo-)therapy. A randomized trial; Supportive Behandlung mit Megestrolacetat waehrend der Radio-(Chemo-)Therapie bei Patienten mit Tumoren im Kopf-Hals-Bereich. Eine randomisierte Studie

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Riepl, M [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Kettner, H [Bristol Arzneimittel GmbH, Muenchen (Germany). Medizinische Abt.; Hinke, A [Wissenschaftlicher Service Pharma, Monheim (Germany); Sauer, R [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik

    1996-03-01

    Tumoranorexie und -kachexie bei Patienten mit infauster Prognose ist bekannt. Ob sich ein supportiver Effekt von Megestrolacetat waehrend einer intensiven Radio-(Chemo-)Therapie ergibt, wurde bislang noch nicht untersucht. Dies erfolgte jetzt bei Patienten mit fortgeschritten Tumoren im Kopf-Hals-Bereich. Waehrend und bis sechs Wochen nach der Strahlentherapie erhielten die Patienten des Therapiearmes 160 mg/d Megestrolacetat. Vor, waehrend und nach der Strahlentherapie wurden anthropometrische und laborchemische Parameter bestimmt sowie die subjektive Lebensqualitaet der Patienten mittels des `Quality of life`-Index nach Padilla et al. erfasst. Ergebnisse: Zur endgueltigen Auswertung standen 61 Patienten (Kontrollarm: n=30, Therapiearm: n=31) zur Verfuegung. Ein Patient lehnte nach Randomisation die weitere Teilnahme ab. Je ein Patient im Kontroll- und Placeboarm schieden bei Verdacht auf Nebenwirkungen (Impotenz, Diarrhoe) aus. Weitere Nebenwirkungen wurden nicht beobachtet. Im Kontrollarm verschlechterten sich die Ernaehrungsparameter (Koerpergewicht, Trizepshautfaltendicke) und das subjektive Befinden unter der Bestrahlung sehr schnell und erholten sich anschliessend kaum. Im Gegensatz dazu konnten die mit Megestrolacetat behandelten Patienten diese Werte auf dem Ausgangsniveau stabiliseren. Dieser Unterschied zeigt sich am deutlichsten bei den ausschliesslich oral ernaehrten Patienten (Gewichtsverlust waehrend der Therapie im Kotrollarm: -4,1 kg; im Therapiearm: -0,8 kg; p=0,004), weniger bei den mittels perkutaner endoskopisch kontrollierten Gastrostomie (PEG) versorgten Patienten (Gewichtsverlust im Kontrollarm: -2,4 kg; im Therapiearm: -0,8 kg; p=0,14). Schlussfolgerungen: Die prophylaktische Gabe von Megestrolacetat kann bei Patienten mit Kopf-Hals-Tumoren waehrend einer Radio/(Chemo-)Therapie eine Verschlechterung des Ernaehrungszustands und tendenziell der Lebensqualitaet verhindern.

  19. Treatment factors influencing survival in pancreatic carcinoma; Der Einfluss der Therapie auf das Ueberleben von Patienten mit Pankreaskarzinom. Eine Analyse von Einzelfaktoren

    Energy Technology Data Exchange (ETDEWEB)

    Warszawski, N.; Warszawski, A.; Schneider, B.M.; Roettinger, E.M. [Ulm Univ. (Germany). Abt. Radiologie 2 (Strahlentherapie); Link, K.H.; Gansauge, F. [Ulm Univ. (Germany). Abt. fuer Allgemeinchirurgie; Lutz, M.P. [Ulm Univ. (Germany). Abt. Innere Medizin 1

    1999-07-01

    Purpose: To identify the impact of treatment factors on overall survival in patients with pancreatic carcinoma. Patients and methods: We performed a follow-up study on 38 patients with adenocarcinoma of the pancreas treated from 1984 to 1998. 18/38 patients were resected. Irradiated volume included the primary tumor (or tumor bed) and regional lymph nodes. Thirty-seven patients received in addition chemotherapy consisting of mitoxantrone, 5-fluorouracil and cis-platin, either i.v. (14/38) or i.a. (23/38). The influence of treatment related factors on the overall survival was tested. Biologically effective dose was calculated by the linear-quadratic model ({alpha}/{beta}=25 Gy) and by losing 0.85 Gy per day starting accelerated repopulation at day 28. Results: Treatment factors influencing overall survival were resection (p=0.02), overall treatment time (p=0.03) and biologically effective dose (p<0.002). Total dose and kind of chemotherapy had no significant influence. Treatment volume had a negative correlation (r=-0.5, p=0.06) with overall survival, without any correlation between tumor size, tumor stage, and treatment volume. In multivariate analysis only biologically effective dose remained significant (p=0.02). Conclusions: Among with surgery, biologically effective dose strongly influences overall survival in patients treated for pancreatic carcinoma. Treatment volume should be kept as small as possible and all efforts should be made to avoid treatments splits in radiation therapy. (orig.) [Deutsch] Ziel: Behandlungsfaktoren zu identifizieren, die einen Einfluss auf das Ueberleben von Patienten mit Pankreaskarzinom haben. Patienten und Methode: In einer nichtrandomisierten Studie wurden 38 Patienten ausgewertet, die von 1984 bis 1998 wegen eines Adenokarzinoms des Pankreas behandelt worden waren. Bei 18/38 Patienten war eine Resektion vorgenommen worden. Das Bestrahlungsvolumen beinhaltete den Primaertumor bzw. das Tumorbett und die regionaeren Lymphknoten

  20. Measurement of thyrotropin receptor antibodies (TRAK) with a second generation assay in patients with Graves' disease; Die Bestimmung von Thyreotropin-Rezeptor-Antikoerpern (TRAK) mit einem Assay der zweiten Generation bei Patienten mit Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Zoephel, K.; Wunderlich, G.; Franke, W.G. [Klinik und Poliklinik fuer Nuklearmedizin, Technische Univ. Dresden (Germany); Koch, R. [Inst. fuer Medizinische Informatik und Biometrie, Technische Univ. Dresden (Germany)

    2000-06-01

    Aim: The detection of TSH-receptor-antibodies (TRAb) in patients (pts) with Graves' disease (GD) is routinely used in nuclear medicine laboratories. It is performed by commercial, porcine radioreceptorassays (RRA) measuring TSH binding inhibitory activity. A second generation assay using the human, recombinant TSH-receptor was developed during the last years. The manufacturer composed this new assay as a coated tube RRA (CT RRA) and claimed a higher sensitivity for GD. Methods: TRAb was measured in 207 pts with various thyroid disorders and 205 healthy controls using the new coated tube RRA (Fa. B.R.A.H.M.S. Diagnostica GmbH, Berlin, Germany) as well as a conventional RRA (Fa. Medipan Diagnostica GmbH, Selchow, Germany): 60 pts suffering from GD showing a relapse after anti-thyroid drug treatment and before radioiodine therapy, 109 pts with disseminated autonomia (DA) and 38 pts suffering from Hashimoto's thyroiditis. A ROC-analysis was performed to find the optimal decision threshold level for positivity. Results: We found 42/60 TRAb-positive pts with GD in the established RRA (threshold 6 U/L) and 52/60 in the CT RRA, respectively. The sensitivity increased from 70% (RRA) to 86,7% (CT RRA). The CT RRA found 2 false positives (one Hashimoto's and one healthy control) and the RRA detected 3 Hashimoto's and 2 healthy controls as false positive. Conclusion: The increased sensitivity of CT RRA for GD provides an advantage compared to conventional RRA, especially in GD-patients relapsing afte antithyroid drug treatment. Functional sensitivity and Interassayvariation of CT RRA are very precisely compared to conventional RRA. Handling of the new assay is also improved. (orig.) [German] Ziel: Die Bestimmung der TSH-Rezeptorantikoerper (TRAK) bei Patienten mit Morbus Basedow ist fester Bestandteil der nuklearmedizinischen In-vitro-Diagnostik. Seit kurzem ist die Bestimmung mit einem TRAK-Assay moeglich, bei dem im Gegensatz zu den herkoemmlichen

  1. Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus; Diagnostische Genauigkeit der Dual-energy-CT-Angiographie bei Patienten mit Diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Schabel, C.; Bongers, M.N.; Syha, R. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Klinikum der Eberhard-Karls-Universitaet, Sektion fuer Experimentelle Radiologie der Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Ketelsen, D.; Homann, G.; Notohamiprodjo, M.; Nikolaou, K.; Bamberg, F. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Thomas, C. [Universitaetsklinikum Duesseldorf, Abteilung fuer Diagnostische und Interventionelle Radiologie, Duesseldorf (Germany)

    2015-04-01

    Herausforderung dar. Ziel dieser Arbeit war die Ermittlung der diagnostischen Genauigkeit der Dual-energy-CT-Angiographie (DE-CTA) im Vergleich zum Goldstandard, der invasiven digitalen Subtraktionsangiographie (DSA) bei der Stenoseerkennung, da die DE-CTA potenziell eine Differenzierung von Verkalkungen und jodhaltigem Kontrastmittel ermoeglicht. Dreissig Patienten mit dem Verdacht auf das Vorliegen oder bekannter PAVK und zusaetzlich bestehendem Diabetes mellitus wurden retrospektiv in die Studie eingeschlossen. Bei allen Teilnehmern wurde eine DE-CTA (Somatom Definition Flash, Siemens Healthcare, Germany), gefolgt von einer invasiven Angiographie durchgefuehrt. Das Vorhandensein von Stenosen in gekruemmten multiplanaren Reformationen (MPR) und Projektionen maximaler Intensitaet (MIP) wurde verblindet evaluiert. Die diagnostische Genauigkeit wurde mit der Angiographie als Goldstandard errechnet. Bei den 30 in die Analyse eingeschlossenen diabetischen Patienten (83 % maennlich, 70,0 ± 10,5 Jahre alt, 83 % Diabetes mellitus Typ 2) war die Praevalenz behandlungsbeduerftiger Stenosen in 331 evaluierten Gefaesssegmenten hoch (30 %). Die DE-CTA detektierte kritische Stenosen mit einer hohen Sensitivitaet und guten Spezifitaet anhand gekruemmter MPR (100 und 93,1 %) und MIP (99 und 91,8 %). In einer Subanalyse war die diagnostische Genauigkeit am hoechsten fuer Stenosen im Bereich der Beckenstrombahn (gekruemmte MPR 97,1 % vs. MIP 100 %) und im Oberschenkelbereich (99,2 vs. 96,6 %) verglichen mit dem Unterschenkelkompartiment (90,9 vs. 88 %). Die DE-CTA weist eine hohe diagnostische Genauigkeit bei der Stenosenerkennung und -charakterisierung im Rahmen der PAVK bei Patienten mit Diabetes mellitus auf, hat jedoch eine eingeschraenkte Genauigkeit im Bereich des Unterschenkelkompartiments. (orig.)

  2. Kyphoplasty combined with intraoperative radiotherapy (Kypho-IORT). Alternative therapy for patients with oligometastatic spinal metastases; Kyphoplastie kombiniert mit intraoperativer Radiotherapie (Kypho-IORT). Therapiealternative fuer den oligometastasierten Patienten mit Wirbelsaeulenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Bludau, F.; Obertacke, U. [Universitaetsklinikum Mannheim, Med. Fakultaet Mannheim der Universitaet Heidelberg, Orthopaedisch-Unfallchirurgisches Zentrum, Mannheim (Germany); Reis, T.; Schneider, F.; Clausen, S.; Wenz, F. [Universitaetsklinikum Mannheim, Med. Fakultaet Mannheim der Universitaet Heidelberg, Klinik fuer Strahlentherapie und Radioonkologie, Mannheim (Germany)

    2015-10-15

    deutlich verbesserten Ueberlebenszeit, sondern auch zu einer Zunahme an ossaeren Metastasen bei Tumorpatienten. Die haeufigste Lokalisation stellt dabei die Wirbelsaeule dar, die Folge koennen Instabilitaet, Schmerz und neurologische Defizite sein. Das interdisziplinaere Tumormanagement der Wirbelsaeule umfasste bisher insbesondere die Stabilisierung und anschliessende Bestrahlung der Metastasen. Eine Reduktion der Eingriffsschwere und Morbiditaet sind ebenso wie die Beachtung und Erhalt der Autarkie des Patienten wichtige Zielparameter bei diesen palliativen Patienten. Die Kyphoplastie kombiniert mit intraoperativer Radiotherapie (Kypho-IORT) stellt eine weitere, moderne Behandlungsoption fuer Patienten dar, bei welcher minimal-invasiv eine lokale Hochdosisbestrahlung im Wirbelkoerper mittels niedrigenergetischen Roentgenstrahlen (50 kV) transpedikulaer vorgenommen wird. Unmittelbar anschliessend erfolgt die Stabilisierung des Wirbelkoerpers ueber das gleiche Portal mittels Kyphoplastie, sodass eine einzeitige Prozedur mit guter Schmerzreduktion und guter lokaler Tumorkontrolle erzielt werden kann. Neben der Praesentation klinischer Daten werden die Indikationsstellungen zur Kypho-IORT in diesem Artikel kritisch dargestellt und mit anderen Therapieoptionen verglichen. Methodische Verbesserungen und Moeglichkeiten zur weiteren Individualisierung der Therapie werden aufgezeigt. Die Kypho-IORT ist eine neue Behandlungsoption fuer Patienten mit Wirbelsaeulenmetastasen. Nach ueber 100 erfolgreichen Anwendungen sind technische Machbarkeit, Patientensicherheit und gute lokale Tumorkontrolle dargelegt, sodass eine Anwendung im klinischen Alltag moeglich und sinnvoll erscheint. Eine Phase-II-Dosiseskalationsstudie ist abgeschlossen und zur Publikation eingereicht, eine Phase-III-Studie zum Vergleich mit konventioneller Bestrahlung ist begonnen worden. (orig.)

  3. Vergleich vom Einsatz Standardisierter Patienten mit Computerfällen in der Psychiatrie und Psychotherapie [Training with standardized patients versus computerized case simulations in psychiatry and psychotherapy: a comparison

    Directory of Open Access Journals (Sweden)

    Mathiak, Klaus

    2010-02-01

    Full Text Available [english] Aims: In this randomized comparative study, we obtained student evaluations for training with standardized patients as well as for computerized case simulations and correlated them with the student’s learning type. Training with standardized patients was also reviewed regarding acceptance.Methods: Medical students in the 5th clinical semester (N = 222 participated in a course with standardized patients (n = 99 or in computerized case simulations (n = 123. Following the course, the students completed a questionnaire including items concerning the methodology and didactics of both courses.Results: Training with standardized patients was evaluated as superior by the students. There was no correlation with the student’s learning type. Conclusions: The results show that it is possible to compare different methods of instruction in a controlled study. Both teaching methods provide the opportunity to practice clinical skills. Particularly in a neuropsychiatric setting, training with standardized patients can complement other methods as a means of developing communication skills.[german] Zielsetzung: Im Rahmen der vorliegenden Studie wurde der Einsatz von Standardisierten Patienten mit computerbasierten Falldemonstrationen in der psychiatrischen Lehre verglichen und die Bewertungen in Relation zu den Lernstilen der Studierenden gestellt. Darüber hinaus sollte die Akzeptanz von Standardisierten Patienten als innovative Lehrform überprüft werden.Methodik: Studierende des Regelstudiengangs Medizin im 5. klinischen Semester (N=222 nahmen entweder an einem Seminar mit Standardisierten Patienten (N=99 oder an einem Seminar mit computerbasierten Falldemonstrationen (N=123 teil. Im Anschluss an den Unterricht füllten die Studierenden einen Evaluationsbogen aus, welcher Fragen zur Bewertung der Methodik und der Didaktik beider Unterrichtsformen enthielt.Ergebnisse: Die Studenten gaben dem Fallunterricht mit Standardisierten Patienten in

  4. Receptor imaging of schizophrenic patients under treatment with typical and atypical neuroleptics; Nuklearmedizinische Rezeptordiagnostik bei schizophrenen Patienten unter Therapie mit typischen und atypischen Neuroleptika

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin der Ludwig-Maximilians-Univ. Muenchen (Germany); Meisenzahl, E. [Psychiatrische Klinik der Ludwig-Maximilians-Univ. Muenchen (Germany); Scherer, J. [Bezirkskrankenhaus Haar (Germany)

    2002-09-01

    -motorische Nebenwirkungen hervorzurufen. Die Besetzung postsynaptischer Dopamin-D2-Rezeptoren wird als ein wesentlicher Aspekt der antipsychotischen Wirksamkeit der Neuroleptika angesehen. Diese koennen nuklearmedizinisch durch [I-123]IBZM-SPECT dargestellt werden. Fuer das typische Neuroleptikum Haloperidol wurde eine dosisabhaengige, exponentielle Besetzung der Dopamin-D2-Rezeptoren nachgewiesen. Ab einem Schwellenwert des spezifischen Bindungsindex von 0,4 (Norm: >0,95) zeigten mit einer Ausnahme alle untersuchten Patienten extrapyramidal-motorische Nebenwirkungen. Auch unter Therapie mit dem atypischen Neuroleptikum Clozapin ergab sich eine exponentielle Dosis-Wirkungsbeziehung mit jedoch einem deutlich flacheren Kurvenverlauf im Vergleich zu Haloperidol. Extrapyramidalmotorische Nebenwirkungen traten bei diesen Patienten nicht auf. Neuere, als atypisch eingestufte Neuroleptika wie Risperidon und Olanzapin zeigten ebenfalls eine exponenzielle Dosis-Wirkungsbeziehung, wobei deren Kurvenverlaeufe zwischen denen von Haloperidol und Clozapin lagen. Extrapyramidal-motorische Nebenwirkungen traten bei den letzteren Neuroleptika seltener als bei Haloperidol, bei Olanzapin nur bei einem Patienten in unserem eigenen Patientengut auf. Das pharmakologische Profil atypischer Neuroleptika zeichnet sich neben der Bindung an die postsynaptischen Dopamin-D2-Rezeptoren auch durch Bindung an Rezeptoren diverser anderer Neurotransmittersysteme, insbesondere des serotonergen Systems, aus. Somit ist wahrscheinlich, dass die niedrigere Inzidenz fuer extrapyramidal-motorische Nebenwirkungen bei atypischen Neuroleptika durch (orig.)

  5. Lernen und Prüfen mit virtuellen Patienten am Zentrum für Kinder- und Jugendmedizin des Universitätsklinikums Heidelberg: Ergebnisse der Evaluation im Rahmen des E-Learning-Preises Baden-Württemberg 2007

    Directory of Open Access Journals (Sweden)

    Tönshoff, Burkhard

    2009-02-01

    Full Text Available Einleitung: Elektronische virtuelle Patienten kommen in der medizinischen Ausbildung zunehmend zum Einsatz. Evaluationen zur umfassenden curricularen Einbindung dieser innovativen E-Learning-Programme liegen bisher nicht vor. Methoden: Virtuelle Patienten wurden entsprechend wichtiger didaktischer Prinzipien gestaltet und seit Jahren sowohl zum Lernen als auch Prüfen im Rahmen des regulären Unterrichts von Medizinstudierenden in der Kinderheilkunde eingesetzt. Dieses Projekt wurde anhand eines Fragebogens des Kompetenzzentrums E-Learning Baden-Württemberg (Ulm evaluiert. Die Stichprobe bestand aus Studierenden des Pädiatrie-Moduls 4 (n=28, die dieses Modul an der Universität Heidelberg vom 25.6.–19.7.07 absolvierten. Ergebnisse: Der Rücklauf betrug 93%. Die Ergebnisse zeigten eine sehr hohe Akzeptanz, Relevanz und Anwenderfreundlichkeit, einen sehr hohen Grad der Integration in das Gesamtcurriculum und einen sehr guten Lernerfolg. Das Projekt erhielt aufgrund der Bewerbungsunterlagen und der Evaluationsergebnisse den 1. Platz des E-Learning-Preises Baden-Württemberg 2007. Diskussion: Die Stichprobe ist klein. Sie bestätigt jedoch die Ergebnisse vorangegangener systematischer Evaluationen mit großen Studierendenzahlen. Fazit: Die umfassende curriculare Einbindung virtueller Patienten wird von Studierenden als sinnvoll und das praxisnahe Lernen unterstützend angesehen.

  6. {sup 1}H-MR-spectroscopic imaging in patients with Alzheimer`s disease; {sup 1}H-MR-spektroskopische Bildgebung bei Patienten mit klinisch gesichertem Morbus Alzheimer

    Energy Technology Data Exchange (ETDEWEB)

    Block, W [Radiogische Klinik der Univ. Bonn (Germany); Traeber, F [Radiogische Klinik der Univ. Bonn (Germany); Kuhl, C K [Radiogische Klinik der Univ. Bonn (Germany); Fric, M [Psychiatrische Universitaetsklinik, Bonn (Germany); Keller, E [Radiogische Klinik der Univ. Bonn (Germany); Lamerichs, R [Philips Medical Systems, Best (Netherlands); Rink, H [Radiogische Klinik der Univ. Bonn (Germany); Moeller, H J [Psychiatrische Universitaetsklinik, Bonn (Germany); Schild, H H [Radiogische Klinik der Univ. Bonn (Germany)

    1995-09-01

    To detect regional differences in accompanying metabolic changes, {sup 1}H-Magnetic Resonance Spectroscopic Imaging was performed in 16 patients with Alzheimer`s disease (AD); the clinical diagnosis was based upon DSM-III-R and NINCDS-ADRDA guidelines. In the hippocampal region metabolic maps of the local distribution of N-acetylaspartate (NAA), choline (Cho), creatine compounds (P(Cr)) and lactate were determined. Ratios of Cho/NAA, (P)Cr/NAA and Cho/(P)Cr calculated from selected hippocampal spectra were compared to those from healthy volunteers (n=17). AD patients demonstrated an increase of Cho/NAA and (P)Cr/NAA ratios caused by increased choline compounds and decreased NAA. These alterations were observed in 11/12 cases in the hippocampal and in 7/12 in the temporo-occipital region. Hippocampal Cho/NAA ratios (0.56{+-}0.19) were significantly elevated compared with controls. The observed elevation of choline compounds in the hippocampus supports the hypothesis that alterations in the cholinergic system play an important role in Alzheimer`s disease. The observed reduction of NAA is due to neuronal degeneration. (orig./MG) [Deutsch] Zur Darstellung von regionalen metabolischen Veraenderungen bei Morbus Alzheimer wurden mit dem Verfahren des {sup 1}H-Magnetic-Resonance-Spectroscopic-Imaging 16 Patienten untersucht, deren Diagnose klinisch entsprechend DSM-III-R- und NINCDS-ADRDA-Kriterien gestellt wurde. In Hoehe des Hippocampus wurden transaxiale ``Metabolitenkarten`` der regionalen Verteilung von N-Acetyl-Aspartat (NAA), cholinhaltiger Verbindungen (Cho), Gesamtkreatin (P(Cr)) und Laktat erstellt. Zur Quantifizierung der Unterschiede zum Normalkollektiv (n=17) wurden die Metabolitenquotienten Cho/NAA, (P)Cr/NAA und Cho/(P)Cr, insbesondere aus der Hippocampusregion, ermittelt. Das Krankheitsbild des M. Alzheimer stellte sich durch eine Erhoehung der Quotienten Cho/NAA und Cho/(P)Cr dar, wobei neben einer Cholinerhoehung die Reduktion des Neurotransmitters NAA

  7. Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin; Magnetresonanztomographie (MRT) der Leber und des Gehirns bei haematologisch-onkologischen Patienten mit Fieber unbekannter Ursache

    Energy Technology Data Exchange (ETDEWEB)

    Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Heussel, G. [Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik

    1998-08-01

    To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamic) and 16 brain MRI (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [Deutsch] Untersuchung des Nutzens der MRT der Leber und des Gehirns bei klinisch auffaelligen haematologischen Patienten mit Fieber unbekannter Ursache. Material und Methoden: Es wurden 20 MRT der Leber (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamisch) und 16 MRT des Gehirns (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) zur Fokussuche bei Infektionsverdacht und Organhinweisen durchgefuehrt. Es erfolgte der Abgleich mit dem weiteren klinischen Verlauf. Ergebnisse: 11/20 MRT-Untersuchungen der Leber zeigten einen Herdbefund: Candidiasis (n=3), Mykobakteriose (n=2

  8. A prospective, double-blind study of prophylaxis of radioxerostomia by coumarin/troxerutine in patients with head and neck cancer; Prospektive, doppelblinde Therapiestudie zur Prophylaxe der Radioxerostomie durch Cumarin/Troxerutin bei Patienten mit Kopf-Hals-Karzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Groetz, K.A.; Al-Nawas, B.; Wagner, W. [Universitaetsklinik fuer Mund-, Kiefer- und Gesichtschirurgie, Mainz (Germany); Henneicke-von Zepelin, H.H.; Wuestenberg, P.; Naser-Hijazi, B. [Schaper und Bruemmer, Salzgitter (Germany). Hauptbereich Medizin; Kohnen, R. [Institute for Medical Research Management and Biometrics, Nuernberg (Germany); Bockisch, A. [Universitaetsklinik und Poliklinik fuer Nuklearmedizin, Essen (Germany); Kutzner, J. [Universitaetsklinik und Poliklinik fuer Radiologie, Mainz (Germany); Belz, G.G. [Zentrum fuer Kardiovaskulaere Pharmakologie, Mainz (Germany)

    1999-08-01

    size was too low to prove statistically also the benefit of coumarin/troxerutine with the scintigraphic method. Sialometry seems not suitable for the assessment of early radiation effects. (orig.) [German] Fragestellung: Eine kausale Behandlung der radiogenen Sialadenitis ist bislang nicht etabliert. In einer prospektiven, randomisierten, plazebokontrollierten Doppelblindstudie sollte die pharmakologische Wirksamkeit von Cumarin/Troxerutin (Venalot {sup trademark} Depot) zur Speicheldruesenprotektion unter einer Kopf-Hals-Bestrahlung bei Malignompatienten ueberprueft werden. Patienten und Methode: 48 Patienten mit Strahlentherapie (60 Gy) eines Kopf-Hals-Malignoms wurden in die Untersuchung eingeschlossen. Die Speicheldruesen lagen ueberwiegend im Herdvolumen der Bestrahlung. Primaere Zielparameter waren Sialometrie, Speicheldruesenfunktionsszintigraphie und fruehe Strahlenfolgen (RTOG-Score). Alle Befunde wurden zu sechs Untersuchungszeitpunkten erhoben: Eine Woche vor Bestrahlung (U1), zu Beginn (U2), zur Haelfte (U3) und am Ende der Bestrahlung (U4) sowie sieben Tage (U5) und 28 Tage post radiationem (U6). Ergebnisse: 23 Patienten (elf mit Verum-, zwoelf mit Plazebobehandlung) beendeten die Studie pruefplankonform mit allen Untersuchungen. Sialometrisch zeigten alle Patienten ab der Haelfte der Strahlentherapie (U3) stark verminderte Mundfluessigkeitsfliessraten, danach betrugen die Mediane der Flussraten 0 ml/min fuer beide Gruppen bis zu U6 (28 Tage nach Bestrahlung). Im Gesamtwirkungsmass nach O'Brien aus Sialoszintigraphie und klinischer Beurteilung war eine tendenzielle Ueberlegenheit von Verum gegenueber Plazebo zu beobachten (p=0,068). Der RTOG-Score zeigte bei allen Untersuchungen nach Bestrahlungsbeginn unter Verum signifikant niedrigere Befundauspraegungen frueher Strahlenfolgen als unter Plazebo (U3 bis U6: Jeweils p<0,05; 'Area under the Curve': p=0,032). Die szintigraphisch bestimmte Exkretionsfraktion zeigte fuer Verum eine tendenziell

  9. Wirkung der seriellen Ganzkörperkältetherapie auf den aktuellen Gesundheitszustand sowie pro- und antiinflammatorische Zytokine bei Patienten mit Fibromyalgie

    OpenAIRE

    Becker, Johanna

    2016-01-01

    Hintergrund: Seit 1980 besteht die Möglichkeit zur Ganzkörperkältetherapie (GKKT), die heute sowohl in geschlossenen wie auch offenen Kammersystemen durchgeführt werden kann. Als Indikationen gelten v. a. rheumatische Erkrankungen. Die Fibromyalgie stellt eine chronische Schmerzerkrankung mit beachtlicher Heterogenität bzgl. ihrer Symptome, biomedizinischen Parameter sowie Therapieantworten dar. Gut 2% der Bevölkerung sind dadurch in ihrer Lebensqualität stark eingeschränkt. Die zur Verfügung...

  10. Kurz-, mittel- und langfristige Effekte einer Schulung für Patienten mit chronisch entzündlichen Darmerkrankungen auf krankheitsbezogene Ängste und Gesundheitskompetenzen

    OpenAIRE

    Berding, Anja

    2017-01-01

    Menschen mit chronisch entzündlichen Darmerkrankungen (CED) leiden unter vielfältigen körperlichen und psychosozialen Einschränkungen. Wie auch bei anderen chronischen Erkrankungen könnten Patientenschulungen ihr psychisches Befinden verbessern (z.B. De Ridder & Schreurs, 2001; Faller, Reusch & Meng, 2011a; Küver, Becker & Ludt, 2008; Schüssler, 1998; Warsi, Wang, LaValley, Avorn & Solomon, 2004). Für CED liegen jedoch nur wenige Schulungsevaluationen vor (z.B. Bregenzer et al., 2005; Mussell...

  11. Rheumatische Erkrankungen beim älteren Patienten

    Directory of Open Access Journals (Sweden)

    Köller M

    2008-01-01

    Full Text Available Muskuloskeletale Erkrankungen stellen beim älteren Menschen die häufigste Ursache für Aktivitätseinschränkungen dar. Die Prävalenz der Osteoarthrose (OA steigt mit dem Lebensalter sprunghaft an. Nach den Allgemeinmaßnahmen ist bei der medikamentösen Therapie der OA Paracetamol der Vorzug zu geben. Die rheumatoide Arthritis (RA als häufigste entzündliche Gelenkerkrankung des Erwachsenenalters zeigt im Alter oft atypische Verlaufsformen und ist unter Umständen von der Polymyalgia rheumatica schwer abzugrenzen. Jedenfalls erscheint die RA beim älteren Patienten oft nicht adäquat behandelt. Auch hier sind konventionelle Therapien wie Methotrexat Mittel der Wahl und Biologika erscheinen ebenso sicher bei älteren Patienten. Das Infektrisiko wird vorwiegend durch die begleitende Kortikosteroid-Dosis bestimmt. Die Polymyalgia rheumatica betrifft in 90 % der Fälle Patienten älter als 60 Jahre. Kortikosteroide sind hier nach wie vor die wichtigste Therapie, welche meist über ein bis zwei Jahre erforderlich ist. Eine Riesenzellarteriitis muss bei Patienten mit PMR immer ausgeschlossen werden. Bei Vorliegen dieser Vaskulitis muss im Falle einer Mitbeteiligung der Augengefäße möglichst rasch eine hoch dosierte Steroidgabe erfolgen. Die Biopsie der Schläfenarterie kann auch einige Zeit nach Therapiebeginn erfolgen, ohne dass die diagnostische Aussagekraft darunter leidet.

  12. Prognostische Bedeutung der physikalischen Streßechokardiographie bei 3329 ambulanten Patienten (5jährige Langzeitstudie)

    OpenAIRE

    Leischik R; Dworrak B; Gülker H; Littwitz H

    2005-01-01

    Hintergrund und Fragestellung: Die Risikoeinschätzung ambulanter Patienten mit thorakaler Schmerzsymptomatik ist ein wichtiges klinisches Problem. Über die prognostische Bedeutung der physikalischen Streßechokardiographie (SE) bei diesem Patientenkollektiv wurde bis jetzt nicht berichtet. Patienten und Methoden: Um die prognostische Bedeutung der physikalischen Streßechokardiographie bei rein ambulanten Patienten zu untersuchen, wurden 3329 Patienten bezüglich des Auftretens schwerer Erei...

  13. Evaluation of quality of life of patients with oral sqamous cell carcinoma. Comparison of two treatment protocols in a prospective study - first results; Beurteilung der Lebensqualitaet von Patienten mit Plattenepithelkarzinomen der Mundhoehle. Vergleich von zwei Behandlungsstrategien in einer prospektiven Studie - erste Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Wiltfang, J.; Bloch-Birkholz, A.; Neukam, F.W.; Kessler, P. [Klinik und Poliklinik fuer Mund-, Kiefer-, Gesichtschirurgie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany); Grabenbauer, G. [Klinik und Poliklinik fuer Strahlentherapie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany); Leher, A. [Inst. fuer Medizininformatik, Biometrie und Epidemiologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany)

    2003-10-01

    Patients and Methods: This longitudinal study prospectively evaluates quality of life in two groups consisting of 53 neoadjuvant and primarily surgically treated patients with oral cancer, using the quality-of-life core questionnaire (QLQ-C30) and the head and neck cancer module (H and N 35) of the European Organization for Research and Treatment of Cancer (EORTC). Results: Postoperatively both groups showed a marked reduction in quality of life. 1 year later quality of life had equalized between the two groups to such an extent that the quality of life scores had almost reached the preoperative level. Both groups showed specific impairments in the symptom scales. In the neoadjuvant therapy group however, global health and the emotional status were reduced to a greater degree than in the other group. Conclusion: Temporary limitations in quality of life can be expected after tumor treatment of oral cancer as presented here. Neoadjuvant therapy concept is more aggressive and might result in a longer disease-free survival, but the restriction in quality of life is more severe. Primary goal is the eradication of the tumor. Nevertheless preservation or reconstruction of a maximum of function is essential for a high level of quality of life. (orig.) [German] Patienten und Methoden: In einer longitudinal angelegten prospektiven Studie wurde die Lebensqualitaet in zwei Patientengruppen mit insgesamt 53 Patienten mit Plattenepithelkarzinomen der Mundhoehle beurteilt. Eine Gruppe (26 Patienten) wurde neoadjuvant mit einer kombinierten Radiochemotherapie vorbehandelt und anschliessend einer Tumorresektion unterzogen. Die verbliebenen 27 Patienten wurden primaer chirurgisch behandelt und postoperativ bestrahlt. Zur Beurteilung der Lebensqualitaet wurden der ''quality of life core questionnaire'' (QLQ-C30) und das so genannte Kopf-Hals-Modul (H and N 35) der ''European Organisation for Research and Treatment of Cancer'' (EORTC

  14. BNP ist ANP, Endothelin und Noradrenalin als Prognoseindikator bei chronisch herzinsuffizienten Patienten überlegen

    OpenAIRE

    Zugck C; Gerhards A; Haass M; Katz N; Kell R; Krüger C; Schellberg D

    2001-01-01

    Zu den etablierten Prognoseindikatoren bei Patienten mit chronischer Herzinsuffizienz zählen der Herz-Thorax-Quotient in der Röntgen-Thoraxaufnahme (HTQ), die linksventrikuläre Ejektionsfraktion (LVEF) und die maximale Sauerstoffaufnahme unter Belastung (VO2max). Darüber hinaus wird zahlreichen neurohumoralen Parametern eine prognostische Wertigkeit zugeschrieben. An 166 Patienten mit chronischer Herzinsuffizienz (Alter 54 ± 9 Jahre; 70 % dilatative Kardiomyopathie; 30 % KHK; LVEF 21 ± 9 %) ...

  15. Management von Patienten mit pulmonaler Hypertonie

    NARCIS (Netherlands)

    Preckel, B.; Eberl, S.; Fräßdorf, J.; Hollmann, M. W.

    2012-01-01

    Due to the increased survival of patients with pulmonary hypertension, even non-cardiac anesthesiologists will see these patients more frequently for anesthesia. The hemodynamic goal in the perioperative period is to avoid an increase in pulmonary vascular resistance (PVR) and to reduce a possibly

  16. Verbesserung bei Patienten durch den Community Reinforcement Approach: Effekte auf Zufriedenheit und psychiatrische Symptome

    NARCIS (Netherlands)

    Roozen, H.G.; Greeven, P.G.J.; Dijkstra, B.A.G.; Bischof, G.

    2013-01-01

    Patienten mit Suchterkrankungen weisen ein eingeschränktes Wohlbefinden auf. Eine Querschnittsstudie mit einem Prä-Post-Behandlungsdesign wurde durchgeführt, um Behandlungs­effekte des Community Reinforcement Approach (CRA) hinsichtlich Zufriedenheit und psychia­trischer Symptome zu erfassen. Die

  17. Evaluation of passive cardiomyoplasty using left- and right-ventricular volume measurements by EBCT and MRI in patients with chronic congestive heart failure; Evaluierung der passiven Kardiomyoplastie mittels links- und rechtsventrikulaerer EBCT- und MRT-Volumetrie bei Patienten mit chronischer Herzinsuffizienz

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, A.; Enzweiler, C.N.H.; Wiese, T.H.; Kivelitz, D.E.; Rogalla, P.; Hamm, B. [Inst. fuer Radiologie, Universitaetsklinikum Charite, Campus Charite Mitte, Humboldt Univ. zu Berlin (Germany); Hotz, H.; Dushe, S.; Konertz, W. [Klinik fuer Kardiovaskulaere Chirurgie, Universitaetsklinikum Charite, Campus Charite Mitte, Humboldt Univ. zu Berlin (Germany)

    2003-08-01

    Purpose: To evaluate the efficacy of passive cardiomyoplasty with the determination of biventricular volumes, global systolic function as well as left-ventricular muscle mass. Materials and Methods: In 19 patients with congestive heart failure of idiopathic or ischemic origin, a polyester mesh-graft was implanted around both ventricles for stabilization and functional support. Before and three months after surgery, 15 patients underwent EBCT and 4 patients with impaired renal function underwent MRI, for the evaluation of the volume and ejection fraction of both ventricles. Results: EBCT demonstrated a decrease from 385 to 310 ml in LV-EDV, from 312 to 242 ml in LV-ESV, from 209 to 160 ml in RV-EDV and from 149 to 87 ml in RV-ESV, and an increase from 20 to 26% in LV-EF and from 37 to 50% in RV-EF as well as a reduction of LV-MM from 300 to 274 g (p < 0.05 each). Similar results were obtained by MRI. Conclusion: Following passive cardiomyoplasty, EBCT and MRI revealed an improvement of the global systolic function as well as a reduction of biventricular volumes and left-ventricular muscle mass. (orig.) [German] Ziel: Evaluierung des Therapieerfolges der passiven Kardiomyoplastie durch Bestimmung der biventrikulaeren Volumina und global systolischen Funktion sowie der linksventrikulaeren Muskelmasse. Methoden: Bei 19 Patienten mit idiopathisch und ischaemisch bedingter Herzinsuffizienz erfolgte die Implantation eines Polyesternetzes um die Ventrikel zu deren Stabilisierung und funktioneller Unterstuetzung. Praeoperativ sowie drei Monate postoperativ wurden bei 15 Patienten durch EBCT und bei 4 Patienten mit eingeschraenkter Nierenfunktion durch MRT die Volumina und Ejektionsfraktion beider Ventrikel sowie die linksventrikulaere Muskelmasse bestimmt. Ergebnisse: Die EBCT zeigte eine Abnahme des LV-EDV von 385 auf 310 ml, des LV-ESV von 312 auf 242 ml, des RV-EDV von 209 auf 160 ml und des RV-ESV von 149 auf 87 ml, eine Zunahme der LV-EF von 20 auf 26% und der RV

  18. Atmospheric Measurements Laboratory (AML)

    Data.gov (United States)

    Federal Laboratory Consortium — The Atmospheric Measurements Laboratory (AML) is one of the nation's leading research facilities for understanding aerosols, clouds, and their interactions. The AML...

  19. Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations; Maligne und benigne Erkrankungen der Brust bei 41 maennlichen Patienten: Mammographie und Sonographie mit histopathologischer Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Partik, B.; Mallek, R.; Pokieser, P.; Wunderbaldinger, P.; Helbich, T.H. [Vienna Univ. (Austria). Klinik fuer Radiodiagnostik; Rudas, M. [Vienna Univ. (Austria). Inst. fuer Klinische Pathologie

    2001-11-01

    Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.) [German] Ziel: Die Befunde von Mammographie und Sonographie bei histologisch gesicherten malignen und benignen Mammaerkrankungen maennlicher Patienten zu evaluieren. Material und Methode: Retrospektiv wurden die in einem Zeitraum von 6 Jahren durchgefuehrten Mammographien und Sonographien bei 41 maennlichen Patienten in Anlehnung an die BI-RADS trademark Klassifikation ausgewertet. Resultate: Es wurden 13 Karzinome, 21 Gynaekomastien, 3 Pseudogynaekomastien, 2 Atherome und 2 weitere benigne Laesionen histologisch diagnostiziert. Die Mammographie zeigte in der Differenzierung maligne versus benigne Laesion

  20. Chronisch-dekompensierter Tinnitus: ein heterogenes Krankheitsbild mit Auswirkungen auf den Behandlungserfolg

    OpenAIRE

    Ivansic, D; Müller, B; Dobel, C; Guntinas-Lichius, O

    2017-01-01

    Einleitung: Bei etwa 5% der Patienten mit chronischem Tinnitus gehen die Ohrgeräusche mit erheblichem Leidensdruck, häufig auch mit psychiatrischen Störung einher. Da es aktuell keine wirksame Behandlung gibt, welche zu Beseitigung des chronischen Tinnitus führt, ist das Therapieziel die Reduktion der Tinnitus-Belastung. Methodik: Es wurden von 7/13 bis 12/14 308 Patienten mit chronischen Tinnitus tagesklinisch interdisziplinär behandelt. Die Tinnitus-Belastung wurde mit Tinnitus-Fragebogen...

  1. Aspekte der Osteoporosetherapie und Frakturprävention bei geriatrischen Patienten

    Directory of Open Access Journals (Sweden)

    Gosch M

    2010-01-01

    Full Text Available Aktuell beträgt der Anteil der Personen 65 Jahre in Österreich 17 %. Nach Schätzungen der WHO wird sich dieser Anteil bis 2025 verdoppeln. Parallel mit der demographischen Veränderung steigt auch die Inzidenz der Oberschenkelhalsfraktur von zurzeit 16.000/Jahr auf 25.000 im Jahr 2050. Mit einer jährlichen Inzidenz von 19,7/100.000 Einwohner weist Österreich innerhalb der EU eine der höchsten Zahlen auf. Die hüftnahen Frakturen sowie die Wirbelkörperfrakturen treten überwiegend als Folge einer bestehenden Osteoporose auf. Die Qualität der Osteoporosebehandlung stellt die Grundvoraussetzung für einen erfolgreichen präventiven Behandlungsansatz dar. Eine ausreichende Kalzium- und Vitamin-D-Zufuhr hat gerade im höheren Alter große Bedeutung, insbesondere auch im Hinblick auf die Sturzprävention. Für einzelne Bisphosphonate, Teriparatid und Strontiumranelat konnte eine signifikante Reduktion des Frakturrisikos bei geriatrischen Patienten nachgewiesen werden. Aus aktuellen Studien wissen wir, dass wir bei Patienten mit einem hohen Risiko eine „number needed to treat“ (NNT von 1:15 erreichen können. Trotz zahlreicher therapeutischer Möglichkeiten steigt die Inzidenz weiter an. Aus verschiedenen internationalen Studien sind uns mögliche Ursachen für diese Entwicklung bekannt. Neben der ungenügenden Compliance der Patienten ist auch die fehlende Awareness der Ärzte problematisch. Eine weitere Herausforderung in der Behandlung der Osteoporose und deren Folgen stellt beim älteren Patienten das Sturzrisiko dar. Screeninguntersuchungen werden in vielen Leitlinien empfohlen, sind im klinischen Alltag jedoch eher die Ausnahme. Wissenschaftliche Daten für geriatrische Patienten bestätigen die Wirksamkeit einer Therapie auch in dieser Altersgruppe. Bedauerlicherweise fließen die vorliegenden Erkenntnisse kaum in die klinische Praxis ein.

  2. Access/AML -

    Data.gov (United States)

    Department of Transportation — The AccessAML is a web-based internet single application designed to reduce the vulnerability associated with several accounts assinged to a single users. This is a...

  3. Acute myeloid leukemia (AML) - children

    Science.gov (United States)

    Acute myeloid leukemia is a cancer of the blood and bone marrow. Bone marrow is the soft tissue inside ... develops quickly. Both adults and children can get acute myeloid leukemia ( AML ). This article is about AML in children.

  4. Diagnose und Therapie einer Depression im höheren Lebensalter – Einflüsse von Patienten- und Arztmerkmalen

    Science.gov (United States)

    von dem Knesebeck, Olaf; Bönte, Markus; Siegrist, Johannes; Marceau, Lisa; Link, Carol; McKinlay, John

    2013-01-01

    Zusammenfassung Studienergebnissee aus dem englischsprachigen Raum zeigen, dass diagnostische und therapeutische Entscheidungen von Hausärzten bei der Versorgung von depressiven Patienten systematischen Einflüssen unterliegen, und dass sowohl Merkmale des Arztes als auch des Patienten unabhängig vom Krankheitsbild Einfluss auf diese Entscheidungen haben. In der vorliegenden Arbeit werden Ergebnisse einer deutschen Studie präsentiert, in der die Einflüsse von Patienten- und Arztmerkmalen auf diagnostische und therapeutische ärztliche Entscheidungen bei einer Depression untersucht wurden. Unter Anwendung eines faktoriellen Experimentaldesigns spielten professionelle Schauspieler in Videofilmen die Rolle von Patienten, die Symptome für eine depressive Erkrankung äußern. In den Videofilmen, die alle auf einem identischen Skript basieren, wurden systematisch die Patientenmerkmale Alter (55 vs. 75 Jahre), Geschlecht und sozialer Status (Hausmeister vs. Lehrer) variiert. Die randomisierte Ärztestichprobe wurde nach dem Arztgeschlecht und professioneller Erfahrung ( 15 Jahre) geschichtet. Der Videofilm wurde insgesamt 128 niedergelassenen Ärzten für Allgemeinmedizin und hausärztlich tätigen Internisten in ihrer Praxis vorgespielt. Danach wurden die Ärzte zu unterschiedlichen Aspekten von Diagnose und Therapie befragt. Es wurde erhoben, ob der Arzt dem Patienten über das gezeigte Gespräch hinausgehende Fragen stellen würde, welche Diagnosen er für wahrscheinlich hält, wie sicher er sich mit seiner Diagnose ist, welche diagnostischen Tests er anordnen würde, ob er den Patienten überweisen würde oder ob er Medikamente verordnen oder ihm Empfehlungen zur Änderung seines Lebensstils geben würde. Die Ergebnisse weisen darauf hin, dass sowohl die Diagnose als auch die Therapie einer Depression durch niedergelassene Hausärzte in Deutschland nur geringfügig durch die untersuchten Merkmale der Patienten und der behandelnden Ärzte beeinflusst wird. PMID

  5. Potenzielle Arzneimittelwechsel-wirkungen und unerwünschte Arzneimittelwirkungen bei stationären dermatologischen Patienten.

    Science.gov (United States)

    Koch, Lukas; Kränke, Birger; Aberer, Werner

    2016-11-01

    Informationen zur Häufigkeit von Arzneimittelwechselwirkungen und unerwünschten Arzneimittelwirkungen zu präsentieren und Hilfestellung zu leisten, wie diese wichtigen Probleme in der pharmakologischen Behandlung stationärer dermatologischer Patienten minimiert werden können. Die Medikation von 1 099 stationären dermatologischen Patienten wurde retrospektiv mittels einer Internet-basierten Software für Medikamenteninteraktionen (Diagnosia ® Check) auf Arzneimittelwechselwirkungen und unerwünschte Arzneimittelwirkungen analysiert. Wir beschreiben eine Gesamthäufigkeit relevanter Arzneimittelwechselwirkungen von 51,7 % mit durchschnittlich 3,2 Interaktionen pro betroffenem stationären Patienten. Arzneimittelkombinationen, die gemieden werden sollten, wurden bei 5,7 % der Studienpopulation festgestellt. Der wichtigste Risikofaktor war die Gesamtzahl der verabreichten Medikamente. Die Arzneimittelgruppen, die bei der Mehrzahl der Wechselwirkungen beteiligt waren, waren Analgetika, Herz-Kreislauf-Medikamente und gerinnungshemmende Medikamente sowie Antidepressiva. Das Risiko unerwünschte Arzneimittelwirkungen auszubilden wurde bei 53,1 % der stationären Patienten als "hoch" eingestuft. Die fünf wichtigsten unerwünschten Nebenwirkungen in dieser Patientengruppe waren Blutungen, Obstipation, anticholinerge Effekte, Sedierung und orthostatische Effekte. Potenzielle Arzneimittelwechselwirkungen sowie unerwünschte Arzneimittelwirkungen sind bei stationären dermatologischen Patienten alarmierend häufig. Bei jedem zweiten Patienten besteht die Gefahr, derartige Wechselwirkungen oder unerwünschte Nebenwirkungen zu erleiden und jeder zwanzigste Patient erhält eine Arzneimittelkombination, die nicht verabreicht werden sollte. Erhöhte Wachsamkeit ist erforderlich, um die gefährdeten Patienten zu erkennen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  6. Radiotherapy, the experience of the patients; Strahlentherapie im Erleben der Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Verres, R. [Heidelberg Univ. (Germany). Medizinische Universitaetsklinik (Ludolf-Krehl-Klinik); Klusmann, D. [eds.] [Hamburg Univ. (Germany). 1. Medizinische Universitaetsklinik

    1998-03-01

    For the patient, a radiotherapy means heavy physical and mental strain. Just like any other medical therapy, radiotherapy demands active cooperation of the patient based on mutual exchange between the patient and the doctor who, in addition to his medical responsibilities, has to develop awareness of the patient`s mental condition and the suitable response. This emphatic relationship may in turn and at times mean a heavy burden for the medical staff. The authors have evaluated for this book a great number of records, protocols and questionnaires accumulated in the course of their work with patients of the radiotherapy department. The book is intended as a source of reference and guidance and a help for all persons and staff involved, who have to cope with the situations encountered in daily work in the clinical departments. The book presents experience and information on a wide range of aspects and problems involved, as e.g.: Interpersonal relations, the patient`s feeling of being in the hands of technology, the difficulty to keep the delicate balance between confidence and non-confidence, the significance of good relations in the clinic for a successful outcome of the therapy, the ways how mental crises can be handled. The material also includes information on a variety of accompanying therapies, both for the actual treatment periods as well as for post-treatment periods where they may be late effects to be mastered. (orig./CB) 11 figs., 9 tabs. [Deutsch] Die Strahlentherapie ist fuer den Patienten mit hohen koerperlichen und seelischen Belastungen verbunden. Da die Mitwirkung des Patienten hier wie bei jeder Behandlung von grosser Bedeutung ist, muss sich der Arzt mit dessen psychischer Befindlichkeit ebenso gruendlich auseinandersetzen, wie mit seinem Gesundheitszustand. Hinzu kommt, dass das Mitfuehlen seelischer Konflikte des Patienten auf das Klinikpersonal zurueckwirken und einen erheblichen Druck erzeugen kann. Die Autoren haben zahlreiche Aufzeichnungen

  7. Einfluss der Lage des aktiven Kontaktes innerhalb des Nucleus subthalamicus auf den Effekt der tiefen Hirnstimulation bei Parkinson Patienten- Eine MRT-basierte Untersuchung

    OpenAIRE

    Wodarg, Fritz

    2013-01-01

    Anhand Prä- und postoperativer MRT-Bilder wird die Lage der Elektroden zur Hochfrequenzstimulation innerhalb des N. subthalamicus bestimmt und mit dem klinischen Ergebnis der Stimulation bei 30 Parkinson Patienten korreliert. Eine Stimulation in lateralen Anteilen des STN bringt signifikant bessere klinische Ergebnisse.

  8. Anwendung des Traumatherapieverfahrens -Narrative Expositionstherapie- bei komplex traumatisierten Patienten unter besonderer Berücksichtigung des Schlafes

    OpenAIRE

    Scharff, Anna-Lena

    2016-01-01

    Die Studie sollte aufgrund der häufigen Komorbidität einer Posttraumatischen Belastungsstörung mit der Borderline Persönlichkeitsstörung die Frage untersuchen, ob die Narrative Expositionstherapie einen Therapieerfolg bei komplex traumatisierten Patienten hat. Desweiteren sollte der Effekt der Therapie auf den Schlaf untersucht werden und eventuell prädiktive Zusammenhänge zwischen Schlafqualität und Therapieerfolg herausgestellt werden.

  9. Fractures of the cervical spine. Diagnostic procedures in patients with severe cranio-cervical trauma; HWS-Frakturen. Diagnostik bei polytraumatisierten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Link, T.M. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Schuierer, G. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Hufendiek, A. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Peters, P.E. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany)

    1994-12-01

    The purpose of our study was to analyze diagnostic procedures of the cervical spine in severely traumatized patients. Findings in plain radiographs and computer radiography of 234 patients were evaluated. The image quality of the plain radiographs was examined. Casualty reports were evaluated retrospectively. Frequency, distribution and morphology of cervical spine fractures were analyzed: 44 fractures in 35 patients were diagnosed, most of the fractures were located in C2 (20/44). Twenty of the fractures diagnosed in CT were not diagnosed in plain radiography and 7 fractures were uncertain findings; 5 fractures were not detected at the casualty site. A new screening procedure in patients with severe head injury is introduced. (orig.) [Deutsch] Ziel der vorliegenden Studie war, die Diagnostik der HWS beim polytraumatisierten Patienten zu analysieren. Retrospektiv wurden Roentgenaufnahmen und Computertomogramme der HWS von 234 polytraumatisierten Patienten analysiert. Konventionelle HWS-Aufnahmen wurden in bezug auf ihre Qualitaet untersucht und der Befund der konventionellen Aufnahmen mit dem der Computertomographie verglichen. Die Befunde vom Unfalltag wurden den retrospektiv validierten Befunden gegenuebergestellt. Haeufigkeit, Verteilung und Morphologie von HWS-Frakturen bei polytraumatisierten Patienten wurden untersucht: 44 Frakturen bei 35 Patienten waren nachweisbar, am haeufigsten Frakturen von HWK 2 (21/44). 20 der Frakturen konnten konventionelle radiologisch nicht und 7 nur fraglich diagnostiziert werden. 5 Frakturen wurden am Unfalltag nicht erkannt. Ein neues Untersuchungsprotokoll mit routinemaessiger computertomographischer Untersuchung von HWK 1 und 2 bei Schaedel-Hirn-Traumata wird vorgestellt. (orig.)

  10. Neural correlates of working memory deficits in schizophrenic patients. Ways to establish neurocognitive endophenotypes of psychiatric disorders; Neuronale Korrelate gestoerter Arbeitsgedaechtnisfunktionen bei schizophrenen Patienten. Ansaetze zur Etablierung neurokognitiver Endophaenotypen psychiatrischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, O. [Universitaet des Saarlandes, Klinik fuer Psychiatrie und Psychotherapie, Homburg (Saar) (Germany); Max-Planck-Institut fuer Kognitions- und Neurowissenschaften, Leipzig (Germany); Gruber, E.; Falkai, P. [Universitaet des Saarlandes, Klinik fuer Psychiatrie und Psychotherapie, Homburg (Saar) (Germany)

    2005-02-01

    This article briefly reviews some methodological limitations of functional neuroimaging studies in psychiatric patients. We argue that the investigation of the neural substrates of cognitive deficits in psychiatric disorders requires a combination of functional neuroimaging studies in healthy subjects with corresponding behavioral experiments in patients. In order to exemplify this methodological approach we review recent findings regarding the functional neuroanatomy of distinct components of human working memory and provide evidence for selective dysfunctions of cortical networks that underlie specific working memory deficits in schizophrenia. This identification of subgroups of schizophrenic patients according to neurocognitive parameters may facilitate the establishment of behavioral and neurophysiological endophenotypes and the development of a neurobiological classification of psychiatric disorders. (orig.) [German] Dieser Beitrag befasst sich mit einigen methodischen Problemen funktionell-bildgebender Studien mit psychiatrischen Patienten, aufgrund derer die Untersuchung der neuronalen Korrelate kognitiver Defizite bei psychiatrischen Erkrankungen einer Kombination funktionell-bildgebender Studien bei gesunden Normalprobanden mit Verhaltensuntersuchungen bei Patienten bedarf. Dieser methodische Ansatz wird am Beispiel von Arbeitsgedaechtnisfunktionen erlaeutert, wobei zunaechst neuere Erkenntnisse zur funktionellen Neuroanatomie verschiedener Komponenten des menschlichen Arbeitsgedaechtnisses referiert werden. Anschliessend werden bei schizophrenen Patienten erhobene Befunde vorgestellt, die auf spezifische Stoerungen der funktionellen Integritaet neuronaler Netzwerke mit Arbeitsgedaechtnisfunktionen hinweisen. Die damit verbundene Identifikation von Subgruppen schizophrener Patienten koennte zur Etablierung verhaltensneurophysiologisch definierter Endophaenotypen psychiatrischer Stoerungsbilder fuehren und die Entwicklung einer neurowissenschaftlich

  11. Role of radiotherapy in age-related macular degeneration. A prospective study; Photonentherapie der subfovealen choroidalen Neovaskularisation bei altersabhaengiger Makuladegeneration. Ergebnisse einer prospektiven Studie an 40 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Prettenhofer, U.; Mayer, R.; Oechs, A.; Pakisch, B.; Stranzl, H.; Willfurth, P.; Hackl, A. [Univ. Graz (Austria). Abt. fuer Strahlentherapie; Haas, A. [Univ. Graz (Austria). Universitaets-Augenklinik

    1998-12-01

    Methoden: Zwischen September 1995 und Juli 1996 wurden 40 Patienten (neun Maenner, 31 Frauen; mittleres Alter 74 Jahre; 61 bis 83 Jahre) im Rahmen einer prospektiven Studie an unserer Abteilung bestrahlt. Acht Patienten hatten die klassische Form, 32 die okkulte Form der Makuladegeneration. Vor der Behandlung sowie ein, drei, sechs und zwoelf Monate nach der Bestrahlung wurden ein kompletter ophthalmologischer Status mit Visus- und Gesichtsfeldbestimmung sowie eine Fluoreszein- und Indozyaningruen-Angiographie durchgefuehrt. Die Bestrahlung erfolgte generell von einem 5,5x4,5 cm grossen lateralen, nicht gekippten Feld in Half-beam-Block-Technik mit 8-MV-Photonen mit einer Einzeldosis von 1,8 Gy bis zu einer Gesamtdosis von 14,4 Gy. Ergebnisse: Bestrahlungsspezifische Nebenwirkungen wurden weder waehrend der Bestrahlung noch in der Nachsorgephase beobachtet. Sechs Monate nach Bestrahlung kam es bei zwei Patienten (5%) zu einer Visusverbesserung, bei 17 (42,5%) Patienten zu einer Stabilisierung und bei 21 (52,5%) Patienten zu einer Verschlechterung. Nach einem Jahr hatte sich bei sechs (15%) Patienten der Visus stabilisiert, bei 34 (85%) Patienten verschlechterte sich die Sehkraft vergleichbar dem Spontanverlauf. Die mittlere Empfindlichkeit des zentralen Gesichtsfeldes verringerte sich von 16,5 auf 12,4 Dezibel (dB). Das Ausmass der Neovaskularisationen, Exsudationen und Membranbildungen nahm bei beiden Formen um ein Fuenf-, bis Siebenfaches zu. Subjektiv hatte sich nach zwoelf Monaten das Sehvermoegen bei drei (7,5%) Patienten verbessert, bei zwoelf (30%) Patienten stabilisiert und bei 25 (62,5%) Patienten verschlechtert. Schlussfolgerung: Mit einer Gesamtdosis von 14,4 Gy konnte nach zwoelf Monaten kein befriedigender Einfluss auf den Spontanverlauf der Erkankung beobachtet werden. Ehe definitive Rueckschluesse gezogen werden koennen, sollten die Ergebnisse bereits laufender bzw. abgeschlossener Multicenterstudien abgewartet werden. (orig.)

  12. Intraläsionale Therapie niedrig maligner primär kutaner B-Zell-Lymphome mit Anti-CD20-Antikörper: Nebenwirkungen korrelieren mit gutem klinischen Ansprechen.

    Science.gov (United States)

    Eberle, Franziska C; Holstein, Julia; Scheu, Alexander; Fend, Falko; Yazdi, Amir S

    2017-03-01

    Die intraläsionale Gabe von Anti-CD20-Antikörpern (Rituximab) wurde als effektive Therapieoption für Patienten mit niedrig malignen primär kutanen B-Zell-Lymphomen beschrieben. Bis heute wurden allerdings keine Parameter identifiziert, welche reproduzierbar ein gutes klinisches Ansprechen dieser Therapie vorhersagen. Ziel dieser Studie ist, sowohl das klinische Ansprechen und die unerwünschten Nebenwirkungen als auch die Patientenwahrnehmung hinsichtlich intraläsionaler Injektionen von anti-CD20-Antikörpern zur Behandlung indolenter primär kutaner B-Zell-Lymphome im Vergleich mit anderen Therapien zu evaluieren. Elf Patienten mit einem primär kutanen B-Zell-Lymphom, namentlich primär kutanes Keimzentrumslymphom (n = 9) und primär kutanes Marginalzonenlymphom (n = 2), welche mittels intraläsionalem Anti-CD20-Antikörper behandelt wurden, wurden retrospektiv evaluiert hinsichtlich der Ansprechrate und unerwünschter Nebenwirkungen sowie in Bezug auf deren Selbsteinschätzung dieser und anderer Therapien des primär kutanen B-Zell-Lymphoms. Patienten, deren primär kutanes B-Zell-Lymphom mittels intraläsionaler Gabe von Anti-CD20-Antikörper behandelt wurde, zeigten ein komplettes oder partielles Ansprechen in 45 % beziehungsweise 27 % aller Patienten. Speziell Patienten mit grippeähnlichen Symptomen nach erfolgter Injektion zeigten ein gutes Ansprechen. Die Mehrheit der Patienten empfand die Therapie mit Rituximab als die beste Therapie im Vergleich zu anderen Therapien wie beispielsweise chirurgische Exzision oder Radiotherapie. Intraläsionales Rituximab ist eine effektive Therapie mit hoher Patientenzufriedenheit. Starke therapiebedingte Nebenwirkungen wie Fieber, Schüttelfrost und Kopfschmerzen nach Gabe von Rituximab könnten als Indikator für gute Wirksamkeit dienen. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  13. AML (Logistics Center) Local Area Network -

    Data.gov (United States)

    Department of Transportation — The AML LAN is designed to facilitate the services and resources needed to support the operations of the FAA Logistics Center users. The AML LAN provides support for...

  14. Neodadjuvante und adjuvante Kurzzeit-Hormontherapie in Kombination mit konformaler HDR-Brachytherapie beim Prostatakarzinom

    Directory of Open Access Journals (Sweden)

    Martin T

    2004-01-01

    Full Text Available Zielsetzung: Auswertung der Behandlungsergebnisse der neoadjuvanten und adjuvanten Kurzzeit-Hormontherapie kombiniert mit konformaler HDR-Brachytherapie und externer Radiotherapie beim Prostatakarzinom. Patienten und Methoden: Von 01/97 bis 09/99 behandelten wir 102 Patienten mit Prostatakarzinomen im Stadium T1–3 N0 M0. Im Stadium T1–2 befanden sich 71, im Stadium T3 31 Patienten. Der mediane prätherapeutische PSA-Wert betrug 15,3 ng/ml. Nach ultraschallgesteuerter transrektaler Implantation von vier Afterloadingnadeln erfolgte die CT-gestützte 3D-Brachytherapie- Planung. Alle Patienten erhielten vier HDR-Implantate mit einer Referenzdosis von 5 Gy oder 7 Gy pro Implantat. Die Zeit zwischen jedem Implantat betrug jeweils 14 Tage. Nach der Brachytherapie folgte die externe Radiotherapie bis 39,6 Gy oder 45,0 Gy. Alle Patienten erhielten eine neoadjuvante und adjuvante Kurzzeit-Hormontherapie, die 2–19 Monate vor der Brachytherapie eingeleitet und 3 Monate nach Abschluß der externen Radiotherapie abgesetzt wurde (mediane Dauer: 9 Monate. Ergebnisse: Die mediane Nachbeobachtungszeit war 2,6 Jahre (range: 2,0–4,1 Jahre. Die biochemische Kontrollrate betrug 82 % nach 3 Jahren. Bei 14/102 Patienten registrierten wir ein biochemisches Rezidiv, bei 5/102 Patienten ein klinisches Rezidiv. Das Gesamtüberleben betrug 90 %, das krankheitsspezifische Überleben 98,0 % nach 3 Jahren. Ein Patient entwickelte eine prostato-urethro-rektale Fistel als späte Grad 4-Toxizität. Akute Grad-3 Toxizitäten traten bei 4 %, späte Grad-3 Toxizitäten bei 5 % der Patienten auf. Schlußfolgerung: Die neoadjuvante und adjuvante Kurzzeit-Hormontherapie kombiniert mit konformaler HDR-Brachytherapie und externer Radiotherapie erweist sich als sichere und wirksame Behandlungsmodalität beim Prostatakarzinom mit minimalen behandlungsbedingten Toxizitäten und einer vielversprechenden biochemischen Kontrollrate nach medianer Nachbeobachtungszeit von 2,6 Jahren.

  15. Mit kokkeri

    DEFF Research Database (Denmark)

    Ejlersen, Søren; Lorang, Louisa

    MIT kokkeri er resultatet af et samarbejde mellem Komiteen for Sundhedsoplysning, Institut for Uddannelse og Pædagogik/Aarhus Universitet og Haver til Maver. Projektet støttes af Nordea-fonden. Bag kogebogens mange opskrifter står en række erfarne madeksperter bestående af Søren Ejlersen, Louisa...

  16. Applanationstonometrie zur nichtinvasiven kontinuierlichen Blutdruckmessung:Vergleich mit der Fingerlichtplethysmographie bei der Kipptisch-Orthostase Testung und Anwendbarkeit für die ergometrische Blutdruckmessung

    OpenAIRE

    Lammers, D. (Dirk)

    2005-01-01

    Die Applanationstonometrie wird mit der Fingerlichtplethysmographie während der Kipptisch-Testung verglichen und die Nutzbarkeit für die Ergometrie geprüft. 31 Patienten wurden einem Kipptisch Orthostase Test unterzogen. Der Patient erhielt kontinuierliches Blutdruckmonitoring durch Colin CBM 7000 am einen und Ohmeda Finapres am anderen Arm. Gleichzeitig wurden Referenzmessungen mittels Oszillometrie durchgeführt. Bei 22 weiteren Patienten wurden Belastungs-EKG’s durchgeführt. Die applanatio...

  17. Prevalence of iodine- and thyroglobulin-negative findings in differentiated thyroid cancer. A retrospective analysis of patients treated from 1961 to 1998 in a university hospital; Haeufigkeit lod- und hTG-negativer Befunde beim differenzierten Schilddruesenkarzinom. Eine retrospektive Analyse der von 1961 bis 1998 in einer Universitaetsklinik behandelten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Klutmann, S.; Jenicke, L.; Geiss-Toenshoff, M.; Bohuslavizki, K.H.; Mester, J.; Clausen, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin

    2001-10-01

    Aim: The prevalence of iodine- and thyroglobulin-negative findings was evaluated in all patients with differentiated thyroid cancer (DTC) treated from 1961 until 1998 at the Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf. Methods: A total of 490 patients with papillary thyroid cancer (PCA) and 242 patients with follicular thyroid cancer (FCA) were analyzed retrospectively. Patients were divided into four groups: 1: no recurrence, 2: recurrent disease, 3: primary metastatic/progressive disease and 4: inconclusive follow-up. Results of iodine scan, serum-TG, and additional imaging modalities as well as histology were compared in all patients. Results: 21/490 (4,3%) of patients with PCA and 16/242 (6,6%) with FCA suffered from recurrent disease. 62/490 (12,7%) of patients with PCA and 59/242 (24,4%) with FCA had primary metastatic/progressive disease. 12/21 patients with PCA and 12/16 with FCA showing up with recurrent disease had a negative iodinescan. 11/21 of patients with PCA and 4/16 with FCA and tumor recurrence had negative serum-TG levels. 14/62 patients with PCA and 14/59 with FCA presenting with primary metastatic/progressive disease had negative iodinescan. 14/62 patients with PCA and 6/59 with FCA had negative serum-TG. Conclusion: The prevalence of iodine-negative recurrent/metastatic disease is in accordance to the literature, whereas the prevalence of TG-negative recurrent/metastatic was noted higher than reported previously. Thus, the commonly used follow-up scheme of DTC is confirmed. However, iodine scan should be regularly performed in patients with high risk of recurrence. (orig.) [German] Ziel: Retrospektiv wurden alle von 1961 bis 1998 in der Abteilung fuer Nukleamedizin des Universitaetsklinikums Hamburg-Eppendorf behandelten Patienten mit einem differenzierten Schilddruesenkarzinom bezueglich des Anteils lod- und/oder hTG-negativer Rezidive analysiert. Methoden: Es wurden 490 Patienten mit einem papillaeren

  18. Die Aufklärung schwer kranker Patienten im interprofessionellen Kontext [Breaking bad news

    Directory of Open Access Journals (Sweden)

    Schildmann, Jan

    2006-11-01

    ärungsprozesses bei der kognitiven und emotionalen Verarbeitung einer schlechten Nachricht. Empirische Untersuchungen belegen die Effektivität erfahrungsorientierter Lehrveranstaltungen zur Ausbildung kommunikativer Fertigkeiten. In dieser Arbeit wird das Kurskonzept einer interprofessionellen Lehrveranstaltung für Medizinstudenten und Krankenpflegeschüler zur Kommunikation mit schwer kranken Patienten im Aufklärungsprozess vorgestellt. Projektbeschreibung: Die fakultative Lehrveranstaltung wurde seit 2002 sieben Mal mit insgesamt 54 Kursteilnehmenden durchgeführt. Lernziele der Lehrveranstaltung sind die Weiterentwicklung kommunikativer Kompetenzen für Gespräche mit schwer kranken Patienten sowie der Erwerb von Kompetenzen zur konstruktiven Rückmeldung (Feedback. In Ergänzung dazu sollen im Rahmen des interprofessionellen Ansatzes Kenntnisse der berufsgruppenspezifischen Aufgaben im Aufklärungsprozess erworben werden. Gespräche mit Simulationspatienten, Diskussionen in Kleingruppen sowie der Austausch mit klinisch erfahrenen Ärzten und Krankenpflegern sind die Wichtigsten in der Lehrveranstaltung eingesetzten Lehrmethoden. Schlussfolgerung: Das Kursangebot wird von Medizinstudenten und Krankenpflegeschülern gut angenommen. Neben der Analyse des individuellen Gesprächsverhaltens wird die Veranstaltung von den Teilnehmern genutzt, um Möglichkeiten der interprofessionellen Zusammenarbeit bei der Patientenaufklärung zu identifizieren. Es besteht ein Mangel an wissenschaftlichen Arbeiten zur Konzeptionalisierung interprofessioneller Ansätze bei der Patientenaufklärung. Dies ist Voraussetzung für die Definition spezifischer Lehr- und Lernziele interprofessioneller Kursveranstaltungen zum Überbringen schlechter Nachrichten und bildet die Grundlage für zukünftige Evaluationsstudien.

  19. MR imaging of the lateral collateral ligaments after ankle sprain; Aussenbandrupturen des Sprunggelenkes - Darstellung mit der MRT vor und nach funktioneller Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Grebe, P. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Kreitner, K.F. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Roeder, W. [Abt. fuer Chirurgie, St-Hildegardis-Krankenhaus, Mainz (Germany); Kersjes, W. [Klinik fuer Radiologie der Universitaetsklinik, Mainz (Germany); Hennes, R. [Abt. fuer Allgemein- und Unfallchirurgie, St. Josefshospital, Wiesbaden (Germany); Runkel, M. [Unfallchirurgische Klinik der Unversitaetsklinik, Mainz (Germany)

    1995-09-01

    35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [Deutsch] 35 Patienten mit klinischem Verdacht auf Aussenbandruptur wurden mit der MRT untersucht. 13 Patienten wurden operiert, 22 konzervativ therapiert. Letztere wurden nach drei Monaten erneut mit MRT und gehaltenen Aufnahmen untersucht. Die MRT-Befunde stimmten in 12 von 13 Faellen mit den operativ erhobenen Befunden ueberein. Nach dreimonatiger konzervativer Therapie waren alle 22 Sprunggelenke stabil. Die rupturierten Baender stellten sich verdickt und durchgaengig dar. (orig./MG)

  20. ERGEBNISSE DER UNTERSUCHUNG VON HB-AL BEI 94 PATIENTEN MIT NIERENINSUFFIZIENZ

    Directory of Open Access Journals (Sweden)

    A

    1983-05-01

    Full Text Available We have qua nt i t a l ed Hb- Al ~n 125 patients . 74 pa t ient s had chronic Renal Failure . 20 of them had Diabetes wi th Renal Fai lure , 21 Diabetics and 10 patients were evaluat ed as control. We have divided the patients with Renal Failure i n 3 groups according to t heir serum c reatin i ne . Hb-Al in a ll groups "as not correlated wi th serum creat i ne. Hb-Al in Diabetic gr oup was highe r than Diabetic patients with Renal Failure . This group a lso had mor e HbA1 than t he gr oup with Renal ~ailure a nd no Diabetes ,and control group . , Hb-Al was correlated with Blood suger i n all pa t i e nt s s o we can u se"nal Failure the me a sureme nt of Hb-Al i n pati ents with Renunder Dial ys i s with gl ucose solution fo r evalua t i o n of sugar meta boli s m.  

  1. CT coronary angiography in patients with atrial fibrillation; CT-Koronarangiographie bei Patienten mit Vorhofflimmern

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, A.; Sommer, T.; Leiss, A.; Naehle, P.; Schild, H.; Flacke, S. [Universitaetsklinikum Bonn, Radiologische Klinik (Germany); Probst, C.; Welz, A. [Universitaetsklinikum Bonn, Klinik fuer Herzchirurgie (Germany)

    2005-12-15

    Purpose: Reliable visualization of the coronary arteries with multislice spiral CT angiography (MSCTA) in patients with atrial fibrillation (AF) remains a challenge despite retrospective ECG gating. A recently developed new algorithm automatically compensates dynamic changes in the heart rate during the scan, thus reducing misregistration and motion artifacts. The HeartBeat-RT algorithm combines a fixed percent delay determined from the first R wave and the fixed offset delay based on the second R wave in the ECG cycle. The purpose of this study was to find out the optimal reconstruction window in MSCTA in patients with AF for each of the three major coronary arteries during the cardiac cycle. Materials and methods: 20 patients with permanent AF were imaged on a 16-slice scanner (slice collimation: 16 x 0.75 mm; rotation time 0.42 s; 140 kV; 380 mAs; 120 ml Ultravist 370 {sup registered} i.v.). The patients had not received any previous drugs for heart frequency regulation. Acquisition was started after bolus tracking of a biphasic bolus of 120 ml Ultravist 370 injected intravenously. Each coronary segment was reconstructed at 0%-90% of the cardiac cycle in increments of 10%. For image analysis we used coronary segments as defined by the American Heart Association. Two blinded independent readers assessed the image quality in terms of visibility and artifacts (five-point rating scale 1=very poor, 2=poor, 3=fair, 4=good and 5=excellent) and the degree of stenosis (five-point rating scale 1=0%, 2=1%-49%, 3=50%-74%, 4=75%-99%, 5=100%) on axial slices, multiplanar reconstructions and three-dimensional volume-rendered images. (orig.)

  2. EEG-Korrelate der Aufmerksamkeit bei Gesunden und Patienten mit Hirnschädigung

    DEFF Research Database (Denmark)

    Wiegand, Iris; Keller, Ingo

    2009-01-01

    -activity (theta-beta ratio) is a suitable variable for neurofeedback therapy.A correlation analysis revealed statistically significant correlations above 0.7 between the theta-beta ratio and error rate and the theta beta ratio and number of correct reactions in healthy subjects. The correlation between theta...... performance on the other hand were lower and statistically not significant. Our results suggest that the theta-beta ratio seems to be a good indicator for attention in healthy subjects and brain-injured patients with attention deficits. It is proposed to use the theta-beta ratio for neurofeedback training....

  3. Cross-disciplinary management of polytrauma patients: radiological screening and comparison; Interdisziplinaeres Management von polytraumatisierten Patienten: Beitrag der Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Messmer, P. [Universitaetskliniken Basel, Dept. Chirurgie, Allgemeinchirurgische Klinik, Abt. Traumatologie (Switzerland); Loew, R.; Jacob, A.L. [Universitaetskliniken Basel, Dept. Medizinische Radiologie, Abt. Diagnostische Radiologie (Switzerland)

    2001-09-01

    The comprehensive survey addresses the various modalities available today for trauma screening and presents a comparative assessment of their value in respect of type of trauma and evidence provided. (orig./CB) [German] Die Versorgung polytraumatischer Patienten stellt hoechste Anforderungen an das Koennen des Radiologen. Neben einer schnellen und schonenden Durchfuehrung der notwendigen Diagnostik darf keine potenziell lebensbedrohende Verletzung uebersehen werden. Die Kriterien fuer eine rationelle Diagnostik wurden im ATLS-Kurs (Advanced Trauma Life Support) zusammengefasst. Es gilt, die sog. 'golden hour' moeglichst effektiv fuer die Primaerdiagnostik und -therapie zu nutzen. Haeufige Verletzungsformen beim Polytrauma sind das Schaedel-Hirn-Trauma, Thoraxverletzungen, Milzverletzungen, Leberverletzungen und Frakturen von Becken, Wirbelsaeule und Extremitaeten. Die Primaere und Sekundaere Radiologische Diagnostik ist abhaengig von der Ausstattung der Klinik und besteht aus einer abdominellen Sonographie, Thorax ap, Beckenuebersicht ap, Halswirbelsaeule seitlich sowie falls vorhanden aus CT und Angiographie. Ein definitiver Schritt zur Verkuerzung der Zeit bis zur Behandlung waeren sterile OP-Einheiten mit integrierter Roentgendiagnostik (moeglichst nativ und CT), die ein staendiges Umlagern und Transportieren des Patienten verhindern koennten. (orig.)

  4. Osteolytic Bone Lesions - A Rare Presentation of AML M6.

    Science.gov (United States)

    Geetha, N; Sreelesh, K P; Priya, M J; Lali, V S; Rekha, N

    2015-01-01

    Acute myeloid leukemia (AML) M6 is a rare form of AML accounting for M6 before. We discuss the case of a 17 year old boy with AML M6, who presented with osteolytic lesion of right humerus. He was treated with induction and consolidation chemotherapy. The present case is the first report in literature of AML M6 presenting with skeletal lesions.

  5. Modified double contrast-enhanced examination of the stomach of adipose patients after vertical gastroplasty; Modifizierte Doppelkontrast-Untersuchung des Magens bei adipoesen Patienten nach vertikaler Gastroplastie

    Energy Technology Data Exchange (ETDEWEB)

    Raissaki, M.T. [Institut fuer Bildgebende Diagnostik, Universitaetsklinik Heraklion (Greece); Prassopoulos, P. [Institut fuer Bildgebende Diagnostik, Universitaetsklinik Heraklion (Greece); Hatjidakis, A.A. [Institut fuer Bildgebende Diagnostik, Universitaetsklinik Heraklion (Greece); Christodoulakis, M. [Klinik fuer Chirurgische Onkologie der Universitaetsklinik Heraklion (Greece); Melissas, J. [Klinik fuer Chirurgische Onkologie der Universitaetsklinik Heraklion (Greece); Gourtsoyiannis, N.C. [Institut fuer Bildgebende Diagnostik, Universitaetsklinik Heraklion (Greece)

    1995-11-01

    The study reported covers 28 patients who were examined once by radiology before surgery, and twice after surgery. The first post-surgery examination was done on days 5-7, the second during the 4th until 6th month after surgery. For the first examination, water-soluble contrast agent was initially applied, then barium containing contrast agent. The second examination was done by modified double contrast technique. The most frequent, pre-surgery findings revealed gastro-esophageal reflux in 13 patients. The first post-surgery control detected a somastenosis in 2 patients, while the second control examination detected complications of various nature in 11 patients and gastro-esophageal reflux in 5 patients. In 6 patients, discrepancy between clinical and radiological findings was stated. The pouch size did not correlate with the frequency of complications, or with the body-to-mass index decrease. The examination method proposed in this article yields pre-surgery information on the anatomy of the stomach, more accurate dewscription of post-surgery complications, and better evaluation of the antireflux effect of the vertical gastroplasty. (orig.) [Deutsch] In der Studie wurden 28 Patienten einmal praeoperativ und zweimal postoperativ roentgenologisch kontrolliert. Die erste postoperative Kontrolle fand am 5.-7. Tag und die zweite im 4.-6. Monat nach dem Eingriff statt. Bei der ersten Kontrolle wurde zuerst wasserloesliches und anschliessend bariumhaltiges Kontrastmittel benutzt, waehrend bei der zweiten Kontrolle eine modifizierte Doppelkontrast-Untersuchung durchgefuehrt wurde. Der haeufigste praeoperative Befund war der gastrooesophageale Reflux bei 13 Patienten. Bei der ersten praeoperativen Kontrolle fand sich bei 2 Patienten eine Stomastenose, waehrend bei der zweiten verschiedene Komplikationen bei 11 sowie gastrooesophagealer Reflux bei 5 Patienten vorlagen. Eine Diskrepanz zwischen radiologischen und klinischen Befunden fanden wir bei 6 Patienten. Die

  6. Initial diagnosis of therapeutically relevant thoracic lesions in polytraumatised patients; Zur Akutdiagnostik therapierelevanter Thoraxverletzungen bei schwer- und polytraumatisierten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Danz, B. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Biehl, C. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Baehren, W. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany)

    1996-04-01

    To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients. 303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes. The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%). Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time. (orig.) [Deutsch] Das Ziel dieser retrospektiven Untersuchung bestand darin, die Wertigkeit der a.p. Thoraxaufnahme im Liegen im Vergleich zur orientierenden Computertomographie der Thoraxorgane im Rahmen der Akutdiagnostik bei schwer- und polytraumatisierten Patienten zu analysieren. Im Zeitraum von 1988 bis 1993 bestand bei 303 Patienten wegen eines Schaedel-Hirn-Traumas die primaere Indikation zu einem CCT. Im Anschluss an das CCT wurde routinemaessig ein orientierendes CT der Thoraxorgane mit im Durchschnitt 6 Schichten ohne Umlagerung und einem medianen Zeitaufwand von 4 Minuten durchgefuehrt. Die Befunde des CT des Thorax wurden mit den Ergebnissen der durchgefuehrten a.p. Thoraxliegendaufnahmen im Hinblick auf die Erfassung therapierelevanter pathologischer Veraenderungen verglichen. Die Sensitivitaet fuer die Erkennung eines Pneumothorax in

  7. Einsatz und Wirksamkeit von Systemtherapien bei Erwachsenen mit schwerer Neurodermitis: Erste Ergebnisse des deutschen Neurodermitis-Registers TREATgermany.

    Science.gov (United States)

    Schmitt, Jochen; Abraham, Susanne; Trautmann, Freya; Stephan, Victoria; Fölster-Holst, Regina; Homey, Bernhard; Bieber, Thomas; Novak, Natalija; Sticherling, Michael; Augustin, Matthias; Kleinheinz, Andreas; Elsner, Peter; Weidinger, Stephan; Werfel, Thomas

    2017-01-01

    Versorgungsregister dienen der Erfassung des Einsatzes und der Wirksamkeit von Therapien unter realen Versorgungsbedingungen und sind als Basis einer evidenzbasierten Gesundheitsversorgung unverzichtbar. Das deutsche Neurodermitis-Register TREATgermany wurde als weltweit erstes Register für Patienten mit schwerer Neurodermitis 2011 initiiert. Erwachsene mit schwerer Neurodermitis (aktuelle/frühere antientzündliche Systemtherapie und/oder objektiver SCORAD ≥ 40) werden über einen Zeitraum von 24 Monaten prospektiv beobachtet. Anhand validierter Erhebungsinstrumente werden die klinische Erkrankungsschwere (EASI, SCORAD), Lebensqualität (DLQI), Symptome, globale Erkrankungsschwere sowie die Patientenzufriedenheit erfasst und die durchgeführten Therapien dokumentiert. Die vorliegende Analyse beschreibt die Charakteristika, Therapiewahl und Wirksamkeit der eingesetzten antiinflammatorischen Systemtherapien der bis Oktober 2014 eingeschlossenen Patienten. An fünf Zentren wurden insgesamt 78 Patienten (Durchschnittsalter 39 Jahre, 61 % männlich) eingeschlossen. Bei den Patienten besteht eine hohe Inanspruchnahme ambulanter und stationärer Leistungen. Ciclosporin war das am häufigsten eingesetzte Systemtherapeutikum und zeigte die höchste klinische Effektivität (EASI-50-Ansprechrate 51 %; EASI-75-Ansprechrate 34 % nach zwölfwöchiger Therapie). Azathioprin, Methotrexat (MTX), Prednisolon oral, Mycophenolat, Alitretinoin und Leflunomid wurden ebenfalls bei einzelnen Patienten eingesetzt. Die vorliegende Registerauswertung gibt wichtige Hinweise zur derzeitigen Versorgung von Erwachsenen mit schwerer Neurodermitis in Deutschland, dokumentiert die hohe Erkrankungslast, den Nutzen vorhandener Therapien und den Bedarf an weiteren, effektiven und in der Langzeitanwendung sicheren Therapieoptionen. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  8. WHO HAS THERAPY-RELATED AML?

    Directory of Open Access Journals (Sweden)

    Robert Gale

    2017-03-01

    Full Text Available Therapy-related leukemia or therapy-related myeloid neoplasm are widely-used terms to designate leukemia developing in persons who previously received anti-cancer therapy (for example, see references 1, 2, especially if the prior anti-cancer therapy included drugs such as alkylators, DNA-intercalators, topoisomerase-2-inhibitors, purines and/or ionizing radiations.   Sometimes specific genes such as AML1, EVI1, NRAS or MLL are mutated by therapy or gene variants are produced which activate mutagens or interfere with DNA repair, such FANC, NQ01 or AML2. 3-5   But how can we know if AML in someone is a therapy-related? Keywords: Therapy-related leukemia; alkylators; ionizing radiations; Topoisomerase Inhibitors; DNA Repair

  9. Psychometric properties of the stress index radiooncology (SIRO) - a new questionnaire measuring quality of life of cancer patients during radiotherapy; Psychometrische Eigenschaften des Stress Index RadioOnkologie (SIRO) - ein neuer Fragebogen zur Erfassung der Lebensqualitaet bei Patienten unter Strahlentherapie

    Energy Technology Data Exchange (ETDEWEB)

    Sehlen, S.; Fahmueller, H.; Lenk, M.; Duehmke, E. [Klinik und Poliklinik fuer Strahlentherapie, Ludwig-Maximilians-Univ., Klinikum Grosshadern, Muenchen (Germany); Herschbach, P. [Inst. und Poliklinik fuer Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie, Technische Univ., Muenchen (Germany); Aydemir, U. [Inst. fuer Biometrie und Epidemiologie, Ludwig-Maximilians-Univ., Klinikum Grosshadern, Muenchen (Germany)

    2003-04-01

    Purpose: In the course of radiotherapy oncological patients often experience considerable psychosocial distress. For its measurement however, no specific questionnaire is available. The stress index radiooncology (SIRO), which is based upon the results of extensive preliminary studies, will be made available as a screening-instrument to facilitate measurement of psychosocial distress of cancer patients, including radiotherapy-induced distress. The aim of this study is, to psychometrically evaluate the preliminary version of the questionnaire, to transfer it to the final version (SIRO) and to gain information about the psychosocial distress of radiooncological patients at the beginning of radiotherapy. Patients and Methods: 104 cancer patients (18 to 85 years) with different diagnoses have been included in the study (Table 1). The data have been assessed by means of the preliminary version of the new questionnaire SIRO, the HADS, EORTC QLQ-C30 and LS. With 25 patients semistructured clinical interviews have been conducted. (orig.) [German] Hintergrund: Die strahlentherapeutische Behandlung von Tumorpatienten ist haeufig mit starken psychosozialen Belastungen verbunden, fuer deren Erfassung es bisher keinen spezifischen Fragebogen gibt. Mit dem stress index radioonkologie (SIRO), der auf den Analyseergebnissen umfangreicher Voruntersuchungen beruht, soll erstmals ein Screening-Instrument zur Verfuegung gestellt werden, mit dem die psychosozialen Belastungen von Tumorpatienten, einschliesslich der durch Strahlentherapie induzierten, erfasst werden koennen. Ziel dieser Studie ist, die Fragebogen-Vorform psychometrisch zu evaluieren und in die endgueltige Fragebogenversion (SIRO) zu ueberfuehren. Darueber hinaus sollen Informationen ueber das psychosoziale Belastungsprofil radioonkologischer Patienten zu Beginn einer Strahlentherapie gewonnen werden. Patienten und Methoden: 104 Tumorpatienten (18-85 Jahre) mit unterschiedlichen Diagnosen wurden in die Studie aufgenommen

  10. Ergebnissse nach arthroskopisch assistiert durchgeführter vorderer Kreuzbandplastik mit Semitendinosussehne als Triple-Implantat in Single-Incision-Technik und femoraler Endobutton-Fixation : Nachuntersuchungen über einen Zeitraum von 1 Jahr

    OpenAIRE

    Seel, Matthias

    2004-01-01

    Das Ziel dieser Arbeit ist die Überprüfung des Stabilitätsgewinnes infolge einer operativen Therapie des rupturierten vorderen Kreuzbandes mit einer ipsilateralen autogenen, femoral mit einem Endobutton fixierten, Semitendinosussehne als Dreifachschlinge bei 103 Patienten, die in der Zeit vom Juli 1993 bis zum Januar 1995 an der Orthopädischen Klinik der Justus-Liebig-Universität in Gießen operiert wurden. Des weiteren sollten im Rahmen dieser Arbeit geschlechtsspezifische Unterschiede, Unter...

  11. AML (Advanced Mud Logging: First Among Equals

    Directory of Open Access Journals (Sweden)

    T. Loermans

    2017-09-01

    Full Text Available During the past ten years an enormous development in mud logging technology has been made. Traditional mud logging was only qualitative in nature, and mudlogs could not be used for the petrophysical well evaluations which form the basis for all subsequent activities on wells and fields. AML however can provide quantitative information, logs with a reliability, trueness and precision like LWD and WLL. Hence for well evaluation programmes there are now three different logging methods available, each with its own pros and cons on specific aspects: AML, LWD and WLL. The largest improvements have been made in mud gas analysis and elemental analysis of cuttings. Mud gas analysis can yield hydrocarbon fluid composition for some components with a quality like PVT analysis, hence not only revolutionising the sampling programme so far done with only LWD/WLL, but also making it possible to geosteer on fluid properties. Elemental analysis of cuttings, e.g. with XRF, with an ability well beyond the capabilities of the spectroscopy measurements possible earlier with LWD/WLL tools, is opening up improved ways to evaluate formations, especially of course where the traditional methods are falling short of requirements, such as in unconventional reservoirs. An overview and specific examples of these AML logs is given, from which it may be concluded that AML now ought to be considered as “first among its equals”.

  12. Pneumonia in immunosuppressed patients; Pneumonien bei immunsupprimierten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Solyanik, O.; Gaass, T.; Hellbach, K. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer klinische Radiologie, Muenchen (Germany); Dinkel, J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer klinische Radiologie, Muenchen (Germany); Comprehensive Pneumology Center Munich (CPC-M), Muenchen (Germany)

    2017-01-15

    Pulmonary infections are a common complication in immunosuppressed patients with a frequently fatal prognosis despite modern prophylactic therapy. An early and correct diagnosis is important for initiation of the appropriate therapy. Chest radiography is the preferred initial imaging examination but is not accurate enough for the detection of pulmonary infections in immunosuppressed patients. Pneumonia is caused by a broad spectrum of pathogens in immunocompromised patients. In addition to imaging, the clinical history and epidemiology also play an important role in the diagnostics. Using epidemiological and anamnestic information, computed tomography (CT) shows a significantly better sensitivity and specificity particularly for the diagnosis of atypical forms of pneumonia. Due to the exact imaging of the different infiltration patterns CT provides an increased sensitivity with respect to the etiological classification of pulmonary infections. This article reviews in particular the radiological findings of commonly occurring pulmonary infections in immunosuppressed patients. (orig.) [German] Pneumonien bei immunsupprimierten Patienten sind haeufige Komplikationen, die trotzt moderner Prophylaxe toedlich verlaufen koennen. Eine korrekte Diagnose ist daher von entscheidender Bedeutung, um die richtige Therapie einleiten zu koennen. Die Roentgenthoraxaufnahme ist selten spezifisch genug fuer die genaue Einordnung atypischer Pneumonien in Folge einer Immunsuppression. Pneumonien unter Immunsuppression werden durch ein sehr breites Erregerspektrum verursacht. Eine wichtige Rolle bei der Diagnosefindung spielen neben der Bildgebung auch die klinische Anamnese und Epidemiologie. Mithilfe der klinischen Anamnese und Epidemiologie bietet die Computertomographie (CT) bei immunsupprimierten Patienten zum einen eine erhoehte Sensitivitaet bei der Detektion insbesondere atypischer Pneumonien. Zum anderen weist die CT durch die exakte Abbildung unterschiedlicher Infiltratmuster

  13. Rekonstruktion mit Netz beim komplexen Prolaps der Frau: Was hilft es der Patientin wirklich?

    Directory of Open Access Journals (Sweden)

    Hierl J

    2010-01-01

    Full Text Available Einleitung: Der komplexe Genitaldeszensus der Frau geht oftmals mit einer deutlichen Einschränkung der Lebensqualität (LQ einher. Dennoch ist der Endpunkt der meisten klinischen Analysen rein anatomischer und funktioneller Natur. In der vorliegenden Untersuchung wurden die Einflüsse der operativen Rekonstruktion mit einem Netz prospektiv auf die LQ evaluiert. Patienten und Methoden: Bei insgesamt 111 Patientinnen mit Deszensus erfolgte zwischen 08/2005 und 12/2007 eine operative Versorgung mittels vaginaler Netzeinlage (anteriorer bzw. kompletter Mesh-Repair. Die LQ wurde prospektiv prä- und postoperativ anhand standardisierter LQ-Fragebögen erfasst. Ergebnisse: Präoperativ zeigte sich bei den Patientinnen eine signifikant reduzierte LQ gegenüber einem Normalkollektiv (p 0,01. Bei 7 % der Patientinnen mit anteriorem, und bei 11 % mit komplettem Mesh-Repair lag postoperativ kein adäquates klinisches Ergebnis vor. In diesem Kollektiv zeigte sich kein signifikanter Unterschied in den LQ-Tests prä- und postoperativ. Bei gutem postoperativem Ergebnis zeigte sich in der Gruppe mit anteriorer Netzeinlage lediglich bei 45 % (p = 0,021, bei kompletter Netzeinlage nur bei 31 % (p = 0,041 eine signifikant verbesserte LQ. Bei kleiner Fallzahl und kurzem Nachbeobachtungszeitraum kann eine gültige Aussage bezüglich der LQ nach Deszensuschirurgie mit Netzeinlage jedoch noch nicht getroffen werden.

  14. Radiation therapy in old patients. Side effects and results of radiation therapy in old patients; Strahlentherapie des alten Patienten. Vertraeglichkeit und Ergebnisse der Strahlentherapie aelterer Personen

    Energy Technology Data Exchange (ETDEWEB)

    Geinitz, H.; Zimmermann, F.B.; Molls, M. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

    1999-03-01

    leads to extensive atherosclerotic vessel damage should be kept in mind. Old patients should be monitored closely during therapy, since the loss of electrolytes or fluid is often not very well tolerated. Conclusion: The indication to radiation therapy of elderly cancer patients should take into account their performance status as well as the extent and the severity of comorbidity. Age per se is seldom a contraindication for radiation therapy. Regarding the available data in literature there is no indication for a dose reduction in radiation therapy only because of age, especially in the curative setting. (orig.) [Deutsch] Hintergrund: Die Anzahl alter Patienten in der Strahlentherapie steigt mit der zunehmenden Alterung der Bevoelkerung. Dennoch werden die damit verbundenen Fragen zur Vertraeglichkeit und Effektivitaet einer Strahlenbehandlung alter Menschen selten diskutiert. Material und Methode: Die Ergebnise einer Literaturrecherche zu epidemiologischen Daten, strahlenbiologischen Aspekten und Ergebnissen der Strahlentherapie alter Patienten werden dargestellt. Ergebnisse: Mit zunehmendem Alter nimmt die Krebsinzidenz zu. Sie liegt bei Maennern aelter als 85 Jahre bei ca. 3,5%. Bei einer durchschnittlichen Lebenserwartung von mehr als vier Jahren ist auch in dieser Altersgruppe der Einsatz einer kurativen Strahlentherapie sinnvoll. Ausserdem deuten verschiedene retrospektive Studien darauf hin, dass die Raten an lokaler Tumorkontrolle und krankheitsspezifischem Ueberleben nach Strahlentherapie mit denen juengerer Patienten vergleichbar sind. Eine Ausnahme bilden unter anderem aeltere Patienten mit Gliomen Grad III bis IV und mit Rektumkarzinom, die ein schlechteres Ueberleben aufweisen. Dieses ist eventuell auf eine weniger aggressive Kombinationstherapie (Tumorresektion) zurueckzufuehren. Obwohl strahlen- und molekularbiologische Daten auf einen Anstieg der Strahlenempfindlichkeit mit zunehmendem Alter hinweisen, wie zum Beispiel das Nachlassen der Kapazitaet

  15. RECHTE VON PERSONEN MIT SEELISCHEN STÖRUNGEN IN PSYCHIATRISCHEN ANSTALTEN DER REPUBLIK KROATIEN - EINE EMPIRISCHE ANALYSE

    Directory of Open Access Journals (Sweden)

    Dalida Rittossa

    2017-01-01

    Full Text Available Nachdem man im Bereich psychischer Gesundheit zu zahlreichen wissenschaftlichen Erkenntnissen gekommen ist, ist es heutzutage völlig klar, dass die Achtung der Rechte psychiatrischer Patienten und die Bedingungen derer Unterbringung in psychiatrischen Anstalten einerseits und der Erfolg in der Behandlung, Deinstitutionalisierung und Destigmatisierung von Patienten andererseits direkt miteinander verbunden sind. In den letzten Jahren aber weisen die Berichte der Bürgerbeauftragten und der Beauftragten für Behinderte sowie auch zahlreiche Urteile des Europäischen Gerichtshofs für Menschenrechte hinsichtlich der Beschwerden von Personen mit seelischen Störungen auf schlechte Bedingungen der Unterbringung und Behandlung von Patienten in psychiatrischen Anstalten der Republik Kroatien hin. Deshalb stellte sich als rechtfertigend heraus, das Ausmaß der Verwirklichung der Rechte psychiatrischer Patienten sowie auch die Bedingungen derer Behandlung zu erforschen. Zu diesem Zweck wurde die Forschung in der Klinik für Psychiatrie „Vrapče“, im psychiatrischen Krankenhaus Rab, im Neuropsychiatrischem Krankenhaus „Dr. Ivan Barbot“ Popovača und im Psychiatrischen Krankenhaus Ugljan durchgeführt, den einzigen psychiatrischen Krankenhäusern in der Republik Kroatien mit Abteilungen für schuldunfähige Personen, welchen nach der Entscheidung des Strafgerichts eine Verwahrung angeordnet wurde. Dabei wurden zwei Fragebögen benutzt: der Basisfragebogen für die Leiter von psychiatrischen Anstalten und der anonyme Fragebogen für eine Patientengruppe von 80 Patienten. Ziel dieser Arbeit ist es, die durch Fragebogen aufgezeigten Ergebnisse zu analysieren.

  16. Cytoprotection with amifostine in the simultaneous radio-chemotherapy of recurrent head and neck cancer; Zytoprotection mit Amifostin im Rahmen der Radiochemotherapie bei vorbestrahlten Kopf-Hals-Karzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Buentzel, J.; Weinaug, R.; Kuettner, K. [Zentralklinikum gGmbH Suedthueringen, Suhl (Germany). Klinik fuer Hals-Nasen-Ohren-Heilkunde, Plastische Operationen; Glatzel, M.; Froehlich, D. [Zentralklinikum gGmbH Suedthueringen, Suhl (Germany). Klinik fuer Strahlentherapie; Schuth, J. [Essex Pharma, Muenchen (Germany)

    1999-11-01

    diese Situation aendert, ist Gegenstand der vorgelegten Analyse erster eigener Erfahrungen. Patienten und Methode: Zwischen 1995 und 1997 unterzogen wir 14 Patienten mit einem Rezidiv- oder Zweitkarzinom des HNO-Gebiets einer nochmaligen Radiochemotherapie (20mal, 1,5 Gy, Carboplatin 70 mg/m{sup 2} an Tag 1 bis 5 und 16 bis 20 der Bestrahlung, 500 mg Amifostin vor jeder Carboplatin-Infusion). 6/14 Patienten erhielten zur weiteren Dosisaufsaettigung eine zusaetzliche Brachytherapie (10 bis 15 Gy). Bei vier der 14 Patienten erfolgte die Radiochemotherapie nach chirurgischem Tumor-Debulking. Resultate: Wir erreichten mit der multimodalen Behandlung drei komplette (21,4%) and acht partielle Remissionen (57,1%). Bei einer medianen Beobachtungsdauer von 13 Monaten sind derzeit 3/14 Patienten verstorben. Haematologische Nebenwirkungen Grad 2 der WHO sahen wir bei einem Patienten. Akute nichthaematologische Nebenwirkungen waren: Mukositis Grad 0/1 bei sieben Patienten, Mukositis Grad 2 bei sieben Patienten, Dysphagie Grad 0/1 bei neun Patienten, Dysphagie Grad 2 bei fuenf Patienten, Xerostomie Grad 1 bei neun Patienten, Xerostomie Grad 2 bei drei Patienten. Einzige schwerwiegende Spaetnebenwirkung war bisher die Ausbildung einer submentalen Fistel im Pharynxtrichter eines laryngektomierten Patienten vier Monate nach Abschluss einer Brachytherapie. Schlussfolgerung: Diese ersten Ergebnisse deuten auf eine moegliche Erweiterung der Behandlungsmoeglichkeiten von Rezidivkarzinomen im Kopf-Hals-Gebiet hin, wenn das selektive Zytoprotektivum Amifostin in eine nochmalige Radiochemotherapie integriert wird. (orig.)

  17. Marketing mit Youtube

    OpenAIRE

    Nufer, Gerd; Kaps, Anne

    2017-01-01

    Die Video-Plattform Youtube ist eine der meistbesuchten Webseiten weltweit. Youtube-Stars erreichen mit ihren Videos große Zuschauergruppen und können als Multiplikatoren für Werbebotschaften dienen. Sie sind oftmals Meinungsführer, denen hohes Vertrauen entgegengebracht wird, weshalb sie sich sehr gut für Influencer-Marketing eignen. Marketing mit Youtube ermöglicht eine offene, mehrwegige, schnelle und kostengünstige Kommunikation mit Kunden, insbesondere jüngeren. Unternehmen können sich d...

  18. MITS machine operations

    International Nuclear Information System (INIS)

    Flinchem, J.

    1980-01-01

    This document contains procedures which apply to operations performed on individual P-1c machines in the Machine Interface Test System (MITS) at AiResearch Manufacturing Company's Torrance, California Facility

  19. Kommunikation mit Mitarbeitern

    Science.gov (United States)

    Spychala, Anne; Fleischmann, Jürgen

    Kommunikation ist der Austausch von Nachrichten und Informationen zwischen Mitarbeitern eines Unternehmens (O'Hair et al. 1997). Dieser Austausch kann persönlich, aber z.B. auch per Telefon, E-Mail oder durch Computersysteme erfolgen. In diesem Kapitel betrachten wir die persönliche Kommunikation zwischen Vorgesetzten und Mitarbeitern. Zur persönlichen Kommunikation mit Mitarbeitern zählen sowohl formelle Gespräche mit Mitarbeitern als auch eher informelle Gespräche zwischen Tür und Angel. Die Gespräche können dabei mit einzelnen Mitarbeitern (z.B. jährliches Mitarbeitergespräch) oder mit Gruppen von Mitarbeitern (z.B. regelmäßige Projekt- oder Teambesprechungen) stattfinden.

  20. Predictive parameters of infectiologic complications in patients after TIPSS; Praediktive Parameter infektiologischer Komplikationen bei Patienten nach TIPSS-Anlage

    Energy Technology Data Exchange (ETDEWEB)

    Cohnen, M.; Saleh, A.; Moedder, U. [Institut fuer Diagnostische Radiologie, Universitaetsklinikum Duesseldorf (Germany); Luethen, R.; Bode, J.; Haeussinger, D. [Klinik fuer Gastroenterologie, Hepatologie und Infektiologie, Universitaetsklinikum Duesseldorf (Germany); Daeubener, W. [Institut fuer Mikrobiologie und Virologie, Universitaetsklinikum Duesseldorf (Germany)

    2003-02-01

    Aim To define predictive parameters of a complicated clinical course after the TIPSS procedure. Blood cultures were drawn prospectively in 41 patients from a central line and from the portal venous blood before stent placement as well as from the central line 20 min after intervention. C-reactive proteine (CRP) (mg/dl) and white blood cell count (WBC,/{mu}l) on the day of TIPSS-procedure (d0), the first (d1) and seven (d7) days after TIPSS were compared in patients with a complicated clinical course (spontaneous bacterial peritonitis, pneumonia, sepsis; group I) to patients without clinical complications (group II) Group I showed a significant increase in CRP (d0: 1.8{+-}1.0; d1: 3.2{+-}1.5; d7: 4.3{+-}3.2), and white blood cell count (d0: 7700{+-}2600; d1: 10800{+-}2800; d7: 7500{+-}1800) on the first day after TIPSS-procedure in comparison to group II (CRP: d0: 1.6{+-}0.6; d1: 1.8{+-}1.0; d7: 1.9{+-}0.6. WBC: d0: 6900{+-}1500; d1: 8000{+-}1600; d7: 7600{+-}1400).Microbiological analysis showed in 12% skin or oral flora in the last sample. The course of CRP and WBC-count during the first week after TIPSS procedure may indicate patients with a potential risk of a complicated clinical course. (orig.) [German] Fragestellung Definition praediktiver Parameter infektiologischer Komplikationen bei Patienten nach TIPSS-Anlage.Methodik Bei 41 Patienten wurden Blutproben prospektiv vor intrahepatischer Stentanlage zentralvenoes und portalvenoes sowie 20 min postinterventionell erneut zentralvenoes entnommen und mikrobiologisch analysiert. C-reaktives Protein (CRP) (mg/dl) und Leukozytenzahl (/{mu}l) wurden am Interventionstag (d0), am 1. (d1) sowie 7 Tage (d7) postinterventionell bestimmt. Patienten mit kompliziertem Verlauf (spontane bakterielle Peritonitis,Pneumonie, Sepsis; Gruppe 1) wurden von Patienten ohne klinische Komplikationen (Gruppe 2) unterschieden.Ergebnisse Gruppe 1 wies einen signifikanten Anstieg des CRP (d0: 1,8{+-}1,0; d1: 3,2{+-}1,5; d7: 4,3{+-}3,2) und

  1. Virtuelle Patienten: Wie werden sie aus Sicht von Medizinstudierenden am besten eingesetzt? [Virtual patients: Which kind of teaching method is most attractive to medical students?

    Directory of Open Access Journals (Sweden)

    Riemer, Martin

    2013-11-01

    Full Text Available [english] “Virtual Patients” (VPs enable medical students to simulate a patient encounter before their first real patient contact. Later they can also be used to assess and train students’ abilities to recognize and treat selected diseases. This is especially valuable as medical schools are normally linked to maximum medical care hospitals with increasing difficulties to present patients with less serious medical conditions to their students . Five different approaches were taken to find out which is the best way to use VPs in medical education. From the student’s points of view best results can be achieved in the majority of cases when students worked in groups of two up to about ten. [german] „Virtuelle Patienten“ (VP ermöglichen es Medizinstudierenden eine Begegnung mit Patienten zu simulieren, bevor sie ihren ersten realen Patientenkontakt haben. Später im Studium können VP genutzt werden, um ausgewählte Krankheiten zu erkennen oder deren Behandlung zu üben. Dies ist besonders wichtig, weil in Ausbildungskrankenhäusern der Maximalversorgung immer weniger Patienten mit normalen Erkrankungen als Beispiel für die Studierenden zu finden sind . Fünf verschiedene Ansätze wurden genutzt um herauszufinden, auf welche Art man VP am besten in der medizinischen Ausbildung einsetzen kann. Aus der Sicht der Studierenden können in der Mehrzahl der Fälle die besten Ergebnisse erzielt werden, wenn Studierende in Gruppen von zwei bis zu ungefähr zehn Personen unterrichtet werden.

  2. Osteoblasts Protect AML Cells from SDF-1-Induced Apoptosis

    Science.gov (United States)

    Kremer, Kimberly N.; Dudakovic, Amel; McGee-Lawrence, Meghan E.; Philips, Rachael L.; Hess, Allan D.; Smith, B. Douglas; van Wijnen, Andre J.; Karp, Judith E.; Kaufmann, Scott H.; Westendorf, Jennifer J.; Hedin, Karen E.

    2014-01-01

    The bone marrow provides a protective environment for acute myeloid leukemia (AML) cells that often allows leukemic stem cells to survive standard chemotherapeutic regimens. Targeting these leukemic stem cells within the bone marrow is critical for preventing relapse. We recently demonstrated that SDF-1, a chemokine abundant in the bone marrow, induces apoptosis in AML cell lines and in patient samples expressing high levels of its receptor, CXCR4. Here we show that a subset of osteoblast lineage cells within the bone marrow can protect AML cells from undergoing apoptosis in response to the SDF-1 naturally present in that location. In co-culture systems, osteoblasts at various stages of differentiation protected AML cell lines and patient isolates from SDF-1-induced apoptosis. The differentiation of the osteoblast cell lines, MC3T3 and W-20-17, mediated this protection via a cell contact-independent mechanism. In contrast, bone marrow-derived mesenchymal cells, the precursors of osteoblasts, induced apoptosis in AML cells via a CXCR4-dependent mechanism and failed to protect AML cells from exogenously added SDF-1. These results indicate that osteoblasts in the process of differentiation potently inhibit the SDF-1-driven apoptotic pathway of CXCR4-expressing AML cells residing in the bone marrow. Drugs targeting this protective mechanism could potentially provide a new approach to treating AML by enhancing the SDF-1-induced apoptosis of AML cells residing within the bone marrow microenvironment. PMID:24851270

  3. Practical radiation protection of the patient in radiological diagnostics; Praktischer Strahlenschutz am Patienten in der radiologischen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Fiebich, M. [Technische Hochschule Mittelhessen, Institut fuer Medizinische Physik und Strahlenschutz, Giessen (Germany)

    2017-07-15

    The use of radiation protection equipment can reduce the radiation exposure of patients. The aim was to show which patient shields should be used for the different types of examination. The results of multiple studies were compiled and analyzed and recommendations made for the use of patient shields. The absolute dose values and the protective effect were considered. Radiological protection should be used in many investigations; particularly in the case of CT investigations, a reasonable dose reduction potential exists due to the higher radiation dose. Based on these recommendations, workflow changes in some types of investigation are expected due to the use of additional patient shields. (orig.) [German] Durch die Verwendung von Strahlenschutzmitteln kann die Strahlenexposition von Patienten reduziert werden. Es soll dargestellt werden, welche Strahlenschutzmittel bei welchen Untersuchungen eingesetzt werden sollen. Die Ergebnisse von Studien wurden zusammengestellt, analysiert und daraus Empfehlungen fuer die Anwendung von Strahlenschutzmitteln erstellt. Dabei wurden die absoluten Dosiswerte und die Schutzwirkung beruecksichtigt. Bei vielen Untersuchungen sind Strahlenschutzmittel anzuwenden, insbesondere bei CT-Untersuchungen besteht aufgrund der hoeheren Strahlendosis ein gutes Dosisreduktionspotenzial. Aufgrund der Empfehlungen ist bei einigen Untersuchungsarten mit veraenderten Arbeitsablaeufen aufgrund der Anwendung weiterer Strahlenschutzmittel zu rechnen. (orig.)

  4. [Kombinierte Anwendung von Strahlentherapie und adjuvanter Therapie mit einem Mistelextrakt (Viscum album L.) zur Behandlung des oralen malignen Melanoms beim Hund: Eine retrospektive Studie].

    Science.gov (United States)

    von Bodungen, Uta; Ruess, Katja; Reif, Marcus; Biegel, Ulrike

    2017-01-01

    Hintergrund: Orale maligne Melanome (OMM) des Hundes zeichnen sich durch schnelles Wachstum, lokale Invasion und hohe Metastasierungsraten aus. Extrakte auf Basis von Viscum album L. (VAE) werden zunehmend in der Krebstherapie sowohl in der Human- als auch in der Veterinärmedizin eingesetzt. Ziel unserer Studie war es zu untersuchen, inwieweit die adjuvante Therapie mit VAE eine therapeutische Option zur Behandlung von OMM ist. Besonderes Augenmerk galt dabei der Überlebenszeit und möglichen Nebenwirkungen. Tiere und Methoden: 26 Hunde mit OMM, die in einem der größten veterinäronkologischen Zentren der Schweiz allesamt eine Strahlentherapie erhielten (teilweise nach operativer Tumorresektion) wurden in die retrospektive Studie eingeschlossen: 18 Hunde wurden mit VAE behandelt (1 ml VAE (Iscador®) in ansteigenden Konzentrationen von 0,1 bis 20 mg/ml subkutan 3-mal pro Woche (VAE-Gruppe), 8 erhielten keine adjuvante Behandlung (Vergleichsgruppe). Wir verglichen die Größenentwicklung der OMM sowie die Überlebenszeit. Ergebnisse: Patienten mit Bestrahlung und adjuvanter VAE-Therapie zeigten mit 236 Tagen eine signifikant längere mediane Überlebenszeit im Vergleich zu Patienten mit Bestrahlung, aber ohne adjuvante VAE-Therapie (49 Tage; Log-Rank-Test: p = 0,0047). Die VAE-Therapie verlängerte die Überlebenszeit um mehr als zwei Drittel (Hazard Ratio (HR) = 0,30, 95%-Konfidenzintervall (KI) 0,11-0,86; p = 0,024), während ein höheres Tumorstadium gemäß UICC (Union internationale contre le cancer) einen statistischen Trend zur Verdopplung des Sterberisikos zeigte (UICC-Stadium III/IV vs. I/II: HR = 2,12, 95%-KI 0,88-5,12; p = 0,095). Zwei Patienten zeigten milde Nebenwirkungen während der VAE-Behandlung. Einer der beiden zeigte 1 Tag lang ein selbstlimitiertes Fieber, bei dem anderen Patienten reduzierten wir die Dosis von einem konzentrierteren zu einem weniger konzentrierten VAE (Serie 0) aufgrund von Müdigkeit, die daraufhin verschwand

  5. Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc; Roentgen-Verlaufsuntersuchung der Halswirbelsaeule nach anteriorer Fusion mit Titaninterponaten

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J; Hutzelmann, A; Heller, M [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Rama, B [Paracelsus Klinik, Osnabrueck (Germany). Klinik fuer Neurochirurgie

    1999-08-01

    Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discectomy and fusion with a new titanium intervertebral disc. Patients and Methods: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 months after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the implants, and the reactions of adjacent bone structures. Results: Implantation of the titanium disc led to post-operative distraction of the intervertebral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vertebral end-plates were found in all patients. We noted partial infractions into the vertebral end-plates in 10/42 segments and slight mobility of the implants in 14/42 segments. Both groups of patients showed reactive spondylosis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Conclusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subsequent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging. (orig.) [German] Ziel: An Patienten mit zervikalen Kompressionssyndromen wurden Stellung und Funktion der Halswirbelsaeule nach Diskektomie und Fusion mit einem neuartigen Titaninterponat untersucht. Patienten und Methoden: Bei 37 Patienten (42 Segmente) wurden praeoperativ sowie 4 Tage, 6 Wochen und 7 Monate postoperativ mit seitlichen Uebersichts- und Funktionsaufnahmen Stellung und Mobilitaet der HWS beurteilt. Erfasst wurden Lageveraenderungen des Titaninterponates und die Reaktion der angrenzenden Wirbelkoerperabschlussplatten. Ergebnisse: Das Titaninterponat bewirkte postoperativ eine

  6. High response rates following paclitaxel/5-FU and simultaneous radiotherapy in advanced head and neck carcinoma; Hohe Remissionsraten unter simultaner Radio- und Chemotherapie mit Paclitaxel/5-FU in der Behandlung fortgeschrittener Kopf-Hals-Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, M.; Westerhausen, M. [St.-Johannes-Hospital, Duisburg (Germany). Medizinische Klinik II; Makoski, H.B. [Staedtische Kliniken, Duisburg (Germany). Radioonkologie; Sesterhenn, K. [St. Anna-Krankenhaus, Duisburg (Germany). HNO-Klinik; Schroeder, R. [Bristol Myers Squibb, Muenchen (Germany). Dept. of Oncology

    1997-11-01

    applizierter Strahlentherapie. Mit dieser multimodalen Therapiestrategie einschliesslich einer interponierten chirurgischen Massnahme haben wir fuer Patienten mit einem Stadium III/IV Fuenf-Jahres-Ueberlebenszeiten von 60% berichtet. Paclitaxel, ein neues Chemotherapeutikum, erreichte im Rahmen einer ECOG-Studie in Monotherapieform eine Ansprechrate von 40%. Patienten und Methoden: Zwischen 1994 und 1997 wurden 30 Patienten mit vorbestehenden Kontraindikationen gegen Cisplatin mit Paclitaxel/5-FU und gleichzeitiger Bestrahlung in einem neoadjuvanten und postoperativ adjuvanten Therapieschema behandelt. Die Patienten erhielten Paclitaxel 175 mg/m{sup 2} an Tag 1+29 und 5-FU als 120stuendige Dauerinfusion in der Dosis 1000 mg/m{sup 2}/d. Die Bestrahlungsdosis betrug praeoperativ 40 und postoperativ 30 Gy. Alle 30 bisher so behandelten Patienten erreichten eine komplette Remission (histologisch operativ gesichert) nach Abschluss des gesamten Behandlungskonzepts. Ergebnisse: Bis heute leben 23/30 Patienten rezidiv/bzw. tumorfrei. In einem Nachbeobachtungszeitraum zwischen 6 und 34 Monaten entwickelten 4 Patienten eine zweite Neoplasie im Bereich der Rauch-Schluckstrasse (Bronchial-Ca., Oesophagus-Ca.), 3 Patienten erlitten ein lokales Rezidiv. Die Gesamttoxizitaet war moderat (Haematotoxizitaet, Neurotoxizitaet) und gut managebar mit supportiven Massnahmen (z.B. PEG-Sonde). Schlussfolgerung: Unsere praeliminaren Ergebnisse der kombinierten Behandlung der fortgeschrittenenen Kopf-Hals-Tumore mit Taxol/5-FU und Strahlentherapie und Operation sind sehr vielversprechend und identisch mit den Behandlungsergebnissen mit Cisplatin/5-FU. (orig.)

  7. Nassi-Schneiderman Diagram in HTML Based on AML

    Science.gov (United States)

    Menyhárt, László

    2013-01-01

    In an earlier work I defined an extension of XML called Algorithm Markup Language (AML) for easy and understandable coding in an IDE which supports XML editing (e.g. NetBeans). The AML extension contains annotations and native language (English or Hungarian) tag names used when coding our algorithm. This paper presents a drawing tool with which…

  8. Mit anderen Augen

    DEFF Research Database (Denmark)

    Ydesen, Christian; Høberg, Per

    2010-01-01

    The article 'Mit anderen Augen' focuses on the debate about the state-church relationship in the German Democratic Republic (GDR). Starting from the immediate assumption that a protestant church and a socialist, Marxist-Leninist state were irreconcilable in the construction of a new society...

  9. Euthyroid goitre with and without functional autonomy: A comparison; Jodmangelstruma mit und ohne funktionelle Autonomie in der euthyreoten Phase: Ein Vergleich

    Energy Technology Data Exchange (ETDEWEB)

    Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    1998-05-01

    Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller

  10. MRI of the fingers in patients with systemic scleroderma. Early results of contrast-enhanced examinations on a dedicated MRI system; MRT der Finger bei systemischer Sklerodermie. Erste Ergebnisse mit kontrastverstaerkten Untersuchungen an einem dedizierten MRT-System

    Energy Technology Data Exchange (ETDEWEB)

    Bonel, H.; Seemann, M.; Reiser, M. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Messer, G.; Walchner, M.; Roecken, M. [Dermatologische Klinik und Poliklinik, Univ. Muenchen (Germany)

    1997-10-01

    Purpose. To estimate disease activity in patients with systemic sclerosis using contrast-enhanced MRI of the skin. Material and Methods. In a pre-study, sequences of a low-field (0.2 T) scanner (Artoscan, Esaote, Genova, Italy) were optimized for detection of intravenous contrast (0.1 mmol/l Gd-DTPA) in six patients with the autoimmune disease systemic scleroderma. Based on the results of the pre-study, 17 patients with scleroderma (7 sclerotic/10 active inflammatory disease) were scanned using gradient-spoiled 3D GRE sequences (FA 90 , TR 100 ms, TE 18 ms), which had been established as most sensitive for intravenous contrast. Contrast enhancement of the skin was determined quantitatively by contrast-to-noise ratios (CNR), comparing post- to pre-contrast and dynamic scans (for 6 min, 1 acquisition/min). Patients in the chronic state with sclerodactylia and active inflammation of the hands were considered separately and compared to a control group (n=10) matched according to age. Results. CNR increase after intravenous contrast was significantly higher in patients with active disease (86{+-}16% increase) than sclerosing disease (29{+-}3%, p<0.05) and the control group (4{+-}2%, p<0.05). The dynamic examination showed a significantly slower decrease after the peak rise in the first minute in patients with active disease (CNR 15.4{+-}0.7 to 14.2{+-}1.4) than in those with chronic disease (14.1{+-}0.5 to 11.3{+-}0.9, p<0.05). (orig.) [Deutsch] Zielsetzung der Arbeit war die Quantifizierung der Entzuendungsreaktion der Haut bei an systemischer Sklerodermie erkrankten Patienten mittels kontrastverstaerkter MRT. Material und Methoden. In einer Vorstudie mit 6 Patienten wurden die Sequenzen eines dedizierten Niederfeldmagnetresonanztomographen (Artoscan, Esaote, Genua, Italien) fuer den Kontrastmittelnachweis (0,1 mmol/l Gd-DTPA i.v.) optimiert. Basierend auf dieser Sequenzoptimierung wurden 17 Patienten mit systemischer Sklerodermie (7 Patienten mit sklerosierender, 10

  11. Fractures of the atlantoaxial complex in the elderly: assessment of radiological spectrum of fractures and factors influencing imaging diagnosis; Frakturen des Atlas und Axis bei aelteren Patienten: Untersuchung des Radiologischen Spektrums der Frakturen und bedeutsamer Faktoren fuer die Bildgebende Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Lomoschitz, F.M. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany); Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Blackmore, C.C.; Linnau, K.F.; Mann, F.A. [Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Stadler, A. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany)

    2004-02-01

    -axialen Komplexes. Material und Methode: Retrospektive Auswertung von 123 Frakturen des atlanto-axialen Komplexes bei 95 konsekutiven aelteren Patienten (65-102 Jahre, mittleres Alter 79 Jahre). Die atlanto-axialen Frakturen wurden anhand der initial durchgefuehrten bildgebenden Untersuchungen der Halswirbelsaeule klassifiziert. Klinische Angaben einschliesslich neurologischer Status bei Aufnahme und Unfallmechanismus wurden fuer jeden Patienten herangezogen. Die Daten wurden hinsichtlich Frakturtypus sowie Assoziation mit klinischen Veraenderungen und Unfallmechanismus ausgewertet. Ergebnisse: Die Mehrzahl der Patienten hatte Frakturen des Axis (95%), zumeist Dens-Frakturen (74%). Isolierte Frakturen des Atlas (5%) und Kombination mit Frakturen der occipitalen Kondylen (3%) oder der Wirbel C3-C7 (8%) waren selten. Ueberwiegende Unfallursache waren Stuerze (59%). Aeltere Patienten, die bei Verkehrsunfaellen verletzt wurden, hatten signifikant haeufiger isolierte Axis-Frakturen und Typ III Dens-Frakturen (p < 0,02). Zusammenfassung: C2 ist bei atlanto-axialen Frakturen bei aelteren Patienten nahezu immer mitbetroffen. Die Unfallursache hat Einfluss auf den Typ atlantoaxialer Frakturen bei aelteren Patienten. (orig.)

  12. Cardiac magnetic resonance imaging in patients with congenital heart disease; Kardiale MRT bei Patienten mit angeborenen Herzfehlern

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, Karl-Friedrich [Mainz Univ. Universitaetsmedizin Mainz (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Kaufmann, Lilly [Mainz Univ. (Germany); Sorantin, Erich [Univ.-Klinik fuer Radiologie, Graz (Austria). Klinische Abt. fuer Kinderradiologie

    2015-06-15

    The prevalence of congenital heart disease (CHD) is around 10 per 1000 live births in Germany. More than 90 % of these patients will survive into adulthood due to improvements in therapy. The classification of CHD may be based according to the anatomic structures involved, to the presence of an intracardiac shunt, the presence of a cyanosis and the intensity of therapy and complexity of the disease. Nearly half of all patients with CHD suffer from an intracardiac shunt, whereas complex cases such as patients with a tetralogy of Fallot or transposition of the great arteries are much more rare. Cardiac magnetic resonance imaging plays an important role in the work-up and follow-up of patients with CHD, especially after infancy and childhood. Depending on the abnormality in question, a multiparametric examination protocol is mandatory. Knowledge of operative procedures and findings of other imaging modalities help to optimize examination and time needed for it.

  13. Radiochemotherapy with gemcitabine and cisplatin in pancreatic cancer - feasible and effective; Radiochemotherapie mit Gemcitabin und Cisplatin bei Pankreaskarzinom - durchfuehrbar und effektiv

    Energy Technology Data Exchange (ETDEWEB)

    Wilkowski, R.; Thoma, M.; Duehmke, E. [Klinik und Poliklinik fuer Strahlentherapie, Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany); Heinemann, V. [Medizinische Klinik III, Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany); Rau, H.G. [Abt. fuer Viszeralchirurgie, Klinikum Dachau (Germany); Wagner, A. [Medizinische Klinik II, Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany); Stoffregen, C. [Lilly Deutschland GmbH, Bad Homburg (Germany)

    2003-02-01

    sequential gemcitabine and cisplatin with radiation is feasible with justifiable side effects. To evaluate the promising remission and survival rates, randomized trials of neoadjuvant and primary chemoradiation are started. (orig.) [German] Hintergrund: Die simultane Radiochemotherapie unter Verwendung von Gemcitabin scheint bei der Behandlung des Pankreaskarzinoms ein hoffnungsvoller Ansatz, da Gemcitabin als Monosubstanz oder in Kombination mit anderen Zytostatika eine verbesserte Wirksamkeit beim (metastasierten) Pankreaskarzinom im Vergleich zu 5-FU-haltigen Therapieschemata zeigt und zudem strahlensensibilisierendes Potential besitzt. In der vorliegenden Arbeit werden die Pilotdaten einer sequentiellen und simultanen Radiochemotherapie unter Verwendung von Gemcitabin und Cisplatin vorgestellt. Patienten und Methode: 57 Patienten (w/m 23/34) mit Pankreaskarzinom wurden insgesamt behandelt, davon 33 Patienten mit inoperablem Tumor, 19 Patienten nach Tumorresektion (R1-Resektion und/oder pN+) sowie fuenf Patienten mit Lokalrezidiv. Die Strahlentherapie wurde in konventioneller Fraktionierung bis zu einer Dosis von 45,0 Gy im Referenzpunkt nach ICRU (50 Patienten 1,8 Gy ED) bzw. 50,0 Gy im Zielvolumen I. Ordnung (sieben Patienten, 45,0 Gy im ZV II. Ordnung, 1,8/2,0 Gy ED) durchgefuehrt. Simultan zur Bestrahlung wurden Cisplatin 30 mg/m{sup 2} und Gemcitabin 300 mg/m{sup 2} an den Tagen 1, 8, 22 und 29 verabreicht. Nach Abschluss der simultanen Radiochemotherapie wurden sequentiell zwei Zyklen Gemcitabin/Cisplatin (1000 mg/m{sup 2}/50 mg/m{sup 2} d 1, 15) verabreicht. Ergebnisse: Bei einer medianen Nachbeobachtungszeit von 8,2 Monaten betraegt die aktuelle mediane Ueberlebenszeit 14,8 Monate (inoperable Patienten 10,3 Monate, postoperative Patienten 15,1 Monate). Bei 19 bzw. vier der 33 inoperablen Patienten trat eine partielle bzw. komplette Remission auf. Insgesamt konnten 14 Patienten sekundaer operiert werden. Unter adaequater Antiemese mit Ondansetron und Dexamethason

  14. Risk of leukaemia following intravenous treatment with {sup 224}Ra - results of a long term follow-up study of ankylosing spondylitis patients; Leukaemierisiko nach intravenoeser {sup 224}Ra-Behandlung - Ergebnisse einer Langzeitstudie an Bechterew-Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenbiologie; Chmelevsky, D. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Goessner, W. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Pathologie

    1993-12-31

    Inkorporation eines kurzlebigen {alpha}-Strahlers werden in der GSF 1473 Bechterew-Patienten beobachtet, die in den Jahren 1948 - 75 zur Behandlung ihrer Krankheit wiederholte intravenoese Injektionen von {sup 224}Ra erhalten haben. Das uebliche Therapieschema beinhaltete 10 - 12 Injektionen a 1,036 MBq (28 {mu}Ci) {sup 224}Ra in woechentlichem Abstand; dies fuehrt bei einem Menschen mit 70 kg Koerpergewicht (Standardmensch) zu einer {alpha}-Skelettdosis von 0,56 - 0,67 Gy. Daneben besteht eine Kontrollgruppe von 1338 Bechterew-Patienten, die nicht mit radioaktiven Praeparaten und/oder Roentgenstrahlen behandelt worden sind. Bis Mai 1993 (mittlere Beobachtungszeit 19,9 Jahre) sind in der Expositionsgruppe 595 und in der Kontrollgruppe 722 Patienten verstorben, fuer 578 bzw. 668 Patienten ist die Todesursache gesichert. Unter anderen beobachteten wir in der Expositionsgruppe 10 Leukaemien (gegenueber 2,7 - 2,8 erwarteten Faellen, p < 0,001) und 6 in der Kontrollgruppe (3,3 - 3,5 erw., p = 0,14). Eine genauere Subklassifikation zeigt, dass in der Expositionsgruppe im besonderen die chronisch-myeloischen Leukaemien (CML) erhoeht sind (4 beob. Faellen gegenueber 0,8 erw., p = 0,009), waehrend sich in der Kontrollgruppe die beobachteten Faelle mit CML im Rahmen des Erwartungswertes bewegen. Aehnliche Beobachtungen wurden in einer anderen, mit weitaus hoeheren Dosen/Dosisleistungen behandelten Patientengruppe, die von Spiess und Mitarbeitern untersucht wird, bisher nicht festgestellt. Diese erhoehte Leukaemiesterblichkeit in unserem Patientenkollektiv stimmt mit Beobachtungen an mit {sup 224}Ra behandelten Maeusen ueberein, die geringe Mengen von knochensuchenden {alpha}-Strahlern erhalten hatten. (orig.)

  15. Aspects of vulnerable patients and informed consent in clinical trials [Aspekte schutzbedürftiger Patienten sowie der Einwilligung nach Aufklärung in klinischen Prüfungen

    Directory of Open Access Journals (Sweden)

    Hundt, Ferdinand

    2013-01-01

    freiwillige Einverständnis ist ein Eckpfeiler aller Regularien von klinischen Prüfungen. Einen Patienten in eine klinische Prüfung aufzunehmen, ohne zuvor die mit seiner Unterschrift versehene schriftliche Einverständnis eingeholt zu haben, ist als schwerwiegendes Fehlverhalten anzusehen. Die Entstehung ethischer Leitlinien begann bereits vor christlicher Zeitrechnung mit dem Hippokratischen Eid. In allen danach für die klinische Forschung entwickelten Leitlinien wird verdeutlicht, dass eine Hauptfunktion der Einwilligung nach Aufklärung die Sicherstellung der Willensfreiheit ist, um auch so das Wohl der Teilnehmer in klinischen Prüfungen sicherzustellen. Minderjährigen ist es nicht möglich ein diesbezüglich bindendes Einverständnis zu geben, dieses Problem wird durch eine Kombination von elterlicher Zustimmung sowie soweit möglich der Einwilligung des Minderjährigen adressiert. Analphabetismus ist betreffs der informierten Einwilligung ein kritischer Aspekt, der die ganze Welt betrifft. Er existiert in allen Gesellschaften, allen Bevölkerungsschichten und in jeder Altersgruppe. Um die Kommunikation mit diesen Patienten zu verbessern, können neue Strategien mittels Verwendung von Videotapes oder animierten Illustrationen und Trickfilmen gelehrt werden. Letztlich scheint die mit dem potentiellen Teilnehmer verbrachte Zeit der beste Weg zu sein, um die Verständigung zu verbessern.Schlussfolgerung: Die Erforschung lebensrettender und lebensverbessernder neuer Behandlungen erfordert eine Partnerschaft, die auf guter Kommunikation und Vertrauen zwischen Patienten und Forschern, Sponsoren, Ethikkommissionen, Behörden, Juristen und Politikern basiert, damit auch schutzbedürftige Patienten ohne Einschränkung von den Ergebnissen kontrollierter klinischer Prüfungen profitieren können.

  16. Retrospective study about 71 patients with anal carcinoma, treated with a uniform radiochemotherapy; Retrospektive Studie an 71 Patienten mit Analkarzinom, behandelt mit einheitlicher Radiochemotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmeth, Alfred J.

    2013-07-17

    The aim of this retrospectively prospective study was to examine the outcome (over all survival, tumorspecific survival, local control, colostomy free survival as well as sideeffects of the tumorspecific treatment) on a roughly homogenous and compared to other studies appropriate large group of 71 patients with diagnosed anal carcinoma. All patients underwent primary radiochemotherapy during the period of 1991 to 2010 in a municipal hospital. The median follow-up consisted of 38 month.

  17. The applicability of the WHO classification in paediatric AML. A NOPHO-AML study

    DEFF Research Database (Denmark)

    Sandahl, Julie D; Kjeldsen, Eigil; Abrahamsson, Jonas

    2015-01-01

    The World Health Organization (WHO) classification of myeloid leukaemia was revised in 2008. It incorporates newly recognized entities and emphasizes the pivotal role of cytogenetic abnormalities. The aim of this study was to evaluate the usability of the WHO classification when applied to a large......(7q) into one group. We found that -7 (n = 14) had significantly poorer outcome than del(7q) (n = 11); 5-year event-free survival 26% vs. 67%, (P = 0·02), and 5-year overall survival 51% vs. 90%, (P = 0·04). The largest group was the highly heterogeneous AML not otherwise specified (NOS) (n = 280...

  18. Carbon dioxide digital subtraction angiography using a new gas management system; Digitale Subtraktionsangiographie mit Kohlendioxid unter Verwendung eines neuen Gasdosiersystems

    Energy Technology Data Exchange (ETDEWEB)

    Schmitz-Rode, T.; Alzen, G.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    1997-07-01

    Purpose: The clinical evaluation of digital subtraction angiography with carbon dioxide using a newly developed low-tech CO{sub 2}-dosage- and injection system. Method and patients: The hand-held system (CO{sub 2} angio set) consists of a dosage chamber in connection with a special stopcock to apportion the gas. By optimising injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection. CO{sub 2} arteriographies were performed on 185 patients. Main indications were renal insufficiency and a history of adverse reactions to iodinated contrast media. In patients with femoral connula access, catheterless reflux angiography was performed. Results: The injection system provided complete and coherent visualisation of the abdominal aorta, visceral, pelvic, and lower limb arteries via catheter (71 cases) or via femoral cannula using reflux technique (114 cases). Stenoses, occlusions, and collaterals were assessable. Employing the gas reflux over the aortic bifurcation bilateral run-off studies up to the calf trifurcation were performed via unilateral femoral cannula. Use of a dedicated stacking software improved image quality of distal femoral, popliteal and calf arteries. Conclusion: The CO{sub 2} management system allows adequate imaging of the arteries below the diaphragm. Ease and safety of use and low costs are advantageous. (orig.) [Deutsch] Ziel: Die klinische Erprobung der digitalen Subtraktionsangiographie mit Kohlendioxid unter Verwendung eines neuentwickelten, einfachen Gasdosier- und Injektionssystems. Methode und Patienten: Eine Dosierkammer mit einstellbarem Volumen in Verbindung mit einem Spezial-Hahn (CO{sub 2}-Angio-Set) portioniert das Gas. Durch Optimierung von Injektionsvolumen und -druck wurde eine konstante Ausstroemcharakteristik angenaehert. Das System wurde

  19. CNS Involvement in AML Patient Treated with 5-Azacytidine

    Directory of Open Access Journals (Sweden)

    Diamantina Vasilatou

    2014-01-01

    Full Text Available Central nervous system (CNS involvement in acute myeloid leukemia (AML is a rare complication of the disease and is associated with poor prognosis. Sometimes the clinical presentation can be unspecific and the diagnosis can be very challenging. Here we report a case of CNS infiltration in a patient suffering from AML who presented with normal complete blood count and altered mental status.

  20. Trisomy 8 in Pediatric Acute Myeloid Leukemia. A NOPHO-AML Study

    DEFF Research Database (Denmark)

    Laursen, Anne Cathrine Lund; Sandahl, Julie Damgaard; Kjeldsen, Eigil

    2016-01-01

    Trisomy 8 (+8) is a common cytogenetic aberration in acute myeloid leukemia (AML); however, the impact of +8 in pediatric AML is largely unknown. We retrospectively investigated 609 patients from the NOPHO-AML database to determine the clinical and cytogenetic characteristics of +8 in pediatric AML...

  1. Atypische niedrig-traumatische Femurfrakturen – Zusammenhang mit Komorbiditäten, internistischen und knochenspezifischen Therapien // Atypical femoral fractures – comorbidities and association with bone-specific therapies

    Directory of Open Access Journals (Sweden)

    Muschitz Ch

    2016-01-01

    ännlichen Patienten mit De novo-Hüftfrakturen, die im größten österreichischen Unfallkrankenhaus im Zeitraum von 2000 bis 2013 behandelt wurden. iErgebnisse:/i 194 Patienten mit einer De novo-niedrig-traumatischen subtrochantären / Schaftfraktur wurden identifiziert: 35 atypische und 159 typische Frakturen. Weibliche Patienten waren in beiden Gruppen signifikant älter. Die mediane Überlebenszeit betrug bei Patienten mit AFF 9 vs. 18 Monate nach typischen Femurfrakturen (p 0,0001. Herzkreislauferkrankungen, Sarkopenie, chronische Nierenerkrankungen, Typ-2-Diabetes, Rauchen (aktuell oder Ex-Raucher und prävalente Fragilitätsfrakturen sowie die gleichzeitige Einnahme von Phenprocoumon, Furosemid und Sulfonylharnstoff wurden häufiger bei AFF-Patienten beobachtet. Wenn auch die Zahl der Patienten mit laufender KST in beiden Gruppen niedrig war (14,5 %, hatten mehr Patienten in der AFF-Gruppe eine frühere KST (71 % vs 49 %; p = 0,016 und erhielten diese Therapien für einen längeren Zeitraum. iDiskussion:/i Eine Kombination von schweren Begleiterkrankungen, langfristigen medikamentösen Therapien und die frühere oder laufende Einnahme von KST sind mit einem erhöhten Risiko für eine AFF verbunden.

  2. Visualization of pulmonary vein stenosis after radio frequency ablation for treatment of atrial fibrillation using multidetector computed tomography with retrospective gating; Darstellung von Pulmonalvenenstenosen nach Radiofrequenzablation zur Behandlung von Vorhofflimmern unter Verwendung der Multidetektor Computertomographie mit retrospektivem Gating

    Energy Technology Data Exchange (ETDEWEB)

    Trabold, T.; Kuettner, A.; Heuschmid, M.; Kopp, A.F.; Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Univ. Tuebingen (Germany); Burgstahler, C.; Mewis, C.; Schroeder, S.; Kuehlkamp, V. [Medizinische Klinik III, Abt. fuer Kardiologie, Univ. Tuebingen (Germany)

    2003-01-01

    Purpose: With the number of radio frequency ablations (RFA) for treatment of chronic atrial fibrillation increasing, the diagnostic evaluation for RFA associated pulmonary vein stenosis is getting more important. This study investigates the feasibility of the visualization of pulmonary vein stenosis using non-invasive multidetector computed tomography. Materials and Methods: Twenty-eight patients were examined following RFA-treatment. A 4-slice (20 patients) and a 16-slice (8 patients) multidetector CT scanner (SOMATOM Volume Zoom and Sensation 16, Siemens, Forchheim, Germany) with retrospective gating was used to assess the pulmonary veins. Lesion severity was determined on a semi-quantitative scale (< 30%, 30 - 50%, > 50%). Results: CT was performed without any complications in all patients. Diagnostic image quality could be obtained in all examinations. The pulmonary veins showed lesions < 30% in four patients, lesions of 30 - 50% in five patients and a stenosis > 50% in one patient. Eighteen patients showed no lesions. Conclusion: Multidetector CT of the pulmonary veins seems to be able to visualize high-grade and low-grade lesions, but larger catheter-controlled studies are needed for further assessment of the diagnostic accuracy and clinical reliability of this noninvasive method. (orig.) [German] Ziel: Mit steigender Anzahl von Radiofrequenzablationen (RFA) zur Behandlung des chronischen Vorhofflimmerns wird die Diagnostik von RFA assoziierten Pulmonalvenenstenosen zunehmend wichtiger. Ziel dieser Studie war es, die Moeglichkeit der Darstellung von Pulmonalvenenstenosen mittels der nichtinvasiven Multidetektor-Computertomographie zu untersuchen. Material und Methoden: 28 Patienten wurden im Anschluss an eine RFA-Behandlung untersucht. Die Untersuchung wurde an einem 4-Zeilen- (20 Patienten) bzw. 16-Zeilen- (8 Patienten) Multidetektor-CT (SOMATOM Volume Zoom bzw. Sensation 16, Siemens, Forchheim, Germany) mit retrospektivem Gating durchgefuehrt. Der

  3. Multimodal diagnosis of multiple and heterogeneous liver lesions in a young patient; Multimodale Bildgebung multipler Leberlaesionen bei einem jungen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Kiessling, F.; Schlemmer, H.-P. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany). Abteilung fuer onkologische Diagnostik und Therapie

    2005-10-01

    The classification of liver lesions is often problematic in particular if they are multiple and show an heterogeneous shape. Here we report of a young patient with multiple liver lesions of up to 3 cm size. Using ultrasound, the lesions were hyper-, hypoechogen or mixed. In serial contrast enhanced CT scans some of the lesions showed the typical enhancement pattern of hemangiomas, however, the diagnosis could still not be faithfully determined for all lesions. Therefore, the patient was conducted to contrast enhanced MRI (Gd-DTPA and MnDPDP). While with Gd-DTPA some of the lesions showed a strong enhancement, they remained hypointense after administration of MnDPDP. Finally to exclude a metastatic disease a {sup 99m}Tc-erythrocyte SPECT was performed confirming the diagnosis of hemangiomas for most of the lesions. Diagnosis was not assessed by biopsy because this would only clarify the diagnosis for one or few of the lesions. The patient was subsequently followed up for 3 years and all lesions remained unchanged. This case clearly illustrates the difficulty to get a certain diagnosis of multiple liver lesions with heterogeneous appearance despite the multimodal diagnostic conduct. (orig.) [German] Bei einer Routineuntersuchung wurden bei einem jungen Patienten sonographisch multiple Leberrundherde mit hyper-, hypoechogener und gemischter Echogenitaet detektiert. Auch mittels triphasischer kontrastmittelverstaerkter CT gelang nur bei einem Teil der Herde die Einstufung als Haemangiome anhand ihres Irisblendenphaenomens. MRT-Untersuchungen unter Verwendung von Gd-DTPA und MnDPDP wurden angeschlossen. Mit Gd-DTPA zeigten einige Herde ein kraeftiges Enhancement, unter Verwendung von MnDPDP jedoch blieben sie hypointens. Auf eine Biopsie wurde verzichtet, da diese nur bei einem oder wenigen Herden die Diagnose liefern wuerde, die anderen Herde aber unter Beruecksichtigung ihrer Heterogenitaet unklar geblieben waeren. Eine Sicherung der Diagnose gelang fuer die meisten

  4. The Hematopoietic Transcription Factors RUNX1 and ERG Prevent AML1-ETO Oncogene Overexpression and Onset of the Apoptosis Program in t(8;21) AMLs

    NARCIS (Netherlands)

    Mandoli, Amit; Singh, Abhishek A.; Prange, Koen H. M.; Tijchon, Esther; Oerlemans, Marjolein; Dirks, Rene; Ter Huurne, Menno; Wierenga, Albertus T. J.; Janssen-Megens, Eva M.; Berentsen, Kim; Sharifi, Nilofar; Kim, Bowon; Matarese, Filomena; Nguyen, Luan N.; Hubner, Nina C.; Rao, Nagesha A.; van den Akker, Emile; Altucci, Lucia; Vellenga, Edo; Stunnenberg, Hendrik G.; Martens, Joost H. A.

    2016-01-01

    The t(8;21) acute myeloid leukemia (AML)-associated oncoprotein AML1-ETO disrupts normal hematopoietic differentiation. Here, we have investigated its effects on the transcriptome and epigenome in t(8,21) patient cells. AML1-ETO binding was found at promoter regions of active genes with high levels

  5. Cytogenetic findings in adult secondary acute myeloid leukemia (AML): frequency of favorable and adverse chromosomal aberrations do not differ from adult de novo AML

    DEFF Research Database (Denmark)

    Preiss, Birgitte S; Bergman, Olav J; Friis, Lone S

    2010-01-01

    During a 15-year period, 161 adult patients were diagnosed with secondary acute myeloid leukemia (s-AML) in the region of Southern Denmark. In 73 patients, the AML diagnosis was preceded by myelodysplastic syndrome (MDS-AML), in 31 patients by an antecedent hematologic disease, and in 57 patients...

  6. Impact of pretreatment variables on the outcome of {sup 131}I therapy with a standardized dose of 150 Gray in Graves` disease; Einfluss praetherapeutischer Variablen auf die Wirkung einer standardisierten {sup 131}J-Therapie mit 150 Gray beim Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Pfeilschifter, J. [Heidelberg Univ., Radiologische Klinik (Germany). Abt. fuer Nuklearmedizin; Elser, H. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I; Haufe, S. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I; Ziegler, R. [Heidelberg Univ., Radiologische Klinik (Germany). Abt. fuer Nuklearmedizin; Georgi, P. [Medizinische Universitaetsklinik und Poliklinik Heidelberg (Germany). Abt. fuer Innere Medizin I

    1997-04-01

    Aim: We examined the impact of several pretreatment variables on thyroid size and function in 61 patients with Graves` disease one year after a standardized [131]I treatment with 150 Gray. Methods: FT3, FT4, and TSH serum concentrations were determined before and 1.5, 3, 6, and 12 months after therapy. Thyroid size was measured by ultrasound and scintigraphy before and one year after therapy. Results: One year after therapy, 30% of the patients had latent or manifest hyperthyroidism, 24% were euthyroid, and 46% had developed latent or manifest hypothyroidism. Age and initial thyroid volume were major predictors of posttherapeutical thyroid function. Thus, persistent hyperthyroidism was observed in 70% of the patients age 50 years and older with a thyroid size of more than 50 ml. With few exception, thyroid size markedly decreased after therapy. Initial thyroid size and age were also major predictors of posttherapeutical thyroid volume. Thyroid size normalized in all patients younger than 50 years of age, independent from initial thyroid size. Conclusion: Radioiodine treatment with 150 Gray causes a considerable decrease in thyroid size in most patients with Graves` disease. Age and initial thyroid volume are important determinants of thyroid function and size after therapy and should be considered in dose calculation. (orig.) [Deutsch] Ziel: Bei 61 Patienten mit einem Morbus Basedow haben wir den Einfluss praetherapeutischer Variablen auf die Funktion und das Volumen der Schilddruese ein Jahr nach einer {sup 131}J-Therapie mit 150 Gray untersucht. Methoden: FT3, FT4, und TSH wurden vor Therapie und eineinhalb, 3, 6 und 12 Monate nach Therapie gemessen. Das Schilddruesenvolumen wurde vor Therapie und ein Jahr nach Therapie sonographisch und szintigraphisch bestimmt. Ergebnisse: Ein Jahr nach Therapie waren 30% der Patienten latent oder manifest hyperthyreot, 24% euthyreot, und 46% latent oder manifest hypothyreot. Lebensalter und Ausgangsvolumen der Schilddruese

  7. Incidental findings of liver, biliary system, pancreas and spleen in asymptomatic patients. Assessment and management recommendations; Zufallsbefunde von Leber, Gallensystem, Pankreas und Milz bei asymptomatischen Patienten. Bewertung und Managementempfehlung

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Tamandl, D.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

    2017-04-15

    The increased use of highly developed imaging procedures, such as multidetector-row computed tomography and magnetic resonance imaging has led to a substantial increase of asymptomatic and unexpected findings. Abdominal CT investigations are particularly affected with a large number of incidental findings. This valuable diagnostic procedure also entails the risk of complex and cost-intensive subsequent investigations with partly invasive procedures. For this reason radiologists are more often confronted with the difficult task of correctly assessing these lesions, to decide on the need for additional investigations and to inform the patient in detail about the clinical relevance. The aims of this article are to describe the most common abdominal incidentalomas, to assist with the interpretation and differential diagnosis and to give recommendations for further management. (orig.) [German] Die vermehrte Verwendung hoch entwickelter bildgebender Verfahren wie Multidetektorcomputertomographie und Magnetresonanztomographie hat zu einer betraechtlichen Zunahme asymptomatischer und unerwarteter Befunde gefuehrt. Besonders betroffen sind abdominelle CT-Untersuchungen mit einer Vielzahl inzidenteller Befunde. Dieses wertvolle Diagnoseverfahren birgt auch die Gefahr aufwendiger und auch kostenintensiver Folgeuntersuchungen mit z. T. invasiven Verfahren. Vor diesem Hintergrund stellt sich fuer den Radiologen immer haeufiger die schwierige Aufgabe, diese Laesionen korrekt einzuschaetzen, ueber die Notwendigkeit einer weiteren Abklaerung zu entscheiden und den Patienten umfassend ueber die klinische Relevanz zu informieren. Das Ziel dieses Artikels ist es, die am haeufigsten vorkommenden abdominellen Zufallsbefunde zu beschreiben sowie Hilfestellung bei ihrer Interpretation und Differenzialdiagnose mit Empfehlungen fuer das weitere Management zu geben. (orig.)

  8. Cytoprotection with amifostine in radiotherapy or combined radio-chemotherapy of head and neck cancer; Zytoprotektion mit Amifostin in der Strahlentherapie bzw. Strahlen-/Chemotherapie von Kopf-Hals-Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Altmann, S.; Hoffmanns, H. [Krankenhaus Maria-Hilf, Moenchengladbach (Germany). Strahlentherapie und Radiologische Onkologie

    1999-11-01

    Therapieformen. In der vorliegenden Untersuchung wird sein Einfluss auf die Akuttoxizitaet der alleinigen Strahlen- bzw. kombinierten Radiochemotherapie bei Patienten mit fortgeschrittenen Kopf-Hals-Tumoren ueberprueft. Patienten und Methodik: Es wurden 23 Patienten mit fortgeschrittenen Kopf-Hals-Tumoren, ueberwiegend im Stadium III und IV, mit praeoperativer Radiatio (n=1), prae- und postoperativer Radiatio (n=5), postoperativer Radiatio (n=11) bzw. kombinierter Radiochemotherapie (n=6) behandelt. Vor jeder Behandlung wurden 500 mg Amifostin intravenoes ueber 15 Minuten verabreicht. Die Therapiedokumentation dieser unselektierten Patientengruppe wurde retrospektiv mit einem historischen Patientenkollektiv verglichen, das 17 Patienten umfasste. Resultate: Bei 15 Patienten (65%) unter Amifostin kam es zu therapiebedingten Nebenwirkungen wie Mukositis und Dermatitis {<=}WHO-Grad 2, welche Radiotherapiepausen (Mittelwert: 6,5, maximal 17 Tage) erforderten. Schleimhaut- bzw. dermatoligische Nebenwirkungen vom WHO-Grad 3 oder 4 wurde bei keinem Patienten beobachtet. In der historischen Kontrollgruppe trat eine signifikant hoehere Akuttoxizitaet auf. Eine Stomatitis oder Epitheliolyse vom WHO-Grad 3 wurde bei sieben Patienten (41%) beobachtet. Bei 15 Patienten (88%) erforderten die therapiebedingten Nebenwirkungen Radiotherapiepausen (Mittelwert: 16, maximal 40 Tage; p=0,0016). Schlussfolgerung: Die zusaetzliche Gabe von Amifostin vor jeder Bestrahlung scheint in einer deutlichen Reduktion der Akuttoxizitaet bei der Strahlen- bzw. kombinierten Strahlen-/Chemotherapie bei Patienten mit Kopf-Hals-Tumoren zu resultieren und eine zeitgerechtere Applikation zu ermoeglichen. (orig.)

  9. PD-1 signaling and inhibition in AML and MDS.

    Science.gov (United States)

    Haroun, Faysal; Solola, Sade A; Nassereddine, Samah; Tabbara, Imad

    2017-09-01

    Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are clinically and molecularly heterogeneous clonal myeloid disorders with a poor prognosis especially in the relapsed refractory setting and in patients above the age of 60. While allogeneic hematopoietic stem cell transplantation (ASCT) is a potentially curative approach, high relapse, morbidity, and mortality rates necessitate the development of alternative therapies. Immune checkpoint inhibitors unmask tumoral immune tolerance and have demonstrated efficacy in the treatment of chemotherapy-resistant hematologic and solid malignancies. The rationale for the investigation of those agents in AML and MDS is supported by an observed increased expression of programmed cell death 1 protein (PD-1) and ligand 1 (PD-L1) in the hematopoietic microenvironment of AML and MDS, and its association with low TP53 and a poor prognosis. Early clinical experience in combination with a hypomethylating agent has shown encouraging responses; however, larger clinical trials are needed to determine the role of checkpoint inhibition in myeloid malignancies.

  10. Outcome of poor response Paediatric AML using early SCT

    DEFF Research Database (Denmark)

    Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas

    2013-01-01

    ) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. RESULTS: Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13......BACKGROUND: Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients...... treated with SCT. MATERIAL AND METHODS: Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17...

  11. {sup 18}F-PET imaging: frequency, distribution and appearance of benign lesions; Die Positronenemissionstomographie des Skelettsystems mit {sup 18}FNa: Haeufigkeit, Befundmuster und Verteilung benigner Veraenderungen

    Energy Technology Data Exchange (ETDEWEB)

    Schirrmeister, H.; Kotzerke, J.; Rentschler, M.; Traeger, H.; Fenchel, S.; Diederichs, C.G.; Reske, S.N. [Ulm Univ. (Germany). Abt. Nuklearmedizin; Nuessle, K. [Ulm Univ. (Germany). Abt. fuer Roentgendiagnostik

    1998-09-01

    Purpose: We evaluated the frequency, distribution and appearance of benign lesions in {sup 18}F-PET scans. Methods: Between March 1996 and May 1997, {sup 18}F-PET scans were performed in 59 patients in addition to conventional planar bone scintigraphy. Eleven patients were subjected to additional SPECT imaging. The main indication was searching for bone metastases (58 pat.). The diagnosis was confirmed radiologically. Results: With {sup 18}F-PET in 39 patients (66,1%) 152 benign lesions, mostly located in the spine were detected. {sup 99m}Tc bone scans revealed 45 lesions in 10 patients. Osteoarthritis of the intervertebral articulations (69%) or of the acromioclavicular joint (15%) were the most common reasons for degenerative lesions detected with {sup 18}F-PET. Osteophytes appeared as hot lesions located at two adjacent vertebral endplates. Osteoarthritis of the intervertebral articulations showed an enhanced tracer uptake at these localizations, whereas endplate fractures of the vertebral bodies appeared very typically; solitary fractures of the ribs could not be differentiated from metastases. Rare benign lesions were not studied. Conclusion: Most of the degenerative lesions (84%) detected with {sup 18}F-PET had a very typical appearance and could be detected with the improved spatial resolution and advantages of a tomographic technique. {sup 18}F-PET had an increased accuracy in detecting degenerative bone lesions. (orig.) [Deutsch] Ziel: Wir untersuchten Haeufigkeit und Befundmuster benigner Skelettveraenderungen mit {sup 18}F-PET. Material und Methoden: Zwischen 3/96 und 5/97 untersuchten wir 59 Patienten mit {sup 18}F-PET zusaetzlich zur planaren, bei 11 Patienten durch SPECT ergaenzten konventionellen Skelettszintigraphie (KS). Hauptindikation war die Metastasensuche (58 Pat.). Die Befundkontrolle erfolgte radiologisch. Ergebnisse: {sup 18}F-PET zeigte bei 39 Patienten (66,1%) 152 meist in der Wirbelsaeule lokalisierte, benigne Mehranreicherungen. Mit der

  12. SIMILARITIES OF ELDERLY AND THERAPY-RELATED AML

    Directory of Open Access Journals (Sweden)

    Francesco D'Alò

    2011-11-01

    Full Text Available Acute myeloid leukemia (AML is a clonal disorder of the hematopoietic stem cell, typical of the elderly, with a median age of over 60 years at diagnosis. In AML, older age is one of the strongest independent adverse prognostic factor, associated with decreased complete response rate, worse disease-free and overall survival, with highest rates of treatment related mortality, resistant disease and relapse, compared to younger patients. While clinical risk factors do not significantly differ between older and younger patients, outcomes are compromised in elderly patients not only by increased comorbidities and susceptibility to toxicity from therapy, but it is now recognized that elderly AML represents a biologically distinct disease, that is itself more aggressive and less responsive to therapy. In elderly individuals prolonged exposure to environmental carcinogens may be the basis for the aggressive biology of the disease. This may also be the basis for similarities between elderly AML and therapy-related myeloid malignancies, mimicking toxic effects of previous cytotoxic treatments on hematopoietic stem cells. Age is itself a risk factor for t-MN, which are more frequent in elderly patients, where also a shorter latency between treatment of primary tumor and t-MN has been reported. Similarities between therapy-related malignancies and elderly AML include morphological aspects, as the presence of multilineage dysplasia preceding and/or concomitant to the development of leukemia, and adverse cytogenetics, including poor karyotype and chromosome 5 and/or 7 abnormalities. Looking at molecular prognosticators in elderly AML, similar to t-MN,  reduced frequency of favorable factors, as reduced number of NPM1 and CEBPA mutated cases has been observed, together with increased incidence of negative factors, as increased MDR1 expression, accelerated telomere shortening  and frequency of methylation changes. Given the unfavorable prognosis of elderly and

  13. Cellular origin of prognostic chromosomal aberrations in AML patients

    DEFF Research Database (Denmark)

    Mora-Jensen, H.; Jendholm, J.; Rapin, N.

    2015-01-01

    chromosomal structural rearrangements and single nucleotide variants (SNVs). Conventional AML diagnostics and recent seminal next-generation sequencing (NGS) studies have identified more than 200 recurrent genetic aberrations presenting in various combinations in individual patients. Significantly, many...... of these aberrations occur in normal hematopoietic stem and progenitor cells (HSCs/HPCs) before definitive leukemic transformation through additional acquisition of a few (that is, mostly 1 or 2) leukemia-promoting driver aberrations. NGS studies on sorted bone marrow (BM) populations of AML patients with a normal...

  14. MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation; MRT der Skaphoidpseudarthrose mit Gd-DTPA. Stadieneinteilung und klinische Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Beutel, F. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Wilhelm, K. [LMU Muenchen (Germany). Abt. fuer Handchirurgie; Tempka, A. [Freie Univ. Berlin (Germany). Klinik fuer Unfall- und Wiederherstellungschirurgie; Schedel, H. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Haas, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Felix, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik

    1994-11-01

    During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T{sub 1} weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T{sub 2}-sequences and axial spin echo T{sub 2} sequences. The T{sub 1} weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T{sub 1} weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden in einem Zeitraum von 2 Jahren 134 Patienten mit einer Skaphoidpseudarthrose (SPA) vergleichend konventionell roentgenologisch und magnetresonanztomographisch untersucht. Ziel der Studie war die Erstellung einer klinisch radiologischen Stadieneinteilung mit Hilfe der kontrastverstaerkten MRT zur Verbesserung von Prognosekriterien. Alle MRT-Untersuchungen wurden an einem 1,5 Tesla-Geraet (SP63) mittels einer Oberflaechenspule unter Verwendung von T{sub 1

  15. Volumetry of metastases from renal cell carcinoma. Comparison with the RECIST criteria; Volumetrie von Metastasen beim Nierenzellkarzinom. Vergleich mit den RECIST-Kriterien

    Energy Technology Data Exchange (ETDEWEB)

    Graser, A.; Becker, C.R.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Stief, C.; Staehler, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Klinik und Poliklinik fuer Urologie, Muenchen (Germany)

    2008-09-15

    For patients with metastasized renal cell carcinoma (RCC), imaging techniques are of great importance. Currently, therapy widely relies on antiangiogenic factors, which frequently lead to relatively subtle changes in the size of lesions. From this aspect the commonly used RECIST criteria (response evaluation criteria in solid tumors) must be considered as imprecise for the evaluation of the response to therapy. This article gives a review on new software-based volumetric methods, which allow therapy-induced changes in the size of metastases from RCC to be detected with higher sensitivity and reproducibility. A comparison of RECIST and volumetry was carried out with data from patients with metastasized RCC to demonstrate the higher sensitivity of the 3D volumetric procedure. (orig.) [German] Bei Patienten mit metastasiertem Nierenzellkarzinom werden an die Bildgebung besondere Anforderungen gestellt. Die Therapie beruht heute in den meisten Faellen auf antiangiogenetischen Wirkstoffen, die im Verlauf teils zu relativ geringen Groessenaenderungen von Laesionen fuehren. Daher sind die oftmals verwendeten RECIST-Kriterien (''response evaluation criteria in solid tumors'') bei der Beurteilung des Therapieansprechens als ungenau anzusehen. In diesem Artikel wird ein Ueberblick ueber neue, softwarebasierte volumetrische Methoden gegeben, die es ermoeglichen, therapieinduzierte Groessenaenderungen von Metastasen beim Nierenzellkarzinom mit hoeherer Sensitivitaet und Reproduzierbarkeit zu detektieren. Anhand eigener Daten wird ein Vergleich von RECIST und Volumetrie bei Patienten mit metastasiertem Nierenzellkarzinom durchgefuehrt und die hoehere Sensitivitaet des automatisierten Verfahrens gezeigt. (orig.)

  16. Die Last mit der Lust

    Directory of Open Access Journals (Sweden)

    Lutz Sauerteig

    2004-03-01

    Full Text Available Robert Jütte legt mit Lust ohne Last eine umfassende, allgemeinverständliche und spannend zu lesende Geschichte der Empfängnisverhütung von der Antike bis in die unmittelbare Gegenwart vor.

  17. Spillerum og mit eget rum

    DEFF Research Database (Denmark)

    2014-01-01

    Undervisningsmaterialet Spillerum udviklet som APP til Ipad med interaktive muligheder. Spillerum som APP - et interaktivt undervisningsmateriale, hvor man ud over at bruge det originale materiale Spillerum elektronisk kan skabe sit eget billedbaserede rum "Mit eget rum" som udgangspunkt for dialog....

  18. Kleben von Kunststoff mit Metall

    CERN Document Server

    Brockmann, W; Käufer, H

    1989-01-01

    Das Buch behandelt das Kleben von Kunststoffen mit Metallen in einer fur den Praktiker verstandlichen und umsetzbaren Form. Es leitet zu Klebeverfahren an, die optimale Ergebnisse hinsichtlich Qualitat, Dauerhaftigkeit und Wirtschaftlichkeit liefern.

  19. MIT-CSR XIS Project

    Science.gov (United States)

    1998-01-01

    This report outlines the proposers' progress toward MIT's contribution to the X-Ray Imaging Spectrometer (XIS) experiment on the Japanese ASTRO-E mission. The report discusses electrical system design, mechanical system design, and ground support equipment.

  20. Outcome of poor response paediatric AML using early SCT.

    Science.gov (United States)

    Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas; Forestier, Erik; Gustafsson, Britt; Ha, Shau-Yin; Heldrup, Jesper; Jahnukainen, Kirsi; Jónsson, Ólafur G; Lausen, Birgitte; Palle, Josefine; Zeller, Bernward; Hasle, Henrik

    2013-03-01

    Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT. © 2012 John Wiley & Sons A/S.

  1. Telomerase inhibition effectively targets mouse and human AML stem cells and delays relapse following chemotherapy

    DEFF Research Database (Denmark)

    Bruedigam, Claudia; Bagger, Frederik Otzen; Heidel, Florian H.

    2014-01-01

    (-/-) LSCs express a specific gene expression signature that can be identified in human AML patient cohorts and is positively correlated with patient survival following chemotherapy. In xenografts of primary human AML, genetic or pharmacological inhibition of telomerase targets LSCs, impairs leukemia...... progression, and delays relapse following chemotherapy. Altogether, these results establish telomerase inhibition as an effective strategy for eliminating AML LSCs....

  2. Magnetic resonance imaging in the evaluation of pneumonia; Nachweis von pneumonischen Infiltraten mit der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Eibel, R.; Herzog, P.; Dietrich, O.; Reiser, M.; Schoenberg, S.O. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Rieger, C.; Ostermann, H. [Ludwig-Maximilians-Universitaet Muenchen (Germany). Abteilung fuer Haematologie/Onkologie, Klinikum Grosshadern

    2006-04-15

    Rundherde mit einem Durchmesser deutlich unterhalb der Schichtdicke nicht mehr zuverlaessig erfasst werden koennen. Auch Verkalkungen sind nicht mit der gleichen Sicherheit wie im CT zu identifizieren. Gleiches gilt fuer den Nachweis von Luftsicheln und -einschluessen in Laesionen. Mit Hilfe der parallelen Bildgebung koennen beide Lungenfluegel in 1-2 Atemstillstaenden mit einer Ortsaufloesung von 6 mm in der z-Achse und Submillimeteraufloesung in der x- und y-Ebene untersucht werden. Raumzeiten <10 min lassen sich so realisieren. Insbesondere fuer die Verlaufsbeurteilung von pneumonischen Infiltraten bei immunsupprimierten Patienten kann die MRT geeignet sein und zu einer geringeren Dosisexposition der Patienten beitragen. (orig.)

  3. Percutaneous therapy of inoperable biliary stenoses and occlusions with a new self-expanding nitinol stent (SMART); Perkutane Therapie inoperabler maligner Stenosen und Verschluesse der Gallenwege mit einem neu entwickelten selbstexpandierbaren Nitinolstent (SMART)

    Energy Technology Data Exchange (ETDEWEB)

    Zorger, N.; Lenhart, M.; Strotzer, M.; Paetzel, C.; Hamer, O.; Feuerbach, S.; Link, J. [Regensburg Univ. (Germany). Inst. fuer Roentgendiagnostik

    2002-10-01

    Objective: To evaluate the treatment of malignant biliary stenoses and occlusions using a new stent. Methods: In a prospective study, 25 patients with malignant obstructive jaundice were treated with SMART stents. The handling and the quality of stent expansion were documented. Stent function was assessed 2-4 days after intervention by cholangiography and laboratory tests. A follow-up was performed three months, after stent placement. Results: All lesions were treated successfully, with a total of 35 stents implanted. In 14 patients a further balloon dilatation was performed after stent placement (8-10 mm diameter/40-80 mm length). The mean serum bilirubin level decreased significantly from 11.6 mg/dl to 4.6 mg/dl after intervention (p<0.05). The follow-up showed a mean serum bilirubin level at 4.0 mg/dl. In 4 cases (16%) a further intervention (PTCD or stent) was performed. Six patients died due to tumor progression. The stents proved to be patent in 79% (n=15) of patients alive at the time of follow-up. Conclusions: Placement of the SMART stent for the therapy of malignant biliary lesions yields good technical and clinical results. (orig.) [German] Zielsetzung: Evaluation der technischen Handhabung und Effizienz eines neu entwickelten Stents zur Therapie maligner Gallenwegsstenosen und Verschluesse. Material und Methodik: In einer prospektiven Studie wurden 25 Patienten mit Verschlussikterus bei maligner Gallengangsstenose palliativ mit dem SMART {sup trademark} -Stent behandelt. Evaluiert wurden die Handhabung des Stents und die Qualitaet der Stententfaltung. Die Stentfunktion wurde nach 2-4 Tagen ueber eine liegende interne/externe Drainage cholangiographisch sowie anhand des Verlaufs der Laborparameter kontrolliert. Eine zusaetzliche Kontrolle der Stentfunktion erfolgte nach drei Monaten. Dabei wurden das subjektive Wohlbefinden des Patienten, der aktuelle Gesamtbilirubinspiegel im Serum und die Anzahl weiterer, im Nachsorgezeitraum durchgefuehrter

  4. Osteolytic bone lesions – A rare presentation of AML M6.

    Directory of Open Access Journals (Sweden)

    Geetha N.

    2015-02-01

    Full Text Available Acute myeloid leukemia (AML M6 is a rare form of AML  accounting  for < 5 % of all AML.  Extramedullary involvement  is very rarely seen in this entity.  Skeletal lesion has not been described in AML M6 before. We discuss the case of  a 17 year old boy with AML M6 who presented with  osteolytic lesion of right humerus.  He was treated with  induction and consolidation chemotherapy. The present case is the first report in literature of AML M6 presenting with skeletal lesions.

  5. Successful treatment of congenital acute myeloid leukemia (AML-M6) in a premature infant.

    Science.gov (United States)

    van Dongen, Joyce C A; Dalinghaus, Michiel; Kroon, Andre A; de Vries, Andrica C H; van den Heuvel-Eibrink, Marry M

    2009-11-01

    Congenital acute myeloid leukemia (AML), and especially AML-M6 is a rare disease with a poor prognosis. Moreover, reports of treatment outcome of congenital AML-M6 in premature infants are not available. We report the first treated case of congenital AML-M6 in a premature girl, who received a full AML protocol. She presented with blueberry-muffin spots, anemia, high white blood cell count, and serious cardiopulmonary distress. Peripheral blood smears showed AML-M6 blasts. After treatment with a sequential low-dose cytarabine after birth and full-dose AML treatment according to the MRC-12 protocol at the age of 2 months, she now is in continuous complete remission for 4 years.

  6. Physical properties of Kentucky's AML landslides: Case studies analyzed

    International Nuclear Information System (INIS)

    Iannacchione, A.T.; Vallejo, L.E.

    1994-01-01

    Once an abandoned mined land (AML) landslide occurs and is identified as an emergency, engineers must rapidly implement a slope stabilization design. Correct slope remediation solutions are generally derived from well-executed geotechnical examinations. This paper summarizes a large body of geotechnical data compiled by the US office of Surface Mining Reclamation and Enforcement (OSM) from AML landslides in eastern Kentucky. Special attention is placed on the examination of subsurface failures, phreatic water levels, soil profiles, and soil composition information from numerous borehole exploration programs. Strength properties calculated from laboratory procedures and stability analysis techniques were also reviewed. Laboratory-determined soil shear strength values were found to be higher than those inferred from stability analysis. This suggests that postfailure determinations of the phreatic surface may be largely inappropriate when used in stability analysis or that laboratory-measured shear strengths are ineffective in replicating in situ colluvium/spoil slope properties

  7. Socioeconomic Status (SES) and Childhood Acute Myeloid Leukemia (AML) Mortality

    Science.gov (United States)

    Knoble, Naomi B.; Alderfer, Melissa A.; Hossain, Md Jobayer

    2016-01-01

    Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3,651 pediatric AML patients, aged 0–19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02–1.12) and 1.05(1.00–1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1: (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3: (high economic/educational disadvantage, high-mobility) and Cluster 6: (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI) = 1.19(1.0–1.4) and 1.23 (1.1–1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. PMID:27543948

  8. A randomized assessment of adding the kinase inhibitor lestaurtinib to first-line chemotherapy for FLT3-mutated AML

    DEFF Research Database (Denmark)

    Knapper, Steven; Russell, Nigel; Gilkes, Amanda

    2017-01-01

    The clinical benefit of adding FMS-like tyrosine kinase-3 (FLT3)-directed small molecule therapy to standard first-line treatment of acute myeloid leukemia (AML) has not yet been established. As part of the UK AML15 and AML17 trials, patients with previously untreated AML and confirmed FLT3-activ...

  9. Schizophrenia as a disconnection syndrome. Studies with functional magnetic resonance imaging and structural equation modeling; Schizophrenie als Diskonnektionssyndrom. Studien mit funktioneller Magnetresonanztomographie und Strukturgleichungsmodellen

    Energy Technology Data Exchange (ETDEWEB)

    Schloesser, R. [Universitaet Jena, Psychiatrische Klinik (Germany); Universitaet Jena, Psychiatrische Klinik, Jena (Germany); Wagner, G.; Koehler, S.; Sauer, H. [Universitaet Jena, Psychiatrische Klinik (Germany)

    2005-02-01

    zeichneten sich zudem durch eine reduzierte interhemisphaerische kortikokortikale Konnektivitaet aus. Dieser Unterschied zu den Gesunden war bei den Patienten unter atypischen Antipsychotika nicht mehr in dieser Auspraegung zu beobachten, was als Ausdruck einer moeglichen positiven Beeinflussung der Informationsverarbeitung bei Patienten unter Atypika interpretiert werden koennte. Die erhaltenen Ergebnisse sind konsistent mit dem Modell der Schizophrenie als einem Diskonnektionssyndrom und frueheren Konzeptionen einer ''kognitiven Dysmetrie'' als Grundlage kognitiver Defizite bei dieser Erkrankung. (orig.)

  10. Transcriptome Profiling of Pediatric Core Binding Factor AML.

    Directory of Open Access Journals (Sweden)

    Chih-Hao Hsu

    Full Text Available The t(8;21 and Inv(16 translocations disrupt the normal function of core binding factors alpha (CBFA and beta (CBFB, respectively. These translocations represent two of the most common genomic abnormalities in acute myeloid leukemia (AML patients, occurring in approximately 25% pediatric and 15% of adult with this malignancy. Both translocations are associated with favorable clinical outcomes after intensive chemotherapy, and given the perceived mechanistic similarities, patients with these translocations are frequently referred to as having CBF-AML. It remains uncertain as to whether, collectively, these translocations are mechanistically the same or impact different pathways in subtle ways that have both biological and clinical significance. Therefore, we used transcriptome sequencing (RNA-seq to investigate the similarities and differences in genes and pathways between these subtypes of pediatric AMLs. Diagnostic RNA from patients with t(8;21 (N = 17, Inv(16 (N = 14, and normal karyotype (NK, N = 33 were subjected to RNA-seq. Analyses compared the transcriptomes across these three cytogenetic subtypes, using the NK cohort as the control. A total of 1291 genes in t(8;21 and 474 genes in Inv(16 were differentially expressed relative to the NK controls, with 198 genes differentially expressed in both subtypes. The majority of these genes (175/198; binomial test p-value < 10(-30 are consistent in expression changes among the two subtypes suggesting the expression profiles are more similar between the CBF cohorts than in the NK cohort. Our analysis also revealed alternative splicing events (ASEs differentially expressed across subtypes, with 337 t(8;21-specific and 407 Inv(16-specific ASEs detected, the majority of which were acetylated proteins (p = 1.5 x 10(-51 and p = 1.8 x 10(-54 for the two subsets. In addition to known fusions, we identified and verified 16 de novo fusions in 43 patients, including three fusions involving NUP98 in six

  11. Verantwortlicher Umgang mit Antibiotika: Notwendigkeit der Antibiotikareduktion in der Aknetherapie.

    Science.gov (United States)

    Gollnick, Harald P M; Buer, Jan; Beissert, Stefan; Sunderkätter, Cord

    2016-12-01

    Der übermäßige oder unkritische weltweite Einsatz von Antibiotika in der Medizin hat die Ausbreitung von Antibiotikaresistenzen beschleunigt. In einigen Bereichen sind viele Antibiotika bei bakteriellen Infektionen, die zuvor noch gut auf antibakterielle Wirkstoffe reagierten, mittlerweile wirkungslos geworden. Dermatologen/Venerologen setzten orale und topische Antibiotika bei der Behandlung von Acne vulgaris routinemäßig ein, obwohl Akne weder eine infektiöse Erkrankung ist noch alleine durch das Propionibacterium getriggert wird. Vielmehr ist sie eine komplexe, chronische entzündliche Hauterkrankung, die durch verschiedene pathogenetische Faktoren wie follikuläre Hyperkeratose, erhöhter Sebumproduktion, bakterielle Proliferation und Entzündung zustande kommt. Folglich sollte eine erfolgreiche Therapie auf die Bekämpfung verschiedener pathogenetischer Faktoren und nicht nur auf die von Propionibacterium acnes abzielen. Daher wurden topische Retinoide und Benzoylperoxid als Mittel der ersten Wahl definiert. Monotherapien mit lokalen Antibiotika sollten insgesamt vermieden werden. Systemische Antibiotika der Tetrazyklin-Gruppe haben bei bestimmen Krankheitsstadien ihren Sinn, ihre Wirkung könnte aber eher auf der antientzündlichen als auf der antibiotischen Reaktion beruhen. Gesundheitsbehörden ermahnen alle Gesundheitsdienstleister, den Einsatz von Antibiotika einzuschränken. Das Nutzen-Risiko-Verhältnis muss bei der Entscheidung für oder gegen eine antibiotische Therapie bei einem einzelnen Patienten immer auch in Bezug auf das öffentliche Interesse am Erhalt der Wirksamkeit von Antibiotika abgewogen werden. Im Folgenden werden das aktuelle Krankheitskonzept zu Acne vulgaris und die sich daraus ableitenden Konsequenzen für den Einsatz von Antibiotika vorgestellt. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  12. Neuroimaging of affect processing in schizophrenia; Funktionelle Bildgebung von emotionalem Verhalten und Erleben bei schizophrenen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Habel, U. [Universitaetsklinikum Aachen (Germany). Klinik fuer Psychiatrie und Psychotherapie; Universitaetsklinikum, Klinik fuer Psychiatrie und Psychotherapie, Aachen (Germany); Kircher, T.; Schneider, F. [Universitaetsklinikum Aachen (Germany). Klinik fuer Psychiatrie und Psychotherapie

    2005-02-01

    Functional imaging of normal and dysfunctional emotional processes is an important tool for a better understanding of the pathophysiology of affective symptoms in schizophrenia patients. These symptoms are still poorly characterized with respect to their neural correlates. Comparisons of cerebral activation during emotional paradigms offered the possibility for a better characterization of cerebral dysfunctions during emotional processing in schizophrenia. Abnormal activation patterns reveal a complex dysfunctional subcortical-cortical network. This is modulated by respective genotypes as well as psycho- and pharmacotherapy. (orig.) [German] Die funktionell bildgebende Untersuchung emotionaler Prozesse und ihrer Dysfunktionen ist fuer ein besseres Verstaendnis der Pathophysiologie emotionaler Stoerungen wesentlich. Schizophrene Patienten zeigen eine Reihe affektiver Symptome, die klinisch relevant, aber nur unzureichend bzgl. ihrer neurobiologischen Korrelate bekannt sind. Der Vergleich zerebraler Aktivierung zwischen gesunden und schizophrenen Patienten waehrend unterschiedlicher emotionaler Paradigmen hat dazu beigetragen, zerebrale Dysfunktionen naeher zu charakterisieren. So weisen auffaellige Aktivierungsmuster auf eine komplex gestoerte subkortikal-kortikale Netzwerkstruktur hin. Deren Modulation durch genetische Faktoren und durch psycho- wie auch pharmakologische therapeutische Interventionen konnte mittlerweile nachgewiesen werden. (orig.)

  13. Non-invasive estimation of intracranial pressure. MR-based evaluation in children with hydrocephalus; Nichtinvasive Bestimmung des intrakraniellen Drucks. MR-basierte Untersuchung bei Kindern mit Hydrozephalus

    Energy Technology Data Exchange (ETDEWEB)

    Muehlmann, M.; Steffinger, D.; Ertl-Wagner, B.; Koerte, I.K. [Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Peraud, A. [Ludwig-Maximilians-Universitaet Muenchen, Abteilung fuer Neurochirurgie, Muenchen (Germany); Lehner, M. [Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universitaet Muenchen, Abteilung fuer Kinderchirurgie, Muenchen (Germany); Heinen, F.; Alperin, N. [University Miami, Department of Radiology, Miller School of Medicine, Miami (United States)

    2012-09-15

    The intracranial pressure (ICP) is a crucially important parameter for diagnostic and therapeutic decision-making in patients with hydrocephalus. So far there is no standard method to non-invasively assess the ICP. Various approaches to obtain the ICP semi-invasively or non-invasively are discussed and the clinical application of a magnetic resonance imaging (MRI)-based method to estimate ICP (MR-ICP) is demonstrated in a group of pediatric patients with hydrocephalus. Arterial inflow, venous drainage and craniospinal cerebrospinal fluid (CSF) flow were quantified using phase-contrast imaging to derive the MR-ICP. A total of 15 patients with hydrocephalus (n=9 treated with shunt placement or ventriculostomy) underwent MRI on a 3 T scanner applying retrospectively-gated cine phase contrast sequences. Of the patients six had clinical symptoms indicating increased ICP (age 2.5-14.61 years, mean 7.4 years) and nine patients had no clinical signs of elevated ICP (age 2.1-15.9 years; mean 9.8 years; all treated with shunt or ventriculostomy). Median MR-ICP in symptomatic patients was 24.5 mmHg (25th percentile 20.4 mmHg; 75th percentile 44.6 mmHg). Median MR-ICP in patients without acute signs of increased ICP was 9.8 mmHg (25th percentile 8.6 mmHg; 75th percentile 11.4 mmHg). Group differences were significant (p < 0.001; Mann-Whitney U-test). The MR-ICP technique is a promising non-invasive tool for estimating ICP. Further studies in larger patient cohorts are warranted to investigate its application in children with hydrocephalus. (orig.) [German] Der intrakranielle Druck (''intracranial pressure'' - ICP) ist ein entscheidender Parameter bei der Diagnostik, Therapie und Verlaufsbeurteilung von Patienten mit Hydrozephalus. Derzeit gibt es keine radiologische Standardmethode, um den intrakraniellen Druck quantitativ zu bestimmen. Methoden zur invasiven und nichtinvasiven Einschaetzung des ICP werden diskutiert und die Anwendung eines MR

  14. The role of therapeutic leukapheresis in hyperleukocytotic AML.

    Directory of Open Access Journals (Sweden)

    Friederike Pastore

    Full Text Available Hyperleukocytosis in AML with leukostasis is a serious life-threatening condition leading to a high early mortality which requires immediate cytoreductive therapy. Therapeutic leukapheresis is currently recommended by the American Society of Apheresis in patients with a WBC>100 G/l with signs of leukostasis, but the role of prophylactic leukapheresis before clinical signs of leukostasis occur is unclear.We retrospectively analyzed the role of leukapheresis in 52 patients (median age 60 years with hyperleukocytotic AML with and without clinical signs of leukostasis. Since leukapheresis was performed more frequently in patients with signs of leukostasis due to the therapeutic policy in our hospital, we developed a risk score for early death within seven days after start of therapy (EDd7 to account for this selection bias and to independently measure the effect of leukapheresis on EDd7.20 patients received leukapheresis in combination to chemotherapy compared to 32 patients who received chemotherapy only. In a multivariate logistic regression model for the estimation of the probability of EDd7 thromboplastin time and creatinine remained as independent significant parameters and were combined to create an EDd7 risk score. The effect of leukapheresis on EDd7 was evaluated in a bivariate logistic regression together with the risk score. Leukapheresis did not significantly change early mortality in all patients with a WBC≥100 G/l.Prophylactic leukapheresis in hyperleukocytotic patients with and without leukostasis did not improve early mortality in our retrospective study. Larger and prospective clinical trials are needed to validate the risk score and to further explore the role of leukapheresis in AML with hyperleukocytosis.

  15. MPL expression on AML blasts predicts peripheral blood neutropenia and thrombocytopenia.

    Science.gov (United States)

    Rauch, Philipp J; Ellegast, Jana M; Widmer, Corinne C; Fritsch, Kristin; Goede, Jeroen S; Valk, Peter J M; Löwenberg, Bob; Takizawa, Hitoshi; Manz, Markus G

    2016-11-03

    Although the molecular pathways that cause acute myeloid leukemia (AML) are increasingly well understood, the pathogenesis of peripheral blood cytopenia, a major cause of AML mortality, remains obscure. A prevailing assumption states that AML spatially displaces nonleukemic hematopoiesis from the bone marrow. However, examining an initial cohort of 223 AML patients, we found no correlation between bone marrow blast content and cytopenia, questioning the displacement theory. Measuring serum concentration of thrombopoietin (TPO), a key regulator of hematopoietic stem cells and megakaryocytes, revealed loss of physiologic negative correlation with platelet count in AML cases with blasts expressing MPL, the thrombopoietin (scavenging) receptor. Mechanistic studies demonstrated that MPL hi blasts could indeed clear TPO, likely therefore leading to insufficient cytokine levels for nonleukemic hematopoiesis. Microarray analysis in an independent multicenter study cohort of 437 AML cases validated MPL expression as a central predictor of thrombocytopenia and neutropenia in AML. Moreover, t(8;21) AML cases demonstrated the highest average MPL expression and lowest average platelet and absolute neutrophil counts among subgroups. Our work thus explains the pathophysiology of peripheral blood cytopenia in a relevant number of AML cases. © 2016 by The American Society of Hematology.

  16. MITS instrumentation error analysis report

    International Nuclear Information System (INIS)

    Nelson, D.W.; Hillon, D.D.

    1980-01-01

    The MITS (Machine Interface Test System) installation consists of three types of process monitoring and control instrumentation: flow, pressure, and temperature. An effort has been made to assess the various instruments used and assign a value to the accuracy that can be expected. Efforts were also made to analyze the calibration and installation procedures to be used and determine how these might effect the system accuracy

  17. MIT miniaturized disk bend test

    International Nuclear Information System (INIS)

    Harling, O.K.; Lee, M.; Sohn, D.S.; Kohse, G.; Lau, C.W.

    1983-01-01

    A miniaturized disk bend test (MDBT) using transmission electron microscopy specimens for the determination of various mechanical properties is being developed at MIT. Recent progress in obtaining strengths and ductilities of highly irradiated metal alloys is reviewed. Other mechanical properties can also be obtained using the MDBT approach. Progress in fatigue testing and in determination of the ductile-to-brittle transition temperature is reviewed briefly. 11 figures

  18. AML with t(7;12)(q36;p13) is associated with infancy and trisomy 19. Data from NOPHO-AML and review of the literature

    DEFF Research Database (Denmark)

    Espersen, Anne Dorte Lerche; Noren-Nyström, Ulrika; Abrahamsson, Jonas

    2018-01-01

    The t(7;12)(q36;p13) (MNX1/ETV6) is not included in the WHO classification but has been described in up to 30% of acute myeloid leukemia (AML) in children ...). A literature review identified 35 patients with this translocation, published between 2000 and 2015. Outcome data were available in 22 cases. The NOPHO-AML (Nordic Society for Pediatric Hematology and Oncology) database contained 651 patients with AML from 1993 to 2014 and seven (1.1%) had the translocation...

  19. Videofluoroscopy of the pharynx and esophagus in patients with globus pharyngis. Comparison with static radiography; Die radiologische Abklaerung des Globus pharyngis. Vergleich der diagnostischen Wertigkeit von konventionellem Roentgen mit der Videokinematographie

    Energy Technology Data Exchange (ETDEWEB)

    Schober, E. [Abt. Roentgen fuer Konservative Faecher, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Schima, W. [Abt. Roentgen fuer Konservative Faecher, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Pokieser, P. [Abt. Roentgen fuer Chirurgische Faecher, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    1995-10-01

    The symptom is associated with a multitude of pharyngoesophageal abnormalities. Our study compares the diagnostic yield of videofluoroscopy to that of static radiography in patients suffering from globus pharnygis. A total of 150 consecutive patients complaining of a lump in the throat, but without evidence of dysphagia, were studied in a standardized fashion with both methods. Videofluoroscopy combined with static radiography revealed morphological or functional abnormalities in 75% of our patients. The combination of the two methods yielded significantly more abnormalities in the pharynx and esophagus than videofluoroscopy or static radiography alone. Esophageal motor disorders, pharyngoesophageal sphincter dysfunction and pharyngeal residue of contrast material proved to be the most common abnormalities. In conclusion, videofluoroscopy combined with static radiography is mandatory in the radiological assessment of patients suffering from the globus sensation. (orig.) [Deutsch] Unsere Studie vergleicht die diagnostische Wertigkeit des konventionellen Roentgens mit jener der Videokineamtographie von Pharynx und Oesophagus bei der Abklaerung des Globusgefuehls. Wir haben 150 konsekutive Patienten mit Globusgefuehl, jedoch ohne Dysphagie mit beiden Methoden nach einem standardisierten Protokoll untersucht. Mittels der Kombination von konventionellem Roentgen mit der Videokinematographie fanden sich bei 75% der Patienten pathologische Veraenderungen. Durch die Kombination beider Methoden konnten signifikant mehr morphologische und funktionelle Stoerungen des Pharynx sowie Oesophagus aufgezeigt werden, als mit der alleinigen konventionellen Technik oder der alleinigen Videokinematographie. Die haeufigsten pathologischen Veraenderungen in unserem Kollektiv waren Oesophagusmotilitaetsstoerungen, eine Dyskinesie des pharyngooesophagealen Sphinkters sowie eine abnorme pharyngeale Kontrastmittelretention. Unsere Ergebnisse belegen eindeutig, dass die radiologische

  20. Isoform-specific potentiation of stem and progenitor cell engraftment by AML1/RUNX1.

    Directory of Open Access Journals (Sweden)

    Shinobu Tsuzuki

    2007-05-01

    Full Text Available AML1/RUNX1 is the most frequently mutated gene in leukaemia and is central to the normal biology of hematopoietic stem and progenitor cells. However, the role of different AML1 isoforms within these primitive compartments is unclear. Here we investigate whether altering relative expression of AML1 isoforms impacts the balance between cell self-renewal and differentiation in vitro and in vivo.The human AML1a isoform encodes a truncated molecule with DNA-binding but no transactivation capacity. We used a retrovirus-based approach to transduce AML1a into primitive haematopoietic cells isolated from the mouse. We observed that enforced AML1a expression increased the competitive engraftment potential of murine long-term reconstituting stem cells with the proportion of AML1a-expressing cells increasing over time in both primary and secondary recipients. Furthermore, AML1a expression dramatically increased primitive and committed progenitor activity in engrafted animals as assessed by long-term culture, cobblestone formation, and colony assays. In contrast, expression of the full-length isoform AML1b abrogated engraftment potential. In vitro, AML1b promoted differentiation while AML1a promoted proliferation of progenitors capable of short-term lymphomyeloid engraftment. Consistent with these findings, the relative abundance of AML1a was highest in the primitive stem/progenitor compartment of human cord blood, and forced expression of AML1a in these cells enhanced maintenance of primitive potential both in vitro and in vivo.These data demonstrate that the "a" isoform of AML1 has the capacity to potentiate stem and progenitor cell engraftment, both of which are required for successful clinical transplantation. This activity is consistent with its expression pattern in both normal and leukaemic cells. Manipulating the balance of AML1 isoform expression may offer novel therapeutic strategies, exploitable in the contexts of leukaemia and also in cord blood

  1. Optimization of radiotherapy planning for Non-Small Cell Lung Cancer (NSCLC) by {sup 18}FDG-PET; Optimierung der Bestrahlungsplanung beim nicht-kleinzelligen bronchialkarzinom (NSCLC) mit Hilfe von {sup 18}FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, S.; Nestle, U.; Kirsch, C.M. [Abt. fuer Nuklearmedizin, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Walter, K. [Abt. fuer Strahlentherapie, Marienkrankenhaus Amberg (Germany); Licht, N.; Schnabel, K. [Abt. fuer Strahlentherapie, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Ukena, D. [Innere Medizin V, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany)

    2002-10-01

    Aim: In recent years, FDG-PET examinations have become more important for problems in oncology, especially in staging of bronchogenic carcinoma. In the retrospective study presented here, the influence of PET on the planning of radiotherapy for patients with non-small-cell lung cancer (NSCLC) was investigated. Methods: The study involved 39 patients with NSCLC who had been examined by PET for staging. They received radiotherapy on the basis of the anterior/posterior portals including the primary tumour and the mediastinum planned according to CT- and bronchoscopic findings. The results of the PET examination were not considered in initial radiotherapy planning. The portals were retrospectively redefined on the basis of FDG uptake considering the size and localization of the primary tumour; and FDG activities outside the mediastinal part of the portals. Results: In 15 out of 39 patients, the CT/PET-planned portals differed from the CT-planned ones. In most cases (n = 12) the CT/PET field was smaller than the CT field. The median geometric field size of the portals was 179 cm{sup 2}, after redefinition using PET 166 cm{sup 2}. In 20 patients with disturbed ventilation caused by the tumour (atelectosis, dystelectosis), a correction of the portal was suggested significantly more frequently than in the other patients (p = 0.03). Conclusions: Our results demonstrate the synergism of topographical (CT) and metabolic (FDG-PET) information, which could be helpful in planning radiotherapy of bronchial carcinoma, especially for patients with disturbed ventilation. (orig.) [German] Ziel: Die FDG-PET-Untersuchung hat in den vergangenen Jahren bei onkologischen Fragestellungen insbesondere beim Staging des Bronchialkarzinoms wachsende Bedeutung erlangt. In der vorliegenden retrospektiven Untersuchung wurde der Einfluss der PET auf die Strahlentherapieplanung bei Patienten mit non-small-cell lung cancer (NSCLC) untersucht. Methoden: Die Untersuchung umfasste 39 Patienten mit

  2. Asymptotically Matched Layer (AML) for transient wave propagation in a moving frame of reference

    DEFF Research Database (Denmark)

    Madsen, Stine Skov; Krenk, Steen

    2017-01-01

    The paper presents an Asymptotically Matched Layer (AML) formulation in a moving frame of reference for transient dynamic response of a multi-layer 2D half-space. A displacement based finite element formulation of the convected domain problem is presented together with the AML formulation in whic...

  3. Initiation of MLL-rearranged AML is dependent on C/EBPα

    DEFF Research Database (Denmark)

    Ohlsson, Ewa; Hasemann, Marie Sigurd; Willer, Anton

    2014-01-01

    have compared gene expression profiles from human MLL-rearranged AML to normal progenitors and identified the myeloid tumor suppressor C/EBPα as a putative collaborator in MLL-rearranged AML. Interestingly, we find that deletion of Cebpa rendered murine hematopoietic progenitors completely resistant...

  4. IL8-CXCR2 pathway inhibition as a therapeutic strategy against MDS and AML stem cells.

    Science.gov (United States)

    Schinke, Carolina; Giricz, Orsolya; Li, Weijuan; Shastri, Aditi; Gordon, Shanisha; Barreyro, Laura; Barreryo, Laura; Bhagat, Tushar; Bhattacharyya, Sanchari; Ramachandra, Nandini; Bartenstein, Matthias; Pellagatti, Andrea; Boultwood, Jacqueline; Wickrema, Amittha; Yu, Yiting; Will, Britta; Wei, Sheng; Steidl, Ulrich; Verma, Amit

    2015-05-14

    Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are associated with disease-initiating stem cells that are not eliminated by conventional therapies. Novel therapeutic targets against preleukemic stem cells need to be identified for potentially curative strategies. We conducted parallel transcriptional analysis of highly fractionated stem and progenitor populations in MDS, AML, and control samples and found interleukin 8 (IL8) to be consistently overexpressed in patient samples. The receptor for IL8, CXCR2, was also significantly increased in MDS CD34(+) cells from a large clinical cohort and was predictive of increased transfusion dependence. High CXCR2 expression was also an adverse prognostic factor in The Cancer Genome Atlas AML cohort, further pointing to the critical role of the IL8-CXCR2 axis in AML/MDS. Functionally, CXCR2 inhibition by knockdown and pharmacologic approaches led to a significant reduction in proliferation in several leukemic cell lines and primary MDS/AML samples via induction of G0/G1 cell cycle arrest. Importantly, inhibition of CXCR2 selectively inhibited immature hematopoietic stem cells from MDS/AML samples without an effect on healthy controls. CXCR2 knockdown also impaired leukemic growth in vivo. Together, these studies demonstrate that the IL8 receptor CXCR2 is an adverse prognostic factor in MDS/AML and is a potential therapeutic target against immature leukemic stem cell-enriched cell fractions in MDS and AML. © 2015 by The American Society of Hematology.

  5. 3 tesla magnetic resonance imaging in children and adults with congenital heart disease; 3-Tesla-Magnetresonanztomographie zur Untersuchung von Kindern und Erwachsenen mit angeborenen Herzfehlern

    Energy Technology Data Exchange (ETDEWEB)

    Voges, I.; Hart, C.; Kramer, H.H.; Rickers, C. [Universitaetsklinikum Schleswig-Holstein, Klinik fuer angeborene Herzfehler und Kinderkardiologie, Kiel (Germany); Jerosch-Herold, M. [Harvard Medical School, Department of Radiology, Brigham and Women' s Hospital, Boston (United States); Helle, M. [Universitaetsklinikum Schleswig-Holstein, Institut fuer Neuroradiologie, Kiel (Germany)

    2010-09-15

    Cardiovascular magnetic resonance imaging (CMR) has become a routinely used imaging modality for congenital heart disease. A CMR examination allows the assessment of thoracic anatomy, global and regional cardiac function, blood flow in the great vessels and myocardial viability and perfusion. In the clinical routine cardiovascular MRI is mostly performed at field strengths of 1.5 Tesla (T). Recently, magnetic resonance systems operating at a field strengths of 3 T became clinically available and can also be used for cardiovascular MRI. The main advantage of CMR at 3 T is the gain in the signal-to-noise ratio resulting in improved image quality and/or allowing higher acquisition speed. Several further differences compared to MRI systems with lower field strengths have to be considered for practical applications. This article describes the impact of CMR at 3 T in patients with congenital heart disease by meanings of methodical considerations and case studies. (orig.) [German] Die kardiovaskulaere Magnetresonanztomographie (MRT) hat sich zu einer etablierten bildgebenden Methode zur Untersuchung von Patienten mit angeborenen Herzfehlern entwickelt. Sie erlaubt in einer einzigen Untersuchung die exakte Beurteilung von Anatomie, globaler und regionaler Funktion, Blutfluessen sowie der myokardialen Perfusion und Vitalitaet. In der klinischen Routine erfolgen die Untersuchungen zumeist bei einer Feldstaerke von 1,5 Tesla (T), mittlerweile gibt es jedoch Geraete und Bildgebungstechniken, die die kardiovaskulaere MRT auch bei 3 T ermoeglichen. Der wesentliche Vorteil der MRT bei 3 T ist das hoehere Signal-zu-Rausch-Verhaeltnis, das sowohl zu einer Verbesserung der Bildqualitaet als auch zu einer Verkuerzung der Untersuchungszeit genutzt werden kann. Darueber hinaus bestehen verschiedene andere Unterschiede gegenueber Systemen mit niedriger Feldstaerke, die im praktischen Einsatz beachtet werden muessen. Dieser Artikel beschreibt die Erfahrungen der 3-T-MRT fuer die

  6. [Initial subretinal localization of acute myeloblastic leukemia (AML5) recurrence].

    Science.gov (United States)

    Le Gall, S; François, S; Urier, N; Genevieve, F; d'Hermies, F; Rachieru, P; Ifrah, N

    2001-10-13

    Reduced visual acuity in patients with acute leucemia can result from many causes including an ocular localization. A patient previously treated for acute myeloblastic leucemia-5 (AML5) developed bilateral vision impairment related to a subretinal localization of the leucemia. Meningeal and bone marrow relapse followed. The subretinal localization responded only to massive systemic steroid treatment. Although asymptomatic, ocular localizations are frequent in leucemia. Their prognostic impact depends on the ocular structure involved and on the chronology of onset--early or late in the leucemia course. The underlying pathophysiological mechanism of ocular involvement remains unexplained but hyperleucocytosis at presentation may be a risk factor and would justify at least systematic specialized examinations and discussion of prophylactic treatment.

  7. American experience in the implementation of AML / CFT system

    Directory of Open Access Journals (Sweden)

    Larin Dmitry

    2016-01-01

    Full Text Available This article presents a research into very specific matters and issues of creating and further improvement of Anti-Money Laundering and Combating the Financing of Terrorism system (abbreviated as AML/CFT in the USA. In contains a precise analysis of key elements of this system, as well as a deep look into the nature and purposes of financial intelligence “FinCEN”. Strong emphasis is laid on The US Foreign Account Tax Compliance Act (FATCA for the reason that, according to this Act, any foreign financial institution is legitimately forced to sign a special agreement with The US Internal Revenue Service (IRS, giving the Service power to maintain control over any American asset within its equity. The latter is understood as a legal right to investigate not only the accounts and property of American taxpayers, but to investigate any account or capital of any foreign institution having American shares or stocks.

  8. Percutaneous CT-guided treatment of osteoidosteomas: combination of drill biopsy and subsequent ethanol injection; Perkutane CT-gesteuerte Behandlung von Osteoidosteomen: kombiniertes Vorgehen mit einem Hohlbohrer und nachfolgender Aethanolinjektion

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Keulers, P. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Vorwerk, D. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Heller, K.D. [Orthopaedische Klinik, RWTH Aachen (Germany); Fuezesi, L. [Inst. fuer Pathologie, RWTH Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)

    1995-03-01

    The purpose of this study was the clinical evaluation of a percutaneous treatment modality in patients with an osteoidosteoma. 6 patients with an osteoidosteoma of the upper (n=1) and lower (n=5) extremity which were confirmed on plain film radiographs and computed tomography underwent CT controlled drill biopsy of the nidus with subsequent injection of 96% ethanol into the biopsy channel to sclerose probably remaining remnants of the nidus. The procedure was started under local anaesthesia, but drilling of the nidus was carried out under a short general anaesthesia using ketamine. The intervention was successful in all patients. No postinterventional infection occurred and no recurrence was observed in any of the patients in a follow-up time between 0.5 and 2 years. (orig./MG) [Deutsch] Zielsetzung der Untersuchungen war die klinische Erprobung eines perkutanen Verfahrens zur Behandlung von Osteoidosteomen. Bei 6 Patienten mit einem nativradiologisch und computertomographisch nachgewiesenen Osteoidosteom im Bereich der oberen (n=1) und der unteren Extremitaet (n=5) wurde perkutan unter CT-Kontrolle der Nidus ausgebohrt und ueber den Bohrkanal 96%iger Alkohol nachinjiziert, um etwaige Nidusreste zu sklerosieren. Der Eingriff wurde in Lokalanaesthesie begonnen, die Ausbohrung des Nidus unter einer Ketanestkurznarkose durchgefuehrt. Das Vorgehen war bei allen Patienten erfolgreich. In keinem Fall wurde eine postinterventionelle Infektion beobachtet. Ueber den Nachbeobachtungszeitraum von 0,5 bis zu 2,5 Jahren trat bei keinem der Patienten ein Rezidiv auf. (orig./MG)

  9. Prenatal origin of childhood AML occurs less frequently than in childhood ALL

    International Nuclear Information System (INIS)

    Burjanivova, Tatiana; Zuna, Jan; Madzo, Jozef; Muzikova, Katerina; Meyer, Claus; Schneider, Bjoern; Votava, Felix; Marschalek, Rolf; Stary, Jan; Trka, Jan

    2006-01-01

    While there is enough convincing evidence in childhood acute lymphoblastic leukemia (ALL), the data on the pre-natal origin in childhood acute myeloid leukemia (AML) are less comprehensive. Our study aimed to screen Guthrie cards (neonatal blood spots) of non-infant childhood AML and ALL patients for the presence of their respective leukemic markers. We analysed Guthrie cards of 12 ALL patients aged 2–6 years using immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangements (n = 15) and/or intronic breakpoints of TEL/AML1 fusion gene (n = 3). In AML patients (n = 13, age 1–14 years) PML/RARalpha (n = 4), CBFbeta/MYH11 (n = 3), AML1/ETO (n = 2), MLL/AF6 (n = 1), MLL/AF9 (n = 1) and MLL/AF10 (n = 1) fusion genes and/or internal tandem duplication of FLT3 gene (FLT3/ITD) (n = 2) were used as clonotypic markers. Assay sensitivity determined using serial dilutions of patient DNA into the DNA of a healthy donor allowed us to detect the pre-leukemic clone in Guthrie card providing 1–3 positive cells were present in the neonatal blood spot. In 3 patients with ALL (25%) we reproducibly detected their leukemic markers (Ig/TCR n = 2; TEL/AML1 n = 1) in the Guthrie card. We did not find patient-specific molecular markers in any patient with AML. In the largest cohort examined so far we used identical approach for the backtracking of non-infant childhood ALL and AML. Our data suggest that either the prenatal origin of AML is less frequent or the load of pre-leukemic cells is significantly lower at birth in AML compared to ALL cases

  10. MIT pebble bed reactor project

    Energy Technology Data Exchange (ETDEWEB)

    Kadak, Andrew C. [Massachusetts Institute of Technology, Cambridge (United States)

    2007-03-15

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis.

  11. MIT pebble bed reactor project

    International Nuclear Information System (INIS)

    Kadak, Andrew C.

    2007-01-01

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis

  12. {sup 31}P-MR spectroscopy of the brain in patients with anorexia nervosa: characteristic differences in the spectra between patients and healthy control subjects; {sup 31}P-MRS des Hirns bei Anorexia nervosa: charakteristische Unterschiede in den Spektren von Patienten und gesunden Vergleichspersonen

    Energy Technology Data Exchange (ETDEWEB)

    Rzanny, R.; Reichenbach, J.R.; Mentzel, H.J.; Pfleiderer, S.O.R.; Kaiser, W.A. [Inst. fuer Diagnostische und Interventionelle Radiologie, Klinikum der Friedrich-Schiller-Univ. Jena (Germany); Freesmeyer, D.; Klemm, S.; Gerhard, U.J.; Blanz, B. [Klinik fuer Kinder- und Jugendpsychiatrie, Klinikum der Friedrich-Schiller-Univ. Jena (Germany)

    2003-01-01

    Purpose: To investigate whether {sup 31}P-MR spectroscopy can detect reduced concentrations of high-energy phosphates, like PCr and NTP, caused by decreased metabolic activity in the brain of patients with anorexia nervosa (AN) and, furthermore, whether any impairment of the cerebral membrane metabolism can be derived from the spectra. Material and Methods: 10 female patients, age range 12 - 20 years and mean BMI (body mass index) of 14.8 {+-} 1.6 kg/m{sup 2}, with clinically diagnosed AN (ICD-10, F50.0) and 10 healthy control subjects, age range 12 - 21 years and mean BMI 19.0 {+-} 2.1 kg/m{sup 2}, without nutritional disturbances: were investigated. {sup 31}P-MR spectroscopy was performed with a 1.5 T MRI unit using single volume selection in the frontal/prefrontal region of brain. Relative metabolic concentrations were quantified by normalizing the peak areas of the metabolites with the total area of the complete phosphorous spectrum, P{sub tot}, as well as with the peak area of β-NTP. Results: Significant differences between the two groups were observed for the metabolic ratios PDE/P{sub tot}, PDE/β-NTP and {alpha}-NTP/P{sub tot} which were lower in the patient group except for {alpha}-NTP/P{sub tot}. These ratios also revealed a statistically significant correlation with the BMI (r{sub PDE/Ptot} = 0.747, r{sub PDE/β-NTP} = 0.57, r{sub {alpha}}{sub -NTP/Ptot} = -0.56; p {<=} 0.1). Reduced relative concentrations of PCr/P{sub tot}, β-NTP/P{sub tot} or Pi/P{sub tot} were not encountered. Conclusion: The lowered PDE/P{sub tot} ratio for patients with AN and its correlation with BMI suggests that decreased BMI induces compositional changes of the phospholipids in the brain, which decrease the fraction of mobile phospholipids. (orig.) [German] Problemstellung: Das Ziel dieser Studie war es zu untersuchen, ob mit Hilfe der {sup 31}P-MR-Spektroskopie ({sup 31}P-MRS) im Gehirn von Patienten mit Anorexia nervosa (AN) verringerte Konzentrationen an

  13. Biotechnology Process Engineering Center at MIT Home

    Science.gov (United States)

    has provided a focal point for biotechnology research and education at MIT. Prominent examples include the NIH Training Program in Biotechnology and the NIH Training Program in Genomics; both of these are -genomic biology. Another example is the new DuPont-MIT Alliance (DMA), focused on materials biotechnology

  14. MR aspect of the prostate in CPPS patients (chronic pelvic pain syndrome); MR-Befundmuster der Prostata bei Patienten mit CPP Syndrom (chronic pelvic pain syndrome)

    Energy Technology Data Exchange (ETDEWEB)

    Wiesinger, B.; Lichy, M.P.; Claussen, C.D.; Schlemmer, H.P. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Naegele, U.; Anastasiadis, A. [Abt. fuer Urologie, Universitaetsklinikum Tuebingen (Germany)

    2008-07-15

    Purpose: to describe typical morphological patterns of abacterial prostatitis using magnetic resonance imagine (MRI) in chronic pelvic pain syndrome patients including spectroscopy. Materials and methods: 18 patients (age range between 25 and 67 years, average 46.2 years) with recurrent chronic pelvic pain syndrome for at least 3 months were evaluated clinically in the urological department and included if there were no suspicious findings from endorectal digital palpation and if their PSA values were < 5 ng/ml. A retrospective analysis of these 18 patients with 30 contrast-enhanced MRI investigations with endorectal coils in 28 of 30 cases was performed with a 1.5T MRI. T2w signal intensity (SI) and spectroscopy data (9/18 patients) were acquired for the normal peripheral zone, the central zone, for the peripheral zone suspected of inflammation and for the muscle including SI ratios for the unaltered and the suspicious inflammatory peripheral zone. Results: typical MR patterns of signal alterations suspected of inflammation of CPPS patients were able to be detected as T2w hypointense triangular, stringy (n = 12, 66.6%) contrast-enhancing signal alterations without a nodular shape with well circumscribed margins of the capsula and without pericapsular signal alterations. In 6 patients changes also had a triangular but more homogeneous aspect (33.3%). Three patients had an additional periurethral uptake (16.6%). T2w SI measurements and T2w SI ratios showed much lower values for the peripheral zone suspected of inflammation as compared to the normal peripheral zone of the prostate (277.29 STD 77.5 to 432.9 STD 112.02 and 4.94 STD 1.47 to 7.58 STD 2.01 respectively). The spectroscopic analysis of the signal alterations suspected of inflammation showed normal Cholin+ Creatin/Citrate SI ratio values in 3 patients (SI < 0.5), ratios suspected of low grade cancer in 3 patients (SI 0.5 and < 0.7) and ratios suspected of intermediate grade prostate cancer in 3 patients (SI > 0.7 and < 3.0). (orig.)

  15. Effects of radiotherapy in the treatment of multiple myeloma; Stellenwert der Strahlentherapie und deren Nebenwirkungen bei der Behandlung von Patienten mit Multiplem Myelom

    Energy Technology Data Exchange (ETDEWEB)

    Ochtrop, Thomas Alexander

    2015-07-01

    Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. Patients and methods: We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie and Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of at least one and up to 6 bony lesions at different times. In order to evaluate the effect of local radiotherapy on pain relief and bone recalcification a uni- and multivariate analysis was performed using a binary logistic regression model to correct for multiple measurements. Complete information on dose, fractionation and volume of radiotherapy was available from 81 patients treated in 136 target volumes for pain relief, and from 69 patients treated in 108 target volumes for recalcification. Total radiation doses varied between 8 Gy to 50 Gy (median dose 25 Gy in 2.5 Gy fractions, 5 times a week). Results: Radiotherapy resulted in complete local pain relief in 31% and partial local pain relief in 54% of the patients. In the univariate analysis, higher total radiation doses (p = 0.023) and higher age (p = 0.014) at the time of radiotherapy were significantly associated with a higher likelihood of pain relief, whereas no significant association was detected for concurrent systemic treatment, type and stage of myeloma and location of bone lesions. The same variables were independent predictors for pain relief in the multivariate analysis. Recalcification was observed in 48% of irradiated bone lesions. In the uni- and multivariate analysis higher radiation doses were significantly associated (p = 0.048) with an increased likelihood of recalcification. Side effects of radiotherapy were generally mild. Conclusions: Higher total biological radiation doses were associated with better pain relief and recalcification in this retrospective evaluation of multiple myeloma patients. In addition, in the elderly the therapeutic measures appear to develop a better analgesic effect.

  16. The detection of gastro-oesophageal reflux in varicose changes of the oesophagus using scintigraphy. Szintigraphischer Nachweis des gastro-oesophagealen Refluxes bei Patienten mit Oesophagusvarizen

    Energy Technology Data Exchange (ETDEWEB)

    Kielmann, U.

    1984-08-27

    Comparative studies carried out in 22 bearers of oesophageal varices and 13 asymptomatic healthy volunteers on the basis of gastric reflux scintigraphy revealed findings to prove the occurrence of physiological reflux for the control group and, by contrast with this observation, markedly prolonged reflux episodes in the patient group. The occurrence of reflux was seen to be linked to the size of the varices found in the terminal oesophagus (negative correlation). A positive and significant correlation could be established between the size of a patient's varices and the frequency of haemorrhages. Bleedings and reflux episodes, however, were observed to be quite unrelated events. The results obtained strongly suggested that gastro-oesophageal reflux cannot be regarded as having a key role in haemorrhages from oesophageal varices. Nor was it possible to find statistical support for the effects of sclerotherapy on the frequency of haemorrhages. This was evidence in confirmation of the fact that obliteration is the obvious method in the treatment of haemorrhaging varices of the oesophagus. (TRV).

  17. Versorgung von Patienten mit chronischem orofazialem Schmerz. Ergebnisse einer Befragung in ambulanten zahnärztlichen und Mund-Kiefer-Gesichts-Chirurgie-Einrichtungen

    NARCIS (Netherlands)

    Wirz, S.; Wartenberg, H. C.; Wittmann, M.; Baumgarten, G.; Knüfermann, P.; Korthaus, T.; Putensen, C.; Nadstawek, J.

    2003-01-01

    OBJECTIVE: The aim of this study was to evaluate the significance attributed by dental and maxillofacial surgeons to the ambulatory management of chronic orofacial pain syndromes. MATERIALS AND METHODS: All the dentists and oral and maxillofacial surgeons working in ambulatory capacities within a

  18. Radiation therapy in patients with cardiac pacemakers or implantable cardioverter defibrillators. Interdisciplinary safety recommendations; Strahlentherapie bei Patienten mit Herzschrittmachern oder implantierbaren Kardioverter-Defibrillatoren. Interdisziplinaere Sicherheitsempfehlungen

    Energy Technology Data Exchange (ETDEWEB)

    Dorenkamp, M.; Haverkmap, W.; Roser, M. [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum (Germany). Medizinische Klinik mit Schwerpunkt Kardiologie; Stromberger, C.; Wust, P. [Charite Universitaetsmedizin Berlin (Germany). Klinik fuer Radioonkologie und Strahlentherapie; Heymann, C. von [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum (Germany). Klinik fuer Anaesthesiologie mit Schwerpunkt operative Intensivmedizin

    2013-01-15

    Background: With increasing numbers of implanted pacemakers and implantable cardioverter defibrillators (ICD) and a rising incidence of malignant tumors, there is a growing probability of radiation-mediated device dysfunction. The only guidelines for the management of patients with cardiac pacemakers in the case of radiation therapy were published in 1994 and have not been updated since then. Based on the current evidence and modern device technology, the present paper aims to develop contemporary and interdisciplinary safety recommendations for the minimization of patient risk. Methods and results: A systematic literature research was carried out including the most relevant medical electronic databases. The search yielded 147 articles published between 1994 and 2012 of which 45 met the selection criteria and of these studies 34 presented primary data (9 in vitro and 25 in vivo studies). The impact of ionizing radiation varied significantly between implanted devices and ranged from no functional changes to complete loss of function. Important device dysfunctions included changes in sensing capability, altered pacing pulses or rate, changed or disabled tachyarrhythmia ICD therapies, early battery depletion and loss of telemetry. Modern pacemakers and ICDs are more sensitive to radiation than older models. Potentially life-threatening complications were observed after exposure of the pulse generator to comparatively low radiation doses (0.11 Gy). Conclusions: Practical recommendations for patient management and safety are presented that can be readily adopted by any institution carrying out radiation therapy. (orig.)

  19. German Roentgen Society statement on MR imaging of patients with cardiac pacemakers; Positionspapier der Deutschen Roentgengesellschaft (DRG) zu MR-Untersuchungen bei Patienten mit Herzschrittmachern

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, T. [German Red Cross Hospital Neuwied (Germany). Dept. of Diagnostic and Interventional Radiology; Luechinger, R. [Zuerich Univ. (Switzerland). Inst. for Biomedical Engineering; Barkhausen, J. [University Hospital Luebeck (Germany). Dept. of Radiology and Nuclear Medicine; Gutberlet, M. [Univ. Leipzig - German Heart Center Leipzig (Germany). Dept. of Diagnostic and Interventional Radiology; Quick, H.H. [University Hospital Essen (Germany). Erwin L. Hahn Inst. for MR Imaging, High Field and Hybrid MR Imaging; Fischbach, K. [University Hospital Magdeburg (Germany). Dept. of Radiology and Nuclear Medicine

    2015-09-15

    The aim of this paper is to inform physicians, especially radiologists and cardiologists, about the technical and electrophysiological background of MR imaging of patients with implanted cardiac pacemakers (PM) and to provide dedicated clinical practice guidelines how to perform MR exams in this patient group. The presence of a conventional PM system is not any more considered an absolute contraindication for MR imaging. The prerequisites for MR imaging on pacemaker patients include the assessment of the individual risk/benefit ratio as well as to obtain full informed consent about the off label character of the procedure and all associated risks. Furthermore the use of special PM-related (e.g. re-programming of the PM) and MRI-related (e.g. limitation of whole body SAR to 2 W/kg) precautions is required and needs to be combined with adequate monitoring during MR imaging using continuous pulsoximetry. MR conditional PM devices are tested and approved for the use in the MR environment under certain conditions, including the field strength and gradient slew rate of the MR system, the maximum whole body SAR value and the presence of MR imaging exclusion zones. Safe MR imaging of patients with MR conditional PM requires the knowledge of the specific conditions of each PM system. If MR imaging within these specific conditions cannot be guaranteed in a given patient, the procedure guidelines for conventional PM should be used. The complexity of MR imaging of PM patients requires close cooperation of radiologists and cardiologists.

  20. Magnetic resonance imaging findings of the brain in adult HIV and AIDS patients; Magnetresonanztomografische Befunde des Gehirns bei adulten Patienten mit HIV und AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, S.P.; Schlegel, P.M.; Fischbach, R.; Heindel, W. [Inst. fuer Klinische Radiologie, Universitaetsklinikum Muenster (Germany); Husstedt, I.W.; Anneken, K.; Evers, S. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Muenster (Germany)

    2008-01-15

    The spectrum of pathology affecting the central nervous system (CNS) in patients suffering from acquired immunodeficiency syndrome (AIDS) includes not only the human immunodeficiency virus (HIV) infection itself but also opportunistic infections and tumors secondary to AIDS. Despite progress in antiretroviral therapy and the subsequent decrease in the incidence of associated diseases, opportunistic infections and tumors secondary to the HIV infection continue to be the limiting factor in terms of survival with AIDS. Therefore, the therapeutic aim is permanent antiretroviral therapy as well as early diagnosis and treatment of opportunistic infections. Magnetic resonance imaging is often the diagnostic method of choice in suspected CNS pathology of HIV patients. In the following, the typical clinical and radiological features of several AIDS-related pathologies are presented and discussed. (orig.)

  1. Pain and quality of life following palliative radiotherapy of bone metastases; Der Einfluss palliativer Strahlentherapie auf Schmerz und Lebensqualitaet bei Patienten mit Knochenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Sauer, N.; Wild, B.; Henningsen, P.; Jakobsen, T. [Klinik fuer Psychosomatische und Allgemeine Klinische Medizin, Univ. Heidelberg (Germany); Leising, D. [Inst. fuer Psychologie, Univ. Wuerzburg (Germany); Treiber, M. [Radiologische Universitaetsklinik, Heidelberg (Germany)

    2006-09-15

    Pain and quality of life following palliative radiotherapy of bone metastases Background and purpose: palliative irradiation is used to provide pain relief and to increase quality of life. Most studies exclude patients with advanced cancer disease and, therefore, a positive selection results. This prospective clinical study investigates the effect of palliative radiotherapy on pain and quality of life of patients with painful bone metastases. Patients and methods: 263 patients with bone metastases due to advanced cancer were observed with respect to pain and quality of life during a 2-month course of radiotherapy. Missing data were substituted by the LOCF method (last observation carried forward) to prevent a biased reduction of data. Results: radiotherapy resulted in pain relief. In the complete group, pain medication was not increased. Quality of life was not affected positively. Side effects of radiotherapy increased remarkably. Conclusion: Radiotherapy leads to pain relief. However, risks and benefits must be considered critically due to side effects. (orig.)

  2. Standardized X-ray reports of the spine in osteogenesis imperfecta; Standard zur Befundung von Roentgenaufnahmen der Wirbelsaeule bei Patienten mit Osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, Friederike; Demant, A.W.; Koerber, S. [Universitaetsklinikum Koeln (Germany). Kinderradiologie, Inst. und Poliklinik fuer Radiologische Diagnostik; Semler, O.; Schoenau, E. [Universitaetsklinikum Koeln (Germany). Osteologie, Klinik und Poliklinik fuer Allgemeine Kinderheilkunde; Lackner, K.J. [Universitaetsklinikum Koeln (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik

    2011-05-15

    Purpose: In this study we present a standard for radiological reports in patients with osteogenesis imperfecta (OI). The parameters can be used to describe X-rays of the lateral spine and give an impartial description of anatomical structures during a treatment with bisphosphonates. Material and Methods: In this retrospective analysis we included 48 patients with OI (31 female, 17 male [1.5 months - 19 years, mean age 9.0 years]). Lateral spine X-rays were analyzed by 2 radiologists before and during treatment. The parameters of the standardized report are degree of kyphoscoliosis, compression of single vertebrae, predominant type of vertebral deformities and extent of vertebral compression (score 1 - 5). Results: There was no clear trend in the change of compression of single vertebrae. Some vertebrae with ventral compression showed an upgrowth to vertebrae with harmonic compression. Other deformities showed only marginal changes. In 26 patients the kyphoscoliosis improved (mean 10 degrees), in 36 patients the thoracic vertebrae compression increased and in 30 patients the vertebral height in the lumbar spine increased. The improvement of vertebral height was 1 point in the thoracic and lumbar spine. Conclusion: We propose a standardized report of X-rays of the lateral spine in patients with OI with quantitative and semiquantitative parameters using morphological criteria. These include compression of single vertebrae, degree of kyphoscoliosis, vertebral deformities and the severity of vertebral compression in the thoracic and lumbar spine. (orig.)

  3. Magnet discolation - An increasing and serious complication following MRI in patients with chochlear implants; Magnetdiskolation - eine zunehmende und folgenreiche Komplikation nach MRT bei Patienten mit Cochlea Implantat

    Energy Technology Data Exchange (ETDEWEB)

    Hassepass, F.; Staubenau, V.; Arndt, S.; Beck, R.; Grauvogel, T.; Aschendorff, A. [Univ. Medical Center Freiburg (Germany). Dept. of Otorhinolaryngology-Head and Neck Surgery; Bulla, S. [Univ. Medical Center Freiburg (Germany). Dept. of Diagnostic Radiology

    2014-07-15

    Cochlear implantation (CI) represents the gold standard in the treatment of children born deaf and postlingually deafened adults. Initial magnetic resonance imaging (MRI) was contraindicated in CI users. Meanwhile, there are specific recommendations concerning MRI compatibility depending on the type of CI system and the device manufacturer. Some CI systems are even approved for MRI with the internal magnet left in place. The aim of this study was to analyze all magnet revision surgeries in CI patients at one CI center and the relationship to MRI scans over time. Between 2000 and 2013, a total of 2027 CIs were implanted. The number of magnet dislocation (MD) surgeries and their causes was assessed retrospectively. In total 12 cases of MD resulting from an MRI scan (0.59 %) were observed, accounting for 52.2 % of all magnetic revision surgeries. As per the labeling, it was considered safe to leave the internal magnet in place during MRI while following specific manufacturer recommendations: MRI intensity of 1.5 Tesla (T) and compression head bandage during examination. A compression head bandage in a 1.5 T MRI unit does not safely prevent MD and the related serious complications in CI recipients. We recommend a Stenvers view radiograph after MRI with the internal magnet in place for early identification of MD, at least in the case of pain during or after MRI examination. MRI in CI patients should be indicated with restraint and patients should be explicitly informed about the possible risks. Recommendations regarding MRI compatibility and the handling of CI patients issued with MRI for the most common CI systems are summarized.

  4. Morphological aspects of liver CT in patients with HIV infections. CT-morphologische Aspekte der Leber bei Patienten mit HIV-Infektion

    Energy Technology Data Exchange (ETDEWEB)

    Schedel, H [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Wicht, L [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Roegler, G [2. Medizinische Klinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Langer, R [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Felix, R [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-07-01

    CT examinations of the liver in HIV-infected patients show more frequent pathological findings. The extended spectrum of differential diagnosis and atypical manifestations of disorders in immunodeficient patients needs to be considered in the interpretation of CT scans. Difficulties in the differential diagnosis of focal hepatic lesions in HIV-infected patients are demonstrated in the following. Besides the relatively common findings in HIV-infection such as hepato- or hepatosplenomegalia, lymphoma, and inflammatory changes of the bowel an infection with Cryptococcus neoformans, hepatitis, and local steatosis of the liver are discussed as the rare causes for suspect computertomographic findings in the live of HIV-infected patients. The examinations were obtained consecutively in 76 HIV-infected patients during abdominal CT staging. (orig.)

  5. Computer-assisted analysis and scientific evaluation of patients with cerebral angiomas. Die computerunterstuetzte Analyse und wissenschaftliche Auswertung von Patienten mit zerebralen Angiomen

    Energy Technology Data Exchange (ETDEWEB)

    Killer, M

    1993-04-01

    The treatment of cerebral arterio-venous malformations currently consists of a combination of different techniques, such as surgical extirpation, endovascular embolization and radiosurgery. Depending on the patient's anamnesis and pathomorphology the objective of the treatment is either a total elimination of the AVM or an improvement of the symptoms. In order to capture the large quantities of data accumulated during the variously combined methods as well as from manifold medical examinations before and during the treatment, a data capture program is presented. This program, developed on the basis of the File Maker 2.0 by Claris, allows the registration of data obtained in preliminary examinations, therapies and follow-ups. The database thus created, allows for a simple and fast registration of all the important parameters pertaining to the current treatment of AVM. The analysis of the data, when related to a particular patient, facilitates determining the further course of action and treatment of this patient. Furthermore the statistical analysis of different relationships of AVM-parameters permits to gain important feedback about the efficacy of the selected strategies of treatment. In this thesis, the data of 143 patients, who underwent treatment for cerebral AVM at the Department of Neurosurgery of the University of Vienna between March 1985 and October 1992 was evaluated. Of these patients 47% were female and 53% male, their mean age being 35.6 years.

  6. Diagnostic value of somatostatin receptor scintigraphy in patients with intracranial tumours. Diagnostische Wertigkeit der Somatostatin-Rezeptor-Szintigraphie bei Patienten mit intrakraniellen Raumforderungen

    Energy Technology Data Exchange (ETDEWEB)

    Luyken, C. (Klinik fuer Neurochirurgie, Koeln Univ. (Germany)); Hildebrandt, G. (Klinik fuer Neurochirurgie, Koeln Univ. (Germany)); Scheidhauer, K. (Klinik fuer Nuklearmedizin, Koeln Univ. (Germany)); Kirsch, B. (Anatomisches Inst., Kiel Univ. (Germany))

    1993-12-01

    The aim of the study was to detect the SR binding sites in intracranial tumours and to evaluate the benefit of SRS in pre- and postoperative diagnostics. 86 patients with 94 intracranial tumours (39 meningiomas, 18 pituitary adenomas, 11 gliomas grade 3 or 4, 8 gliomas grade 2, 5 neurinomas, 5 intracranial metastases, 4 tumours of the orbit, 2 neurofibromas, 1 brain abscess and 1 cystic lesion) were examined. [sup 111]In-octreotide was injected i.v. as 10 [mu]g or 20 [mu]g bolus, corresponding to 110 or 220 MBq (3 or 6 mCi). Gamma-camera images and SPECT were obtained 3-6 h and 24 h post injection. The scintigraphic evaluation was performed without knowledge of CT and MRI results. The histological classification corresponded to the WHO grading system. Somatostatin binding sites were detected in vito using somatostatin-gold conjugates. All patients with meningiomas showed a high focal tracer uptake corresponding to SR binding sites in vitro, whereas only in 50% of the pituitary adenomas SRS was positive. Neurinomas did not show any tracer uptake. In patients with gliomas with disturbed blood-brain-barrier positive tracer uptake was detected, while none of the gliomas with intact blood-brain-barrier could be visualized by SRS but showed somatostatin binding sites in vitro. In intracranial metastases a local tracer uptake was detected in vivo. In vitro 3 of 4 cases showed somatostatin binding sites. In 2 cases extracranial tracer uptake showed the primary tumour and metastases of the lymphnodes. Somatostatin receptor scintigraphy can help to detect or to exclude meningiomas especially in the cerebellopontine angle or in the orbit. In intracranial metastases SRS may point to the primary tumour or other metastases. In all other intracranial tumours receptor scintigraphy provides no clinical relevant information. (orig./MG)

  7. Percutaneous arteriovenous shunting in patients with severe COPD. A new interventional radiological treatment; Perkutane arteriovenoese Shuntanlage bei Patienten mit schwerer COPD. Eine neue interventionelle radiologische Technik

    Energy Technology Data Exchange (ETDEWEB)

    Schlosser, Thomas; Forsting, M. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Burbelko, M. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Ulrich, M. [Parkkrankenhaus Leipzig (Germany). Klinik fuer Innere Medizin/Angiologie/Kardiologie; Ludwig, F.; Reutiman, T. [ROX Medical, San Clemente, CA (United States); Antoch, G. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Adamus, R. [Klinikum Nuernberg Nord (Germany). Inst. fuer Radiologie

    2013-03-15

    Purpose: The aim of this study was to evaluate the technical feasibility and safety of a new interventional radiological technique to create a shunt percutanously between the external iliac vein and artery in patients with severe COPD. Materials and Methods: 40 patients were included in this multicenter trial. In 38 patients the artery was punctured from the vein using a novel crossing needle. A special delivery system was used to implant a novel nitinol device (ACS, ROX Medical) between the artery and the vein to maintain a 4 mm calibrated and structured fistula between the two vessels. Results: Shunt implantation was successful in 38 patients. The perfused arteriovenous shunts could be well documented in DSA and the diameter was measured between 3 and 4 mm in all cases. Peri-interventional non-flow-limiting dissection of the iliac artery occurred in one patient. Post-interventional venous bleeding in two patients was treated successfully by local compression. In one patient a peripheral artery thrombembolism was successfully treated by thrombolysis. Conclusion: The new interventional radiological technique to create an arteriovenous shunt in the iliac vessels presented in this study has proven to be feasible and safe. (orig.)

  8. MR enterography sequence evaluation for patients with Crohn's disease; Sequenz-Evaluation fuer die MR-Enterografie fuer Patienten mit Morbus Crohn

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, S.; Dendle, L.M.; Friedrich, C.; Wiggermann, P.; Stroszczynski, C.; Schreyer, A.G. [Universitaetsklinikum Regensburg (Germany). Inst. fuer Roentgendiagnostik; Pawlik, M. [Caritas-Krankenhaus St. Josef, Regensburg (Germany). Klinik fuer Anaesthesiologie, Intensiv- und Notfallmedizin; Ott, C. [Universitaetsklinikum Regensburg (Germany). Klinik und Poliklinik fuer Innere Medizin I; Agha, A. [Universitaetsklinikum Regensburg (Germany). Klinik und Poliklinik fuer Chirurgie

    2013-05-15

    Purpose: To evaluate a routine MR enterography (MRE) protocol for patients with Crohn's disease (CD) in order to assess and rank the subjectively most important sequences regarding diagnostic decisions. Materials and Methods: We prospective ly examined 84 patients (42 male) with known CD using a coronal T2/T1-weighted balanced SSFP (TrueFISP), axial T2-weighted single shot TSE (HASTE) as well as an axial T1-weighted gradient-echo sequence (2D-FLASH) before intravenous contrast application and a 2D-FLASH sequence with axial and coronal orientation after in travenous contrast application. 4 experienced radiologists subjectively evaluate d the sequences independently using a scale between 1 and 5 (1 = excellent; 5 = non-diagnostic) regarding their diagnostic significance for a final radiologic d ecision. The ranking of the different sequences was statistically tested by the Friedman analysis. Results: The following ranking was found: HASTE sequences wer e ranked prior to contrast-enhanced axial gradient-echo (2D-FLASH). The third to fifth ranking was TrueFISP, the axial contrast-enhanced 2D-FLASH and the 2D-FLA SH without contrast, respectively. Differences between the first and second rank were significant (p < 0.05), and all other differences were highly significant (p < 0.01). Conclusion: The stable and fast T2-weighted MR sequences without intravenous contrast represented by axial HASTE and coronal TrueFISP were ranked as number 1 and 3. The examination protocol should be completed by a coronal T 1-weighted gradient-echo-sequence after contrast injection, which can be supplemented by an axial acquisition. The T1-weighted gradient-echo sequence without contrast could be omitted. (orig.)

  9. 1H-MR-spectroscopy in Anorexia nervosa; characteristic differences between patients and normal controls; 1H-MR-Spektroskopie bei Anorexia nervosa: Charakteristische Unterschiede zwischen Patienten und gesunden Probanden

    Energy Technology Data Exchange (ETDEWEB)

    Hentschel, F. [ZI Mannheim (Germany). Abt. fuer Neuroradiologie; Moeckel, R.; Schlemmmer, H.P.; Gueckel, F.; Koepke, J.; Georgi, M. [Universitaetsklinik Mannheim (Germany). Inst. fuer Klinische Radiologie; Markus, A.; Goepel, C.; Schmidt, M.H. [ZI Mannheim (Germany). Klinik fuer Kinder- und Jugendpsychiatrie

    1999-03-01

    Results: The ratio of NAA/PCr in both voxels were not significantly different when comparing patients vs. controls. Patients showed significantly higher ratios of choline-containing components (Cho) or, respectively Cho/PCr and NAA/PCr in the white matter. Distinct, but not significant differences were detected both for m-Ino and m-Ino/PCr in the parieto-occipital region and for the Cho- and m-Ino cotained ratios in the thalamus. Conclusion: AN is not associated with neuronal damage. The ratio of Cho/PCr and NAA/Cho may reflect the disturbance of membrane-turnover. It is possible that the increase of membrane catabolism leads to a hyperosmolar state. The change of m-Ino/PCr ratio may reflect the regulation of osmolarity. (orig.) [Deutsch] Ergebnisse: In den beiden Voxeln wies N-acetylspartat (NAA) als NAA/PCr keine relevanten Unterschiede zwischen Patienten mit AN und Kontrollen auf. Signifikante Unterschiede wurden ausschliesslich fuer Cholin (Cho) resp. die Quotienten Cho/PCr und NAA/Cho in der POR gefunden. Die Ergebnisse fuer myo-Inositol (m-Ino) resp. den Quotienten m-Ino/PCr in der POR und beider relevanter Cho-Metabolitenratios in der ThR unterschieden sich z.T. deutlich, aber nicht signifikant. Diskussion: Unveraendertes NAA als NAA/PCr spricht in Korrelation mit den reversiblen klinischen und hirnmorphologischen Befunden dafuer, dass es bei der AN nicht zu einem neuronalen Untergang kommt. Als Ursache fuer die Erhoehung des Peaks von Cho/PCr ist ein vermehrter Membrankatabolismus bei der AN zu diskutieren, der zu einer Veraenderung des osmotischen Druckes im Gewebe fuehrt. In diesem Zusammenhang ist auch die Bedeutung des m-Ino als Osmolyt zu eroertern, wenngleich die Ergebnisse bei differierenden Einzelwerten fuer m-Ino/PCr noch keine einheitliche Interpretation zulassen. (orig.)

  10. Rapid expansion of preexisting nonleukemic hematopoietic clones frequently follows induction therapy for de novo AML.

    Science.gov (United States)

    Wong, Terrence N; Miller, Christopher A; Klco, Jeffery M; Petti, Allegra; Demeter, Ryan; Helton, Nichole M; Li, Tiandao; Fulton, Robert S; Heath, Sharon E; Mardis, Elaine R; Westervelt, Peter; DiPersio, John F; Walter, Matthew J; Welch, John S; Graubert, Timothy A; Wilson, Richard K; Ley, Timothy J; Link, Daniel C

    2016-02-18

    There is interest in using leukemia-gene panels and next-generation sequencing to assess acute myelogenous leukemia (AML) response to induction chemotherapy. Studies have shown that patients with AML in morphologic remission may continue to have clonal hematopoiesis with populations closely related to the founding AML clone and that this confers an increased risk of relapse. However, it remains unknown how induction chemotherapy influences the clonal evolution of a patient's nonleukemic hematopoietic population. Here, we report that 5 of 15 patients with genetic clearance of their founding AML clone after induction chemotherapy had a concomitant expansion of a hematopoietic population unrelated to the initial AML. These populations frequently harbored somatic mutations in genes recurrently mutated in AML or myelodysplastic syndromes and were detectable at very low frequencies at the time of AML diagnosis. These results suggest that nonleukemic hematopoietic stem and progenitor cells, harboring specific aging-acquired mutations, may have a competitive fitness advantage after induction chemotherapy, expand, and persist long after the completion of chemotherapy. Although the clinical importance of these "rising" clones remains to be determined, it will be important to distinguish them from leukemia-related populations when assessing for molecular responses to induction chemotherapy. © 2016 by The American Society of Hematology.

  11. The Proteasome Inhibitor Bortezomib Sensitizes AML with Myelomonocytic Differentiation to TRAIL Mediated Apoptosis

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, Marianne van; Murphy, Eoin [Apoptosis Research Center, National University of Ireland, University Road, Galway (Ireland); School of Natural Sciences, National University of Ireland, University Road, Galway (Ireland); Morrell, Ruth [Apoptosis Research Center, National University of Ireland, University Road, Galway (Ireland); School of Natural Sciences, National University of Ireland, University Road, Galway (Ireland); School of Medicine, National University of Ireland, University Road, Galway (Ireland); Knapper, Steven [Department of Haematology, School of Medicine, Cardiff University, Heath Park, CF14 4XN Cardiff (United Kingdom); O' Dwyer, Michael [Apoptosis Research Center, National University of Ireland, University Road, Galway (Ireland); School of Medicine, National University of Ireland, University Road, Galway (Ireland); Samali, Afshin; Szegezdi, Eva, E-mail: eva.szegezdi@nuigalway.ie [Apoptosis Research Center, National University of Ireland, University Road, Galway (Ireland); School of Natural Sciences, National University of Ireland, University Road, Galway (Ireland)

    2011-03-15

    Acute myeloid leukemia (AML) is an aggressive stem cell malignancy that is difficult to treat. There are limitations to the current treatment regimes especially after disease relapse, and therefore new therapeutic agents are urgently required which can overcome drug resistance whilst avoiding unnecessary toxicity. Among newer targeted agents, both tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) and proteasome inhibitors show particular promise. In this report we show that a combination of the proteasome inhibitor bortezomib and TRAIL is effective against AML cell lines, in particular, AML cell lines displaying myelomonocytic/monocytic phenotype (M4/M5 AML based on FAB classification), which account for 20-30% of AML cases. We show that the underlying mechanism of sensitization is at least in part due to bortezomib mediated downregulation of c-FLIP and XIAP, which is likely to be regulated by NF-κB. Blockage of NF-κB activation with BMS-345541 equally sensitized myelomonocytic AML cell lines and primary AML blasts to TRAIL.

  12. [Application of Next Generation Sequencing for AML/MDS Diagnosis and Treatment].

    Science.gov (United States)

    Cheng, Huan-Chen; Liu, Sheng-Wei; Liu, Yu; Zhao, Xue-Fei; Li, Wei; Qiu, Lin; Ma, Jun

    2017-12-01

    To detect the mutations of AML/MDS- related genes by using next generation sequencing (NGS), to analyze the mutation levels of each genes in the AML/MDS and the sensitivity of NGS, and to evaluate the feasibility of gene mutations for monitoring the MRD and predicating the progression of diseases. The specimens were collected from primary AML (68 cases) and MDS (57 cases) patients from August 2015 to June 2016 in the Harbin Institute of Hematology and Oncology. The mutations of 22 related genes were detected by using AML/MDS-NGS chips. TET2 gene showed the highest mutation rate in AML (55.9%) and MDS (56.1%). The gene mutations were as follows: CEBPA (11.8%), DNMT3A (7.4%), C-KIT (7.4%) and FLT3-ITD (7.4%) in AML, and U2AF1 (10.5%) and SRSF2 (10.5%) in MDS. All the genes had specific mutation sites except TP53 and CEBPA. The mutations of FLT3, C-KIT and CEBPA became negative in the 5 AML patients in remission when compared with those at primary attack, but the mutation rate of TET2 gene was not obviously changed, whereas the mutation rate of the 5 MDS patients was not significantly changed. The new gene mutations appeared in 3 MDS patients with disease progression, but the mutation rate was not changed significantly in the disease progression. The gene mutation rate still has not been changed significantly even after remission. Both AML and MDS have their own specific mutated genes and sites. Some gene mutations, such as CEBPA, can be used as an effective indicator to monitoring MRD in AML patients, but those only used for the evaluation of the disease progression and prognosis in MDS patients.

  13. Low-dose fractionated percutaneous teletherapy in age-related macular degeneration with subfoveolar neovascularization - 3 year results; 3 Jahre Erfahrung mit der niedrig dosierten fraktionierten perkutanen Teletherapie bei subfoveolaeren Neovaskularisationen. Klinische Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schittkowski, M.; Schneider, H.; Guthoff, R. [Universitaetsaugenklinik Rostock (Germany); Grueschow, K.; Ziegler, P.G.; Fietkau, R. [Zentrum fuer Radiologie, Univ. Rostock (Germany)

    2001-07-01

    The effect of low dose fractionated percutaneous teletherapy to visual acuity and the changes in subfoveolar neovascular membranes in age-related macular degeneration were investigated. Patients and Method: 126 eyes of 118 patients (age 55-89 years; mean 74 ys.) were treated. Best distal and near visual acuity was assessed prior to (= initial visual acuity [IVA]) and 3, 6, 12, 18, 24, and 36 months after teletherapy. Fluorescein angiography was performed prior to and 6, 12, 24 and 36 months after radiation therapy. For analysis patients were divided into different groups by IVA and membrane size. Maximal duration of observation was 36 months. Teletherapy was done by a 9-MeV photon linear accelerator through a lateral port in half-beam technique with a single dose of 2 Gy up to a total dose of 20 Gy within 12 days. Results: No severe negative side effects have been observed. Eight patients reported of epiphora and four patients complained of transient sicca syndrome. Visual acuity decreased more than one line in the group IVA 0.05-0.2. The group IVA 0.3-0.5 remained unchanged for 1 year. We found a tendency for increased visual acuity in group IVA {>=} 0.6 for 18 months. After that time both groups showed decreased visual acuity, but all these patients reported of reduced metamorphopsia and increased color and contrast perception. Conclusions: There is an influence of low dose fractionated percutaneous teletherapy on visual acuity, subfoveal neovascular membranes and metamorphopsia. IVA and duration of anamnesis play an important role. There seems to be no persistent effect; possibly increased dosage will bring a benefit. (orig.) [German] Es wurde die Wirkung der Bestrahlung auf die Sehschaerfe bei altersabhaengiger Makuladegeneration mit chorioidalen Neovaskularisationen, die nach den MPS-Kriterien einer Laserkoagulation nicht zugaenglich sind, untersucht. Patienten und Methode: 126 Augen von 118 Patienten im Alter von 55-89 Jahren (Mittel 74) wurden behandelt. Ein

  14. High Frequency of AML1/RUNX1 Point Mutations in Radiation-Associated Myelodysplastic Syndrome Around Semipalatinsk Nuclear Test Site

    OpenAIRE

    Dinara, ZHARLYGANOVA; Hironori, HARADA; Yuka, HARADA; Sergey, SHINKAREV; Zhaxybay, ZHUMADILOV; Aigul, ZHUNUSOVA; Naylya J., TCHAIZHUNUSOVA; Kazbek N., APSALIKOV; Vadim, KEMAIKIN; Kassym, ZHUMADILOV; Noriyuki, KAWANO; Akiro, KIMURA; Masaharu, HOSHI; Department of Radiation Biophysics, Research Institute for Radiation Biology and Medicine, Hiroshima University; Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University

    2008-01-01

    It is known that bone marrow is a sensitive organ to ionizing radiation, and many patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) have been diagnosed in radiation-treated cases and atomic bomb survivors in Hiroshima and Nagasaki. The AML1/RUNX1 gene has been known to be frequently mutated in MDS/AML patients among atomic bomb survivors and radiation therapy-related MDS/AML patients. In this study, we investigated the AML1 mutations in radiation-exposed patients wi...

  15. Use of recombinant, human TSH radioiodine therapy in patients with differentiated thyroid carcinoma; Radioiodtherapie des differenzierten Schilddruesenkarzinoms nach Vorbehandlung mit rekombinantem, humanem TSH

    Energy Technology Data Exchange (ETDEWEB)

    Luster, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2001-12-01

    We describe the use of recombinant human TSH (rhTSH) in conjunction with ablative radioiodine therapy (RIT) in 11 patients (16 total treatments) with advanced and/or recurrent DTC (5 papillary, 6 follicular) for whom withdrawal of thyroid hormone suppressive therapy (THST) to increase serum TSH was not an option. Indications for rhTSH use in these patients included inability to tolerate withdrawal of thyroid hormones due to poor physical condition or inability to achieve sufficient serum TSH levels after THST withdrawal. All patients had undergone thyroidectomy and most (9/11) had received prior radioablative therapy after THST withdrawal. In 7 cases (5 patients), post-therapy Tg levels assessed at a mean of 4.3 months (range 2-10 months) after I-131 therapy were decreased by at least 30% compared to pre-therapy levels. In an additional 3 patients, whole body scans performed at follow-up indicated decreased or stabilized tumor burden compared to pre-therapy scans or marked clinical improvement was found. Three patients died of progressive disease within 2 months of therapy before follow-up assessments occurred. No adverse events were reported among the 8 surviving patients. The results suggest that rhTSH offers a promising alternative to THST withdrawal to allow radioablative therapy under maximal TSH stimulation in patients with advanced recurrent DTC who would not otherwise be able to receive this treatment. This therapeutic indication extends the clinical potential of the new agent, already demonstrated to be effective for use with I-131 for diagnostic purposes. However in some patients suffering from highly aggressive tumors the poor prognosis will not be improved. (orig.) [German] An unserer Klinik liegen bislang Erfahrungen mit 16 Radioiodtherapien (RIT) (z.T. mehrfache Anwendung) unter rhTSH vor. Die ueberwiegende Mehrzahl der Patienten wurde wegen einer fortgeschrittenen Tumorerkrankung mit dem Risiko einer lebensbedrohlichen Verschlechterung in

  16. Internetbasierte Krankenhaussuche : Informationsbedarfe der Patienten, Qualitätsindikatoren der Krankenhausbehandlung und Anforderungen an Suchmaschinen

    OpenAIRE

    Freiwald, Gert; Magdeburg, Jörn; Fihlon, Frank

    2010-01-01

    Die vorliegende Arbeit ist entstanden im Rahmen eines von Michael Simon betreuten studentischen Projektes im Studiengang Diplom-Pflegemanagement. Ziel des gemeinsamen Projektes war eine Bestandsaufnahme und Evaluation internetbasierter Krankenhaussuchmaschinen. Das Projekt bestand aus drei Teilprojekten, startete im Wintersemester 2006/2007 und schloss im Frühjahr 2008 mit einem gemeinsamen Projektbericht ab. Die jetzt vorgelegte Veröffentlichung ist eine überarbeitete Fassung des Projektberi...

  17. Rehabilitation of deaf persons with cochlear implants; Rehabilitation Hoergeschaedigter mit Cochlearimplantaten

    Energy Technology Data Exchange (ETDEWEB)

    Gstoettner, W.; Hamzavi, J. [Universitaetsklinik fuer Hals-Nasen-Ohrenheilkunde, Wien (Austria); Czerny, C. [Universitaetsklinik fuer Radiologie, Wien (Austria)

    1997-12-01

    In the last decade, the rehabilitation of postlingually deaf adults and prelingually deaf children with cochlear implants has been established as a treatment of deafness. The technological development of the implant devices and improvement of the surgical technique have led to a considerable increase of hearing performance during the last years. The postlingually deaf adults are able to use the telephone and may be integrated in their original job. Prelingually deaf children can even visit normal schools after cochlear implantation and hearing rehabilitation training. In order to preoperatively establish the state of the cochlear, radiological diagnosis of the temporal bone is necessary. High resolution computerized tomography imaging of the temporal bone with coronar and axial 1 mm slices and MRI with thin slice technique (three dimensional, T2 weighted turbo-spinecho sequence with 0.7 mm slices) have proved to be valuable according to our experience. Furthermore a postoperative synoptical X-ray, in a modified Chausse III projection, offers good information about the position of the implant and insertion of the stimulating electrode into the cochlea. (orig.) [Deutsch] In der letzten Dekade hat sich der operative Einsatz von Cochlearimplantaten fuer die Rehabilitation taubgeborener Kinder und ertaubter Erwachsenen als erfolgreiche Therapie etabliert. Durch technische Weiterentwicklung der Implantatsysteme und Verbesserung der Operationstechnik konnten in den letzten Jahren die Hoerleistungen der Patienten deutlich verbessert werden. Postlingual ertaubte Erwachsene koennen nun oftmals wieder ins Berufsleben eingegliedert werden und praelingual ertaubte Kinder koennen regulaere Schulen besuchen. Im Rahmen der Voruntersuchung fuer die Cochlearimplantation ist die radiologische Felsenbeindiagnostik von besonderer Bedeutung. Hochaufloesendes CT des Felsenbeins in koronaren und axialen Ebenen mit 1 mm Schichtdicke und MRT in Duennschichttechnik (dreidimensionale, T2

  18. Non-invasive diagnosis in cerebral ischemia by means of magnetic resonance imaging and near-infrared spectroscopy; Nichtinvasive Diagnostik zerebraler Ischaemie mit Kernspintomographie und Nahe-Infrarotspektroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Piepgras, A. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Gueckel, F. [Heidelberg Univ., Mannheim (Germany). Inst. fuer Klinische Radiologie; Laemmler, B. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Weigel, R. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik; Schmiedek, P. [Heidelberg Univ., Mannheim (Germany). Neurochirurgische Klinik

    1994-11-01

    We describe the non-invasive assessment of cerebrovascular reserve capacity by means of near-infrared spectroscopy (NIRS) and magnetic resonance imaging. Both methods are compared with transcranial Doppler sonography. There is a good correlation of the three methods in the changes in cerebral oxygen saturation and in blood velocity following acetazolamide stimulation of cerebral blood flow, except found in one patient with unilateral carotid artery occlusion. In this patient we found a decreased cerebrovascular reserve capacity, revealed by a magnetic resonance technique designed to quantify CBV and CBF. We postulate a raised oxygen extraction as raised oxygen extraction as the cause of his changes in oxygen saturation. (orig.) [Deutsch] Die Abschaetzung der zerebrovaskulaeren Reservekapazitaet unter Verwendung der Nahe-Infrarotspektroskopie und der Kernspintomographie zur nichtinvasiven klinischen Anwendung wird beschrieben. Beide Verfahren werden mit der transkraniellen Dopplersonographie verglichen. Bei Normalpersonen (n=3) zeigte sich eine gute Uebereinstimmung von Aenderungen der zerebralen Sauerstoffsaettigung mit Aenderungen der Blutflussgeschwindigkeit nach Acetazolamidstimulation der Hirndurchblutung. Diese Uebereinstimmung war bei einem Patienten mit kernspintomographisch nachgewiesener eingeschraenkter zerebrovaskulaerer Reservekapazitaet bei unilateralem Verschluss der A.carotis interna nicht gegeben. Dies wird auf eine pathologisch ehoehte Sauerstoffausschoepfung zurueeckgefuehrt. (orig.)

  19. Dynamic MR imaging: Follow-up study after femoral head core decompression and rhBMP-2 instillation in patients with avascular necrosis of the femoral head; Dynamische Magnetresonanztomographie (MRT): Verlaufsbeobachtung nach Femurkerndekompression und Auffuellung mit rekombinantem, humanem Bone morphogenetic Protein-2 (rhBMP-2) bei avaskulaerer Femurkopfnekrose

    Energy Technology Data Exchange (ETDEWEB)

    Schedel, H. [Klinik Prof. Schedel, Kellberg (Germany); Schneller, A. [Humboldt-Universitaet, Berlin (Germany). Klinik fuer Allgemein- und Transplantationschirurgie; Vogl, T.; Mueller, H.F.; Maeurer, J.; Felix, R. [Humboldt-Universitaet, Berlin (Germany). Strahlenklinik und Poliklinik; Suedkamp, N. [Humboldt-Universitaet, Berlin (Germany). Unfall- und Wiederherstellungschirurgie; Eisenschenk, A. [Freie Univ. Berlin (Germany). Orthopaedische Klinik und Poliklinik

    2000-07-01

    Material and Methods: Six patients with avascular necrosis of the femoral head ARCO-stage I- or II-lesions were treated surgically by femoral head core decompression. Three of these patients were additionally treated with rhBMP-2-instillation. The progression or regression could be confirmed by T1- and T2-weighted spinecho-sequences (zero, four, ten, sixteen weeks and 24 months follow up). Results: Corresponding ARCO-classification with partly more sensitive measurement of vitality signs in comparison to the optical X-ray classification. The objective, quantitative measurement of signalintensity post contrast medium reduces the influence of experience and level of education. The dynamic sequences results are reproducable. (orig.) [German] Material und Methoden: Sechs Patienten mit avaskulaerer Nekrose des Femurkopfes des Stadiums I oder II nach ARCO wurden einer Femurkerndekompression unterzogen. Drei dieser Patienten erhielten zusaetzlich eine rhBMP-2-Auffuellung. Zum Zeitpunkt null, vier, zehn, sechszehn Wochen und 24 Monaten post OP erfolgte die kernspintomographische Untersuchung mit T1- und T2-gewichteten Sequenzen unter besonderer Beruecksichtigung der dynamischen Untersuchungssequenz nach Gabe von Gd-DTPA (Gadopentetsaeure, Dimegluminsalz; Magnevist {sup trademark}) zur Dokumentation der Signalintensitaetssteigerung pro Zeiteinheit in der Nekroseregion. Ergebnisse: Uebereinstimmende Stadienklassifikation nach ARCO mit zum Teil empfindlicherer Messung von Vitalitaetszeichen im Vergleich zu rein visuellen roentgenologischen Einteilung. Die objektive, quantitative Messung des Signalintensitaetssteigerungsverhaltens nach Kontrastmittelgabe im Bereich der Femurkopfnekrose kann den Einfluss von subjektiven Eigenschaften des Untersuchers (Erfahrung, Ausbildungsstand) reduzieren, wobei die Ergebnisse der Dynamiksequenzen objektiv reproduzierbar sind. (orig.)

  20. Detection of liver lesions with gadolinium-enhanced VIBE sequence in comparison with SPIO-enhanced MRI; Detektion von Leberlaesionen mit der Gadolinium-verstaerkten VIBE-Sequenz im Vergleich zur SPIO-verstaerkten MRT

    Energy Technology Data Exchange (ETDEWEB)

    Heim, P.; Steiner, P.; Dieckmann, C.; Adam, G. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie; Schoder, V. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Inst. fuer Medizinische Biometrie und Epidemiologie; Kuhlencordt, R. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Allgemein-, Viszeral-, und Thoraxchirurgie

    2003-10-01

    Purpose: Detection of malignant liver lesions with gadolinium-enhanced volumetric interpolated breath-hold examination (VIBE) in comparison with SPIO-enhanced MRT (four different SPIO-enhanced T2w sequences) and histological and imaging follow-up in non-cirrhotic livers at 1.5 T. Patients and methods: Twenty-two patients with suspected focal liver lesions prospectively underwent a gadolinium-enhanced 3D VIBE. Four T2w sequences (HASTE sequence, fast spin-echo-sequence with and without fat-saturation, FLASH 2D gradient echo-sequence) after administration of superparamagnetic iron oxide (SPIO) served as gold standard combined with histological work-up in 17 patients and histological and imaging follow-up in five patients. The image quality was evaluated and the detectability of intrahepatic lesions was rated by the alternative free-response receiver operating characteristic (AFROC) analysis. In addition, the contrast-to-noise ration was compared. Results: Altogether 49 malignant and 35 benign liver lesions were found. Concerning the image quality, VIBE turned out to be of slightly poorer image quality than the SPIO-enhanced examination with HASTE sequence (4.95 vs. 5.0). The fast spin-echo-sequence without fat-saturation demonstrated the highest contrast-to-noise ratio. All sequences showed a comparable certainty in detecting lesion (area under the curve 0.68-0.74) and identifying malignant liver lesions. Conclusions: Despite the small number of patients, VIBE seems to be a comparable, inexpensive and fast method in diagnosing malignant liver lesions. (orig.) [German] Ziel: Detektion maligner Leberlaesionen mit der Gadolinium-verstaerkten 3D-Gradientenecho-Sequenz in Atemanhaltetechnik (VIBE-Sequenz) im Vergleich mit der SPIO-verstaerkten MRT (vier verschiedene SPIO-verstaerkte T2-gew. Sequenzen) sowie histologischen und bildgebenden (Verlaufs-) Untersuchungen in nicht-zirrhotischen Lebern bei 1,5 T. Patienten und Methoden: 22 Patienten mit Verdacht auf maligne

  1. The emerging role of immune checkpoint based approaches in AML and MDS.

    Science.gov (United States)

    Boddu, Prajwal; Kantarjian, Hagop; Garcia-Manero, Guillermo; Allison, James; Sharma, Padmanee; Daver, Naval

    2018-04-01

    The development of immune checkpoint inhibitors represents a major breakthrough in the field of cancer therapeutics. Pursuant to their success in melanoma and numerous solid tumor malignancies, these agents are being investigated in hematological malignancies including acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). Although AML/MDS have traditionally been considered to be less immunogenic than solid tumor malignancies, recent pre-clinical models suggest a therapeutic role for immune checkpoint inhibition in these diseases. CTLA-4 inhibition may be especially effective in treating late post-allogeneic stem cell transplant relapse of AML in patients with limited or no graft versus host disease. Immune checkpoint inhibition, specifically PD-1 inhibition, demonstrated limited single agent efficacy in patients with relapsed AML and with MDS post-hypomethylating therapy. Rationally designed combinations of PD-1 inhibitors with standard anti-leukemic therapy are needed. Hypomethylating agents such as azacitidine, up-regulate PD-1, PD-L1, and PD-L2 in patients with AML/MDS and up-regulation of these genes was associated with the emergence of resistance. The combination of azacitidine and PD-1/PD-L1 inhibition may be a potential mechanism to prevent or overcome resistance to 5-azacitidine. A number of such combinations are being evaluated in clinical trials with early encouraging results. Immune checkpoint inhibition is also an attractive option to improve relapse-free survival or eliminate minimal residual disease post induction and consolidation by enhancing T-cell surveillance in patients with high-risk AML. The ongoing clinical trials with checkpoint inhibitors in AML/MDS will improve our understanding of the immunobiology of these diseases and guide us to the most appropriate application of these agents in the therapy of AML/MDS.

  2. Focal Adhesion Kinase as a Potential Target in AML and MDS.

    Science.gov (United States)

    Carter, Bing Z; Mak, Po Yee; Wang, Xiangmeng; Yang, Hui; Garcia-Manero, Guillermo; Mak, Duncan H; Mu, Hong; Ruvolo, Vivian R; Qiu, Yihua; Coombes, Kevin; Zhang, Nianxiang; Ragon, Brittany; Weaver, David T; Pachter, Jonathan A; Kornblau, Steven; Andreeff, Michael

    2017-06-01

    Although overexpression/activation of focal adhesion kinase (FAK) is widely known in solid tumors to control cell growth, survival, invasion, metastasis, gene expression, and stem cell self-renewal, its expression and function in myeloid leukemia are not well investigated. Using reverse-phase protein arrays in large cohorts of newly diagnosed acute myeloid leukemia (AML) and myeloid dysplastic syndrome (MDS) samples, we found that high FAK expression was associated with unfavorable cytogenetics ( P = 2 × 10 -4 ) and relapse ( P = 0.02) in AML. FAK expression was significantly lower in patients with FLT3 -ITD ( P = 0.0024) or RAS ( P = 0.05) mutations and strongly correlated with p-SRC and integrinβ3 levels. FAK protein levels were significantly higher in CD34 + ( P = 5.42 × 10 -20 ) and CD34 + CD38 - MDS ( P = 7.62 × 10 -9 ) cells compared with normal CD34 + cells. MDS patients with higher FAK in CD34 + cells tended to have better overall survival ( P = 0.05). FAK expression was significantly higher in MDS patients who later transformed to compared with those who did not transform to AML and in AML patients who transformed from MDS compared with those with de novo AML. Coculture with mesenchymal stromal cells (MSC) increased FAK expression in AML cells. Inhibition of FAK decreased MSC-mediated adhesion/migration and viability of AML cells and prolonged survival in an AML xenograft murine model. Our results suggest that FAK regulates leukemia-stromal interactions and supports leukemia cell survival; hence, FAK is a potential therapeutic target in myeloid leukemia. Mol Cancer Ther; 16(6); 1133-44. ©2017 AACR . ©2017 American Association for Cancer Research.

  3. Patient-derived acute myeloid leukemia (AML) bone marrow cells display distinct intracellular kinase phosphorylation patterns

    International Nuclear Information System (INIS)

    Shults, Keith; Flye, Leanne; Green, Lisa; Daly, Thomas; Manro, Jason R; Lahn, Michael

    2009-01-01

    Multiparametric analyses of phospho-protein activation in patients with acute myeloid leukemia (AML) offers a quantitative measure to monitor the activity of novel intracellular kinase (IK) inhibitors. As recent clinical investigation with FMS-like tyrosine-3 inhibitors demonstrated, targeting IK with selective inhibitors can have a modest clinical benefit. Because multiple IKs are active in patients with AML, multikinase inhibitors may provide the necessary inhibition profile to achieve a more sustained clinical benefit. We here describe a method of assessing the activation of several IKs by flow cytometry. In 40 different samples of patients with AML we observed hyper-activated phospho-proteins at baseline, which is modestly increased by adding stem cell factor to AML cells. Finally, AML cells had a significantly different phospho-protein profile compared with cells of the lymphocyte gate. In conclusion, our method offers a way to determine the activation status of multiple kinases in AML and hence is a reliable assay to evaluate the pharmacodynamic activity of novel multikinase inhibitors

  4. Therapy-related AML/MDS after treatment of low-grade B-cell lymphoma

    International Nuclear Information System (INIS)

    Yanada, Masamitsu

    2008-01-01

    Described is the therapy-related AML (acute myelogenetic leukemia)/MDS (myelo-dysplasia syndrome), which is manifested after various treatments of low-grade B-cell lymphoma and has strongly attracted attention because of the markedly improved prognosis due to recent advantages of the therapy for the disease. AML/MDS occurs several years after chemotherapy and/or radiation therapy which cause DNA damage in hematopoietic cells, and the AML/MDS risk is known increased in patients undergone especially with autologous transplantation of those cells. AML/MDS has the feature similar to that caused either by alkylating agent or by topoisomerase-2 inhibitor, and the disease by radiation belong to the former. Yet unclear is the problem whether malignant cells causing the disease after therapy are derived from the remaining cells in the graft or in the body. Although irradiations of total body and total lymphaden as well as chemotherapy are said to be related to AML/MDS and local irradiation does not contribute to its risk, the most important factor for the disease is considered to be the autotransplantation as the recurrence occurs in 50% after it. Thus the treatment history should be taken into consideration for suppressing AML/MDS, for which follow up with consideration for the disease is required particularly after autotransplantation. (R.T.)

  5. Overview of MIT, ADIP irradiation experiments

    International Nuclear Information System (INIS)

    Kohse, G.; Harling, O.K.; Grant, N.J.

    1985-06-01

    Various rapidly solidified austenitic, ferritic and copper alloys have been produced at MIT for inclusion in ADIP neutron irradiation experiments. A brief summary of the alloys and their preparation and the achieved or projected irradiation parameters is provided

  6. Biotechnology Process Engineering Center at MIT - Overview

    Science.gov (United States)

    | Facsimile (617) 253-2400 | e-mail: bpec-www@mit.edu THERAPEUTIC GENE BIOTECHNOLOGY INDUSTRIAL CONSORTIUM Board (ICAB) in Therapeutic Gene Biotechnology. ICAB Member Representatives review our research progress

  7. MITS Data Acquisition Subsystem Acceptance Test procedure

    International Nuclear Information System (INIS)

    Allison, R.

    1980-01-01

    This is an acceptance procedure for the Data Acquisition Subsystem of the Machine Interface Test System (MITS). Prerequisites, requirements, and detailed step-by-step instruction are presented for inspecting and performance testing the subsystem

  8. MIT research reactor. Power uprate and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Lin-Wen [Nuclear Reactor Laboratory, Massachusetts Inst. of Technology, Cambridge, MA (United States)

    2012-03-15

    The MIT Research Reactor (MITR) is a university research reactor located on MIT campus. and has a long history in supporting research and education. Recent accomplishments include a 20% power rate to 6 MW and expanding advanced materials fuel testing program. Another important ongoing initiative is the conversion to high density low enrichment uranium (LEU) monolithic U-Mo fuel, which will consist of a new fuel element design and power increase to 7 MW. (author)

  9. Hamlet er manden i mit liv

    DEFF Research Database (Denmark)

    Rösing, Lilian Munk

    2009-01-01

    Hamlet er manden i mit liv. Min elskede. Jeg har en drøm om at frelse ham. At redde ham ud af sin mors soveværelse og ind i mit. Væk fra det ødipale Helvede han befinder sig i, fastlåst mellem et svin af en faderskikkelse (Claudius) og en alt for idealiseret far (gamle Hamlet), vågende over sin m...

  10. Expression Profiling of Ribosome Biogenesis Factors Reveals Nucleolin as a Novel Potential Marker to Predict Outcome in AML Patients.

    Directory of Open Access Journals (Sweden)

    Virginie Marcel

    Full Text Available Acute myeloid leukemia (AML is a heterogeneous disease. Prognosis is mainly influenced by patient age at diagnosis and cytogenetic alterations, two of the main factors currently used in AML patient risk stratification. However, additional criteria are required to improve the current risk classification and better adapt patient care. In neoplastic cells, ribosome biogenesis is increased to sustain the high proliferation rate and ribosome composition is altered to modulate specific gene expression driving tumorigenesis. Here, we investigated the usage of ribosome biogenesis factors as clinical markers in adult patients with AML. We showed that nucleoli, the nucleus compartments where ribosome production takes place, are modified in AML by analyzing a panel of AML and healthy donor cells using immunofluorescence staining. Using four AML series, including the TCGA dataset, altogether representing a total of about 270 samples, we showed that not all factors involved in ribosome biogenesis have clinical values although ribosome biogenesis is increased in AML. Interestingly, we identified the regulator of ribosome production nucleolin (NCL as over-expressed in AML blasts. Moreover, we found in two series that high NCL mRNA expression level was associated with a poor overall survival, particular in elderly patients. Multivariate analyses taking into account age and cytogenetic risk indicated that NCL expression in blast cells is an independent marker of reduced survival. Our study identifies NCL as a potential novel prognostic factor in AML. Altogether, our results suggest that the ribosome biogenesis pathway may be of interest as clinical markers in AML.

  11. c-Jun N-terminal kinase mediates AML1-ETO protein-induced connexin-43 expression

    International Nuclear Information System (INIS)

    Gao Fenghou; Wang Qiong; Wu Yingli; Li Xi; Zhao Kewen; Chen Guoqiang

    2007-01-01

    AML1-ETO fusion protein, a product of leukemia-related chromosomal translocation t(8;21), was reported to upregulate expression of connexin-43 (Cx43), a member of gap junction-constituted connexin family. However, its mechanism(s) remains unclear. By bioinformatic analysis, here we showed that there are two putative AML1-binding consensus sequences followed by two activated protein (AP)1 sites in the 5'-flanking region upstream to Cx43 gene. AML1-ETO could directly bind to these two AML1-binding sites in electrophoretic mobility shift assay, but luciferase reporter assay revealed that the AML1 binding sites were not indispensable for Cx43 induction by AML1-ETO protein. Conversely, AP1 sites exerted an important role in this event. In agreement, AML1-ETO overexpression in leukemic U937 cells activated c-Jun N-terminal kinase (JNK), while its specific inhibitor SP600125 effectively abrogated AML1-ETO-induced Cx43 expression, indicating that JNK signaling pathway contributes to AML1-ETO induced Cx43 expression. These results would shed new insights for understanding mechanisms of AML1-ETO-associated leukemogenesis

  12. Early clinical phase of patient's management after polytrauma using 1- and 4-slice helical CT; Fruehes klinisches Management nach Polytrauma mit 1- und 4-Schicht-Spiral-CT

    Energy Technology Data Exchange (ETDEWEB)

    Kloeppel, R.; Kahn, T. [Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Schreiter, D. [Chirurgische Intensivtherapieabteilung, Zentrum fuer Chirurgie, Universitaetsklinikum Leipzig (Germany); Dietrich, J. [Abt. Neuroradiologie der Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Josten, C. [Klinik und Poliklinik fuer Unfall- und Wiederherstellungschirurgie, Zentrum fuer Chirurgie, Universitaetsklinikum Leipzig (Germany)

    2002-07-01

    In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established. Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results.The procedure is designed as follows: after life-thretening treatment x-ray of chest and ultrasound are carried out in the emergency room. Then the patient is moved to CT. From 1998 to december 2000 241 patients were examined using a single slice helical CT (Somatom plus 4), in 2001 79 patients using a 4-slice helical CT (Somatom VZ, Siemens Med.Sol.). After CT selected radiograms of the extremities were taken.359 of 360 procedures were carried out successfully. Excluding 1 case (death during 1-sl. h CT) all relevant lesions of head, neck, and body were diagnosed. Although the patients had an injury severity score of {approx}30. The change from 1slice-helical CT to 4 slice-helical CT allowed us to reduce the stay in the CT room from 28 to 16 min. The total lethality decreased by {approx}4%.Advantages for the patient arose from the standardized examination protocol using multislice CT. If integrated in an interdisciplinary management concept, it is a good compromise between examination time, comprehensive diagnostic imaging, life-saving therapeutic procedures, and therapy planning. (orig.) [German] Die klinische Erstversorgung Polytraumatisierter schliesst inzwischen in vielen Unfallkliniken den fruehzeitigen Einsatz der Spiral-CT ein. Kann die neuerlich eingefuehrte Mehrschicht-Spiral-CT Ergebnisse und Patientenmanagement weiter verbessern?Nach lebensrettenden Sofortmassnahmen, Thoraxroentgen und Notsonographie im Schockraum erfolgte die CT: Von 1998-2000 wurden 241 Patienten mit einem 1-Schicht-Spiral-CT (Somatom plus 4) und in 2001 79 Patienten mit einem 4-Schicht-Spiral-CT (Somatom VZ, beide Siemens Med. Sol.) untersucht. Klinisch ausgewaehlte Extremitaetenaufnahmen wurden ergaenzt.359 von 360 Untersuchungen verliefen erfolgreich

  13. Deposition of radon decay products on the skin of balneotherapy patients in Gastein; Anlagerung von Radon-Folgeprodukten auf der Haut von Patienten bei der Baedertherapie in Gastein

    Energy Technology Data Exchange (ETDEWEB)

    Tempfer, H.; Schober, A.; Lettner, H.; Hofmann, W. [Inst. fuer Physik und Biophysik, Univ. Salzburg (Austria); Foisner, W. [Thermentempel Bad Hofgastein (Austria); Steger, F. [Oesterreichisches Forschungszentrum Seibersdorf GesmbH (Austria)

    2001-07-01

    ). Eine der Anwendungen des Thermalwassers ist die Exposition der Patienten in einer 450 1 fassenden Wanne (Best'sche Wanne) mit anschliessender Ruhephase. Um die Hypothese, dass die Zerfallsprodukte des Radons eine wichtige Rolle bei der therapeutischen Wirkung spielen, zu ueberpruefen, sollte das Anlagerungsverhalten der Rn-Folgeprodukte untersucht werden. Nach einem Aufenthalt der Testpersonen von 20 Minuten in der Wanne wurde der Aktivitaetsverlauf an verschiedenen Punkten des Koerpers (Unterarme, Bauch, Unterschenkel) alpha-spektrometrisch gemessen. Aus den Spektren und den Zerfallskurven koennen die Aktivitaeten der einzelnen Folgeprodukte {sup 218}Po, {sup 214}Pb und {sup 214}Bi/{sup 214}Po unterschieden werden. Um den zeitlichen Verlauf der Zerfallsproduktanlagerung zu untersuchen, wurde eine Versuchsperson dem Wasser jeweils fuer 10, 20, 30, 40 und 60 Minuten ausgesetzt; danach wurde wieder der Aktivitaetsverlauf ueber 30 Minuten aufgezeichnet. Die Messungen zeigten, dass sich die Aktivitaeten der einzelnen Zerfallsprodukte auf der Haut stark unterscheiden. Einerseits scheint die Verteilung am Koerper keineswegs homogen zu sein, andererseits konnten individuelle Unterschiede zwischen den einzelnen Person beobachtet werden. So schwankten die Mittelwerte der Aktivitaeten auf der Haut zwischen 1,2 Bq/cm{sup 2} und 4,1 Bq/cm{sup 2}. Die Exposition und Messung von Kupfer- und PVC-Platten bestaetigten fruehere Ergebnisse, nach denen sich Radonzerfallsprodukte auf unbelebten Flaechen weniger stark anlagern als auf belebten. Aus der Tatsache, dass die Zerfallsprodaktivitaeten auf der Haut bemerkenswert hoch sind, erscheint ein moeglicher Zusammenhang mit der Heilwirkung seht wahrscheinlich. (orig.)

  14. Outcome of children with acute myeloid leukaemia (AML) experiencing primary induction failure in the AIEOP AML 2002/01 clinical trial.

    Science.gov (United States)

    Quarello, Paola; Fagioli, Franca; Basso, Giuseppe; Putti, Maria C; Berger, Massimo; Luciani, Matteo; Rizzari, Carmelo; Menna, Giuseppe; Masetti, Riccardo; Locatelli, Franco

    2015-11-01

    Paediatric patients with acute myeloid leukaemia (AML) who fail induction due to primary resistance to chemotherapy account for a significant proportion of cases and have a particularly dismal prognosis. We report the clinical and biological data, and final outcome of 48 paediatric patients with primary-resistant AML enrolled in the Associazione Italiana di Ematologia e Oncologia Pediatrica AML 2002/01 clinical trial. These patients had a significantly higher white blood cell count at diagnosis compared to other AML patients. Cytogenetic and molecular features did not differ between patients with primary induction failure and patients allocated to the high-risk group. For the whole patient population, the probability of overall survival, event-free survival (EFS) and disease-free survival (DFS) was 21·8% ± 6·2, 20·4% ± 5·9, and 49·5% ± 11·3, respectively. Twenty-eight (58%) patients received haematopoietic stem cell transplantation (HSCT); 3 were autologous and 25 were allogeneic. Patients who underwent HSCT had improved EFS (31·2% vs. 5%, P < 0·0001). Only one of the 20 patients who did not receive HSCT is alive and disease free. The 19 patients in complete remission at time of HSCT showed significantly better DFS than the 9 with active disease (46% vs. 0%, P = 0·02). This study represents one of the largest series with long-term follow up of paediatric AML patients with primary refractory disease. Children who underwent transplantation had an encouraging long-term outcome. Disease recurrence remains the major cause of treatment failure; a better understanding of the disease biology is desirable to develop more effective treatment strategies. © 2015 John Wiley & Sons Ltd.

  15. Untersuchungen an Eisen- und Lanthanoidhaltigen Koordinationsclustern mit Triazolat- sowie Semiquinonato-Liganden

    OpenAIRE

    Kriese, Thomas

    2016-01-01

    Magnetische Untersuchungen an Lanthanoiddimeren mit Semiquinonato-Liganden. Gemischtvalente Eisen-Koordinationsclustern. Lanthanoid-Koordinationscluster mit zwölf Lanthanoiden aber mit verschiedenen Clusterladungen.

  16. Comparison of childhood myelodysplastic syndrome, AML FAB M6 or M7, CCG 2891: report from the Children's Oncology Group.

    Science.gov (United States)

    Barnard, Dorothy R; Alonzo, Todd A; Gerbing, Robert B; Lange, Beverly; Woods, William G

    2007-07-01

    Myelodysplastic syndromes (MDS), acute erythroleukemia (FAB M6), and acute megakaryocytic leukemia (FAB M7) have overlapping features. Children without Down syndrome or acute promyelocytic leukemia who were newly diagnosed with primary myelodysplastic syndrome or acute myeloid leukemia (AML) M6 or M7 were compared to children with de novo AML M0-M5. All children were entered on the Children's Cancer Group therapeutic research study CCG 2891. The presentation and outcomes of the 132 children diagnosed with MDS (60 children), AML FAB M6 (19 children), or AML FAB M7 (53 children) were similar. Children with AML FAB M7 were diagnosed at a significantly younger age (P = 0.001). Children with MDS, M6, or M7 had significantly lower white blood cell (WBC) counts (P = 0.001), lower peripheral blast counts (P M6 and AML M7 resemble MDS in presentation, poor induction success rates, and outcomes.

  17. Radiation exposure to the patient caused by single-photon transmission measurement for 3D whole-body PET; Die Strahlenexposition des Patienten durch die Einzelphotonen-Transmissionsmessung bei der PET

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, A.; Donsch, P.; Kirsch, C.M. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Nuklearmedizin; Seifert, H. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. Strahlentherapie der Radiologischen Klinik

    2000-11-01

    Patienten durch die Transmissionsmessung mittels Einzelphotonenquellen bei der PET. Material und Methode: Zwei Cs-137-Punktquellen (E{gamma}=662 keV, A=614 MBq) werden zur Transmissionsmessung im Einzelphotonenmodus an einem 3D-Scanner (ECAT ART) eingesetzt. Bei der Simulation einer Ganzkoerper-Transmission (axiale Laenge: 75 cm, 6 ueberlappende Bettpositionen), werden Dosismessungen mit Thermolumineszenzdosimetern unter Verwendung eines Thorax- und eines Abdomenphantoms durchgefuehrt. Aus den Messwerten wurde in Anlehnung an den Report Nr. 60 der ICRP die effektive Dosis fuer die Transmissionsmessung abgeschaetzt. Ergebnisse: Bei einer Gesamtaufnahmedauer von 360 min (60 min pro Bettposition) ergaben sich folgende Energiedosen: Oberflaeche (Xyphoid) 189 {mu}Gy, Herz 196 {mu}Gy, Lunge 234 {mu}Gy, BWS 240 {mu}Gy, Niere 207 {mu}Gy, Leber 204 {mu}Gy, Gonaden 205 {mu}Gy, Schilddruese 249 {mu}Gy und Blase 185 {mu}Gy, aus denen sich ein Konversionsfaktor von 1,7*10{sup -4} mSv/(h*MBq) errechnete. Die Abschaetzung der effektiven Dosis fuer den Patienten aufgrund einer Transmissionsmessung (Akquisitionszeit von 3,2 min pro Bettposition) ergab einen Wert von 11 {mu}Sv. Die Abschaetzung des Verhaeltnisses der Konversionsfaktoren durch Transmissionsmessung im Einzelphotonen- und im Koinzidenzmodus (zwei Ge-68/Ga-68-Linienquellen mit jeweils 40 MBq) ergab einen Wert von 0,18. Der Vergleich zwischen den effektiven Dosen durch die Transmission im Einzelphotonen-Modus und die Emission (bei Injektion von 250 MBq FDG) ergab ein Verhaeltnis von 2,3*10{sup -3}. Schlussfolgerung: Die Strahlenexposition der Patienten durch die Transmissionsmessung in der 3D-PET ist vernachlaessigbar gering. Sie wird durch die Verwendung der Einzelphotonenmethode mit kollimierten Punktquellen relativ hoher Aktivitaet im Vergleich zur Koinzidenzmethode mit nicht-kollimierten Linienquellen relativ niedriger Aktivitaet weiter reduziert. (orig.)

  18. Minimally invasive thyroidectomy (MIT): indications and results.

    Science.gov (United States)

    Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

    2013-01-01

    To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

  19. Age-related epigenetic drift in the pathogenesis of MDS and AML.

    Science.gov (United States)

    Maegawa, Shinji; Gough, Sheryl M; Watanabe-Okochi, Naoko; Lu, Yue; Zhang, Nianxiang; Castoro, Ryan J; Estecio, Marcos R H; Jelinek, Jaroslav; Liang, Shoudan; Kitamura, Toshio; Aplan, Peter D; Issa, Jean-Pierre J

    2014-04-01

    The myelodysplastic syndrome (MDS) is a clonal hematologic disorder that frequently evolves to acute myeloid leukemia (AML). Its pathogenesis remains unclear, but mutations in epigenetic modifiers are common and the disease often responds to DNA methylation inhibitors. We analyzed DNA methylation in the bone marrow and spleen in two mouse models of MDS/AML, the NUP98-HOXD13 (NHD13) mouse and the RUNX1 mutant mouse model. Methylation array analysis showed an average of 512/3445 (14.9%) genes hypermethylated in NHD13 MDS, and 331 (9.6%) genes hypermethylated in RUNX1 MDS. Thirty-two percent of genes in common between the two models (2/3 NHD13 mice and 2/3 RUNX1 mice) were also hypermethylated in at least two of 19 human MDS samples. Detailed analysis of 41 genes in mice showed progressive drift in DNA methylation from young to old normal bone marrow and spleen; to MDS, where we detected accelerated age-related methylation; and finally to AML, which markedly extends DNA methylation abnormalities. Most of these genes showed similar patterns in human MDS and AML. Repeat element hypomethylation was rare in MDS but marked the transition to AML in some cases. Our data show consistency in patterns of aberrant DNA methylation in human and mouse MDS and suggest that epigenetically, MDS displays an accelerated aging phenotype.

  20. The TPO/c-MPL pathway in the bone marrow may protect leukemia cells from chemotherapy in AML Patients.

    Science.gov (United States)

    Dong-Feng, Zeng; Ting, Liu; Yong, Zhang; Cheng, Chang; Xi, Zhang; Pei-Yan, Kong

    2014-04-01

    Accumulating evidence indicates that the interaction of human LSCs (leukemic stem cells) with the hematopoietic microenvironment, mediated by the thrombopoietin (TPO)/c-MPL pathway, may be an underlying mechanism for resistance to cell cycle-dependent cytotoxic chemotherapy. However, the role of TPO/c-MPL signaling in AML (acute myelogenous leukemia) chemotherapy resistance hasn't been fully understood. The c-MPL and TPO levels in different AML samples were measured by flow cytometry and ELISA. We also assessed the TPO levels in the osteoblasts derived from bone mesenchymal stem cells (BMSCs). The survival rate of an AML cell line that had been co-cultured with different BMSC-derived osteoblasts was measured to determine the IC50 of an AML chemotherapy drug daunorubicin (DNR). The levels of TPO/c-MPL in the initial and relapse AML patients were significantly higher than that in the control (P MPL expression was found in the bone marrow mononuclear cells of the relapse AML patients. More importantly, the IC50 of DNR in the HEL + AML-derived osteoblasts was the highest among all co-culture systems. High level of TPO/c-MPL signaling may protect LSCs from chemotherapy in AML. The effects of inhibition of the TPO/c-MPL pathway on enhancing the chemotherapy sensitivity of AML cells, and on their downstream effector molecules that direct the interactions between patient-derived blasts and leukemia repopulating cells need to be further studied.

  1. Magnetosphere - Ionosphere - Thermosphere (MIT) Coupling at Jupiter

    Science.gov (United States)

    Yates, J. N.; Ray, L. C.; Achilleos, N.

    2017-12-01

    Jupiter's upper atmospheric temperature is considerably higher than that predicted by Solar Extreme Ultraviolet (EUV) heating alone. Simulations incorporating magnetosphere-ionosphere coupling effects into general circulation models have, to date, struggled to reproduce the observed atmospheric temperatures under simplifying assumptions such as azimuthal symmetry and a spin-aligned dipole magnetic field. Here we present the development of a full three-dimensional thermosphere model coupled in both hemispheres to an axisymmetric magnetosphere model. This new coupled model is based on the two-dimensional MIT model presented in Yates et al., 2014. This coupled model is a critical step towards to the development of a fully coupled 3D MIT model. We discuss and compare the resulting thermospheric flows, energy balance and MI coupling currents to those presented in previous 2D MIT models.

  2. Spontanes Liquorunterdrucksyndrom - Übersicht und Fallpräsentation anhand von fünf Patienten

    OpenAIRE

    Richter S; Riedl M; Mickocki J; Parigger S; Hartmann W; Brücke T

    2006-01-01

    Das spontane Liquorunterdrucksyndrom (SLUDS) wurde erstmals 1938 beschrieben: Leitsymptom ist ein lageabhängiger, orthostatischer Kopfschmerz, der durch aufrechte Position provoziert wird. Ursächlich besteht ein vermindertes Liquorvolumen mit absolut oder relativ vermindertem Liquordruck, bei vorwiegend zervikalen oder zervikothorakalen Liquorleckagen. Diagnostisch stehen MRT mit Gadoliniumgabe und die Liquorszintigraphie zur Verfügung. Die Therapie der Wahl ist ausreichende Flüssigkeitszu...

  3. Myeloid Sarcoma Predicts Superior Outcome in Pediatric AML; Can Cytogenetics Solve the Puzzle?

    Science.gov (United States)

    Pramanik, Raja; Tyagi, Anudishi; Chopra, Anita; Kumar, Akash; Vishnubhatla, Sreenivas; Bakhshi, Sameer

    2018-06-01

    The purpose of our study was to evaluate the clinical, cytogenetic, and molecular features, and survival outcomes in patients with acute myeloid leukemia (AML) with myeloid sarcoma (MS) and compare them with patients with AML without MS. This was a retrospective analysis of de novo pediatric AML patients with or without MS diagnosed at our cancer center between June 2003 and June 2016. MS was present in 121 of 570 (21.2%), the most frequent site being the orbit. Patients with MS had a younger median age (6 years vs. 10 years) and presented with higher hemoglobin and platelet but lower white blood cell count compared with patients without MS. Further, t (8; 21) (P < .01), loss of Y chromosome (P < .01), and deletion 9q (P = .03) were significantly higher in patients with AML with MS. Event-free survival (EFS; P = .003) and overall survival (OS; P = .001) were better among patients with AML with MS (median EFS 21.0 months and median OS 37.1 months) compared with those with AML without MS (median EFS 11.2 months and median OS 16.2 months). The t (8; 21) was significantly associated with MS (odds ratio, 3.92). In a comparison of the 4 groups divided according to the presence or absence of MS and t (8; 21), the subgroup of patients having MS without concomitant t (8; 21) was the only group to have a significantly better OS (hazard ratio, 0.53; 95% confidence interval, 0.34-0.82; P = .005). Although t (8; 21) was more frequently associated with MS, it did not appear to be the reason for better outcome. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. AML1/ETO trans-activates c-KIT expression through the long range interaction between promoter and intronic enhancer.

    Science.gov (United States)

    Tian, Ying; Wang, Genjie; Hu, Qingzhu; Xiao, Xichun; Chen, Shuxia

    2018-04-01

    The AML1/ETO onco-fusion protein is crucial for the genesis of t(8;21) acute myeloid leukemia (AML) and is well documented as a transcriptional repressor through dominant-negative effect. However, little is known about the transactivation mechanism of AML1/ETO. Through large cohort of patient's expression level data analysis and a series of experimental validation, we report here that AML1/ETO transactivates c-KIT expression through directly binding to and mediating the long-range interaction between the promoter and intronic enhancer regions of c-KIT. Gene expression analyses verify that c-KIT expression is significantly high in t(8;21) AML. Further ChIP-seq analysis and motif scanning identify two regulatory regions located in the promoter and intronic enhancer region of c-KIT, respectively. Both regions are enriched by co-factors of AML1/ETO, such as AML1, CEBPe, c-Jun, and c-Fos. Further luciferase reporter assays show that AML1/ETO trans-activates c-KIT promoter activity through directly recognizing the AML1 motif and the co-existence of co-factors. The induction of c-KIT promoter activity is reinforced with the existence of intronic enhancer region. Furthermore, ChIP-3C-qPCR assays verify that AML1/ETO mediates the formation of DNA-looping between the c-KIT promoter and intronic enhancer region through the long-range interaction. Collectively, our data uncover a novel transcriptional activity mechanism of AML1/ETO and enrich our knowledge of the onco-fusion protein mediated transcription regulation. © 2017 Wiley Periodicals, Inc.

  5. Grosse Axiallager mit Hybridschmierung - Theoretische und experimentelle Betrachtungen

    DEFF Research Database (Denmark)

    Santos, Ilmar; Fuerst, Axel

    2003-01-01

    Der vorliegende Artikel praesentiert die Simulation eines grossen axialen Kippsegmentlagers unter Beruecksichtigung der hybriden Schmierung, d.h. gleichzeitige hydrodynamische und hydrostatische Schmierung. Ein Vergleich mit Messungen zeigt, dass fuer das betrachtete Lager mit 2,2 m Durchmesser die...

  6. Disease evolution and outcomes in familial AML with germline CEBPA mutations

    DEFF Research Database (Denmark)

    Tawana, Kiran; Wang, Jun; Renneville, Aline

    2015-01-01

    collected from 10 CEBPA-mutated families, representing 24 members with acute myeloid leukemia (AML). Whole-exome (WES) and deep sequencing were performed to genetically profile tumors and define patterns of clonal evolution. Germline CEBPA mutations clustered within the N-terminal and were highly penetrant......, with AML presenting at a median age of 24.5 years (range, 1.75-46 years). In all diagnostic tumors tested (n = 18), double CEBPA mutations (CEBPAdm) were detected, with acquired (somatic) mutations preferentially targeting the C-terminal. Somatic CEBPA mutations were unstable throughout the disease course...

  7. Gene expression profiling in MDS and AML: potential and future avenues

    DEFF Research Database (Denmark)

    Theilgaard-Mönch, K; Boultwood, J; Ferrari, S

    2011-01-01

    Today, the classification systems for myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) already incorporate cytogenetic and molecular genetic aberrations in an attempt to better reflect disease biology. However, in many MDS/AML patients no genetic aberrations have been identified yet...... with regard to diagnosis, prediction of clinical outcome, discovery of novel subclasses and identification of novel therapeutic targets and novel drugs. As many challenges remain ahead, we discuss the pitfalls of this technology and its potential including future integrative studies with other genomics...

  8. Wrestling with Pedagogical Change: The TEAL Initiative at MIT

    Science.gov (United States)

    Breslow, Lori

    2010-01-01

    In the late 1990s, the physics department at the Massachusetts Institute of Technology (MIT) had a problem. The department was responsible for teaching the two required physics courses that are part of the General Institute Requirements (GIRs), MIT's core curriculum--Physics I (mechanics, or in MIT parlance, 8.01) and Physics II (electricity and…

  9. Phase I Trial of the Selective Inhibitor of Nuclear Export, KPT-330, in Relapsed Childhood ALL and AML

    Science.gov (United States)

    2018-03-05

    Relapsed Acute Lymphoblastic Leukemia (ALL); Refractory Acute Lymphoblastic Leukemia (ALL); Relapsed Acute Myelogenous Leukemia (AML); Refractory Acute Myelogenous Leukemia (AML); Relapsed Mixed Lineage Leukemia; Refractory Mixed Lineage Leukemia; Relapsed Biphenotypic Leukemia; Refractory Biphenotypic Leukemia; Chronic Myelogenous Leukemia (CML) in Blast Crisis

  10. MIT professor wins major international math prize

    CERN Multimedia

    Allen, S

    2004-01-01

    Mathematicians Isadore Singer of MIT and Sir Michael Francis Atiyah of the University of Edinburgh will share an $875,000 award as winners of the second Abel Prize, which some hope will come to be seen as a Nobel Prize for math.

  11. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This document details procedures for the operation of the MITS (Machine Interface Test System) Feed and Withdrawal Subsystem (F and W). Included are fill with UF 6 , establishment of recycle and thruput flows, shutdown, UF 6 makeup, dump to supply container, Cascade dump to F and W, and lights cold trap dump, all normal procedures, plus an alternate procedure for trapping light gases

  12. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This procedure details the steps involved in filling two of the four MITS (Machine Interface Test System) Feed and Withdrawal subsystem main traps and the Sample/Inventory Make-up Pipette with uranium hexafluoride from the ''AS RECEIVED'' UF 6 supply

  13. Nuclear matter as an MIT bag crystal

    International Nuclear Information System (INIS)

    Zhang, Q.; Derreth, C.; Schaefer, A.; Greiner, W.

    1986-01-01

    An MIT bag crystal model of nuclear matter is formulated. The energy bands of the quarks are calculated as a function of the overlap between adjacent bags. A clear indication of substantial overlap is found. Accordingly, infinite nuclear matter is more similar to a quark gas than to a nucleonic structure. (author)

  14. Editorial 3/2015: Handeln mit Symbolen

    Directory of Open Access Journals (Sweden)

    Alessandro Barberi

    2015-09-01

    Full Text Available Die paradigmatische Unterscheidung zwischen Sozial- und Kulturwissenschaften, die spätestens seit den 1980er Jahren eingehend diskutiert wurde, lässt sich anhand des Bereichs des Symbolischen auf den Punkt bringen: Ist das Symbolische nur ein Effekt von sozialen, ökonomischen oder medialen Strukturen einer gegebenen Gesellschaft oder reproduzieren sich Strukturen nur durch die symbolischen Handlungen der AkteurInnen innerhalb einer gegebenen Kultur? So hatte etwa der klassische "harte" Strukturalismus bei Claude Lévi-Strauss, Jacques Lacan und dem frühen Michel Foucault symbolische Ordnungen (und d. i. hier die Sprache als eine unbewusst determinierende Voraussetzung von menschlicher Interaktion begriffen, woraufhin mit dem Post- bzw. Neostrukturalismus die Rückkehr der individuellen Äußerung, der parole, des speech acts (und d. i. hier das Sprechen, also der symbolischen Handlung in den Mittelpunkt rückte. Medienpädagogisch ist diese Unterscheidung gerade dann von Interesse, wenn es darum geht, wie Lehrende und Lernende sich zueinander verhalten, interagieren und dabei eben mit Symbolen handeln. Insofern ist es bemerkenswert, dass – fast parallel zu Foucaults Unterscheidung von diskursiven und nicht-diskursiven Praktiken – auch Dieter Baacke 1973 von diskursiven und nicht-diskursiven Symbolen gesprochen hat. Denn – wie auch im Rahmen des "Symbolischen Interaktionismus" von George Herbert Mead argumentiert wurde – können Symbole nur im Rahmen einer gegebenen Diskursökonomie von AkteurInnen diskursiv ausgetauscht werden und konstituieren dabei Erfahrungen bzw. Wahrnehmungen und somit auch die soziale bzw. kulturelle Wirklichkeit. Insofern ist die Frage nach dem Symbolischen immer auch eine Frage nach den Möglichkeiten der Handlungstheorie (im Sinne Jürgen Habermas’ bzw. der Praxeologie (im Sinne Pierre Bourdieus. Die Redaktion der MEDIENIMPULSE geht in diesem Zusammenhang theoretisch und praktisch von Entscheidungsimpulse

  15. Redoxspeziation von endlagerrelevanten Elementen mit Hilfe von Trennmethoden gekoppelt an ein Massenspektrometer mit induktiv gekoppeltem Plasma

    OpenAIRE

    Graser, Carl-Heinrich

    2015-01-01

    Im Rahmen dieser Arbeit wurden Redoxspeziationsanalysen von Eisen, Neptunium und Plutonium per CE-SF-ICP-MS durchgeführt. Durch Optimierung der Trennparameter konnten Trennungen der Pu Oxidationsstufen III bis VI und Trennungen der Np Oxidationsstufen IV bis VI binnen 15 Minuten mit einer Nachweisgrenze von 10-12 M durchgeführt werden. Die Trennung der Fe Oxidationsstufen II und III gelang in weniger als 5 Minuten mit einer Nachweisgrenze von 5-10-8 M.

  16. KRAS (G12D Cooperates with AML1/ETO to Initiate a Mouse Model Mimicking Human Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Shanmin Zhao

    2014-01-01

    Full Text Available Background/Aims: It has been demonstrated that KRAS mutations represent about 90% of cancer-associated mutations, and that KRAS mutations play an essential role in neoplastic transformation. Cancer-associated RAS mutations occur frequently in acute myeloid leukemia (AML, suggesting a functional role for Ras in leukemogenesis. Methods: We successfully established a mouse model of human leukemia by transplanting bone marrow cells co-transfected with the K-ras (G12D mutation and AML1/ETO fusion protein. Results: Mice transplanted with AML/ETO+KRAS co-transduced cells had the highest mortality rate than mice transplanted with AML/ETO- or KRAS-transduced cells (115d vs. 150d. Upon reaching a terminal disease stage, EGFP-positive cells dominated their spleen, lymph nodes, peripheral blood and central nervous system tissue. Immunophenotyping, cytologic analyses revealed that AML/ETO+KRAS leukemias predominantly contained immature myeloid precursors (EGFP+/c-Kit+/Mac-1-/Gr-1-. Histologic analyses revealed that massive leukemic infiltrations were closely packed in dense sheets that effaced the normal architecture of spleen and thymus in mice transplanted with AML1/ETO + KRAS co-transduced cells. K-ras mRNA and protein expression were upregulated in bone marrow cells of the K-ras group and AML1/ETO + Kras group. The phosphorylation of MEK/ERK was significantly enhanced in the AML1/ETO + Kras group. The similar results of the AML1/ETO + Nras group were consistent with those reported previously. Conclusion: Co-transduction of KrasG12D and AML1/ETO induces acute monoblastic leukemia. Since expression of mutant K-ras alone was insufficient to induce leukemia, this model may be useful for investigating the multi-step leukemogenesis model of human leukemia.

  17. The TAK1-NF-κB axis as therapeutic target for AML

    NARCIS (Netherlands)

    Bosman, Matthieu Cornelis Johannes; Schepers, Hein; Jaques, Jennifer; Vos, Annet; Quax, Wim Johannes; Schuringa, Jan Jacob; Vellenga, Edo

    2014-01-01

    Development and maintenance of leukemia can partially be attributed to alterations in (anti) apoptotic gene expression. Genome-wide transcriptome analyses revealed that 89 apoptosis-associated genes were differentially expressed between patient acute myeloid leukemia (AML) CD34(+) cells and normal

  18. Acute erythremic myelosis (true erythroleukaemia): a variant of AML FAB-M6.

    Science.gov (United States)

    Hasserjian, R P; Howard, J; Wood, A; Henry, K; Bain, B

    2001-03-01

    Classic erythroleukaemia (acute myeloid leukaemia M6, or M6 AML) is defined as an excess of myeloblasts in an erythroid predominant background. Leukaemia variants in which the primitive blast cells are demonstrably erythroid are extremely rare and poorly characterised. Variably referred to as "true erythroleukaemia" or "acute erythremic myelosis", they are often included within the M6 AML category even though they do not meet strict criteria for this type of AML. Two cases of acute erythroid neoplasia are presented with clinical, morphological, immunophenotypic, and cytogenetic analysis. Both patients presented with profound anaemia, one in a setting of long standing myelodysplasia. Bone marrow examination revealed a predominant population of highly dysplastic erythroid cells in both cases. In one case, the liver was infiltrated by neoplastic erythroid cells. Both patients died within four months of diagnosis. This report illustrates that cases of acute leukaemia occur in which the dominant neoplastic cell is a primitive erythroid cell without an accompanying increase in myeloblasts. This does not preclude the neoplastic clone originating in a multipotent haemopoietic stem cell, as suggested by cases arising in patients with myelodysplasia. Acute erythremic myelosis should be recognised as a distinct variant of M6 AML.

  19. Genetic and epigenetic similarities and differences between childhood and adult AML

    DEFF Research Database (Denmark)

    Juhl-Christensen, Caroline; Ommen, Hans Beier; Aggerholm, Anni

    2012-01-01

    The biology of acute myeloid leukemia (AML) is complex and includes both genetic and epigenetic aberrations. We addressed the combined consequences of promoter hypermethylation of p15, CDH1, ER, MDR1, and RARB2 and mutation of NPM1, CEBPA, FLT3, and WT1 in a Danish cohort of 70 pediatric and 383...

  20. Zosuquidar restores drug sensitivity in P-glycoprotein expressing acute myeloid leukemia (AML)

    International Nuclear Information System (INIS)

    Tang, Ruoping; Faussat, Anne-Marie; Perrot, Jean-Yves; Marjanovic, Zora; Cohen, Simy; Storme, Thomas; Morjani, Hamid; Legrand, Ollivier; Marie, Jean-Pierre

    2008-01-01

    Chemotherapeutic drug efflux via the P-glycoprotein (P-gp) transporter encoded by the MDR1/ABCB1 gene is a significant cause of drug resistance in numerous malignancies, including acute leukemias, especially in older patients with acute myeloid leukemia (AML). Therefore, the P-gp modulators that block P-gp-mediated drug efflux have been developed, and used in combination with standard chemotherapy. In this paper, the capacity of zosuquidar, a specific P-gp modulator, to reverse chemoresistance was examined in both leukemia cell lines and primary AML blasts. The transporter protein expressions were analyzed by flow cytometry using their specific antibodies. The protein functionalities were assessed by the uptake of their fluorescence substrates in presence or absence their specific modulators. The drug cytotoxicity was evaluated by MTT test. Zosuquidar completely or partially restored drug sensitivity in all P-gp-expressing leukemia cell lines tested and enhanced the cytotoxicity of anthracyclines (daunorubicin, idarubicin, mitoxantrone) and gemtuzumab ozogamicin (Mylotarg) in primary AML blasts with active P-gp. In addition, P-gp inhibition by zosuquidar was found to be more potent than cyclosporine A in cells with highly active P-gp. These in vitro studies suggest that zosuquidar may be an effective adjunct to cytotoxic chemotherapy for AML patients whose blasts express P-gp, especially for older patients

  1. Prognostic Value of RUNX1 Mutations in AML: A Meta-Analysis

    Science.gov (United States)

    Jalili, Mahdi; Yaghmaie, Marjan; Ahmadvand, Mohammad; Alimoghaddam, Kamran; Mousavi, Seyed Asadollah; Vaezi, Mohammad; Ghavamzadeh, Ardeshir

    2018-02-26

    The RUNX1 (AML1) gene is a relatively infrequent mutational target in cases of acute myeloid leukemia (AML). Previous work indicated that RUNX1 mutations can have pathological and prognostic implications. To evaluate prognostic value, we conducted a meta-analysis of 4 previous published works with data for survival according to RUNX1 mutation status. Pooled hazard ratios for overall survival and disease-free survival were 1.55 (95% confidence interval (CI) = 1.11–2.15; p-value = 0.01) and 1.76 (95% CI = 1.24–2.52; p-value = 0.002), respectively, for cases positive for RUNX1 mutations. This evidence supports clinical implications of RUNX1 mutations in the development and progression of AML cases and points to the possibility of a distinct category within the newer WHO classification. Though it must be kept in mind that the present work was based on data extracted from observational studies, the findings suggest that the RUNX1 status can contribute to risk-stratification and decision-making in management of AML. Creative Commons Attribution License

  2. Peptide microarray profiling identifies phospholipase C gamma 1 (PLC-γ1) as a potential target for t(8;21) AML

    NARCIS (Netherlands)

    Mahmud, Hasan; Scherpen, Frank J. G.; Meeuwsen de Boer, Tiny; Lourens, Harm-Jan; Schoenherr, Caroline; Eder, Matthias; Scherr, Michaela; Guryev, Victor; de Bont, Eveline S.

    2017-01-01

    The t(8;21) (q22;q22) chromosomal translocation is one of the most frequent genetic alterations in acute myeloid leukemia (AML) which has a need for improved therapeutic strategies. We found PLC-γ1 as one of the highest phosphorylated peptides in t(8;21) AML samples compared to NBM or CN-AML in our

  3. Grundlegende Steuerungsverfahren im heterogenen Logistiknetz mit Kanban

    Science.gov (United States)

    Dickmann, Eva; Dickmann, Philipp; Lödding, Hermann; Möller, Niklas; Rücker, Thomas; Schneider, Herfried M.; Zäh, Michael F.

    In vielen Unternehmen werden heterogene (verschiedene) Steuerungen in einem abgestimmten Konzept kombiniert. Je nach Anwendungsfall und Rahmenbedingungen werden Kombinationen allgemein bekannter Steuerungen oder Steuerungsvarianten gemischt eingesetzt, um eine optimale Steuerung für unterschiedliche Fälle zu erreichen. Hierbei stehen neben den bekannten und weit verbreiteten Methoden, wie Material Requirements Planning (MRP) oder Kanban, auch weniger bekannte oder neue Methoden zur Auswahl, wie die Produktionssteuerung mit dezentraler, bestandsorientierter Fertigungsregelung (DBF). Kanban ist ein simples und effizientes Steuerungskonzept, das in der klassischen Form für spezifische einfache Anwendungsfälle umsetzbar ist. Hochentwickelte Steuerungsalgorithmen können helfen, komplexe Abläufe optimal abzubilden. Mit einer grundlegenden Vereinfachung der Abläufe kann allerdings in vielen Fällen ein wesentlich stärkerer und umfassender Verbesserungseffekt erzielt werden. Die wesentliche Fragestellung sollte folglich lauten: Warum ist der Ablauf nicht mit einer einfachen Steuerung wie Kanban abzubilden? Um die Vorteile des Konzepts auch in untypischen Bereichen anwenden zu können, sind jedoch verschiedene Varianten oder Kanban-ähnliche Steuerungsmethoden entstanden. Darüber hinaus sind in der Praxis hybride Steuerungen im Einsatz, welche so kombiniert werden, dass die Zusammensetzung anspruchsvolle Eigenschaftsbilder noch exakt abbildet. In der Praxis basieren die Steuerungsentscheidungen nur zu einem kleinen Teil auf den eigentlichen Steuerungsalgorithmen, wie sie uns das MRP-System zur Verfügung stellt. Moderne Steuerungswelten" schließen alle relevanten Informationsquellen in eine heterogene Entscheidungsmatrix mit ein. Letztlich zählt nicht, ob die Entscheidung auf den Informationen aus dem MRP-System oder auf Softfacts basierend getroffen wurde, sondern nur, ob die Entscheidung erfolgreich war.

  4. Untersuchungen zum Potential eines Verbrennungsmotors mit Druckwellenlader

    OpenAIRE

    Binder, Emanuel

    2015-01-01

    Mithilfe der Abgasturboaufladung lässt sich der Kraftstoffverbrauch im Fahrzeugbetrieb durch das Anheben der spezifischen Motorleistung senken. Im Gegensatz zur mechanischen Aufladung verschlechtert sich jedoch mit der Abgasturbolaufladung das Ansprechverhalten. Eine Möglichkeit den Zielkonflikt von Kraftstoffverbrauch und Ansprechverhalten zu lösen ist es, den Abgasturbolader durch einen Druckwellenladers zu ersetzen. Dieser überträgt die Abgasenergie direkt auf die Frischluft in Form von Dr...

  5. The MIT miniaturized disk bend test

    International Nuclear Information System (INIS)

    Harling, O.K.; Lee, M.; Sohn, D.S.; Kohse, G.; Lau, C.W.

    1983-01-01

    A miniaturized disk bend test (MDBT) using transmission electron microscopy specimens for the determination of various mechanical properties is being developed at MIT. Recent progress in obtaining strengths and ductilities of highly irradiated metal alloys is reviewed. Possibilities exist for applying the MDBT approach to the determination of other mechanical properties. Progress in fatigue testing and in determination of the ductile-to-brittle transition temperature is reviewed briefly

  6. Virtuelle Auskunft mit Mehrwert : Chatbots in Bibliotheken

    OpenAIRE

    Christensen, Anne

    2008-01-01

    Die virtuelle Auskunft mit Hilfe elektronischer Informationsassistenten, auch Chatbots oder Chatterbots genannt, ist ein seit dem Jahr 2004 zu beobachtender Trend im deutschen Bibliothekswesen. Die Arbeit stellt die vier Chatbots ASKademicus, Stella, INA und das Sachsen-I vor. Am Beispiel von Stella aus der SUB Hamburg werden dann die Funktionsweise von Chatbots sowie die Anforderungen an die Konzeption dieser virtuellen Berater erläutert. Den Schwerpunkt der Arbeit bilden der Vergleich von C...

  7. Tc-99m-bicisate (ECD)-brain-SPECT in rapidly progressive dementia; Hirn-SPECT mit Tc-99m-Bicisat (ECD) bei rasch progredientem dementiellen Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Marienhagen, J.; Eilles, C. [Regensburg Univ. (Germany). Abt. fuer Nuklearmedizin; Weingaertner, U.; Blaha, L. [Bezirkskrankenhaus Mainkofen (Germany). Psychiatrische Klinik; Zerr, I.; Poser, S. [Goettingen Univ. (Germany). Klinik und Poliklinik fuer Neurologie

    1999-07-01

    We present a 61-year-old male patient with progressive dementia. A brain SPECT with Tc-99m-bicisate was performed for confirmation of clinically suspected Alzheimer-dementia. At the time of the SPECT-investigation marked apraxia and aphasia besides severe dementia were present. Electrophysiological as well as anatomical neuroimaging findings showed non-diagnostic alterations. SPECT revealed distinct perfusion defects, which made Alzheimer Dementia unlikely. The further course of the patient was determined by rapidly progressive deterioration with development of akinetic mutism. Thereafter, increased levels of neuron-specific enolase as well as 14-3-3 proteins were found in the cerebro-spinal fluid (CSF). The patient finally died with signs of cerebral decortication. Due to the clinical course and the CSF-findings the patient's final diagnosis was Creutzfeld-Jakob-disease, nevertheless no autopsy was performed. The presented case report underscores the clinical utility of perfusion brain SPECT in the differential diagnosis of dementias. (orig.) [German] Wir berichten ueber einen 61jaehrigen Patienten mit progredientem dementiellen Syndrom, der unter der Verdachtsdiagnose einer Demenz vom Alzheimer-Typ (DAT) zur Hirn-SPECT-Untersuchung mit TC-99m-Bicisat (ECD) vorgestellt wurde. Zum Untersuchungszeitpunkt bestanden neben dem Vollbild einer Demenz eine ausgepraegte Apraxie und Aphasie bei unspezifischen Veraenderungen im EEG sowie der neuroradiologischen Bildgebung. In der Hirn-SPECT-Untersuchung fanden sich fuer eine DAT untypische ausgedehnte, vorwiegend rechtshemisphaerische Perfusionsstoerungen. Im weiteren Verlauf rasche Progredienz des Krankheitsbildes mit Entwicklung eines akinetischen Mutismus sowie Nachweis erhoehter Werte der neuronspezifischen Enolase und des 14-3-3-Proteins im Liquor. Der Patient verstarb schliesslich unter dem Bild einer Decortication. Aufgrund des klinischen Verlaufs sowie der Liquorbefunde wurde, da eine autoptische Befundsicherung

  8. Proliferative status of primitive hematopoietic progenitors from patients with acute myelogenous leukemia (AML).

    Science.gov (United States)

    Guan, Y; Hogge, D E

    2000-12-01

    One possible explanation for the competitive advantage that malignant cells in patients with acute myelogenous leukemia (AML) appear to have over normal hematopoietic elements is that leukemic progenitors proliferate more rapidly than their normal progenitor cell counterparts. To test this hypothesis, an overnight 3H-thymidine (3H-Tdr) suicide assay was used to analyze the proliferative status of malignant progenitors detected in both colony-forming cell (CFC) and long-term culture initiating cell (LTC-IC) assays from the peripheral blood of nine patients with newly diagnosed AML. Culture of AML cells in serum-free medium with 100 ng/ml Steel factor (SF), 20 ng/ml interleukin 3 (IL-3) and 20 ng/ml granulocyte colony-stimulating factor (G-CSF) for 16-24 h maintained the number of AML-CFC and LTC-IC at near input values (mean % input +/- s.d. for CFC and LTC-IC were 78 +/- 33 and 126 +/- 53, respectively). The addition of 20 muCi/ml high specific activity 3H-Tdr to these cultures reduced the numbers of both progenitor cell types from most of the patient samples substantially: mean % kill +/- s.d. for AML-CFC and LTC-IC were 64 +/- 27 and 82 +/- 16, respectively, indicating that a large proportion of both progenitor populations were actively cycling. FISH analysis of colonies from CFC and LTC-IC assays confirmed that most cytogenetically abnormal CFC and LTC-IC were actively cycling (mean % kill +/- s.d.: 68 +/- 26 and 85 +/- 13, respectively). Interestingly, in six patient samples where a significant number of cytogenetically normal LTC-ICs were detected, the % kill of these cells (74 +/- 20) was similar to that of the abnormal progenitors. These data contrast with the predominantly quiescent cell cycle status of CFC and LTC-IC previously observed in steady-state peripheral blood from normal individuals but also provide evidence that a significant proportion of primitive malignant progenitors from AML patients are quiescent and therefore may be resistant to standard

  9. [Detection of heterogeneity and evolution of subclones in t(8;21) AML by QM-FISH].

    Science.gov (United States)

    Wang, Ying-chan; Hu, Lin-ping; Lin, Dong; Li, Cheng-wen; Yuan, Tian; Jia, Yu-jiao; Tian, Zheng; Tang, Ke-jing; Wang, Min; Wang, Jian-xiang

    2013-10-01

    To explore the heterogeneous subclones in acute myeloid leukemia (AML) with t(8;21) by quantitative multicolor- fluorescence in situ hybridization (QM-FISH), and to figure out whether there is putative ancestral relationship among different subclones. Bacterial artificial chromosomes (BAC) clones that contain the targeted genes including AML1, ETO, WT1, p27 and c-kit were searched in the data base UCSC Genome Bioinformatics. Multicolor FISH probes were prepared by linking fluorescein labeled dUTP or dCTP to targeted genes by nick translation. Bone marrow mononuclear cells from t (8;21) AML patients are dropped on to the wet surface of glass slides after hypotonic treatment and fixation. After hybridization, the fluorescence signals were captured by Zeiss fluorescence microscope. The copy number of AML1, ETO, WT1, p27, c- kit and the AML1-ETO fusion gene in AML1-ETO positive cells was counted. The cells with same signals were defined as a subclone. Various subclones were recorded and their proportions were calculated, and their evolutionary relationship was deduced. The subclones in matched primary and relapsed samples were compared, the evolution of dominant clones were figured out and the genomic abnormality that is associated with relapse and drug resistance were speculated. In this study, 36 primary AML with t(8;21) cases and 1 relapsed case paired with the primary case were detected. In these 36 primary cases, 4 cases (11.1%) acquired additional AML1-ETO fusion signal, 3(8.3%) had additional AML1 signal, 4(11.1%) had additional ETO signal, 20(55.6%) had additional WT1 signal, 15(41.7%) had additional p27 signal and 14(38.9%) had additional c-kit signal. In addition, 10(27.8%) displayed AML1 signal deletion, and such an aberration represents statistic significance in male patients. It seems that male patients usually accompany AML1 signal deletion. Of 36 cases, 28(77.8 %) harbored at least 2 subclones (ranged from 2 to 10). According to the genetic signature of

  10. Genome-wide analysis of histone H3 acetylation patterns in AML identifies PRDX2 as an epigenetically silenced tumor suppressor gene

    DEFF Research Database (Denmark)

    Agrawal-Singh, Shuchi; Isken, Fabienne; Agelopoulos, Konstantin

    2012-01-01

    to have lower H3Ac levels in AML compared with progenitor cells, which suggested that a large number of genes are epigenetically silenced in AML. Intriguingly, we identified peroxiredoxin 2 (PRDX2) as a novel potential tumor suppressor gene in AML. H3Ac was decreased at the PRDX2 gene promoter in AML......With the use of ChIP on microarray assays in primary leukemia samples, we report that acute myeloid leukemia (AML) blasts exhibit significant alterations in histone H3 acetylation (H3Ac) levels at > 1000 genomic loci compared with CD34+ progenitor cells. Importantly, core promoter regions tended......, which correlated with low mRNA and protein expression. We also observed DNA hypermethylation at the PRDX2 promoter in AML. Low protein expression of the antioxidant PRDX2 gene was clinically associated with poor prognosis in patients with AML. Functionally, PRDX2 acted as inhibitor of myeloid cell...

  11. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.

    Science.gov (United States)

    Döhner, Hartmut; Estey, Elihu; Grimwade, David; Amadori, Sergio; Appelbaum, Frederick R; Büchner, Thomas; Dombret, Hervé; Ebert, Benjamin L; Fenaux, Pierre; Larson, Richard A; Levine, Ross L; Lo-Coco, Francesco; Naoe, Tomoki; Niederwieser, Dietger; Ossenkoppele, Gert J; Sanz, Miguel; Sierra, Jorge; Tallman, Martin S; Tien, Hwei-Fang; Wei, Andrew H; Löwenberg, Bob; Bloomfield, Clara D

    2017-01-26

    The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease. © 2017 by The American Society of Hematology.

  12. High frequency of streptococcal bacteraemia during childhood AML therapy irrespective of dose of cytarabine

    DEFF Research Database (Denmark)

    Johannsen, Katrine Helle; Handrup, Mette Møller; Lausen, Birgitte Frederiksen

    2013-01-01

    of cytarabine and more chemotherapy series (n = 6) than other protocols with the potential increased risk of severe VGS infections. PROCEDURE: Medical records of all Danish children enrolled on the NOPHO-AML-2004 protocol between January 2004 and September 2011 (n = 45) were retrospectively reviewed and all...... rate of VGS seemed independent of high-dose cytarabine but was more likely caused by the intensive chemotherapy treatment leading to severe mucositis and neutropenia....

  13. Socioeconomic status (SES) and childhood acute myeloid leukemia (AML) mortality risk: Analysis of SEER data.

    Science.gov (United States)

    Knoble, Naomi B; Alderfer, Melissa A; Hossain, Md Jobayer

    2016-10-01

    Socioeconomic status (SES) is a complex construct of multiple indicators, known to impact cancer outcomes, but has not been adequately examined among pediatric AML patients. This study aimed to identify the patterns of co-occurrence of multiple community-level SES indicators and to explore associations between various patterns of these indicators and pediatric AML mortality risk. A nationally representative US sample of 3651 pediatric AML patients, aged 0-19 years at diagnosis was drawn from 17 Surveillance, Epidemiology, and End Results (SEER) database registries created between 1973 and 2012. Factor analysis, cluster analysis, stratified univariable and multivariable Cox proportional hazards models were used. Four SES factors accounting for 87% of the variance in SES indicators were identified: F1) economic/educational disadvantage, less immigration; F2) immigration-related features (foreign-born, language-isolation, crowding), less mobility; F3) housing instability; and, F4) absence of moving. F1 and F3 showed elevated risk of mortality, adjusted hazards ratios (aHR) (95% CI): 1.07(1.02-1.12) and 1.05(1.00-1.10), respectively. Seven SES-defined cluster groups were identified. Cluster 1 (low economic/educational disadvantage, few immigration-related features, and residential-stability) showed the minimum risk of mortality. Compared to Cluster 1, Cluster 3 (high economic/educational disadvantage, high-mobility) and Cluster 6 (moderately-high economic/educational disadvantages, housing-instability and immigration-related features) exhibited substantially greater risk of mortality, aHR(95% CI)=1.19(1.0-1.4) and 1.23 (1.1-1.5), respectively. Factors of correlated SES-indicators and their pattern-based groups demonstrated differential risks in the pediatric AML mortality indicating the need of special public-health attention in areas with economic-educational disadvantages, housing-instability and immigration-related features. Copyright © 2016 Elsevier Ltd. All

  14. MIT-Skywalker: On the use of a markerless system.

    Science.gov (United States)

    Goncalves, Rogerio S; Hamilton, Taya; Krebs, Hermano I

    2017-07-01

    This paper describes our efforts to employ the Microsoft Kinect as a low cost vision control system for the MIT-Skywalker, a robotic gait rehabilitation device. The Kinect enables an alternative markerless solution to control the MIT-Skywalker and allows a more user-friendly set-up. A study involving eight healthy subjects and two stroke survivors using the MIT-Skywalker device demonstrates the advantages and challenges of this new proposed approach.

  15. Optimierung der Hupkraftverteilung eines airbagintegrierten Automobillenkrades mit Hilfe einer Parameterstudie

    OpenAIRE

    Pietsch, Karsten

    2011-01-01

    Die Hupkraftverteilung eines airbagintegrierten Automobillenkrades wird mit Hilfe einer Parameterstudie in MathCAD so optimiert, das an jeder Krafteinleitungsposition die Hupe mit einer geforderten Mindestkraft betätigt werden kann. Nach der Modellierung in MathCAD der zugehörigen Geometrie und der Dimensionierung der Federlagerung ist das zugehörige mechanische Ersatzmodell mit Hilfe einer Parameterstudie verändert worden, so dass die Hupkraftforderung erfüllt wird.

  16. Problems getting from the laboratory to the field: Reclamation of an AML site

    International Nuclear Information System (INIS)

    Dick, W.A.; Stehouwer, R.C.

    1994-01-01

    Acid and toxic abandoned mineland sites provide an opportunity whereby flue gas desulfurization (FGD) by-product can be beneficially used as a reclamation amendment material. Studies are needed to compare the effectiveness of FGD by-product, as compared with resoil, for reclamation purposes. Initial studies provided information about the chemical and physical properties of the FGD by-product and how to transport and blend the FGD by-product with yard waste compost. Greenhouse studies indicated that rates of 125 dry tons/acre of FGD and 50 dry tons/acre of yard waste compost would provide optimum results for reclamation of acid and toxic spoil contained at the Fleming abandoned mineland (AML) site. Their results showed that heavy metal loading rates were much lower using the FGD/compost mixture than using resoil material. Dioxin in the mixture was also less than the 5 ppt level considered as normal background. The technical problems of using FGD by-product for reclamation of an AML site were solved. However, considerable efforts to educate the public about the merits of reclaiming the Fleming AML site using this FGD/compost mixture were required before initiating field reclamation activities. Education efforts must continue if FGD by-products are to achieve general acceptance as a reclamation alternative to resoil in cases where resoil is of scarce supply

  17. A multigene array for measurable residual disease detection in AML patients undergoing SCT

    Science.gov (United States)

    Goswami, M; McGowan, K S; Lu, K; Jain, N; Candia, J; Hensel, N F; Tang, J; Calvo, K R; Battiwalla, M; Barrett, A J; Hourigan, C S

    2015-01-01

    AML is a diagnosis encompassing a diverse group of myeloid malignancies. Heterogeneous genetic etiology, together with the potential for oligoclonality within the individual patient, have made the identification of a single high-sensitivity marker of disease burden challenging. We developed a multiple gene measurable residual disease (MG-MRD) RQ–PCR array for the high-sensitivity detection of AML, retrospectively tested on 74 patients who underwent allo-SCT at the NHLBI in the period 1994–2012. MG-MRD testing on peripheral blood samples prior to transplantation demonstrated excellent concordance with traditional BM-based evaluation and improved risk stratification for post-transplant relapse and OS outcomes. Pre-SCT assessment by MG-MRD predicted all clinical relapses occurring in the first 100 days after allo-SCT compared with 57% sensitivity using WT1 RQ–PCR alone. Nine patients who were negative for WT1 prior to transplantation were correctly reclassified into a high-risk MG-MRD-positive group, associated with 100% post-transplant mortality. This study provides proof of principle that a multiple gene approach may be superior to the use of WT1 expression alone for AML residual disease detection. PMID:25665046

  18. [Bernt Ahrenholz : Verweise mit Demonstrativa im Gesprochenen Deutsch...] / Klaus Geyer

    Index Scriptorium Estoniae

    Geyer, Klaus

    2008-01-01

    Arvustus: Ahrenholz, Bernt. Verweise mit Demonstrativa im gesprochenen Deutsch : Grammatik, Zweitspracherwerb und Deutsch als Fremdsprache. Berlin ; New York : de Gruyter, 2007. (Linguistik - Impulse & Tendenzen ; 17)

  19. Results of radiotherapy for meningeomas with high risk for local recurrence. A retrospective analysis; Ergebnisse der Strahlentherapie bei Meningeomen mit hohem Rezidivrisiko. Eine retrospektive Analyse

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, C.; Dornfeld, S.; Friedrich, S.; Baumann, M. [Technische Univ. Dresden (Germany). Klinik und Poliklinik fuerStrahlentherapie und Radioonkologie; Schwarz, R. [Universitaetskrankenhaus Hamburg-Eppendorf (Germany). Abt. fuer Strahlentherapie

    1998-12-01

    Aim: Retrospective assessment of the efficacy of radiatiotherapy for meningeomas with high risk for local recurrence. Patients and methods: Records of 67 patients with meningeomas treated from 1974 to 1995 at 2 centres were analyzed. Follow-up time ranged from 0.8 to 213 months (median: 61 months). Radiation therapy was given either after local failure or after biopsy or subtotal resection. The ratio between malignant (n=20) and benign (n=47) meningenoma was 1:2.4. Median age of the patients was 55 years (7 to 77 years). Radiation treatment was given at 1.5 to 2 Gy per fraction to 36 to 79.5 Gy. Survival rates were calculated by the Kaplan-Meier method. Statistical comparisons were performed with the log-rank test and the Cox proportional hazards model. The Bonferroni method was used to correct for multiple comparisons. Results: Five- and 10-year disease-free survival rates were 82%{+-}5% (standard error) and 70%{+-}9%. Local control rates at 5 and 10 years were 78%{+-}5% and 68%{+-}9%. In uni- and multivariate analysis histology, sex, total dose and center showed no significant influence on the results. Patients age was significant for local control (univariate p=0.02; multivariate p=0.03) and disease-free survival (univariate/multivariate p=0.04). The postoperative tumor burden had a significant influence of disease-free survival (multivariate P=0.04). After Bonferroni correction no significant influenc e was observed. We did not observe late side effects, especially brain necrosis. Conclusions: Despite of the negative selection of our patients we observed high survival- and local control rates after radiation therapy. This underscores the role of radiation therapy in the treatment of meningeomas with high risk of local failure. (orig.) [Deutsch] Hintergrund: Retrospektive Auswertung der Behandlungsergebnisse der Bestrahlung von Meningeomen mit hohem Rezidivrisiko. Patienten und Methode: Im Zeitraum zwischen 1974 und 1995 wurden an zwei Zentren insgesamt 67

  20. MIT - Mighty Steps toward Energy Sustainability

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Settlemyre, Kevin [Sustainable IQ, Inc., Arlington, MA (United States); Bosnic, Zorana [HOK, San Francisco, CA (United States)

    2012-07-01

    Massachusetts Institute of Technology (MIT) partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit existing buildings to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program.1 Lawrence Berkeley National Laboratory (LBNL) provided technical expertise in support of this DOE program. MIT is one of the U.S.’s foremost higher education institutions, occupying a campus that is nearly 100 years old, with a building floor area totaling more than 12 million square feet. The CBP project focused on improving the energy performance of two campus buildings, the Ray and Maria Stata Center (RMSC) and the Building W91 (BW91) data center. A key goal of the project was to identify energy saving measures that could be applied to other buildings both within MIT’s portfolio and at other higher education institutions. The CBP retrofits at MIT are projected to reduce energy consumption by approximately 48%, including a reduction of around 72% in RMSC lighting energy and a reduction of approximately 55% in RMSC server room HVAC energy. The energy efficiency measure (EEM) package proposed for the BW91 data center is expected to reduce heating, ventilation, and air-conditioning (HVAC) energy use by 30% to 50%, depending on the final air intake temperature that is established for the server racks. The RMSC, an iconic building designed by Frank Gehry, houses the Computer Science and Artificial Intelligence Laboratory, the Laboratory for Information and Decision Systems, and the Department of Linguistics and Philosophy.

  1. Functional-anatomic evaluation of dilated uropathies in children using combined MR-nephrography and MR-urography compared to renal scintigraphy; Funktionell-anatomische Diagnostik dilatierter Uropathien bei Kindern mit kombinierter MR-Nephrographie und MR-Urographie im Vergleich zur renalen Isotopennephrographie

    Energy Technology Data Exchange (ETDEWEB)

    Reither, M. [Abt. fuer bildgebende Diagnostik am Kinderkrankenhaus Park Schoenfeld, Kassel (Germany); Tuerkay, S. [GE Medical Systems Deutschland GmbH, Solingen (Germany)

    2004-02-01

    ,95). Wegen technischer Fehler konnten die Studien bei 8 Kindern nicht ausgewertet werden. Beim Vergleich des Obstruktionsgrades gab es eine Uebereinstimmung bei 57 von 62 Patienten, 3 Faelle wurden ueber-, 2 unterbewertet. Bis auf eine liessen sich alle primaer sonographisch gestellten und im Verlauf durch weitere Bildgebung ergaenzten morphologischen Diagnosen MR-urographisch bestaetigen. Obwohl korrekt dargestellt, gab es bei einer Doppelanlage mit Ureterozele und funktionsloser oberer Anlage zunaechst eine Fehlinterpretation. (orig.)

  2. Caspase-3 controls AML1-ETO-driven leukemogenesis via autophagy modulation in a ULK1-dependent manner.

    Science.gov (United States)

    Man, Na; Tan, Yurong; Sun, Xiao-Jian; Liu, Fan; Cheng, Guoyan; Greenblatt, Sarah M; Martinez, Camilo; Karl, Daniel L; Ando, Koji; Sun, Ming; Hou, Dan; Chen, Bingyi; Xu, Mingjiang; Yang, Feng-Chun; Chen, Zhu; Chen, Saijuan; Nimer, Stephen D; Wang, Lan

    2017-05-18

    AML1-ETO (AE), a fusion oncoprotein generated by t(8;21), can trigger acute myeloid leukemia (AML) in collaboration with mutations including c-Kit, ASXL1/2, FLT3, N-RAS, and K-RAS. Caspase-3, a key executor among its family, plays multiple roles in cellular processes, including hematopoietic development and leukemia progression. Caspase-3 was revealed to directly cleave AE in vitro, suggesting that AE may accumulate in a Caspase-3-compromised background and thereby accelerate leukemogenesis. Therefore, we developed a Caspase-3 knockout genetic mouse model of AML and found that loss of Caspase-3 actually delayed AML1-ETO9a (AE9a)-driven leukemogenesis, indicating that Caspase-3 may play distinct roles in the initiation and/or progression of AML. We report here that loss of Caspase-3 triggers a conserved, adaptive mechanism, namely autophagy (or macroautophagy), which acts to limit AE9a-driven leukemia. Furthermore, we identify ULK1 as a novel substrate of Caspase-3 and show that upregulation of ULK1 drives autophagy initiation in leukemia cells and that inhibition of ULK1 can rescue the phenotype induced by Caspase-3 deletion in vitro and in vivo. Collectively, these data highlight Caspase-3 as an important regulator of autophagy in AML and demonstrate that the balance and selectivity between its substrates can dictate the pace of disease. © 2017 by The American Society of Hematology.

  3. Proteasome inhibition enhances the efficacy of volasertib-induced mitotic arrest in AML in vitro and prolongs survival in vivo.

    Science.gov (United States)

    Schnerch, Dominik; Schüler, Julia; Follo, Marie; Felthaus, Julia; Wider, Dagmar; Klingner, Kathrin; Greil, Christine; Duyster, Justus; Engelhardt, Monika; Wäsch, Ralph

    2017-03-28

    Elderly and frail patients, diagnosed with acute myeloid leukemia (AML) and ineligible to undergo intensive treatment, have a dismal prognosis. The small molecule inhibitor volasertib induces a mitotic block via inhibition of polo-like kinase 1 and has shown remarkable anti-leukemic activity when combined with low-dose cytarabine. We have demonstrated that AML cells are highly vulnerable to cell death in mitosis yet manage to escape a mitotic block through mitotic slippage by sustained proteasome-dependent slow degradation of cyclin B. Therefore, we tested whether interfering with mitotic slippage through proteasome inhibition arrests and kills AML cells more efficiently during mitosis. We show that therapeutic doses of bortezomib block the slow degradation of cyclin B during a volasertib-induced mitotic arrest in AML cell lines and patient-derived primary AML cells. In a xenotransplant mouse model of human AML, mice receiving volasertib in combination with bortezomib showed superior disease control compared to mice receiving volasertib alone, highlighting the potential therapeutic impact of this drug combination.

  4. Regulation of Trib2 by an E2F1-C/EBPα feedback loop in AML cell proliferation.

    LENUS (Irish Health Repository)

    Rishi, Loveena

    2014-04-10

    The loss of regulation of cell proliferation is a key event in leukemic transformation, and the oncogene tribbles (Trib)2 is emerging as a pivotal target of transcription factors in acute leukemias. Deregulation of the transcription factor E2F1, normally repressed by CCAAT enhancer-binding protein α (C\\/EBPα)-p42, occurs in acute myeloid leukemia (AML), resulting in the perturbation of cell cycle and apoptosis, emphasizing its importance in the molecular pathogenesis of AML. Here we show that E2F family members directly regulate Trib2 in leukemic cells and identify a feedback regulatory loop for E2F1, C\\/EBPα, and Trib2 in AML cell proliferation and survival. Further analyses revealed that E2F1-mediated Trib2 expression was repressed by C\\/EBPα-p42, and in normal granulocyte\\/macrophage progenitor cells, we detect C\\/EBPα bound to the Trib2 promoter. Pharmacological inhibition of the cell cycle or Trib2 knockdown resulted in a block in AML cell proliferation. Our work proposes a novel paradigm whereby E2F1 plays a key role in the regulation of Trib2 expression important for AML cell proliferation control. Importantly, we identify the contribution of dysregulated C\\/EBPα and E2F1 to elevated Trib2 expression and leukemic cell survival, which likely contributes to the initiation and maintenance of AML and may have significant implications for normal and malignant hematopoiesis.

  5. MRI of focal liver lesions using a 1.5T turbo-spinecho technique compared with spinecho technique; MRT fokaler Leberlaesionen bei 1,5T Turbo-Spinecho im Vergleich mit der Spinecho-Technik

    Energy Technology Data Exchange (ETDEWEB)

    Steiner, S. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Vogl, T.J. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Fischer, P. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Steger, W. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Neuhaus, P. [Chirurgische Klinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Keck, H. [Chirurgische Klinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1995-08-01

    In our study 35 patients with suspected focal liver lesions were examined. Standardised imaging protocol included a conventional T{sub 2}-weighted SE sequence (T{sub R}/T{sub E} = 2000/90/45, acquisition time = 10.20) as well as a T{sub 2}-weighted TSE sequence (T{sub R}/T{sub E} = 4700/90, acquisition time = 6.33). Calculation of S/N and C/N ratio as a basis of quantitative evaluation was done using standard methods. A diagnostic score was implemented to enable qualitative assessment. In 7% (n=2) the TSE sequence enabled detection of further liver lesions showing a size of less than 1 cm in diameter. Comparing anatomical details the TSE sequence was superior. S/N and C/N ratio of anatomic and pathologic structures of the TSE sequence were higher compared to results of the SE sequence. (orig./MG) [Deutsch] In einer prospektiven Studie wurden 35 Patienten mit fokalen Leberlaesionen untersucht. Das standardisierte Untersuchungsschema der Studie umfasste eine konventionelle SE-Sequenz mit T{sub R}/T{sub E} = 2000/90/45 (Akquisitionszeit = 10,20 min) sowie eine TSE-Sequenz mit T{sub R}/T{sub E} = 4700/90 (Akquisitionszeit = 6.33 min). Die Berechnung des S/R- sowie der K/R-Quotienten als Grundlage des quantitativen Vergleichs erfolgte nach Standardmethoden. Der qualitative Vergleich beider Sequenzen erfolgte durch Einschaetzung der Bildqualitaet anhand eines Stufenschemas. In 7% (n=2) konnten mit Hilfe der TSE-Sequenz mehr suspekte Laesionen detektiert werden. Ein Vergleich der Darstellung der anatomischen Detailerkennbarkeit zeigte Ueberlegenheit der TSE-Sequenz. Die S/R-Quotienten und K/R-Quotienten bezogen auf anatomische und pathologische Strukturen wiesen fuer die Turbo-Spinecho-Sequenz hoehere Werte auf. (orig./MG)

  6. Thyroid hemiagenesis with immunthyropathy; Schilddruesenhemiagenesie mit Immunthyreopathie

    Energy Technology Data Exchange (ETDEWEB)

    Mikosch, P.; Gallowitsch, H.J.; Kresnik, E.; Lind, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie

    1999-06-01

    A case of Graves` disease occurring in a patient with hemiagenesis is presented. The detection of the rare occurrence of a congential hemiagenesis is often made by either clinical symptoms of thyroid dysfunction or anatomical abnormalities such as nodular goiter. The symptoms of hyperthyroidism in the current case led to the diagnostic confirmation by scintiscanning and ultrasonography of an absent lobe. Anti-thyroid antibody studies documented the presence of Graves` disease within the remaining lobe. (orig.) [Deutsch] Die Hemiagenesie der Schilddruese stellt eine seltene angeborene Veraenderung dar. Diese angeborene Variante der Schilddruesenanlage wird in den meisten Faellen durh Auffaelligkeiten der Funktion oder der Groesse des vorhandenen Schilddruesenlappens zufaellig gefunden. Der Fall einer 57jaehrigen Frau mit einer Schilddruesenhemiagenesie in Kombination mit einer Immunthyreopatie Basedow wird vorgestellt. Die Zuweisung der Patientin zur Untersuchung erfolgte wegen einer Schilddruesenueberfunktion. Die erforderlichen diagnostischen Schritte zur Erstellung dieser beiden Schilddruesenveraenderungen waren ein 99m-Tc-Schilddruesenszintigramm, Ultraschall und Laborparameter der Schilddruese (fT4, TT3, bTSH, TAK, TPO, TRAK). (orig.)

  7. Physik gestern und heute: Visualisierung mit der Schlierenmethode

    Science.gov (United States)

    Heering, Peter

    2006-07-01

    Der Name des österreichischen Forschers Ernst Mach ist heute noch mit der Schallgeschwindigkeit verbunden. Diese Auszeichnung resultiert aus Machs Untersuchungen, wie sich Projektile mit Überschallgeschwindigkeit durch die Luft bewegen. Gerade in jüngster Zeit hat die Anwendung derartiger Methoden durch technische Modifikationen wieder einen Aufschwung erfahren.

  8. Role of the Phosphorylation of mTOR in the Differentiation of AML Cells Triggered with CD44 Antigen

    KAUST Repository

    Darwish, Manar M

    2013-05-01

    Acute myeloid leukemia (AML) is a hematological disorder characterized by blockage of differentiation of myeloblasts. To date, the main therapy for AML is chemotherapy. Yet, studies are seeking a better treatment to enhance the survival rate of patients and minimize the relapsing of the disease. Since the major problem in these cells is that they are arrested in cellular differentiation, drugs that could induce their differentiation have proven to be efficient and of major interest for AML therapy. CD44 triggering appeared as a promising target for AML therapy as it has been shown that specific monoclonal antibodies, such as A3D8 and H90, reversed the blockage of differentiation, inhibited the proliferation of all AML subtypes, and in some cases, induced cell apoptosis. Studies conducted in our laboratory have added strength to these antibodies as potential treatment for AML. Indeed, our laboratory found that treating HL60 cells with A3D8 shows a decrease in the phosphorylation of the mammalian target of Rapamycin (mTOR) kinase correlated with the inhibition of proliferation/induction of differentiation of AML cells.The relationship between the induction of differentiation and the inhibition of proliferation and the decrease of mTOR phosphorylation remains to be clarified. To study the importance of the de-phosphorylation of mTOR and the observed effect of CD44 triggering on differentiation and/or proliferation, we sought to prepare phospho-mimic mutants of the mTOR kinase that will code for a constitutively phosphorylated form of mTOR and used two main methods to express this mutant in HL60 cells: lentiviral and simple transfection (cationic-liposomal transfection).

  9. Pubertal development and fertility in survivors of childhood acute myeloid leukemia treated with chemotherapy only: a NOPHO-AML study.

    Science.gov (United States)

    Molgaard-Hansen, Lene; Skou, Anne-Sofie; Juul, Anders; Glosli, Heidi; Jahnukainen, Kirsi; Jarfelt, Marianne; Jónmundsson, Guðmundur K; Malmros, Johan; Nysom, Karsten; Hasle, Henrik

    2013-12-01

    More than 60% of children with acute myeloid leukemia (AML) become long-term survivors. Most are cured using chemotherapy without hematopoietic stem cell transplantation (HSCT). We report on pubertal development and compare self-reported parenthood among AML survivors and their siblings. We included 137 children treated for AML according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML-84, -88, and -93 trials, who were alive by June 2007. Patients with relapse or treated with HSCT were excluded. AML survivors participated in a physical and biochemical examination (n = 102) and completed a questionnaire (n = 101). One of their siblings completed an identical questionnaire (n = 84). At a median follow-up of 11 years (range 5-25) after diagnosis of AML the survivors (median age 16 years, range 5-36) were either prepubertal or had entered puberty normally. Serum levels of FSH, LH, testosterone, estradiol, sex hormone binding globulin (SHBG), inhibin A and B, and testicular volumes were within normal ranges. Anti-Müllerian hormone (AMH) levels were decreased in 5 of 40 postpubertal females. Mean reported age at menarche was 13.1 (range 11-17) years. Among survivors 15 years of age or older 31% of females reported pregnancies and 9% of males reported pregnancies in their partners, rates comparable with the frequency reported by their siblings. Most AML survivors treated with chemotherapy had normal pubertal development and fertility, however, AMH levels were decreased in 13% of postpubertal females. Longer follow-up is necessary to evaluate possible risk of premature ovarian failure. © 2013 Wiley Periodicals, Inc.

  10. Therapy Related AML/MDS Following Treatment for Childhood Cancer: Experience from a Tertiary Care Centre in North India.

    Science.gov (United States)

    Vyas, Chintan; Jain, Sandeep; Kapoor, Gauri

    2018-01-01

    Therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) is a devastating late effect of cancer treatment. There is limited data on incidence of t-AML/MDS from India. We retrospectively studied pediatric t AML/MDS at our institute between January 1996 and December 2015. Among 1285 children, 8 patients developed t-AML with a median age of 15.5 years. Overall incidence of t-AML/MDS was 0.62% [0.99% (4/402) in solid tumours and 0.45% (4/883) in leukemia/lymphoma, P  = 0.26] with 6390 patient years of follow up. Primary malignancy included sarcoma [bone (2), soft tissue (2)], B-non-Hodgkin lymphoma (2) and acute lymphoblastic leukemia (2). The median cumulative equivalent doses of cyclophosphamide, doxorubicin and etoposide were 6.8, 270 and 2.5 gm/m 2 respectively. Two patients received radiotherapy [rhabdomyosarcoma (50 Gy), synovial sarcoma (45 Gy)]. The median latency period to develop t-AML/MDS was 24 months (range 16.5-62 months). Most common FAB morphology was M4/M5 (7/8) and cytogenetic abnormality was MLL rearrangement (4/8). Five patients opted for treatment, 4 achieved remission out of which 2 patients are alive and disease free. Short latency periods, absence of pre-leukemic phase and 11q23 translocations were characteristic in the patients with t-AML/MDS. In view of poor outcome with conventional therapy, novel strategies and prevention need to be considered.

  11. MACH MIT: Deutsches Wochenende am Karlsfluss (MACH MIT: a German Week-End on the Charles River).

    Science.gov (United States)

    Reizes, Sonia; Kramsch, Claire J.

    1980-01-01

    Describes a joint high school/college pilot program planned by Massachusetts foreign language teachers and hosted by M.I.T. The success of the program dubbed "MACH MIT Total Immersion German Weekend" is attributed to the concept of active involvement, which was implemented through games, seminars, shows, cooking and other activities.…

  12. Design of the randomized, Phase III, QUAZAR AML Maintenance trial of CC-486 (oral azacitidine) maintenance therapy in acute myeloid leukemia.

    Science.gov (United States)

    Roboz, Gail J; Montesinos, Pau; Selleslag, Dominik; Wei, Andrew; Jang, Jun-Ho; Falantes, Jose; Voso, Maria T; Sayar, Hamid; Porkka, Kimmo; Marlton, Paula; Almeida, Antonio; Mohan, Sanjay; Ravandi, Farhad; Garcia-Manero, Guillermo; Skikne, Barry; Kantarjian, Hagop

    2016-02-01

    Older patients with acute myeloid leukemia (AML) have worse rates of complete remission and shorter overall survival than younger patients. The epigenetic modifier CC-486 is an oral formulation of azacitidine with promising clinical activity in patients with AML in Phase I studies. The Phase III, randomized, double-blind, placebo-controlled QUAZAR AML Maintenance trial (CC-486-AML-001) examines CC-486 maintenance therapy (300 mg/day for 14 days of 28-day treatment cycles) for patients aged ≥55 years with AML in first complete remission. The primary end point is overall survival. Secondary end points include relapse-free survival, safety, health-related quality of life and healthcare resource utilization. This trial will investigate whether CC-486 maintenance can prolong remission and improve survival for older patients with AML.

  13. Pre- and post-operative evaluation of ventricular function, muscle mass and valve morphology by MR tomography in Ebstein's anomaly; Prae- und postoperative Beurteilung der ventrikulaeren Funktion, Muskelmasse und Klappenmorphologie bei der Ebstein-Anomalie mit der Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Gutberlet, M.; Oellinger, H.; Amthauer, H.; Hoffmann, T.; Felix, R. [Charite-Campus Virchow, Berlin (Germany). Klinik fuer Strahlenheilkunde; Ewert, P.; Nagdyman, N.; Lange, P. [Deutsches Herzzentrum Berlin (Germany). Abt. fuer Angeborene Herzfehler/Kinderkardiologie; Hetzer, R. [Deutsches Herzzentrum Berlin (Germany). Abt. fuer Herz-, Thorax- und Gefaesschirurgie

    2000-05-01

    Purpose: To evaluate the value of MRT with spin echo (SE) and CINE gradient echo (GE) sequences for the pre- and postoperative assessment of patients with Ebstein's anomaly. Methods: Twelve patients within the ages of four to 49 years (mean 22{+-}12 years) were examined pre- (n=5) or postoperatively (n=7) after tricuspid valve reconstruction with a 1.5 T scanner. For the anatomical assessment, an ECG-gated transverse SE-sequence, for the assessment of valve morphology and function as well as for volumetry a CINE GE-sequence with retrospective gating was used. With the use of the multislice-multiphase technique, after summing up the manually outlined epi- and endocardial areas, endsystolic (ESV) and enddiastolic volumes (EDV), ejection fraction (EF), stroke volume (SV), and muscle mass (MM) were calculated for both ventricles. Results: The differentiation of the displaced parts of the tricuspid valve (TV) was insufficient with static SE, but was possible in all patients with CINE-MRT. Like in Doppler echocardiography, a qualitative assessment of tricuspid insufficiency was possible in CINE-MRT, the mean incompetence grade preoperative was 1.8 ({+-}0.8), postoperative 0.7 ({+-}0.5). The mean RV-EF in the preoperative group was 41.8% ({+-}6.4), in the postoperative group 47.9% ({+-}10.6), the mean LV-EF preoperative 47.4% ({+-}8.5%), postoperative 63,0% ({+-}9.4). Conclusion: CINE-MRT should rather be used than SE for the assessment of valve morphology. EF, muscle mass and tricuspid incompetence can also be calculated pre- and postoperative with CINE-MRT. (orig.) [German] Zielsetzung: Zu ermitteln, welchen Beitrag die MRT mit der Spin-Echo-(SE) bzw. CINE-Gradienten-Echo-Sequenz (GE) zur prae- und postoperativen Beurteilung bei Patienten mit Ebstein-Anomalie leisten kann. Material und Methode: Es wurden 12 Patienten im Alter zwischen 4 und 49 Jahren (im Mittel 22{+-}12 Jahre) prae- (n=5) oder postoperativ (n=7) nach einer Trikuspidalklappenkonstruktion an einem 1

  14. Pressurized grout remote backfilling at AML sites near Beulah and Zap, North Dakota

    International Nuclear Information System (INIS)

    Weiner, E.J.; Dodd, W.E.

    1999-01-01

    The Abandoned Mine Lands (AML) Division of the North Dakota Public Service Commission (PSC) is charged with the reclamation of hazardous abandoned mine sites in North Dakota. Several underground lignite coalmines were operated near the cities of Beulah and Zap, North Dakota, from the early 1900's until about 1955. Coal seams in this area were relatively thick and the overburden generally shallow. As these mines have deteriorated with time, deep collapse features, or sinkholes, have surfaced in many areas. These features are very dangerous, especially when they occur at or near residential and commercial areas and public roads. In the past five years, sinkholes have surfaced beneath a commercial building (boat dealership, lounge, and gas station) and beneath a nearby occupied mobile home north of Beulah. sinkholes have also surfaced near KHOL Radio Station in Beulah and in the right of way of a public road south of Zap. The AML Division has conducted several emergency sinkhole-filling projects in these areas. In 1995--97, the AML Division conducted exploratory drilling which confirmed the presence of collapsing underground mines at these sites. The remediation of these sites around Beulah/Zap will take place over several years and involve three or more separate contracts due to budget considerations. In 1997, the AML Division began reclamation at these sties utilizing pressurized grout remote backfilling. In this technique, a cementitious grout is pumped through cased drill holes directly into the mine cavities to fill them and thereby stabilize the surface from collapse. The successful contractor for Phase One of the project was The Concrete Doctor, Inc. (TCDI). This paper will concentrate on Phase One of this work performed from June through September 1997. This project is especially interesting because grout was pumped through holes drilled inside the occupied commercial building. Grout was also pumped through angled holes that intercepted mined workings directly

  15. Pressurized grout remote backfilling at AML sites near Beulah and Zap, North Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Weiner, E.J.; Dodd, W.E.

    1999-07-01

    The Abandoned Mine Lands (AML) Division of the North Dakota Public Service Commission (PSC) is charged with the reclamation of hazardous abandoned mine sites in North Dakota. Several underground lignite coalmines were operated near the cities of Beulah and Zap, North Dakota, from the early 1900's until about 1955. Coal seams in this area were relatively thick and the overburden generally shallow. As these mines have deteriorated with time, deep collapse features, or sinkholes, have surfaced in many areas. These features are very dangerous, especially when they occur at or near residential and commercial areas and public roads. In the past five years, sinkholes have surfaced beneath a commercial building (boat dealership, lounge, and gas station) and beneath a nearby occupied mobile home north of Beulah. sinkholes have also surfaced near KHOL Radio Station in Beulah and in the right of way of a public road south of Zap. The AML Division has conducted several emergency sinkhole-filling projects in these areas. In 1995--97, the AML Division conducted exploratory drilling which confirmed the presence of collapsing underground mines at these sites. The remediation of these sites around Beulah/Zap will take place over several years and involve three or more separate contracts due to budget considerations. In 1997, the AML Division began reclamation at these sties utilizing pressurized grout remote backfilling. In this technique, a cementitious grout is pumped through cased drill holes directly into the mine cavities to fill them and thereby stabilize the surface from collapse. The successful contractor for Phase One of the project was The Concrete Doctor, Inc. (TCDI). This paper will concentrate on Phase One of this work performed from June through September 1997. This project is especially interesting because grout was pumped through holes drilled inside the occupied commercial building. Grout was also pumped through angled holes that intercepted mined workings

  16. Tumor Lysis Syndrome (TLS following intrathecal chemotherapy in a child with acute myelogenous leukemia (AML

    Directory of Open Access Journals (Sweden)

    Chana L. Glasser, MD

    2017-01-01

    Full Text Available Tumor Lysis Syndrome (TLS is a well-known complication of induction therapy for hematologic malignancies. It is characterized by rapid breakdown of malignant white blood cells (WBCs leading to metabolic derangements and serious morbidity if left untreated. Most commonly, TLS is triggered by systemic chemotherapy, however, there have been case reports of TLS following intrathecal (IT chemotherapy, all in patients with acute lymphoblastic leukemia (ALL/lymphoma. Here, we report the first case of a patient with acute myelogenous leukemia (AML who developed TLS following a single dose of IT cytosine arabinoside (Ara-C.

  17. ABCB1-Gen-Polymorphismus in einer polnischen Kohorte ist mit Risiko für bullöses Pemphigoid assoziiert.

    Science.gov (United States)

    Rychlik-Sych, Mariola; Barańska, Małgorzata; Dudarewicz, Michał; Skrętkowicz, Jadwiga; Żebrowska, Agnieszka; Owczarek, Jacek; Waszczykowska, Elżbieta

    2017-05-01

    Polymorphismen im ABCB1-Gen, das für das P-Glykoprotein kodiert, können die intrazelluläre Konzentration von Xenobiotika beeinflussen und so zur Entwicklung von Autoimmunerkrankungen, einschließlich des bullösen Pemphigoids (BP), beitragen. In der vorliegenden Studie sollte untersucht werden, ob in einer polnischen Kohorte die C3435T- und G2677T/A-Polymorphismen im ABCB1-Gen mit dem Risiko für ein BP assoziiert sind. Die Studie umfasste 71 Patienten mit BP und 156 gesunde Probanden. Der C3435T-Polymorphismus wurde mittels PCR-RFLP bestimmt und der G2677T/A-Polymorphismus mittels Allel-spezifischer PCR. Es gab zwar keine Korrelation zwischen dem C3435-Polymorphismus und dem BP-Risiko, aber wir konnten eine derartige Assoziation hinsichtlich des G2677T/A-Polymorphismus nachweisen. Das relative Risiko eines BP war bei Personen mit dem 2677TA-Genotyp um mehr als den Faktor fünf erhöht (OR = 5,52; p = 0,0063) und bei Trägern des 2677TT-Genotyps mehr als verdoppelt (OR = 2,40; p = 0,0076). Mit 2,40 (p = 0,000018) war die OR bei Trägern des 2677T-Allels ebenfalls erhöht. Die höhere Prävalenz des 2677GG-Genotyps und des 2677G-Allels bei der Kontrollgruppe sowie eine OR < 1,0 (0,22 beziehungsweise 0,33) legen eine Schutzfunktion des 2677G-Allels hinsichtlich der Ausbildung eines BP nahe. Die Ergebnisse der vorliegenden Studie zeigen, dass der G2677T/A-Polymorphismus im ABCB1-Gen das Risiko für die Entstehung eines BP beeinflussen könnte. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  18. Kunden- und wettbewerbsorientierte Produktentwicklung mit QFD: Kundenorientierte Produktentwicklung mit Hilfe von Quality Function Deployment (QFD)

    OpenAIRE

    Schloske, Alexander

    2013-01-01

    Die Produktentwicklung von heute muss in immer kürzeren Zeiträumen kunden- und kostenorientierte Produkte entwickeln. Zur systematischen Unterstützung dieser Aufgabe im Rahmen der Produktentwicklung wird die Methode Quality Function Deployment (QFD) eingesetzt. Die konsequente Umsetzung der Stimme des Kunden in die Sprache des Unternehmens gelingt mit Quality Function Deployment (QFD). Die Methode wertet systematisch Kundenanforderungen an Produkte aus und führt zu innovativen Lösungen, die s...

  19. Unveiling the role of PAK2 in CD44 mediated inhibition of proliferation, differentiation and apoptosis in AML cells

    KAUST Repository

    Aldehaiman, Mansour M.

    2018-04-01

    Acute myeloid leukemia (AML) is a heterogeneous disease characterized by the accumulation of immature nonfunctional highly proliferative hematopoietic cells in the blood, due to a blockage in myeloid differentiation at various stages. Since the success of the differentiation agent, All-trans retinoic acid (ATRA), in the treatment of acute promyelocytic leukemia (APL), much effort has gone into trying to find agents that are able to differentiate AML cells and specifically the leukemic stem cell (LSC). CD44 is a cell surface receptor that is over-expressed on AML cells. When bound to anti-CD44 monoclonal antibodies (mAbs), this differentiation block is relieved in AML cells and their proliferation is reduced. The molecular mechanisms that AML cells undergo to achieve this reversal of their apparent phenotype is not fully understood. To this end, we designed a study using quantitative phosphoproteomics approaches aimed at identifying differences in phosphorylation found on proteins involved in signaling pathways post-treatment with CD44-mAbs. The Rho family of GTPases emerged as one of the most transformed pathways following the treatment with CD44-mAbs. The P21 activated kinase 2(PAK2), a target of the Rho family of GTPases, was found to be differentially phosphorylated in AML cells post-treatment with CD44-mAbs. This protein has been found to possess a role similar to that of a switch that determines whether the cell survives or undergoes apoptosis. Beyond confirming these results by various biochemical approaches, our study aimed to determine the effect of knock down of PAK2 on AML cell proliferation and differentiation. In addition, over-expression of PAK2 mutants using plasmid cloning was also explored to fully understand how levels of PAK2 as well as the alteration of specific phospohorylation sites could alter AML cell responses to CD44-mAbs. Results from this study will be important in determining whether PAK2 could be used as a potential therapeutic target

  20. Connect MDS/AML: design of the myelodysplastic syndromes and acute myeloid leukemia disease registry, a prospective observational cohort study.

    Science.gov (United States)

    Steensma, David P; Abedi, Medrdad; Bejar, Rafael; Cogle, Christopher R; Foucar, Kathryn; Garcia-Manero, Guillermo; George, Tracy I; Grinblatt, David; Komrokji, Rami; Ma, Xiaomei; Maciejewski, Jaroslaw; Pollyea, Daniel A; Savona, Michael R; Scott, Bart; Sekeres, Mikkael A; Thompson, Michael A; Swern, Arlene S; Nifenecker, Melissa; Sugrue, Mary M; Erba, Harry

    2016-08-19

    Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are myeloid neoplasms in which outgrowth of neoplastic clones disrupts normal hematopoiesis. Some patients with unexplained persistent cytopenias may not meet minimal diagnostic criteria for MDS but an alternate diagnosis is not apparent; the term idiopathic cytopenia of undetermined significance (ICUS) has been used to describe this state. MDS and AML occur primarily in older patients who are often treated outside the clinical trial setting. Consequently, our understanding of the patterns of diagnostic evaluation, management, and outcomes of these patients is limited. Furthermore, there are few natural history studies of ICUS. To better understand how patients who have MDS, ICUS, or AML are managed in the routine clinical setting, the Connect MDS/AML Disease Registry, a multicenter, prospective, observational cohort study of patients newly diagnosed with these conditions has been initiated. The Connect MDS/AML Disease Registry will capture diagnosis, risk assessment, treatment, and outcomes data for approximately 1500 newly diagnosed patients from approximately 150 community and academic sites in the United States in 4 cohorts: (1) lower-risk MDS (International Prognostic Scoring System [IPSS] low and intermediate-1 risk), with and without del(5q); (2) higher-risk MDS (IPSS intermediate-2 and high risk); (3) ICUS; and (4) AML in patients aged ≥ 55 years (excluding acute promyelocytic leukemia). Diagnosis will be confirmed by central review. Baseline patient characteristics, diagnostic patterns, treatment patterns, clinical outcomes, health economics outcomes, and patient-reported health-related quality of life will be entered into an electronic data capture system at enrollment and quarterly for 8 years. A tissue substudy to explore the relationship between karyotypes, molecular markers, and clinical outcomes will be conducted, and is optional for patients. The Connect MDS/AML Disease

  1. Peniskarzinom mit exulzerierten Lymphknotenmetastasen links inguinal

    Directory of Open Access Journals (Sweden)

    Presich K

    2003-01-01

    Full Text Available Im Oktober 2001 wurde ein 53jähriger Patient mit ausgedehnten exulzerierten Lymphknotenmetastasen rechts inguinal an einer auswärtigen chirurgischen Abteilung vorgestellt. Im Rahmen der Durchuntersuchung fand sich eine verhärtete, von einem nicht retrahierbaren Präputium verdeckte Glans als mögliches Primum. Eine Circumcision sowie Biopsie aus der Glans ergaben das histologische Ergebnis eines invasiven, schwach verhornenden Plattenepithelkarzinoms mittleren Differenzierungsgrades (G2-G3. In einer Unterbauch-Computertomographie wurde rechts inguinal ein ausgedehnter, ca. 10 cm messender, teils solider, teils nekrotischer Prozeß, bis an die großen Gefäße heranreichend, beschrieben. Die linke Leiste war unauffällig.

  2. Current activities at the MIT Research Reactor

    International Nuclear Information System (INIS)

    Hu Linwen; Bernard, John A.; Harling, Otto K.; Kohse, Gordon E.; Ames, Michael; Olmez, Ilhan

    1998-01-01

    The MIT Research Reactor (MITR) is a MW nuclear research reactor that is owned and operated by the Massachusetts Institute of Technology to further its educational and research goals at both the undergraduate and graduate level. The reactor first achieved criticality in 1958. It was largely rebuilt in 1973/1974 by MIT staff and students, and its current license expires in August 1999. The current facility, which is designated as the MITR-H, uses a compact core with finned, aluminum-clad, plate-type fuel that is cooled and moderated by light water and reflected by heavy water. The reactor core can hold twenty-seven fuel elements. However, the normal configuration is twenty-four elements. A maximum of four fuel elements can be replaced with in-core experimental facilities. A unique feature of the MITR-II's design is that fixed absorber plates can be inserted in the upper half of the core. These cause the flux to peak in the lower half which benefits experimenters and also facilitates a fuel strategy that involves inversion of fuel elements midway through their life cycle. The MITR-II currently operates continuously for four weeks followed by shutdown of a few days for maintenance. This paper provides an overview of current activities at the MITR including preparations for re-licensing. The status of an on-going Phase-I clinical trial of boron neutron capture therapy for both glioblastoma multiforme and metastatic melanoma is described as well as the design of a fission converter facility for BNCT. Environmental research using neutron activation analysis is summarized as well as in-pile research focussed on LWR water chemistry and structural materials. (author)

  3. Teaching ``The Physics of Energy'' at MIT

    Science.gov (United States)

    Jaffe, Robert

    2009-05-01

    New physics courses on energy are popping up at colleges and universities across the country. Many require little or no previous physics background, aiming to introduce a broad audience to this complex and critical problem, often augmenting the scientific message with economic and policy discussions. Others are advanced courses, focussing on highly specialized subjects like solar voltaics, nuclear physics, or thermal fluids, for example. About two years ago Washington Taylor and I undertook to develop a course on the ``Physics of Energy'' open to all MIT students who had taken MIT's common core of university level calculus, physics, and chemistry. By avoiding higher level prerequisites, we aimed to attract and make the subject relevant to students in the life sciences, economics, etc. --- as well as physical scientists and engineers --- who want to approach energy issues in a sophisticated and analytical fashion, exploiting their background in calculus, mechanics, and E & M, but without having to take advanced courses in thermodynamics, quantum mechanics, or nuclear physics beforehand. Our object was to interweave teaching the fundamental physics principles at the foundations of energy science with the applications of those principles to energy systems. We envisioned a course that would present the basics of statistical, quantum, and fluid mechanics at a fairly sophisticated level and apply those concepts to the study of energy sources, conversion, transport, losses, storage, conservation, and end use. In the end we developed almost all of the material for the course from scratch. The course debuted this past fall. I will describe what we learned and what general lessons our experience might have for others who contemplate teaching energy physics broadly to a technically sophisticated audience.

  4. RUNX1/AML1 point mutations take part in the pathogenesis of radiation-and therapy-related myeloid neoplasms

    International Nuclear Information System (INIS)

    Harada, Yuka; Kimura, Akiro; Harada, Hironori

    2012-01-01

    High frequency of myelodysplastic syndrome (MDS) has been reported in Hiroshima A-bomb exposed survivors, in resident around Semipalatinsk Nuclear Laboratory and in exposed people by Chernobyl Nuclear Power Station Accident. MDS/acute myeloid leukemia (AML) is thought to be caused by mutation of runt-related transcription factor 1 (RUNX1) gene after a long time post exposure to relatively low dose radiation. In this study, participation of RUNX1/AML1 point mutations was examined in pathogenesis of the title neoplasms experienced in authors' facility. Subjects were 18/417 cases in whom myeloproliferative neoplasms (MPN) had switched to MDS or AML in the follow-up period of 1-25 years, and 11/124 cases in whom t-MN (therapy-related myeloid neoplasms) had developed during the remission of acute promyelocytic leukemia (APL) in the 1-9.7 years follow up. Point mutations were analyzed by PCR-single strand conformation polymorphism (PCR-SSCP) followed by base sequencing. In the former cases above, RUNX1 point mutation was found in 5/18 cases and in the latter, 4/11. When patients with persistent decrease of blood cells post therapy of APL were followed up for mutation, their RUNX1 point mutation was detected before they were diagnosed to be morbid of MDS/AML. The point mutation was thus a biomarker of myelo-hematogenic cancer, and was thought useful for early diagnosis of MDS and AML. (T.T.)

  5. Design and kinetic analysis of hammerhead ribozyme and DNAzyme that specifically cleave TEL-AML1 chimeric mRNA

    International Nuclear Information System (INIS)

    Choi, Woo-Hyung; Choi, Bo-Ra; Kim, Jae Hyun; Yeo, Woon-Seok; Oh, Sangtaek; Kim, Dong-Eun

    2008-01-01

    In order to develop the oligonucleotides to abolish an expression of TEL-AML1 chimeric RNA, which is a genetic aberration that causes the acute lymphoblastic leukemia (ALL), hammerhead ribozymes and deoxyoligoribozymes that can specifically cleave TEL-AML1 fusion RNA were designed. Constructs of the deoxyribozyme with an asymmetric substrate binding arm (Dz26) and the hammerhead ribozyme with a 4 nt-bulged substrate binding arm in the stem III (buRz28) were able to cleave TEL-AML1 chimeric RNA specifically at sites close to the junction in vitro, without cleaving the normal TEL and AML1 RNA. Single-turnover kinetic analysis under enzyme-excess condition revealed that the buRz28 is superior to the Dz26 in terms of substrate binding and RNA-cleavage. In conjunction with current progress in a gene-delivery technology, the designed oligonucleotides that specifically cleave the TEL-AML1 chimeric mRNA are hoped to be applicable for the treatment of ALL in vivo

  6. Effects of TLR agonists on maturation and function of 3-day dendritic cells from AML patients in complete remission

    Directory of Open Access Journals (Sweden)

    Merk Martina

    2011-09-01

    Full Text Available Abstract Background Active dendritic cell (DC immunization protocols are rapidly gaining interest as therapeutic options in patients with acute myeloid leukemia (AML. Here we present for the first time a GMP-compliant 3-day protocol for generation of monocyte-derived DCs using different synthetic Toll-like receptor (TLR agonists in intensively pretreated patients with AML. Methods Four different maturation cocktails were compared for their impact on cell recovery, phenotype, cytokine secretion, migration, and lymphocyte activation in 20 AML patients and 25 healthy controls. Results Maturation cocktails containing the TLR7/8 agonists R848 or CL075, with and without the addition of the TLR3 agonist poly(I:C, induced DCs that had a positive costimulatory profile, secreted high levels of IL-12(p70, showed chemotaxis to CCR7 ligands, had the ability to activate NK cells, and efficiently stimulated antigen-specific CD8+ T cells. Conclusions Our results demonstrate that this approach translates into biologically improved DCs, not only in healthy controls but also in AML patients. This data supports the clinical application of TLR-matured DCs in patients with AML for activation of innate and adaptive immune responses.

  7. Acute toxicity of postoperative radiochemotherapy with amifostine vs radiochemotherapy alone in head and neck cancer patients. Preliminary results of a randomized trial; Nebenwirkungen einer postoperativen Radiochemotherapie mit Amifostin versus alleiniger Radiochemotherapie bei Kopf-Hals-Tumoren. Vorlaeufige Ergebnisse einer prospektiv randomisierten Untersuchung

    Energy Technology Data Exchange (ETDEWEB)

    Vacha, P; Marx, M; Engel, A; Richter, E; Feyerabend, T [Medizinische Univ. Luebeck (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    1999-11-01

    Purpose: Experimental and clinical data suggest a reduction of radiation-induced acute toxicity by amifostine. We investigated this issue in a randomized trial comparing radiochemotherapy (RCT) versus radiochemotherapy and amifostine (RCT+A) in patients with head and neck cancer. Patients and methods: Forty-seven patients with pharyngeal or laryngeal cancer (T{sub 1-2}N{sub 1-2}G{sub 3},T{sub 3-4}N{sub 0-2}G{sub 1-3}) were randomized to receive RCT alone (21 patients) or RCT+A (21 patients). Patients were irradiated up to 60 Gy (R{sub 0}) or 70 Gy (R{sub 1/2}). Chemotherapy consisted of 70 mg/m{sup 2} carboplatin and was administered over 5 days in the 1st and 5th week of the radiotherapy course. 250 mg amifostine were applied daily just before each radiotherapy session. Acute toxicity was evaluated according to the Common Toxicity Criteria (CTC). As for xerostomia no patients with laryngeal cancer were assessed because in these cases only small volumes of the salivary glands were within the treatment volume. To evaluate the overall toxicity a summarized CTC score of all observed side effects was calculated. Results: Forty-two patients were evaluable. Clinical characteristics (age, sex, Karnofsky index, tumor-staging) were well balanced in both treatment groups. Amifostine provided reduction in xerostomia and mucositis. Conclusions: According to our preliminary results amifostine has a radioprotective effect on salivary glands. Mucositis can be reduced during radiochemotherapy. At this point of patient accrual the difference between both groups are statistically not significant. To improve the radioprotective effects of amifostine in clinical practice the application of a higher dose (>250 mg) seems to be necessary. (orig.) [German] Ziel: Diese Untersuchung soll die Frage beantworten, ob bei der postoperativen Radiochemotherapie von Patienten mit HNO-Tumoren eine zusaetzliche Amifostin-Medikation Ausmass und Haeufigkeit akuter Strahlenreaktionen vermindert

  8. Multicenter study of radiosynoviorthesis. Clinical outcome in osteoarthritis and other disorders with concomitant synovitis in comparison with rheumatoid arthritis; Multizenterstudie zur Radiosynoviorthese: Klinische Ergebnisse bei aktivierten Arthrosen und anderen Gelenkerkrankungen mit chronischer Synovialitis im Vergleich zur rheumatoiden Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rau, H.; Lohmann, K.; Spitz, J. [Praxis fuer Nuklearmedizin, am Staedtischen Klinikum Wiesbaden (Germany); Franke, C. [Praxis fuer Nuklearmedizin, Hamburg (Germany); Goretzki, G. [Praxis fuer Nuklearmedizin, Bielefeld (Germany); Lemb, M.A. [Praxis fuer Nuklearmedizin, Bremen (Germany); Mueller, J. [Klinik fuer Nuklearmedizin, Kantonspital St. Gallen (Switzerland); Panholzer, P.J. [Abt. fuer Nuklearmedizin und Endokrinologie, PET-Zentrum, Krankenhaus der Barmherzigen Schwestern, Linz (Austria); Stelling, E. [Praxis fuer diagnostische und therapeutische Nuklearmedizin, Berlin (Germany)

    2004-04-01

    Aim: evaluation of the effectiveness of radiosynoviorthesis (RSO) in osteoarthritis and other disorders with concomitant synovitis versus rheumatoid arthritis by means of a standardized questionnaire. Patients, methods: 803 RSO treatments were monitored in 691 patients by standardized questionnaires of 7 centers in 3 countries. Patients were assigned to 3 groups according to their age (20-40, 41-60, 61-80 years). Additionally, the data were analyzed separately for patients with rheumatoid arthritis (group A) and those with osteoarthritis, psoriasis arthritis, pigmental villonodular synovitis or persistent effusions after joint replacement (group B). Results: ameliorations of joint pain, swelling/effusion or flexibility were found in 80% of group A and 56% of group B (p <0.01). Quality of life improved in 78% of group A and 59% of group B (p <0.01). The response rate was similar for small- and large-sized joints in group A, but significantly higher for large-sized joints in group B (p <0.01). The positive effects on joint pain, swelling/effusion or flexibility lasted longer in group A (p <0.01). Repeated RSOs were as effective as initial ones. The clinical outcome was neither influenced by age, nor gender, nor transient immobilisation for 48 hours after RSO. Conclusion: although slightly more efficient in rheumatoid arthritis, RSO represents an effective treatment option also in osteoarthritis and other disorders with concomitant synovitis. (orig.) [German] Ziel: Effektivitaetsvergleich der Radiosynoviorthese (RSO) bei aktivierter Arthrose und anderen Gelenkerkrankungen mit chronischer Synovialitis versus rheumatoider Arthritis. Ueberpruefung der Eignung eines standardisierten Fragebogens fuer Multizenterstudien. Patienten, Methoden: Bei 691 Patienten wurden 803 RSO-Behandlungsverlaeufe von 7 Zentren in 3 Laendern mit Hilfe eines standardisierten Fragebogens erfasst. Die Patienten wurden 3 Alterskategorien (20-40, 41-60 und 61-80 Jahre) zugeordnet. Ausserdem wurden

  9. Paclitaxel Induced MDS and AML: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Udit Bhaskar Bhatnagar

    2016-01-01

    Full Text Available Therapy related acute myelogenous leukemia (AML and myelodysplastic syndromes (MDS have been classically linked to alkylating agents and topoisomerase inhibitors. They constitute about 1% of all AMLs. There is less evidence on association of taxanes (paclitaxel and docetaxel with these myeloid neoplasms. We present a case of paclitaxel therapy related acute myelogenous leukemia after treatment of endometrial cancer with a regimen containing paclitaxel and carboplatin. A 63-year-old female underwent surgery followed by a total of 6 cycles of chemotherapy with carboplatin and paclitaxel. Six months after last cycle of chemotherapy, she was diagnosed with myelodysplastic syndrome with refractory anemia and excess blasts. Six weeks later, she had worsening anemia and thrombocytopenia which prompted a bone marrow biopsy which revealed acute myelomonocytic leukemia. A thorough literature review revealed 12 other case reports where taxanes have been implicated in the development of therapy related myeloid neoplasm. Based on the timeline of events in our patient, paclitaxel is the likely culprit in the pathogenesis of this myeloid neoplasm. This rare but significantly grave adverse effect should be kept in consideration when deciding on treatment options for gynecological malignancies.

  10. Final Technical Report for the MIT Annular Fuel Research Project

    International Nuclear Information System (INIS)

    Mujid S. Kazimi; Pavel Hejzlar

    2008-01-01

    MIT-NFC-PR-082 (January 2006) Abstract This summary provides an overview of the results of the U.S. DOE funded NERI (Nuclear Research Energy Initiative) program on development of the internally and externally cooled annular fuel for high power density PWRs. This new fuel was proposed by MIT to allow a substantial increase in power density (on the order of 30% or higher) while maintaining or improving safety margins. A comprehensive study was performed by a team consisting of MIT (lead organization), Westinghouse Electric Corporation, Gamma Engineering Corporation, Framatome ANP(formerly Duke Engineering) and Atomic Energy of Canada Limited

  11. Long-term remission in BCR/ABL-positive AML-M6 patient treated with Imatinib Mesylate.

    Science.gov (United States)

    Pompetti, Franca; Spadano, Antonio; Sau, Antonella; Mennucci, Antonio; Russo, Rosa; Catinella, Virginia; Franchi, Paolo Guanciali; Calabrese, Giuseppe; Palka, Giandomenico; Fioritoni, Giuseppe; Iacone, Antonio

    2007-04-01

    BCR/ABL-positive acute myeloid leukemia (AML) is a rare disease, characterized by a poor prognosis, with resistance to induction chemotherapy and frequent relapses in responsive patients. Here we report a case of BCR/ABL-positive AML-M6 who, after relapse, was treated with Imatinib Mesylate (600 mg/die) and within 4 months achieved a cytogenetic and molecular complete response. After more than 4 years of continuous Imatinib therapy, nested RT-PCR for BCR/ABL is persistently negative. The case reported shows that the response obtained with Imatinib Mesylate in BCR/ABL-positive AML may be long lasting, offering a chance of successful treatment for this poor prognosis group of patients.

  12. Osteonecrosis - A rare complication of HIV infection. Association with numerous risk factors; Osteonekrose: eine seltene Komplikation der HIV-Infektion. Assoziation mit bestimmten Risikofaktoren

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, D.; Behrens, G.; Stoll, M.; Schmidt, R.E. [Medizinische Hochschule Hannover (Germany). Abt. Klinische Immunologie

    2000-03-13

    Osteonecrosis is a rare complication of HIV infection. The presumptive cause of the aseptic osteonecrosis is a distrubed blood supply to the bone. Most cases of osteonecrosis are associated with numerous risk factors, such as use of steroids, alcohol abuse, coagulopathies or metabolic derangements. Since conventional X-rays appear unremarkable, early forms often go unrecognized or are diagnosed late. Methods of establishing the diagnosis are MRI and three-phase skeletal scintigraphy. The pathogenesis of osteonecrosis in HIV infection is unclear. So far, about 30 cases have been reported in the literature. We would recommend that in HIV patients with typical symptoms - in particular when classical risk factors are present - osteonecrosis be included in the differential diagnostic considerations. (orig.) [German] Die Osteonekrose ist eine seltene Komplikation der HIV-Infektion. Als Ursache werden Stoerungen in der Gefaessversorgung des Knochengewebes angenommen. Aufgrund unauffaelliger Befunde im konventionellen Roentgen werden Fruehformen haeufig verkannt oder erst verspaetet diagnostiziert. Methoden zur Diagnosesicherung sind die Kernspintomographie oder die 3-Phasen-Knochenszintigraphie. Die Pathogenese der Osteonekrose bei der HIV-Infektion ist unklar. Bisher sind in der Literatur etwa 30 Kasuistiken beschrieben. Wir empfehlen, bei Vorliegen einer typischen Symptomatik bei HIV-Patienten - insbesondere wenn typische Risikofaktoren vorliegen - die Osteonekrose in die differenzialdiagnostischen Ueberlegungen mit einzubeziehen. (orig.)

  13. Cellular intrinsic mechanism affecting the outcome of AML treated with Ara-C in a syngeneic mouse model.

    Directory of Open Access Journals (Sweden)

    Wenjun Zhao

    Full Text Available The mechanisms underlying acute myeloid leukemia (AML treatment failure are not clear. Here, we established a mouse model of AML by syngeneic transplantation of BXH-2 derived myeloid leukemic cells and developed an efficacious Ara-C-based regimen for treatment of these mice. We proved that leukemic cell load was correlated with survival. We also demonstrated that the susceptibility of leukemia cells to Ara-C could significantly affect the survival. To examine the molecular alterations in cells with different sensitivity, genome-wide expression of the leukemic cells was profiled, revealing that overall 366 and 212 genes became upregulated or downregulated, respectively, in the resistant cells. Many of these genes are involved in the regulation of cell cycle, cellular proliferation, and apoptosis. Some of them were further validated by quantitative PCR. Interestingly, the Ara-C resistant cells retained the sensitivity to ABT-737, an inhibitor of anti-apoptosis proteins, and treatment with ABT-737 prolonged the life span of mice engrafted with resistant cells. These results suggest that leukemic load and intrinsic cellular resistance can affect the outcome of AML treated with Ara-C. Incorporation of apoptosis inhibitors, such as ABT-737, into traditional cytotoxic regimens merits consideration for the treatment of AML in a subset of patients with resistance to Ara-C. This work provided direct in vivo evidence that leukemic load and intrinsic cellular resistance can affect the outcome of AML treated with Ara-C, suggesting that incorporation of apoptosis inhibitors into traditional cytotoxic regimens merits consideration for the treatment of AML in a subset of patients with resistance to Ara-C.

  14. An AML1-ETO/miR-29b-1 regulatory circuit modulates phenotypic properties of acute myeloid leukemia cells.

    Science.gov (United States)

    Zaidi, Sayyed K; Perez, Andrew W; White, Elizabeth S; Lian, Jane B; Stein, Janet L; Stein, Gary S

    2017-06-20

    Acute myeloid leukemia (AML) is characterized by an aggressive clinical course and frequent cytogenetic abnormalities that include specific chromosomal translocations. The 8;21 chromosomal rearrangement disrupts the key hematopoietic RUNX1 transcription factor, and contributes to leukemia through recruitment of co-repressor complexes to RUNX1 target genes, altered subnuclear localization, and deregulation of the myeloid gene regulatory program. However, a role of non-coding microRNAs (miRs) in t(8;21)-mediated leukemogenesis is minimally understood. We present evidence of an interplay between the tumor suppressor miR-29b-1 and the AML1-ETO (also designated RUNX1-RUNX1T1) oncogene that is encoded by the t(8;21). We find that AML1-ETO and corepressor NCoR co-occupy the miR-29a/b-1 locus and downregulate its expression in leukemia cells. Conversely, re-introduction of miR-29b-1 in leukemia cells expressing AML1-ETO causes significant downregulation at the protein level through direct targeting of the 3' untranslated region of the chimeric transcript. Restoration of miR-29b-1 expression in leukemia cells results in decreased cell growth and increased apoptosis. The AML1-ETO-dependent differentiation block and transcriptional program are partially reversed by miR-29b-1. Our findings establish a novel regulatory circuit between the tumor-suppressive miR-29b-1 and the oncogenic AML1-ETO that controls the leukemic phenotype in t(8;21)-carrying acute myeloid leukemia.

  15. Hif-1α and Hif-2α synergize to suppress AML development but are dispensable for disease maintenance.

    Science.gov (United States)

    Vukovic, Milica; Guitart, Amelie V; Sepulveda, Catarina; Villacreces, Arnaud; O'Duibhir, Eoghan; Panagopoulou, Theano I; Ivens, Alasdair; Menendez-Gonzalez, Juan; Iglesias, Juan Manuel; Allen, Lewis; Glykofrydis, Fokion; Subramani, Chithra; Armesilla-Diaz, Alejandro; Post, Annemarie E M; Schaak, Katrin; Gezer, Deniz; So, Chi Wai Eric; Holyoake, Tessa L; Wood, Andrew; O'Carroll, Dónal; Ratcliffe, Peter J; Kranc, Kamil R

    2015-12-14

    Leukemogenesis occurs under hypoxic conditions within the bone marrow (BM). Knockdown of key mediators of cellular responses to hypoxia with shRNA, namely hypoxia-inducible factor-1α (HIF-1α) or HIF-2α, in human acute myeloid leukemia (AML) samples results in their apoptosis and inability to engraft, implicating HIF-1α or HIF-2α as therapeutic targets. However, genetic deletion of Hif-1α has no effect on mouse AML maintenance and may accelerate disease development. Here, we report the impact of conditional genetic deletion of Hif-2α or both Hif-1α and Hif-2α at different stages of leukemogenesis in mice. Deletion of Hif-2α accelerates development of leukemic stem cells (LSCs) and shortens AML latency initiated by Mll-AF9 and its downstream effectors Meis1 and Hoxa9. Notably, the accelerated initiation of AML caused by Hif-2α deletion is further potentiated by Hif-1α codeletion. However, established LSCs lacking Hif-2α or both Hif-1α and Hif-2α propagate AML with the same latency as wild-type LSCs. Furthermore, pharmacological inhibition of the HIF pathway or HIF-2α knockout using the lentiviral CRISPR-Cas9 system in human established leukemic cells with MLL-AF9 translocation have no impact on their functions. We therefore conclude that although Hif-1α and Hif-2α synergize to suppress the development of AML, they are not required for LSC maintenance. © 2015 Vukovic et al.

  16. MIT gets good marks for fighting gender discrimination

    Science.gov (United States)

    Gwynne, Peter

    2011-05-01

    The Massachusetts Institute of Technology (MIT) has made "significant progress" in increasing the number of female faculty members, with their numbers in science and engineering almost doubling over the last decade.

  17. Behandlung des chronischen Tinnitus mit repetitiver transkranieller Magnetstimulation

    OpenAIRE

    Kleinjung, T

    2012-01-01

    Tinnitus ist eine Funktionsstörung des Hörsystems, die von verschiedenen Strukturen und Ebenen ausgehen kann. Tinnitus geht mit neuroplastischen Veränderungen im zentralen auditorischen System einher. Existenz eines „Tinnitus-Netzwerkes“.

  18. Laser mit instabilem Resonator fuer ringfoermige aktive Medien

    OpenAIRE

    Jarosch, U.K.; Habich, U.; Plum, H.D.

    1996-01-01

    Beschrieben werden Laser mit instabilen Resonatoren, die ringfoermige Medien effektiv ausnutzen, unabhaengig davon, ob es sich um feste, fluessige oder gasfoermige Medien handelt. Die Erfindung zeichnet sich dadurch aus, dass die Auskopplung des Strahles (5.1) eines Ringresonators entlang eines Spaltes oder eines Kreisringes ueber dem gesamten Umfang vorgesehen ist, wobei der Laserresonator durch Ringspiegel (1,2) mit torusfoermiger Spiegelflaeche gebildet und von den Waenden des Ringspaltes ...

  19. MIT CSAIL and Lincoln Laboratory Task Force Report

    Science.gov (United States)

    2016-08-01

    funded through MIT LL, most notably through by the MIT LL Technology Office (TO). TO funding has come through a diverse set of venues: ASD (R&E) Line...many and varied opportunities to participate could better cohere research interests at each institution and between them as well. 3.4.2 Autonomy-at...applications. Near-data processing is about migrating selected processing operations from the central processing unit (CPU) of traditional computer

  20. Molekulargenetische Charakterisierung einer Familie mit Usher-Syndrom

    OpenAIRE

    Zimmer, AJ; Arndt, S; Aschendorff, A; Birkenhäger, R

    2009-01-01

    Einleitung: Das Usher-Syndrom definiert eine genetisch und klinisch heterogene autosomal rezessiv vererbte Erkrankung mit dem gleichzeitigen Auftreten von Innenohrschwerhörigkeit bis hin zur Taubheit, teilweise Vestibularisausfall und Netzhautdegeneration (Retinitis Pigmentosa). Bisher wird das Usher-Syndrom in drei verschiedene Hauptgruppen (USH1-3) mit unterschiedlicher phänotypischer Ausprägung eingeteilt. Für das Usher-Syndrom sind 12 Genorte bekannt, für die bereits acht Gene identifizi...

  1. A geometrodynamical approach to the MIT confinement scheme

    International Nuclear Information System (INIS)

    Martellini, M.; Sodano, P.

    1978-01-01

    Starting from the strong gravity theory of Salam-Isham-Strathdee the M.I.T. bag is identified as a certain region of the global extension of a De Sitter-Schwarzschild solution. As a result the M.I.T. bag radius, a geometrical interpretation of the binding Lagrangian term and a rate of decaying of the ''bag manifold'' into the flat space (which, however, does not lead to observable quark wave functions) are obtained. (author)

  2. Direct MR Arthrography of the wrist in comparison with Arthroscopy: A prospective study on 125 patients; Direkte MR-Arthrographie des Handgelenks im Vergleich zur Arthroskopie: Eine prospektive Studie an 125 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.; Christopoulos, G.; Coblenz, G.; Froehner, S. [Institut fuer Diagnostische und Interventionelle Radiologie der Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany); Meier, R.; Lanz, U.; Krimmer, H. [Klinik fuer Handchirurgie GmbH, Bad Neustadt an der Saale (Germany)

    2003-07-01

    attitude of caution must be adopted in diagnosing lesions of the articular cartilage of the wrist. (orig.) [German] Ziel: Bestimmung der diagnostischen Genauigkeit der direkten MR-Arthrographie in der Diagnostik von intraartikulaeren Pathologien des Handgelenks. Material und Methoden: Prospektiv und geblindet wurden 125 Patienten mit karpaler Beschwerdesymptomatik am Tag vor einer Arthroskopie mittels direkter Arthro-MR-Tomographie untersucht. Nach radiokarpaler und mediokarpaler Injektion eines Kontrastmittelgemisches wurden an einem 1,5-Tesla-Scanner folgende Sequenzen akquiriert: koronal T1-w SE, koronal T1-w SE fettsaturiert, koronal T1-/T2*-DESS-3D und sagittal T2*-w MEDIC. Die MR-tomographischen Befunde wurden in einer statistischen Analyse mit denen der Arthroskopie verglichen (SEN=Sensitivitaet, SPE=Spezifitaet, PPV=positiver Vorhersagewert, NPV=negativer Vorhersagewert, ACC=Genauigkeit). Ergebnisse: Im Vergleich mit der Arthroskopie als diagnostischem Goldstandard wies die MR-Arthroskopie folgende diagnostische Kenndaten auf: Detektion von TFCC-Laesionen: SEN 97,1%, SPE 96,4%, PPV 97,1%, NPV 96,4%, ACC 96,8%. Fuer den Nachweis kompletter Rupturen des Lig. scapholunatum: SEN 91,7%, SPE 100%, PPV 100%, NPV 99,1%, ACC 99,2% (Teilrupturen: SEN 62,5%, SPE 100%, PPV 100%, NPV 94,8%, ACC 95,2%). Erkennen von Laesionen des hyalinen Gelenkknorpels: SEN 84,2%, SPE 96,2%, PPV 80%, NPV 97,1%, ACC 94,4%. Im Gesamtkollektiv fanden sich nur 3 Laesionen des Lig. lunotriquetrum. Schlussfolgerungen: Fuer das Erkennen intraartikulaerer Pathologien des Handgelenks ist die MR-Tomographie in direkter Arthrographie-Technik gut geeignet, da sie bessere diagnostische Ergebnisse liefert im Vergleich zu den Literaturmitteilungen der Nativuntersuchung. Mit einer Genauigkeit von deutlich ueber 90% ist die Indikation zur direkten MR-Arthrographie bei klinisch begruendetem Verdacht auf eine Komplettruptur des skapholunaeren Ligaments oder des ulnokarpalen Komplexes gegeben. (orig.)

  3. Renal, gastrointestinal, and hepatic late effects in survivors of childhood acute myeloid leukemia treated with chemotherapy only--a NOPHO-AML study

    DEFF Research Database (Denmark)

    Skou, Anne-Sofie; Glosli, Heidi; Jahnukainen, Kirsi

    2014-01-01

    BACKGROUND: We investigated the spectrum, frequency, and risk factors for renal, gastrointestinal, and hepatic late adverse effects in survivors of childhood acute myeloid leukemia (AML) without relapse treated with chemotherapy alone according to three consecutive AML trials by the Nordic Society...

  4. Functionally deregulated AML1/RUNX1 cooperates with BCR-ABL to induce a blastic phase-like phenotype of chronic myelogenous leukemia in mice.

    Directory of Open Access Journals (Sweden)

    Kiyoko Yamamoto

    Full Text Available Patients in the chronic phase (CP of chronic myelogenous leukemia (CML have been treated successfully following the advent of ABL kinase inhibitors, but once they progress to the blast crisis (BC phase the prognosis becomes dismal. Although mechanisms underlying the progression are largely unknown, recent studies revealed the presence of alterations of key molecules for hematopoiesis, such as AML1/RUNX1. Our analysis of 13 BC cases revealed that three cases had AML1 mutations and the transcript levels of wild-type (wt. AML1 were elevated in BC compared with CP. Functional analysis of representative AML1 mutants using mouse hematopoietic cells revealed the possible contribution of some, but not all, mutants for the BC-phenotype. Specifically, K83Q and R139G, but neither R80C nor D171N mutants, conferred upon BCR-ABL-expressing cells a growth advantage over BCR-ABL-alone control cells in cytokine-free culture, and the cells thus grown killed mice upon intravenous transfer. Unexpectedly, wt.AML1 behaved similarly to K83Q and R139G mutants. In a bone marrow transplantation assay, K83Q and wt.AML1s induced the emergence of blast-like cells. The overall findings suggest the roles of altered functions of AML1 imposed by some, but not all, mutants, and the elevated expression of wt.AML1 for the disease progression of CML.

  5. The impact of TEL-AML1 (ETV6-RUNX1) expression in precursor B cells and implications for leukaemia using three different genome-wide screening methods

    International Nuclear Information System (INIS)

    Linka, Y; Ginzel, S; Krüger, M; Novosel, A; Gombert, M; Kremmer, E; Harbott, J; Thiele, R; Borkhardt, A; Landgraf, P

    2013-01-01

    The reciprocal translocation t(12;21)(p13;q22), the most common structural genomic alteration in B-cell precursor acute lymphoblastic leukaemia in children, results in a chimeric transcription factor TEL-AML1 (ETV6-RUNX1). We identified directly and indirectly regulated target genes utilizing an inducible TEL-AML1 system derived from the murine pro B-cell line BA/F3 and a monoclonal antibody directed against TEL-AML1. By integration of promoter binding identified with chromatin immunoprecipitation (ChIP)-on-chip, gene expression and protein output through microarray technology and stable labelling of amino acids in cell culture, we identified 217 directly and 118 indirectly regulated targets of the TEL-AML1 fusion protein. Directly, but not indirectly, regulated promoters were enriched in AML1-binding sites. The majority of promoter regions were specific for the fusion protein and not bound by native AML1 or TEL. Comparison with gene expression profiles from TEL-AML1-positive patients identified 56 concordantly misregulated genes with negative effects on proliferation and cellular transport mechanisms and positive effects on cellular migration, and stress responses including immunological responses. In summary, this work for the first time gives a comprehensive insight into how TEL-AML1 expression may directly and indirectly contribute to alter cells to become prone for leukemic transformation

  6. MRD in AML: it is time to change the definition of remission.

    Science.gov (United States)

    Ossenkoppele, Gert J; Schuurhuis, Gerrit Jan

    2014-01-01

    The possibility of defining residual disease far below the morphological level of 5% blast cells is changing the landscape of risk classification in acute myeloid leukemia (AML). The so-called minimal residual disease (MRD) approach at this time can establish the presence of leukemia cells down to levels of 1:1000-1:10(6) white blood cells, compared to 1:20 for morphology. Availability of the newer and more sensitive technology to quantify the level of leukemic burden raises the issue of whether MRD should emerge as a new definition of complete response. This paper explores some of the issues surrounding such a change in definition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Low-dose total body irradiation and G-CSF without hematopoietic stem cell support in the treatment of relapsed or refractory acute myelogenous leukemia (AML), or AML in second or subsequent remission

    International Nuclear Information System (INIS)

    Shulman, Lawrence N.; Tarbell, Nancy J.; Storen, Elizabeth; Marcus, Karen; Mauch, Peter M.

    1998-01-01

    Purpose: Patients with relapsed acute myelogenous leukemia (AML), who are not eligible for bone marrow transplantation, have a poor prognosis when treated with chemotherapy alone. Total body irradiation (TBI) is an effective modality against AML when used in doses of 1000-1400 cGy with hematopoietic stem cell support. We undertook a phase I study of TBI with granulocyte-colony-stimulating factor (G-CSF) support, without stem cell support in patients with AML either in relapse or second or subsequent remission. Methods and Materials: Patients with relapsed AML, or AML in second or subsequent remission were treated in a phase I study of TBI followed by G-CSF. The first dose level was 200 cGy. After the initial cohort of patients it was clear that patients with overt leukemia did not benefit from this treatment, and subsequent patients were required to be in remission at the time of TBI. Results: Eleven patients were treated, 4 in overt relapse, and 7 in remission. 200 cGy was used in all, and dose escalation was not possible due to prolonged thrombocytopenia in all patients but one. Neutrophil recovery was adequate in those patients who remained in remission after TBI. Patients with overt leukemia had transient reduction in blast counts, but rapid recurrence of their leukemia. Patients treated in remission had short remissions, with the exception of one patient who is in remission 32 months after treatment. Conclusion: There is some antileukemic effect of TBI even at 200 cGy, though this dose appears to be too low to help a significant number of patients. If TBI is to be escalated without stem cell support, then a thrombopoietic agent will need to be used

  8. Circumvention of ara-C resistance by aphidicolin in blast cells from patients with AML.

    Science.gov (United States)

    Sargent, J M; Elgie, A W; Williamson, C J; Lewandowicz, G M; Taylor, C G

    2001-03-02

    Treatment failure in AML is often attributed to P-glycoprotein-associated multidrug resistance. However, the importance of increased DNA repair in resistant cells is becoming more apparent. In order to investigate the ability of the DNA repair inhibitor aphidicolin to modulate drug resistance, we continually exposed blasts cells, isolated from 22 patients with AML, to a variety of agents +/- 15 microM aphidicolin for 48 hours. Cell survival was measured using the MTT assay. Overall, there was no significant effect of aphidicolin on sensitivity to daunorubicin, doxorubicin, etoposide or fludarabine. However, there was a marked increase in sensitivity to ara-C with a median 4.75-fold increase overall (range 0.8-80-fold;P< 0.005). The effect of aphidicolin was significantly greater in blast cells found resistant in vitro to ara-C (8.9-fold compared to 2.12-fold, P< 0.01). This observation was further validated by the correlation between ara-C LC(50)and extent of modulation effect (P< 0.05). Cells isolated from 10 cord blood samples were also tested in order to establish the haematological toxicity of combining ara-C and aphidicolin. The therapeutic index (LC(50)normal cells/tumour cells) for ara-C + aphidicolin was higher than that for ara-C alone suggesting no increased myelotoxicity for the combination. Increased cytotoxicity without increased haematotoxicity makes the combination of ara-C plus aphidicolin ideal for inclusion in future clinical trials. Copyright 2001 Cancer Research Campaign.

  9. ERG and FLI1 binding sites demarcate targets for aberrant epigenetic regulation by AML1-ETO in acute myeloid leukemia

    NARCIS (Netherlands)

    Martens, Joost H. A.; Mandoli, Amit; Simmer, Femke; Wierenga, Bart-Jan; Saeed, Sadia; Singh, Abhishek A.; Altucci, Lucia; Vellenga, Edo; Stunnenberg, Hendrik G.

    2012-01-01

    ERG and FLI1 are closely related members of the ETS family of transcription factors and have been identified as essential factors for the function and maintenance of normal hematopoietic stem cells. Here genome-wide analysis revealed that both ERG and FLI1 occupy similar genomic regions as AML1-ETO

  10. Calreticulin exposure by malignant blasts correlates with robust anticancer immunity and improved clinical outcome in AML patients

    Science.gov (United States)

    Fucikova, Jitka; Truxova, Iva; Hensler, Michal; Becht, Etienne; Kasikova, Lenka; Moserova, Irena; Vosahlikova, Sarka; Klouckova, Jana; Church, Sarah E.; Cremer, Isabelle; Kepp, Oliver; Kroemer, Guido; Galluzzi, Lorenzo; Salek, Cyril

    2016-01-01

    Cancer cell death can be perceived as immunogenic by the host only when malignant cells emit immunostimulatory signals (so-called “damage-associated molecular patterns,” DAMPs), as they die in the context of failing adaptive responses to stress. Accumulating preclinical and clinical evidence indicates that the capacity of immunogenic cell death to (re-)activate an anticancer immune response is key to the success of various chemo- and radiotherapeutic regimens. Malignant blasts from patients with acute myeloid leukemia (AML) exposed multiple DAMPs, including calreticulin (CRT), heat-shock protein 70 (HSP70), and HSP90 on their plasma membrane irrespective of treatment. In these patients, high levels of surface-exposed CRT correlated with an increased proportion of natural killer cells and effector memory CD4+ and CD8+ T cells in the periphery. Moreover, CRT exposure on the plasma membrane of malignant blasts positively correlated with the frequency of circulating T cells specific for leukemia-associated antigens, indicating that ecto-CRT favors the initiation of anticancer immunity in patients with AML. Finally, although the levels of ecto-HSP70, ecto-HSP90, and ecto-CRT were all associated with improved relapse-free survival, only CRT exposure significantly correlated with superior overall survival. Thus, CRT exposure represents a novel powerful prognostic biomarker for patients with AML, reflecting the activation of a clinically relevant AML-specific immune response. PMID:27802968

  11. Unveiling the role of PAK2 in CD44 mediated inhibition of proliferation, differentiation and apoptosis in AML cells

    KAUST Repository

    Aldehaiman, Mansour M.

    2018-01-01

    the success of the differentiation agent, All-trans retinoic acid (ATRA), in the treatment of acute promyelocytic leukemia (APL), much effort has gone into trying to find agents that are able to differentiate AML cells and specifically the leukemic stem cell

  12. Defining AML and MDS second cancer risk dynamics after diagnoses of first cancers treated or not with radiation

    NARCIS (Netherlands)

    Radivoyevitch, T.; Sachs, R. K.; Gale, R. P.; Molenaar, R. J.; Brenner, D. J.; Hill, B. T.; Kalaycio, M. E.; Carraway, H. E.; Mukherjee, S.; Sekeres, M. A.; Maciejewski, J. P.

    2016-01-01

    Risks of acute myeloid leukemia (AML) and/or myelodysplastic syndromes (MDS) are known to increase after cancer treatments. Their rise-and-fall dynamics and their associations with radiation have, however, not been fully characterized. To improve risk definition we developed SEERaBomb R software for

  13. Prospect of mechanical engineering. Report from MIT; Kikai kogaku no atarashii tenkai. MIT kara no hokoku

    Energy Technology Data Exchange (ETDEWEB)

    Asada, H [Massachusetts Inst. of Technology, Cambridge, MA (United States)

    1996-01-05

    The author of this article is a professor of Department of Mechanical Engineering of Massachusetts Institute of Technology (MIT) and the director general of Laboratory for Information Systems and Technology of the institute. At Department of Mechanical Engineering of Engineering Faculty of world-famous MIT, Laboratory for Information Systems and Technology was established in 1994 and in the same year, the curricula of the department were greatly revised after 30 years for its enforcement from the new semester starting from September, 1995. These two occasions are suggestive for guessing the future of mechanical engineering, hence its aim and meaning are introduced. Department of Mechanical Engineering aims to bring up system integrators who can consolidate systems based on wide-ranged knowledge, and its basic subjects are divided into 4 subjects namely dynamics and control, heat and fluid, system engineering and control, and design and production, and it has been decided that each of them is taught in equal weight and in parallel. Also as a new study field in the above Department of Mechanical Engineering, nanotechnology and artificial intelligence, and high-technological aircraft and networks are shown as examples.

  14. MR imaging - guided corticosteroid-infiltration of the sacroiliac joints: pain therapy of sacroiliitis in patients with ankylosing spondylitis; Magnetresonanzgesteuerte Kortikosteroid-Infiltration der Sakroiliakalgelenke: Schmerztherapie der Sakroiliitis bei Patienten mit Spondylitis ankylosans

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, J.; Koenig, C.W.; Clasen, S.; Claussen, C.D.; Pereira, P.L. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Guenaydin, I.; Koetter, I. [Medizinische Klinik und Poliklinik II, Rheumaambulanz, Eberhard-Karls-Univ. Tuebingen (Germany); Kastler, B. [Univ. de Franche Comte, CHU Minjoz, Besancon (France)

    2005-04-01

    Purpose: To evaluate the efficacy and specific properties of MR imaging-guided corticosteroid infiltration of the sacroiliac (SI) joints in the treatment of therapy-refractory sacroiliitis in patients with ankylosing spondylitis. Materials and Methods: In this study, 26 patients were prospectively included. Inclusion criteria were AS with therapy refractory acute sacroiliitis and inflammatory back pain {>=} 6 months. The intervention was performed using an open low-field MR-scanner. Inflammatory back pain was assessed on a visual analog scale (VAS). Success of the therapy was defined as an absolute reduction of the VAS score {<=} 5, a relative reduction of the VAS score {>=} 35% and persisting improvement {>=} 2 months. The grade of sacroiliitis was documented using high-field MR imaging. Variables were compared using McNemar test and Wilcoxon test. The mean remission time was calculated using a Kaplan-Meier analysis. A p-value < 0.05 was considered statistically significant. Results: The intervention was technically successfully performed in all patients. Following MR imaging-guided corticosteroid infiltration of the SI joints, the VAS score improved from 8 (5-10) points to 4.5 (0-8) points(-44%) in all patients (n=26), which was statistically significant (p<0.001). Of 26 patients, 22 (85%) fulfilled the predefined criteria for successful therapy. This group had a statistically significant (p<0.01) improvement of the VAS score from 8 (6-10) to 3 (0-5) (-63%). Improvement was seen after 7 (1-30) days. There was a marked reduction of the subchondral bone marrow edema (-38%). The mean remission time was 12 (4-18) months. Conclusion: MR imaging-guided corticosteroid infiltration of the SI joints proved to be an effective therapy of inflammatory back pain in patients with therapy refractory AS. With the ability of multiplanar imaging, precise localization of the bone marrow edema and the lack of ionizing radiation, interventional MR imaging currently represents the superior method for the treatment of the predominantly young patient group presenting with ankylosing spondylitis. Owing to short intervention times, open MR-scanners are ideally suited for MR imaging-guided infiltration of the SI joints. (orig.)

  15. Long-term fate of left atrial thrombi and incidence of cerebral embolism under continuous anticoagulation therapy; MR-tomographische Evaluation der Inzidenz zerebraler Embolien bei Patienten mit Vorhofflimmern und linksatrialen Thromben

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    Strach, K.; Meyer, C.; Hackenbroch, M.; Schild, H.; Sommer, T. [Radiologische Universitaetsklinik Bonn (Germany); Tiemann, K. [Medizinische Universitaetsklinik und Poliklinik II, Bonn (Germany); Haase, J. [Klinik Rotes Kreuz, Frankfurt/Main (Germany); Pizulli, L. [Petruskrankenhaus, Bonn (Germany); Omran, H. [St. Marien-Hospital, Bonn (Germany)

    2005-12-15

    Purpose: Patients (pts.) with atrial fibrillation (AF) and atrial thrombi are known to have an increased risk for cerebral embolism. However, little is known about the clinical course of atrial thrombi and the incidence of cerebral embolism in those patients during anticoagulation therapy. The high sensitivity of MR imaging (MRI) including diffusion-weighted imaging (DWI) suggests that this technique could provide an improved estimate of cerebral embolism associated with the presence of left atrial thrombi. The aims of this prospective study were to evaluate (1) the prevalence of clinically silent and apparent cerebral embolism in pts. with newly diagnosed AF and atrial thrombi using MRI/DWI, (2) the long-term fate of atrial thrombi under continued anticoagulation therapy and (3) the incidence of cerebral embolism during a follow-up period of 12 months with continuous anticoagulation therapy. Materials and methods: The study group consisted of 32 pts. with (1) newly diagnosed AF and evidence of left atrial (LA) thrombi detected by TEE and (2) a new start of anticoagulation therapy [International Normalized Ratio (INR) 2.0-3.0]. 19 pts. with (1) newly diagnosed AF and no evidence of atrial thrombi and (2) an equivalent anticoagulation regimen served as the control group. In both groups (a) MRI/DWI studies of the brain (weeks 0, 4, 8, 12, 20, 28, 36, 44, and 52), (b) transesophageal echocardiographic studies (TEE) for assessment of LA-Thrombi (weeks 0 and 52) and (c) clinical neurological assessments (weeks 0, 20 and 52) were performed. Results: In the study group (AF and LA-Thrombi) 11 out of 32 pts. (34%) displayed signs of acute (n=8) or chronic (n=3) cerebral embolism in the initial MRI studies. In 4 out of 32 pts.(13%), MRI/DWI depicted new or additional cerebral emboli (n=12) during the follow-up period despite continuous anticoagulation therapy. 2 (n=2/4; 50%) of these patients had clinically apparent neurological deficits. In the control group 1 out of 19 pts. (5%) showed evidence of chronic cerebral embolism as assessed by MRI/DWI at the beginning of the study (week 0). No embolic cerebral lesions were detected during the 12-month follow-up. Within 12 months only 63% (n=20/32) of LA thrombi in the study group resolved completely under anticoagulation. (orig.)

  16. Integration of cardiac computed tomography into pulmonary vein isolation in patients with paroxysmal atrial fibrillation; Integration einer praeinterventionellen Computertomografie des Herzens in die therapeutische Pulmonalvenenisolation bei Patienten mit paroxysmalem Vorhofflimmern

    Energy Technology Data Exchange (ETDEWEB)

    Weber, T.F. [Abt. Radiologie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Klemm, H.; Willems, S. [Klinik und Poliklinik fuer Kardiologie und Angiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Koops, A.; Adam, G.; Begemann, P.G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Nagel, H.D. [Philips Medizin Systeme GmbH, Hamburg (Germany)

    2007-12-15

    Purpose: Detailed anatomic information of the left atrium is necessary for securely performing radiofrequency ablation of atrial fibrillation-triggering ectopies in the pulmonary vein ostia. In this study the impact of a preinterventionally acquired cardiac computed tomography (CT) on pulmonary vein isolation (PVI) was assessed. Materials and methods: Examinations of 54 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed. In 27 patients a supplementary cardiac CT was obtained prior to PVI (CT group, 12 women, 15 men, 59.7 {+-} 9.9 years of age): 16 x 1.5 mm collimation, 0.2 pitch, 120 kV tube voltage, 400 effective mAs. The fluoroscopy time, effective dose and quantity of radiofrequency (RF) pulses of the following catheter ablation were compared to 27 patients undergoing stand-alone PVI (11 women, 16 men, 62.0 {+-} 9.9 years of age). Mann-Whitney tests served for statistical comparison. Results: CT datasets were successfully integrated into the ablation procedure of each patient in the CT group. The mean quantity of RF pulses was significantly lower in the CT group (22.1 {+-} 8.0 vs. 29.1 {+-} 11.9, p = 0.030), and a significant reduction of fluoroscopy time was found (41.8 {+-} 12.0 min vs. 51.2 {+-} 16.0 min, p = 0.005). Effective doses of the catheter ablation differed in an equivalent dimension but altogether not significantly (14.9 {+-} 10.0 mSv vs. 20.0 {+-} 16.0 mSv, p = 0.203). The mean additive effective dose of the cardiac CT was 85 {+-} 0.3 mSv. (orig.)

  17. Long-term survival of patients with primary oral squamous cell carcinoma. Comparison of two treatment protocols in a prospective study; 5-Jahres-Ueberlebenswahrscheinlichkeit von Patienten mit primaeren Plattenepithelkarzinomen der Mundhoehle. Vergleich von zwei Behandlungsstrategien in einer prospektiven Studie

    Energy Technology Data Exchange (ETDEWEB)

    Kessler, P.; Bloch-Birkholz, A.; Neukam, F.W. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Mund-, Kiefer-, Gesichtschirurgie; Grabenbauer, G.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Klinik und Poliklinik fuer Strahlentherapie; Leher, A. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Medizininformatik, Biometrie und Epidemiologie; Vairaktaris, E. [Univ. of Athens Medical School (Greece). Dept. of Maxillofacial Surgery

    2007-04-15

    Background and Purpose: In recent years, different concepts for the treatment of oral squamous cell carcinomas (OSCC) have been developed; these include preoperative simultaneous neoadjuvant radiochemotherapy and one-stage surgery with tumor ablation and reconstruction. When considering long-term survival, there is substantial evidence that multimodality treatment based on a neoadjuvant radiochemotherapy is superior to adjuvant therapy concepts based on a surgical approach with postoperative irradiation. The aim of this study was to discuss the 5-year survival rate in a neoadjuvant and an adjuvant combination treatment in patients with primary OSCC. Patients and Methods: This nonrandomized longitudinal study prospectively evaluates the long-term tumor-free survival in 128 patients with oral cancer. Two groups consisting of 74 neoadjuvantly and 54 primarily surgically treated patients were formed. 99 patients suffered from stage III and IV disease according to the UICC criteria. Long-term survival was estimated according to the Kaplan-Meier assumption. Results: The neoadjuvant treatment increases the prospect of a long-term tumor-free survival. According to Kaplan-Meier assumption the estimation for a 5-year tumor-free survival in OSCC in category T1 is 83.1% in neoadjuvant, and 70.1% in adjuvant treatment, in T2 79.6% and 57.7%, in T3 68.2% and 33.2%, in T4 51.4% and 30.5%, respectively. Significance (p < 0.05) could be proven for T1 (p = 0.002), T2 (p = 0.028), and T4 (p < 0.0001) tumors. The effectiveness of the preoperative radiochemotherapy was demonstrated in the pathohistological result of tumor-free resection specimens in 28 patients of the neoadjuvant treatment group (37.8%). On the other hand, four patients died during the preoperative combination therapy. 64.8% of the patients in the adjuvant and 71.6% in the neoadjuvant treatment group survived the observation period. Conclusion: Neoadjuvant therapy is highly effective and results in a better 5-year survival rate than adjuvant treatment. All patients with primary OSCC should be selected for such a treatment. Future therapy concepts should combine the effectiveness of a systemic treatment with the safety of a limited surgical resection of the tumor site to preserve as much function as possible.

  18. Preoperative mapping of speech-eloquent areas with functional magnetic resonance imaging (fMRI): comparison of different task designs; Praeoperatives Mapping der Sprachareale mittels funktioneller Magnetresonanztomographie (fMRT) bei Patienten mit Hirntumoren: Ein Paradigmenvergleich

    Energy Technology Data Exchange (ETDEWEB)

    Prothmann, S.; Zimmer, C. [Leipzig Univ. (Germany). Abt. fuer Neuroradiologie; Puccini, S.; Dalitz, B.; Kuehn, A.; Kahn, T. [Leipzig Univ. (Germany). Klinik und Poliklinik fuer Diagnostische Radiologie; Roedel, L. [Leipzig Univ. (Germany). Klinik und Poliklinik fuer Neurochirurgie

    2005-11-15

    Purpose: Functional magnetic resonance imaging (fMRI) is a well-established, non-invasive method for pre-operative mapping of speech-eloquent areas. This investigation tests three simple paradigms to evaluate speech lateralisation and visualisation of speech-eloquent areas. Materials and Methods: 14 healthy volunteers and 16 brain tumour patients were given three tasks: to enumerate months in the correct order (EM), to generate verbs fitting to a given noun (GV) and to generate words fitting to a given alphabetic character (GW). We used a blocked design with 80 measurements which consisted of 4 intervals of speech activation alternating with relaxation periods. The data were analysed on the basis of the general linear model using Brainvoyager {sup registered}. The activated clusters in the inferior frontal (Broca) and the posterior temporal (Wernicke) cortex were analysed and the laterality indices calculated. Results: In both groups the paradigms GV and GW activated the Broca's area very robustly. Visualisation of the Wernicke's area was best achieved by the paradigm GV. The paradigm EM did not reliably stimulate either the frontal or the temporal cortex. Frontal lateralisation was best determined by GW and GV, temporal lateralisation by GV. Conclusion: The paradigms GV and GW visualise two essential aspects of speech processing: semantic word processing and word production. In a clinical setting with brain tumour patients, both, GV and GW can be used to visualise frontal and temporal speech areas, and to determine speech dominance. (orig.)

  19. Magnetic resonance cholangiographic (MRCP) features of ischemic-type biliary lesions (ITBL). A case-control study; Magnetresonanz-Cholangiografie (MRCP) bei Patienten mit Ischemic-Type Biliary Lesions (ITBL). Eine Fall-Kontroll-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Kroencke, T.J.; Renz, D.M.; Bucourt, M. de; Poellinger, A. [Charite, Berlin (Germany). Klinik fuer Radiologie; Heidenhain, C.; Neuhaus, P. [Charite, Berlin (Germany). Klinik fuer Allgemein-, Visceral- und Transplantationschirurgie CVK

    2011-08-15

    Purpose: To evaluate the spectrum of MR cholangiography (MRCP) features of ischemic-type biliary lesions (ITBL) after orthotopic liver transplantation (OLT). Materials and Methods: 30 patients (16 m, 14 f) with an average age of 52 years (9 - 69 y) were examined in two 1.5 MR units using breath-hold 2D-SS-FSE-sequences and 3D-MRCP sequences. 20 of the 30 patients had an established ITBL, and the remaining 10 patients were post-OLT controls. MRCPs were evaluated independently by two experienced radiologists that were blinded to the clinical history as well as the results of other imaging modalities. All images were analyzed for the presence of 16 different pathological features. Differences between ITBL patients and controls were analyzed using the Mann-Whitney-U Test. Inter-rater variability was tested using the Cohen's Kappa test. Results: Abnormal findings of bile ducts were seen in all patients. The most common findings were (in percentage for reader 1/2) intrahepatic bile duct dilatation (95 %/95 %) and extrahepatic bile duct stenoses (95 %/85 %), followed by intrahepatic main duct stenoses (90 %/95 %) and segmental duct stenoses (85 %/85 %). Differences between ITBL patients and controls were significant for most of the analyzed features (Mann-Whitney-U test, p < 0.05). For 12 of 16 features, there was substantial or almost perfect agreement (K = 0.61 - 1.00), for 2 of 16 features moderate agreement (K = 0.41- 0.60) and for 2 of 16 features fair agreement (K < 0.40). Conclusion: In patients with ITBL, MR cholangiography reveals characteristic features that may allow differentiation from other biliary complications after liver transplantation. (orig.)

  20. MRI-based flow measurements in the main pulmonary artery to detect pulmonary arterial hypertension in patients with cystic fibrosis; MRT-basierte Flussmessungen im Truncus pulmonalis zur Detektion einer pulmonal-arteriellen Hypertonie in Patienten mit zystischer Fibrose

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, T.; Anjorin, A.; Abolmaali, N. [TU Dresden (Germany). OncoRay, Biologisches und Molekulares Imaging; Posselt, H. [Frankfurt Univ. (Germany). Klinik fuer Paediatrie I, Muskoviszidoseambulanz; Smaczny, C. [Frankfurt Univ. (Germany). Medizinische Klinik I, Pneumologie und Allergologie; Vogl, T.J. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2009-02-15

    Development of pulmonary arterial hypertension (PH) is a common problem in the course of patients suffering from cystic fibrosis (CF). This study was performed to evaluate MRI based flow measurements (MR{sub venc}; Velocity ENCoding) to detect signs of an evolving PH in patients suffering from CF. 48 patients (median age: 16 years, range: 10 - 40 years, 25 female) suffering from CF of different severity (mean FEV1: 74 % {+-} 23, mean Shwachman-score: 63 {+-} 10) were examined using MRI based flow measurements of the main pulmonary artery (MPA). Phase-contrast flash sequences (TR: 9.6 ms, TE: 2.5 ms, bandwidth: 1395 Hertz/Pixel) were utilized. Results were compared to an age- and sex-matched group of 48 healthy subjects. Analyzed flow data where: heart frequency (HF), cardiac output (HZV), acceleration time (AT), proportional acceleration time related to heart rate (ATr), mean systolic blood velocity (MFG), peak velocity (Peak), maximum flow (Fluss{sub max}), mean flow (Fluss{sub mitt}) and distensibility (Dist). The comparison of means revealed significant differences only for MFG, Fluss{sub max} and Dist, but overlap was marked. However, using a scatter-plot of AT versus MFG, it was possible to identify five CF-patients demonstrating definite signs of PH: AT = 81 ms {+-} 14, MFG = 46 {+-} 11 cm/s, Dist = 41 % {+-} 7. These CF-patients where the most severely affected in the investigated group, two of them were listed for complete heart and lung transplantation. The comparison of this subgroup and the remaining CF-patients revealed a highly significant difference for the AT (p = 0.000001) without overlap. Screening of CF-patients for the development of PH using MR{sub venc} of the MPA is not possible. In later stages of disease, the quantification of AT, MFG and Dist in the MPA may be useful for the detection, follow-up and control of therapy of PH. MR{sub venc} of the MPA completes the MRI-based follow-up of lung parenchyma damage in patients suffering from CF. (orig.)

  1. Diffusion-weighted imaging in the diagnostic evaluation of the hydrocephalus in patients with acute or chronic increase in cerebral pressure; Diffusionsgewichtete Bildgebung in der Diagnostik des Hydrocephalus - Untersuchungen an Patienten mit akuter und ohne akute Hirndrucksymptomatik

    Energy Technology Data Exchange (ETDEWEB)

    Dorenbeck, U. [Abt. fuer Neuroradiologie, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Inst. fuer Roentgendiagnostik, Universitaetsklinik Regensburg (Germany); Schlaier, J. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinik Regensburg (Germany); Feuerbach, S.; Seitz, J. [Inst. fuer Roentgendiagnostik, Universitaetsklinik Regensburg (Germany)

    2005-01-01

    Purpose: to investigate whether diffusion-weighted imaging (DWI) in magnetic resonance imaging (MRI) provides additional information about the periventricular white matter for the assessment of hydrocephalus. Materials and methods: sixteen MRI examinations (11 with acutely increased cerebral pressure, 5 without symptoms) on 15 patients with hydrocephalus (4 patients with communicating hydrocephalus and 11 patients with obstructive hydrocephalus) were analyzed. One symptomatic patient subsequently became asymptomatic. We investigated the ''apparent diffusion coefficient'' (ADC) in the subcortical and periventricular white matter. The ADCs of the study patients were compared with those of a healthy control group. Results: symptomatic patients with hydrocephalus, 6/11 showed periventricular edema and a significantly higher ADC values in the periventricular region than in the subcortical white matter. 5/11 symptomatic patients showed significantly higher ADC values even in the absence of periventricular interstitial edema (both groups contained patients with communicating and obstructive hydrocephalus). All 5 asymptomatic patients with hydrocephalus did not have a significantly higher ADC values in the periventricular region. Conclusion: in patients with hydrocephalus and acutely increased cerebral pressure, DWI showed a significantly higher ADC values in the periventricular region even without visible interstitial edema on conventional MRI sequences. (orig.)

  2. Comparison of conventional full spine radiographs and fluoroscopic scanning method in young patients with idiopathic scoliosis; Vergleich von konventioneller Wirbelsaeulenganzaufnahme und fluoroskopischer Scan-Methode bei jungen Patienten mit idiopathischer Skoliose

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, J.; Kottke, R.; Claussen, C. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Kluba, T.; Niemeyer, T.; Hahnfeldt, T. [Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Tuebingen (Germany); Vonthein, R. [Inst. fuer Medizinische Biometrie, Universitaetsklinikum Tuebingen (Germany); Kamm, K.F. [Philips Medizin Systeme GmbH, Hamburg (Germany)

    2005-08-01

    Purpose: evaluation of low-dose full spine radiographs using fluoroscopic images for the assessment of the Cobb angle measurement in patients with scoliosis. Material and methods: twenty-one consecutive patients (aged 10-27 years, mean age 14 years) with a conventional full spine examination (film speed class 800) underwent a follow-up exam using digital pulsed fluoroscopy (Multi Diagnost 4, Philips Medical Systems, Eindhoven, The Netherlands). The mean follow-up was 9 months. During a synchronized scan with a C-arm speed of 4 cm/sec fluoroscopic images were stored with a pulsed frequency of 3 images per second. The single images were merged and reconstructed to one image with the software easy spine (Philips medical Systems, Eindhoven, The Netherlands). The corresponding dose-area product values (DAP) of both methods were compared. Three independent observers assessed Cobb angles and image quality for each technique. Results: the mean DAP values for conventional imaging was 94.9 cGy x cm{sup 2} and for fluoroscopy 7.8 cGy x cm{sup 2}, respectively. A significant dose reduction of 91.8% (CI 91% to 95%) was calculated. The average absolute angle difference between the observers was found to be 2.7 for conventional imaging and 2.4 for the fluoroscopic method. Interobserver standard deviation of 2.9 was lower than the 5.3 for conventional images. Image quality was better in the conventional images. Conclusion: using the scanning method, we could achieve a mean reduction of the radiation dose of 92%, while the accuracy of the Cobb angle measurements was comparable for both techniques despite of reduced image quality of digital fluoroscopy. (orig.)

  3. Retinoic Acid for High-risk Neuroblastoma Patients after Autologous Stem Cell Transplantation - Cochrane Review Retinsäure nach erfolgter autologer Stammzelltransplantation bei Hochrisiko-Patienten mit Neuroblastom - Cochrane Review

    NARCIS (Netherlands)

    Peinemann, F.; van Dalen, E. C.; Berthold, F.

    2016-01-01

    Neuroblastoma is a rare malignant disease and patients with high-risk neuroblastoma have a poor prognosis. Retinoic acid has been shown to inhibit growth of human neuroblastoma cells and has been considered as a potential candidate for improving the outcome. The objective was to evaluate effects of

  4. Detection of prostate carcinomas with T1-weighted dynamic contrast-enhanced MRI. Value of two-compartment model; Detektion von Prostatakarzinomen mit T1-gewichteter Kontrastmittel-unterstuetzter dynamischer MRT. Wertigkeit des Zweikompartimentemodells

    Energy Technology Data Exchange (ETDEWEB)

    Kiessling, F.; Lichy, M.; Farhan, N.; Delorme, S.; Kauczor, H.U. [Abteilung fuer Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany); Grobholz, R. [Abteilung fuer Pathologie, Universitaetsklinikum Mannheim (Germany); Heilmann, M. [Abteilung fuer Physik in der Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany); Michel, M.S.; Trojan, L. [Abteilung fuer Urologie, Universitaetsklinikum Mannheim (Germany); Werner, A.; Rabe, J. [Institut fuer Klinische Radiologie, Universitaetsklinikum Mannheim (Germany); Schlemmer, H.P. [Abteilung fuer Diagnostische Radiologie, Universitaetsklinikum Tuebingen (Germany)

    2003-06-01

    Aim The suitability of dynamic parameters of the two-compartment model for detecting prostate carcinomas and its correlation with tumor microvascular density were evaluated. The study included 43 patients with biopsy-proven prostate carcinoma: 28 were examined by 1.0-T MRI (Turbo-FLASH) and 15 by 1.5-T MRI (FLASH) with infusion of 0.1 mmol/kg Gd-DTPA. Signal time curves were parametrized with an open two-compartment model in amplitude and exchange rate constants (k{sub ep}).The microvascular density of resected prostate carcinomas was determined. The microvascular density in the tumors was significantly higher than in the adjacent healthy prostate tissue and correlated in both sequences with k{sub ep}. Prostate carcinomas of the peripheral zone were demarcated by amplitude and k{sub ep}. In the Turbo-FLASH sequence there was a significant difference between the tumor tissue and healthy peripheral zone in terms of k{sub ep} and in the FLASH sequence in terms of amplitude. Prostate carcinomas can be visualized with dynamic T1-weighted MR sequences using a two-compartment model. Moreover, the parameter k{sub ep} reveals the microvascular density in the tumor and can thus provide valuable clinical information for characterizing the tumors. (orig.) [German] Die Eignung dynamischer Parameter des Zweikompartimentemodells zur Erkennung von Prostatakarzinomen und deren Korrelation mit der Tumormikrogefaessdichte wurden evaluiert. 43 Patienten mit bioptisch gesichertem Prostatakarzinom wurden untersucht, 28 mit 1,0 T- (Turbo-FLASH-) und 15 bei 1,5-T-MRT (FLASH) unter Infusion von 0,1 mmol/kg Gd-DTPA. Signal-Zeit-Kurven wurden nach einem offenen Zweikompartimentemodell in Amplitude sowie Austauschratenkonstante (k{sub ep}) parametrisiert. An resezierten Prostatakarzinomen wurde die Mikrogefaessdichte bestimmt.Ergebnisse Die Mikrogefaessdichte in den Tumoren war signifikant hoeher als im angrenzenden gesunden Prostatagewebe und korrelierte bei beiden Sequenzen mit k{sub ep

  5. First clinical experience with extended planning and navigation in an interventional MRI unit; Erste klinische Erfahrungen mit einer erweiterten Eingriffsplanung und Navigation am interventionellen MRT

    Energy Technology Data Exchange (ETDEWEB)

    Moche, M.; Schneider, J.P.; Schulz, T.; Voerkel, C.; Kahn, T.; Busse, H. [Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Schmitgen, A.; Bublat, M. [Fraunhofer-Inst. fuer Angewandte Informationstechnik, St. Augustin (Germany); Trantakis, C. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Leipzig (Germany); Bennek, J. [Klinik und Poliklinik fuer Kinderchirurgie, Univ. Leipzig (Germany)

    2004-07-01

    -Datensaetze dienen der Eingriffsplanung. Der Informationsgehalt dieser Referenzdaten wird durch Ueberlagerung zusaetzlicher Bildmodalitaeten (u.a. fMRT, CT) und durch farbige Darstellung der Bereiche frueher und rascher Kontrastmittelaufnahme erhoeht. Mit Hilfe dieses Systems wurden innerhalb von 18 Monaten 123 Patienten operiert (Gehirn: 64, Nasennebenhoehle: 9, Mamma: 20, Leber: 17, Knochen: 9, Muskel: 4). Der durchschnittliche Zeitaufwand der 64 Hirnoperationen wurde mit dem von 36 Eingriffen mit herkoemmlicher Navigation verglichen. Ergebnisse: Im Vergleich zur schnellen, kontinuierlichen Bildgebung des MRT-Systems (0,25 Bilder/s) erlauben erst die hoehere Qualitaet sowie die Echtzeitdarstellung (4 Bilder/s) der aus dem 3-D-Referenzdatensatz rekonstruierten MR-Bilder eine angemessene Auge-Hand-Koordination. Patienten- bzw. Gewebeverlagerungen lassen sich fruehzeitig intraoperativ erkennen und die Navigation kann durch Aktualisierung der Referenzdaten sicher fortgefuehrt werden. Das System zeichnete sich durch eine hohe Stabilitaet, effiziente Systemintegration und einfache Bedienbarkeit aus. Die bildgestuetzten Hirnoperationen dauerten trotz zusaetzlicher, noch zu optimierender Arbeitsschritte nicht signifikant laenger. (orig.)

  6. The novel AML stem cell associated antigen CLL-1 aids in discrimination between normal and leukemic stem cells.

    Science.gov (United States)

    van Rhenen, Anna; van Dongen, Guus A M S; Kelder, Angèle; Rombouts, Elwin J; Feller, Nicole; Moshaver, Bijan; Stigter-van Walsum, Marijke; Zweegman, Sonja; Ossenkoppele, Gert J; Jan Schuurhuis, Gerrit

    2007-10-01

    In CD34(+) acute myeloid leukemia (AML), the malignant stem cells reside in the CD38(-) compartment. We have shown before that the frequency of such CD34(+)CD38(-) cells at diagnosis correlates with minimal residual disease (MRD) frequency after chemotherapy and with survival. Specific targeting of CD34(+)CD38(-) cells might thus offer therapeutic options. Previously, we found that C-type lectin-like molecule-1 (CLL-1) has high expression on the whole blast compartment in the majority of AML cases. We now show that CLL-1 expression is also present on the CD34(+)CD38(-) stem- cell compartment in AML (77/89 patients). The CD34(+)CLL-1(+) population, containing the CD34(+)CD38(-)CLL-1(+) cells, does engraft in nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice with outgrowth to CLL-1(+) blasts. CLL-1 expression was not different between diagnosis and relapse (n = 9). In remission, both CLL-1(-) normal and CLL-1(+) malignant CD34(+)CD38(-) cells were present. A high CLL-1(+) fraction was associated with quick relapse. CLL-1 expression is completely absent both on CD34(+)CD38(-) cells in normal (n = 11) and in regenerating bone marrow controls (n = 6). This AML stem-cell specificity of the anti-CLL-1 antibody under all conditions of disease and the leukemia-initiating properties of CD34(+)CLL-1(+) cells indicate that anti-CLL-1 antibody enables both AML-specific stem-cell detection and possibly antigen-targeting in future.

  7. The Runt domain of AML1 (RUNX1) binds a sequence-conserved RNA motif that mimics a DNA element.

    Science.gov (United States)

    Fukunaga, Junichi; Nomura, Yusuke; Tanaka, Yoichiro; Amano, Ryo; Tanaka, Taku; Nakamura, Yoshikazu; Kawai, Gota; Sakamoto, Taiichi; Kozu, Tomoko

    2013-07-01

    AML1 (RUNX1) is a key transcription factor for hematopoiesis that binds to the Runt-binding double-stranded DNA element (RDE) of target genes through its N-terminal Runt domain. Aberrations in the AML1 gene are frequently found in human leukemia. To better understand AML1 and its potential utility for diagnosis and therapy, we obtained RNA aptamers that bind specifically to the AML1 Runt domain. Enzymatic probing and NMR analyses revealed that Apt1-S, which is a truncated variant of one of the aptamers, has a CACG tetraloop and two stem regions separated by an internal loop. All the isolated aptamers were found to contain the conserved sequence motif 5'-NNCCAC-3' and 5'-GCGMGN'N'-3' (M:A or C; N and N' form Watson-Crick base pairs). The motif contains one AC mismatch and one base bulged out. Mutational analysis of Apt1-S showed that three guanines of the motif are important for Runt binding as are the three guanines of RDE, which are directly recognized by three arginine residues of the Runt domain. Mutational analyses of the Runt domain revealed that the amino acid residues used for Apt1-S binding were similar to those used for RDE binding. Furthermore, the aptamer competed with RDE for binding to the Runt domain in vitro. These results demonstrated that the Runt domain of the AML1 protein binds to the motif of the aptamer that mimics DNA. Our findings should provide new insights into RNA function and utility in both basic and applied sciences.

  8. Funktionelle Elektrostimulation Paraplegischer Patienten.

    Science.gov (United States)

    Kern, Helmut

    2014-07-08

    Functional Electrical Stimulation on Paraplegic Patients. We report on clinical and physiological effects of 8 months Functional Electrical Stimulation (FES) of quadriceps femoris muscle on 16 paraplegic patients. Each patient had muscle biopsies, CT-muscle diameter measurements, knee extension strength testing carried out before and after 8 months FES training. Skin perfusion was documented through infrared telethermography and xenon clearance, muscle perfusion was recorded through thallium scintigraphy. After 8 months FES training baseline skin perfusion showed 86 % increase, muscle perfusion was augmented by 87 %. Muscle fiber diameters showed an average increase of 59 % after 8 months FES training. Muscles in patients with spastic paresis as well as in patients with denervation showed an increase in aerob and anaerob muscle enzymes up to the normal range. Even without axonal neurotropic substances FES was able to demonstrate fiberhypertrophy, enzyme adaptation and intracellular structural benefits in denervated muscles. The increment in muscle area as visible on CT-scans of quadriceps femoris was 30 % in spastic paraplegia and 10 % in denervated patients respectively. FES induced changes were less in areas not directly underneath the surface electrodes. We strongly recommend the use of Kern's current for FES in denervated muscles to induce tetanic muscle contractions as we formed a very critical opinion of conventional exponential current. In patients with conus-cauda-lesions FES must be integrated into modern rehabilitation to prevent extreme muscle degeneration and decubital ulcers. Using FES we are able to improve metabolism and induce positive trophic changes in our patients lower extremities. In spastic paraplegics the functions "rising and walking" achieved through FES are much better training than FES ergometers. Larger muscle masses are activated and an increased heart rate is measured, therefore the impact on cardiovascular fitness and metabolism is much greater. This effectively addresses and prevents all problems which result from inactivity in paraplegic patients.

  9. Sacroiliitis in children with spondyloarthropathy: therapeutic effect of CT-guided intra-articular corticosteroid injection; Sakroiliitis bei Kinder mit Spondylarthropathie: Therapeutischer Effekt der CT-gestuetzten intraartikulaeren Kortikosteroid-Injektionen

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, T.; Hermann, K.G.A.; Diekmann, F.; Hamm, B. [Humboldt-Universitaet, Berlin (Germany). Universitaetsklinikum Charite, Inst. fuer Radiologie; Biedermann, T. [HELIOS Klinikum Berlin (Germany). II. Klinik fuer Kinderheilkunde und Jugendmedizin, Abt. Kinderrheumatologie; Braun, J. [Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus (Germany); Bollow, M. [Augusta-Krankenhaus, Bochum (Germany). Inst. fuer Radiologie

    2003-06-01

    . The follow-up dynamic MRI (0.1 mmol/kg body weight) during therapy showed a statistically significant lower contrast-enhancement in both groups (group 1: 117{+-}43% versus 38{+-}24%, p<0.05; group 2: 127{+-}59% versus 38{+-}22%, p<0.05). One third of the patients of group 2 showed progression of joint destruction despite absence of subjective complaints. (orig.) [German] Ziel: Prospektive Pruefung des therapeutischen Effektes der CT-gesteuerten intraartikulaeren Kortikosteroid-Injektion entzuendlicher Sakroiliakalgelenke (SIG) bei Kindern mit juveniler Spondylarthropathie (jSpA) im Vergleich zur konventionellen Therapie mit nichtsteroidalen Antirheumatika (NSAR) sowie Bestimmung der Wertigkeit der Magnetresonanztomographie (MRT) bei der Indikationsstellung und der Therapieverlaufskontrolle. Material und Methode: Bei 89 Kindern mit bekannter jSpA wurden mittels dynamischer MRT uni- oder bilaterale Sakroiliitiden diagnostiziert. Bei allen 89 Patienten wurde daraufhin eine Therapie mit NSAR eingeleitet bzw. bereits bestehende Therapien fortgesetzt. Vier Wochen nach der diagnostischen MRT wurden zwei Gruppen definiert: 33 Patienten mit klinischem Response auf NSAR (Gruppe 1) und 56 Nonresponder (Gruppe 2). Die Patienten der Gruppe 2 wurden unter Belassung der NSAR zusaetzlich einer CT-gestuetzten (Low-Dose-Technik) intraartikulaeren Kortikosteroid-Injektion zugefuehrt, wobei insgesamt 83 SIG punktiert und infiltriert wurden (27 bilateral, 29 unilateral). Die Indikationsstellung zur Intervention beruhte auf der zuvor MR-tomographisch gesicherten Entzuendungsaktivitaet. Klinische Therapieverlaufskontrollen erfolgten in 8- bis 12-woechigen Intervallen ueber einen Zeitraum von 20 Monaten. MRT-Verlaufskontrollen wurden bei allen 56 Kindern der Gruppe 2 und bei 15 von 33 Kindern der Gruppe 1 in einem Zeitraum von 8{+-}4 Monaten nach der Erstuntersuchung durchgefuehrt. Ergebnisse: Ingesamt 87,5% der komplikationslos punktierten Kinder der Gruppe 2 (Standardtherapie

  10. [Postoperative adjuvante Therapie mit einem Mistelextrakt (Viscum album ssp. album) bei Hündinnen mit Mammatumoren].

    Science.gov (United States)

    Biegel, Ulrike; Stratmann, Nina; Knauf, Yvonne; Ruess, Katja; Reif, Marcus; Wehrend, Axel

    2017-01-01

    Hintergrund: Canine Mammatumoren (CMT) sind wegen ihrer Häufigkeit und hohen Malignitätsrate eine Herausforderung für die Veterinärmedizin. Bisher ist noch keine postoperative adjuvante Therapie als wirksamer Standard etabliert und in den nächsten Jahren wohl auch nicht zu erwarten. Zusätzlich ist die Frage nach der Verträglichkeit einer adjuvanten Therapie mit Erhaltung oder Verbesserung der Lebensqualität (LQ) wichtig. Die Therapie mit Mistelextrakten (Viscum album L.; VAE) ist in der Humanonkologie nach adjuvanter Tumorbasistherapie (Chemotherapie und Bestrahlung) eine sehr häufig verwendete, zusätzliche adjuvante Behandlungsmethode. Auch bei verschiedenen Tierarten werden inzwischen Mistelpräparate in der Onkologie erfolgreich angewendet. Methoden: Überprüfung von Wirkung und Nutzen einer postoperativen, adjuvanten Misteltherapie beim CMT sowie Erfassung der LQ unter der VAE-Behandlung. Ausgewertet wurden 56 Hündinnen mit Mammaadenokarzinom, 33 ausschließlich operierte Kontrolltiere und 23 operierte Tiere, die adjuvant VAE erhielten. Ergebnisse: Die mediane Überlebenszeit (MST) aller Tiere (n = 56) betrug 32 Monate (Interquartilbereich 13-51 Monate). Im deskriptiven Vergleich der Überlebenszeiten (ST) nach Kaplan-Meier waren nach 12, 24, 36 bzw. 48 Monaten noch 24, 20, 15 bzw. 5 Hündinnen (entsprechend 72,7%, 60,6%, 45,1%, 12,4%) der Kontrollgruppe sowie 19, 14, 11 und 1 Hündin (82,6%, 60,9%, 47,8%, 4,3%) der VAE-Gruppe am Leben. Die VAE-Therapie führte zu einem geringeren Gesamtversterberisiko, das statistisch nicht signifikant war (Hazard Ratio (HR) 0,530, 95%-Konfidenzintervall (KI) 0,222-1,262; p = 0,15). Tendenziell (p = 0,07) zeigte sich eine Verringerung des tumorbedingten Sterberisikos auf 25% (HR 0,251, 95%-KI 0,056-1,122). Schlussfolgerungen: Es kann eine Tendenz zur Senkung des tumorbedingten Sterberisikos der VAE-Gruppe bei guter Verträglichkeit der Therapie angenommen werden. Die LQ der Tiere blieb über die gesamte

  11. Ibrutinib synergizes with poly(ADP-ribose) glycohydrolase inhibitors to induce cell death in AML cells via a BTK-independent mechanism.

    Science.gov (United States)

    Rotin, Lianne E; Gronda, Marcela; MacLean, Neil; Hurren, Rose; Wang, XiaoMing; Lin, Feng-Hsu; Wrana, Jeff; Datti, Alessandro; Barber, Dwayne L; Minden, Mark D; Slassi, Malik; Schimmer, Aaron D

    2016-01-19

    Targeting Bruton's tyrosine kinase (BTK) with the small molecule BTK inhibitor ibrutinib has significantly improved patient outcomes in several B-cell malignancies, with minimal toxicity. Given the reported expression and constitutive activation of BTK in acute myeloid leukemia (AML) cells, there has been recent interest in investigating the anti-AML activity of ibrutinib. We noted that ibrutinib had limited single-agent toxicity in a panel of AML cell lines and primary AML samples, and therefore sought to identify ibrutinib-sensitizing drugs. Using a high-throughput combination chemical screen, we identified that the poly(ADP-ribose) glycohydrolase (PARG) inhibitor ethacridine lactate synergized with ibrutinib in TEX and OCI-AML2 leukemia cell lines. The combination of ibrutinib and ethacridine induced a synergistic increase in reactive oxygen species that was functionally important to explain the observed cell death. Interestingly, synergistic cytotoxicity of ibrutinib and ethacridine was independent of the inhibitory effect of ibrutinib against BTK, as knockdown of BTK did not sensitize TEX and OCI-AML2 cells to ethacridine treatment. Thus, our findings indicate that ibrutinib may have a BTK-independent role in AML and that PARG inhibitors may have utility as part of a combination therapy for this disease.

  12. The micro turbine: the MIT example; La micro turbine: l'exemple du MIT

    Energy Technology Data Exchange (ETDEWEB)

    Ribaud, Y. [Office National d' Etudes et de Recherches Aerospatiales (ONERA-DEFA), 92 - Chatillon (France)

    2001-10-01

    The micro turbine study began a few years ago at the MIT, with the participation of specialists from different fields. The purpose is the development of a MEMS (micro electro mechanical systems) based, 1 cm in diameter, micro gas turbine. Potential applications are devoted to micro drone propulsion, electric power generation for portable power sources in order to replace heavy Lithium batteries, satellite motorization, the surface distributed power for boundary suction on plane wings. The manufacturing constraints at such small scales lead to 2-D extruded shapes. The physical constraints stem from viscous effects and from limitations given by 2-D geometry. The time scales are generally shorter than for conventional machines. Otherwise the material properties are better at such length scales. Transposition from conventional turbomachinery laws is no more applicable and new design methods must be established. The present paper highlights the project progress and the technology breakthroughs. (author)

  13. The rarity of ALDH(+) cells is the key to separation of normal versus leukemia stem cells by ALDH activity in AML patients.

    Science.gov (United States)

    Hoang, Van T; Buss, Eike C; Wang, Wenwen; Hoffmann, Isabel; Raffel, Simon; Zepeda-Moreno, Abraham; Baran, Natalia; Wuchter, Patrick; Eckstein, Volker; Trumpp, Andreas; Jauch, Anna; Ho, Anthony D; Lutz, Christoph

    2015-08-01

    To understand the precise disease driving mechanisms in acute myeloid leukemia (AML), comparison of patient matched hematopoietic stem cells (HSC) and leukemia stem cells (LSC) is essential. In this analysis, we have examined the value of aldehyde dehydrogenase (ALDH) activity in combination with CD34 expression for the separation of HSC from LSC in 104 patients with de novo AML. The majority of AML patients (80 out of 104) had low percentages of cells with high ALDH activity (ALDH(+) cells; cells (≥1.9%; ALDH-numerous AML). In patients with ALDH-rare AML, normal HSC could be separated by their CD34(+) ALDH(+) phenotype, whereas LSC were exclusively detected among CD34(+) ALDH(-) cells. For patients with ALDH-numerous AML, the CD34(+) ALDH(+) subset consisted mainly of LSC and separation from HSC was not feasible. Functional analyses further showed that ALDH(+) cells from ALDH-numerous AML were quiescent, refractory to ARA-C treatment and capable of leukemic engraftment in a xenogenic mouse transplantation model. Clinically, resistance to chemotherapy and poor long-term outcome were also characteristic for patients with ALDH-numerous AML providing an additional risk-stratification tool. The difference in spectrum and relevance of ALDH activity in the putative LSC populations demonstrates, in addition to phenotypic and genetic, also functional heterogeneity of leukemic cells and suggests divergent roles for ALDH activity in normal HSC versus LSC. By acknowledging these differences our study provides a new and useful tool for prospective identification of AML cases in which separation of HSC from LSC is possible. © 2014 UICC.

  14. Islam, Migration und Integration: Konflikte jugendlicher Migranten mit islamischem Hintergrund

    Directory of Open Access Journals (Sweden)

    Ilhan Kizilhan

    2008-04-01

    Full Text Available Der Islam mit seinen verschiedenen Verhaltensweisen und Verboten spielt direkt oder indirekt immer noch eine wichtige Rolle im alltäglichen Leben vieler Migranten. Religiöse Vorschriften zeichnen sich dadurch aus, dass ihrer Achtung nicht juristisch, sondern durch sozialen Druck Nachdruck verliehen wird (Verwandtschaft, religiöse Lehrer, islamische Gemeinde, religiöse Vereine etc. und dass ihre Missachtung mit Folgen in Form von Ausgrenzung, Missachtung und Diskriminierung einhergeht. Die kulturellen Vorstellungen der ersten Generation unterscheiden sich auf Grund der unterschiedlichen Biografien von denen der zweiten und dritten durch den Grad der Verwurzelung in der kulturellen Identität und der Verbundenheit mit traditionellen Wertvorstellungen. Fehlende Integrationskonzepte, Ausgrenzung im Migrationsland auf der einen und weltweite staatliche und halbstaatliche Konflikte im Namen des Islams bis hin zum Terrorismus auf der anderen Seite haben einen erheblichen Einfluss auf den Integrationsgrad von jugendlichen Migranten im Aufnahmeland.

  15. Professionell entwickeln mit Java EE 7 das umfassende Handbuch

    CERN Document Server

    Salvanos, Alexander

    2014-01-01

    Ein praxisorientiertes Lehrbuch zur JEE 7 und zugleich ein Standardwerk, das Sie auf Ihrem Weg zum Enterprise-Entwickler begleitet. Inklusive Best Practices für leichtgewichtige Enterprise Applications, Standards zu servicebasierten Anwendungen, Persistence API, Dependency Injection, HTML5 und Performance-Tuning. Aus dem Inhalt: Grundlagen und Installation Software-Architektur mit Java EE Webanwendungen mit HTML5 und CSS3 Java Standard Tag Library Asynchrone Servlets und Non-blocking I/O Datenbanken anbinden mit der JDBC API Java Server Faces Datenbank-Organisation Java Persistence API Objektrelationales Mapping Transaktionssicherheit Performance-Tuning Internationalisierung Enterprise Java Beans WebSockets PrimeFaces Deployment Galileo Press heißt von jetzt an Rheinwerk Verlag.

  16. Fallstudie SIG - Supply Chain Prototyp mit Coca Cola Beverages

    OpenAIRE

    Senger, Enrico

    2003-01-01

    SIG, ein führender Lieferant von Verpackungsmaterialien für Getränke, hat mit Coca Cola CPFR, collaborative planning, forecasting and replenishment realisiert. Das Unternehmen kann elektronisch und ohne Zeitverzug (vorher mit bis zu 15 Tagen Verspätung) auf die Lagerbestände und Verkaufsvorhersagen bei Coca Cola zugreifen. Coca Cola erhält die exakten Liefermengen und zeiten. Coca Cola konnte dadurch den Lagerbestand von Verpackungsmaterial um 50% senken. Dies reduziert die Bearbeitungszeit d...

  17. Untersuchungen zur Farbreaktion von Amilorid, Chlorhexidin und Proguanil mit Hypobromit

    OpenAIRE

    Huth, Silke

    2004-01-01

    Bei der Reaktion von Amiloridhydrochlorid (1· HCl) mit Brom in alkalischer Lösung wird ein gelbbraunes Dehydrierungsprodukt erhalten, daß als 3-(3-Amino-1,2,4-oxadiazol-5-yl)-5-chlor-2,6-pyrazindiamin (6) identifiziert werden konnte. Durch Vergleich von Massen- und NMR-Spektren der Verbindung 6 mit Spektren von 1· HCl und Referenzsubstanzen I-III konnte auf die verbindung 6 geschlossen werden. Die Struktur wurde durch eine Röntgenstrukturanalyse abgesichert. Erhitzen von Amiloridhydrochlorid ...

  18. Hinderniserkennung und -verfolgung mit einer PMD-kamera im automobil

    Science.gov (United States)

    Schamm, Thomas; Vacek, Stefan; Natroshvilli, Koba; Marius Zöllner, J.; Dillmann, Rüdiger

    Die Detektion von Hindernissen vor dem Automobil ist eine Hauptanforderung an moderne Fahrerassistenzsysteme (FAS). In dieser Arbeit wird ein System vorgestellt, das mit Hilfe einer PMDKamera (Photomischdetektor) Hindernisse auf der Fahrspur erkennt und deren relevante Parameter bestimmt. Durch die PMD-Kamera werden zunächst 3D-Tiefenbilder der Fahrzeugumwelt generiert. Nach einem initialen Filterprozess werden im Tiefenbild mit Hilfe eines Bereichswachstumsverfahrens Hindernisse gesucht. Zur Stabilisierung des Verfahrens und zur Parameterberechnung wird ein Kaiman Filter eingesetzt. Das Ergebnis ist eine Liste aller Hindernisse im Fahrbereich des Automobils.

  19. Granulocytic Sarcoma by AML M4eo (inv16 after Allogeneic Stem Cell Transplantation without Bone Marrow Involvement

    Directory of Open Access Journals (Sweden)

    Stephan Zaenker

    2011-01-01

    Full Text Available Granulocytic sarcoma (GS represents a rare type of extramedullar manifestation from the acute myeloid leukaemia (AML. We report the case of a patient with recurrences of AML M4eo leukaemia in the uterus and the small intestine at 3 and 5 years, respectively, after matched related peripheral blood stem cell transplantation (PBSCT. The patient underwent the withdrawal of immunosuppression, hysterectomy, and local irradiation at first relapse, as well as systemic chemotherapy and donor lymphocyte infusions at second recurrence, inducing a second and third complete remission, respectively. At year six after transplantation, the patient experienced disease progression by meningeosis leukaemia to which she succumbed despite intrathecal chemotherapy. Following allogeneic stem cell transplantation, awareness for atypical manifestations of granulocytic sarcoma appears prudent, the cellular immunotherapy should aim at immunological disease control.

  20. Incidence of extramedullary relapse after haploidentical SCT for advanced AML/myelodysplastic syndrome.

    Science.gov (United States)

    Yoshihara, S; Ikegame, K; Kaida, K; Taniguchi, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Okada, M; Soma, T; Ogawa, H

    2012-05-01

    Extramedullary (EM) relapse of leukemia after allo-SCT in patients with AML/myelodysplastic syndrome has been increasingly reported. The reduced effectiveness of the GVL effect in EM sites, as compared with BM, has been suggested to underlie this problem. We retrospectively analyzed the pattern of relapse after haploidentical SCT (haplo-SCT), performed as the first or second SCT. Among 38 patients who received haplo-SCT as their first SCT, the cumulative incidences of BM and EM relapse at 3 years were 40.5 and 10.9%, respectively. Among 19 patients who received haplo-SCT as their second SCT, the cumulative incidences of BM and EM relapse were 30.9 and 31.9%, respectively. Moreover, most of the patients who underwent repeat haplo-SCT for the treatment of EM relapse had further EM relapse at other sites. Post-relapse survival did not differ significantly with different patterns of relapse. The frequent occurrence of EM relapse after haplo-SCT, particularly when performed as a second SCT, suggests that the potent GVL effect elicited by an HLA disparity also occurs preferentially in BM. Our findings emphasize the need for a treatment strategy for EM relapse that recognizes the reduced susceptibility of EM relapse to the GVL effect.

  1. Chemical Space of FLT3 Inhibitors as Potential Anti-AML Drugs.

    Science.gov (United States)

    Lan, Qing-Yuan; Zhi, Yan-Le; Heng, Hao; Tian, Jie-Yi; Guo, Xiao-Xing; Liu, Hai-Chun; Chen, Ya-Dong; Lu, Tao; Lu, Shuai

    2017-11-20

    FLT3 is a member of receptor tyrosine kinase III family, mainly expressed in hematopoietic cells. The aberrant expression and function of FLT3 are strongly related to leukemia, especially acute myeloid leukemia. Its varieties of amino-acid residues mutations, such as FLT3-ITDs and -TKDs, can induce constant proliferation of hematological tumor cells with poor prognosis. Hence FLT3 serves as a promising target in AML chemotherapy. This review focused on the progress of FLT3 inhibitors study including those that have entered clinical trials or were reported in numerous patents all over the world. Thus, we provided a useful reference for the development of new anti-leukemia drugs. Through a comprehensive retrospective study, FLT3 inhibitors in several patent applications were identified and classified into five categories, including quinolone-related, indole-related, ureas, pyrimidines and other compounds. For each category of compounds, the structural feature, SAR, biological activity and current research status were thoroughly reviewed and analyzed. Although some of those compounds expressed potent bioactivities and have reached the advanced clinical trials for the treatment of leukemia, there are still several problems need to be faced before they enter the market eventually, especially the drug resistance issue. The improvement of therapeutic potency for FLT3 inhibitors might depend on the useful combination therapy and further refinement of the intrinsic properties of FLT3 inhibitors. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Benefit of high-dose daunorubicin in AML induction extends across cytogenetic and molecular groups.

    Science.gov (United States)

    Luskin, Marlise R; Lee, Ju-Whei; Fernandez, Hugo F; Abdel-Wahab, Omar; Bennett, John M; Ketterling, Rhett P; Lazarus, Hillard M; Levine, Ross L; Litzow, Mark R; Paietta, Elisabeth M; Patel, Jay P; Racevskis, Janis; Rowe, Jacob M; Tallman, Martin S; Sun, Zhuoxin; Luger, Selina M

    2016-03-24

    The initial report of the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Cancer Research Group trial E1900 (#NCT00049517) showed that induction therapy with high-dose (HD) daunorubicin (90 mg/m(2)) improved overall survival in adults cytogenetics or aFLT3-ITD mutation. Here, we update the results of E1900 after longer follow-up (median, 80.1 months among survivors), focusing on the benefit of HD daunorubicin on common genetic subgroups. Compared with standard-dose daunorubicin (45 mg/m(2)), HD daunorubicin is associated with a hazard ratio (HR) for death of 0.74 (P= .001). Younger patients (cytogenetics (HR, 0.51;P= .03 and HR, 0.68;P= .01, respectively). Patients with unfavorable cytogenetics were shown to benefit from HD daunorubicin on multivariable analysis (adjusted HR, 0.66;P= .04). Patients with FLT3-ITD (24%),DNMT3A(24%), and NPM1(26%) mutant AML all benefited from HD daunorubicin (HR, 0.61,P= .009; HR, 0.62,P= .02; and HR, 0.50,P= .002; respectively). HD benefit was seen in the subgroup of older patients (50-60 years) with the FLT3-ITD or NPM1 mutation. Additionally, the presence of an NPM1 mutation confers a favorable prognosis only for patients receiving anthracycline dose intensification during induction. © 2016 by The American Society of Hematology.

  3. Compliance with the AM+L4776L/CFT International Standard; Lessons from a Cross-Country Analysis

    OpenAIRE

    Concha Verdugo Yepes

    2011-01-01

    This paper assesses countries' compliance with the Anti-Money Laundering and Combating the Financing of Terrorism (AML/CFT) international standard during the period 2004 to 2011. We find that overall compliance is low; there is an adverse impact on financial transparency created by the cumulative effects of poor implementation of standards on customer identification; and the current measurements of compliance do not take into account an analysis of ML/FT risk, thereby undermining their credib...

  4. Comparing cancer vs normal gene expression profiles identifies new disease entities and common transcriptional programs in AML patients

    DEFF Research Database (Denmark)

    Rapin, Nicolas; Bagger, Frederik Otzen; Jendholm, Johan

    2014-01-01

    Gene expression profiling has been used extensively to characterize cancer, identify novel subtypes, and improve patient stratification. However, it has largely failed to identify transcriptional programs that differ between cancer and corresponding normal cells and has not been efficient in iden......-karyotype AML, which allowed for the generation of a highly prognostic survival signature. Collectively, our CvN method holds great potential as a tool for the analysis of gene expression profiles of cancer patients....

  5. Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML).

    Science.gov (United States)

    Ghodraty-Jabloo, Vida; Alibhai, Shabbir M H; Breunis, Henriette; Puts, Martine T E

    2016-05-01

    Acute myeloid leukemia (AML) is characterized by sudden onset, intensive treatment, a poor prognosis, and significant relapse risk. Quality of life (QOL) and well-being among AML survivors have been extensively studied during the 6 months of active treatment. However, it is not clear what survivors experience after active treatment. The purpose of our study was to explore how AML survivors describe their longer-term physical and psychosocial well-being and how they cope with these challenges. We conducted a prospective qualitative study and interviewed 19 adult participants (11 had completed treatment, 8 were receiving maintenance chemotherapy). Data were collected using semi-structured interviews that were audio-recorded and transcribed verbatim. The grounded theory approach was used for data analysis. A marked improvement in physical health was reported; however, psychosocial well-being was compromised by enduring emotional distress. A range of emotion- and problem-focused coping strategies were reported. Keeping one's mind off negative things through engaging in formal work or informal activities and seeking control were the two most commonly used coping strategies. Seeking social support for reassurance was also common. Problem-focused strategies were frequently described by the ongoing treatment group to manage treatment side effects. Although physical symptoms improved after completion of treatment, psychosocial distress persisted over longer period of time. In addition, essential needs of AML survivors shifted across survivorship as psychological burden gradually displaced physical concerns. The integral role of coping mechanisms in the adaptation process suggests a need for effective and ongoing psychological interventions.

  6. Nuclear accumulation of SHIP1 mutants derived from AML patients leads to increased proliferation of leukemic cells.

    Science.gov (United States)

    Nalaskowski, Marcus M; Ehm, Patrick; Rehbach, Christoph; Nelson, Nina; Täger, Maike; Modest, Kathrin; Jücker, Manfred

    2018-05-28

    The inositol 5-phosphatase SHIP1 acts as negative regulator of intracellular signaling in myeloid cells and is a tumor suppressor in myeloid leukemogenesis. After relocalization from the cytoplasm to the plasma membrane SHIP1 terminates PI3-kinase mediated signaling processes. Furthermore, SHIP1 is also found in distinct puncta in the cell nucleus and nuclear SHIP1 has a pro-proliferative function. Here we report the identification of five nuclear export signals (NESs) which regulate together with the two known nuclear localization signals (NLSs) the nucleocytoplasmic shuttling of SHIP1. Mutation of NLSs reduced the nuclear import and mutation of NESs decreased the nuclear export of SHIP1 in the acute myeloid leukemia (AML) cell line UKE-1. Interestingly, four SHIP1 mutants (K210R, N508D, V684E, Q1153L) derived from AML patients showed a nuclear accumulation after expression in UKE-1 cells. In addition, overexpression of the AML patient-derived mutation N508D caused an increased proliferation rate of UKE-1 cells in comparison to wild type SHIP1. Furthermore, we identified serine and tyrosine phosphorylation as a molecular mechanism for the regulation of nucleocytoplasmic shuttling of SHIP1 where tyrosine phosphorylation of distinct residues i.e. Y864, Y914, Y1021 reduces nuclear localization, whereas serine phosphorylation at S933 enhances nuclear localization of SHIP1. In summary, our data further implicate nuclear SHIP1 in cellular signaling and suggest that enhanced accumulation of SHIP1 mutants in the nucleus may be a contributory factor of abnormally high proliferation of AML cells. Copyright © 2017. Published by Elsevier Inc.

  7. Parallelization experience with four canonical econometric models using ParMitISEM

    NARCIS (Netherlands)

    Baştürk, N.; Grassi, S.; Hoogerheide, L.; van Dijk, H.K.

    2016-01-01

    This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm, introduced by Hoogerheide et al. (2012), provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of

  8. Parallelization Experience with Four Canonical Econometric Models Using ParMitISEM

    NARCIS (Netherlands)

    N. Basturk (Nalan); S. Grassi (Stefano); L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)

    2016-01-01

    textabstractThis paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm, introduced by Hoogerheide, Opschoor and Van Dijk (2012), provides an automatic and flexible method to approximate a non-elliptical target density

  9. Parallelization experience with four canonical econometric models using ParMitISEM

    NARCIS (Netherlands)

    Bastürk, Nalan; Grassi, S.; Hoogerheide, L.; van Dijk, Herman K.

    2016-01-01

    This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of Student-t densities, where only a kernel of

  10. Regulation of Trib2 by an E2F1-C/EBPα feedback loop in AML cell proliferation

    DEFF Research Database (Denmark)

    Rishi, Loveena; Hannon, Maura; Salomè, Mara

    2014-01-01

    α (C/EBPα)-p42, occurs in acute myeloid leukemia (AML), resulting in the perturbation of cell cycle and apoptosis, emphasizing its importance in the molecular pathogenesis of AML. Here we show that E2F family members directly regulate Trib2 in leukemic cells and identify a feedback regulatory loop......The loss of regulation of cell proliferation is a key event in leukemic transformation, and the oncogene tribbles (Trib)2 is emerging as a pivotal target of transcription factors in acute leukemias. Deregulation of the transcription factor E2F1, normally repressed by CCAAT enhancer-binding protein...... for E2F1, C/EBPα, and Trib2 in AML cell proliferation and survival. Further analyses revealed that E2F1-mediated Trib2 expression was repressed by C/EBPα-p42, and in normal granulocyte/macrophage progenitor cells, we detect C/EBPα bound to the Trib2 promoter. Pharmacological inhibition of the cell cycle...

  11. Functional analysis of P-glycoprotein and multidrug resistance associated protein related multidrug resistance in AML-blasts.

    Science.gov (United States)

    Brügger, D; Herbart, H; Gekeler, V; Seitz, G; Liu, C; Klingebiel, T; Orlikowsky, T; Einsele, H; Denzlinger, C; Bader, P; Niethammer, D; Beck, J F

    1999-05-01

    Despite the high effectiveness of various P-glycoprotein (P-gp) modulating substances in vitro their clinical value e.g. for combination treatment of acute myelogenous leukemias (AML) remains still unclear. This might be explainable by recent findings that other factors than P-gp (e.g. the multidrug resistance associated protein (MRP)) may also be involved in clinical occurring drug resistance. To study P-gp and MRP mediated MDR in AML blasts from patients with relapses at the functional level we measured rhodamine 123 (RHO) efflux in combination with a P-gp specific (SDZ PSC 833) or a MRP specific (MK571) modulator, respectively. Furthermore, direct antineoplastic drug action was monitored by determination of damaged cell fraction of a blast population using flow cytometry. We generally found strongly modulated RHO efflux by SDZ PSC 833 but slight RHO-efflux modulation by MK571 in blasts from relapsed states of AML expressing MDR1 or MRP mRNA at various levels. We could not demonstrate, though, significant PSC 833 or MK571 mediated modulation of the cytotoxic effects of etoposide. The results point to the possibility that combination of etoposide and a modulator might not improve responses to chemotherapy by targeting P-gp or MRP exclusively.

  12. Induced Mitogenic Activity in AML-12 Mouse Hepatocytes Exposed to Low-dose Ultra-Wideband Electromagnetic Radiation

    Directory of Open Access Journals (Sweden)

    P. B. Tchounwou

    2005-04-01

    Full Text Available Ultra–wideband (UWB technology has increased with the use of various civilian and military applications. In the present study, we hypothesized that low-dose UWB electromagnetic radiation (UWBR could elicit a mitogenic effect in AML-12 mouse hepatocytes, in vitro. To test this hypothesis, we exposed AML-12 mouse hepatocytes, to UWBR in a specially constructed gigahertz transverse electromagnetic mode (GTEM cell. Cells were exposed to UWBR for 2 h at a temperature of 23°C, a pulse width of 10 ns, a repetition rate of 1 kHz, and field strength of 5-20 kV/m. UWB pulses were triggered by an external pulse generator for UWBR exposure but were not triggered for the sham exposure. We performed an MTT Assay to assess cell viability for UWBR-treated and sham-exposed hepatocytes. Data from viability studies indicated a time-related increase in hepatocytes at time intervals from 8-24 h post exposure. UWBR exerted a statistically significant (p < 0.05 dose-dependent response in cell viability in both serum-treated and serum free medium (SFM -treated hepatocytes. Western blot analysis of hepatocyte lysates demonstrated that cyclin A protein was induced in hepatocytes, suggesting that increased MTT activity after UWBR exposure was due to cell proliferation. This study indicates that UWBR has a mitogenic effect on AML-12 mouse hepatocytes and implicates a possible role for UWBR in hepatocarcinoma.

  13. Solution structure of a DNA mimicking motif of an RNA aptamer against transcription factor AML1 Runt domain.

    Science.gov (United States)

    Nomura, Yusuke; Tanaka, Yoichiro; Fukunaga, Jun-ichi; Fujiwara, Kazuya; Chiba, Manabu; Iibuchi, Hiroaki; Tanaka, Taku; Nakamura, Yoshikazu; Kawai, Gota; Kozu, Tomoko; Sakamoto, Taiichi

    2013-12-01

    AML1/RUNX1 is an essential transcription factor involved in the differentiation of hematopoietic cells. AML1 binds to the Runt-binding double-stranded DNA element (RDE) of target genes through its N-terminal Runt domain. In a previous study, we obtained RNA aptamers against the AML1 Runt domain by systematic evolution of ligands by exponential enrichment and revealed that RNA aptamers exhibit higher affinity for the Runt domain than that for RDE and possess the 5'-GCGMGNN-3' and 5'-N'N'CCAC-3' conserved motif (M: A or C; N and N' form Watson-Crick base pairs) that is important for Runt domain binding. In this study, to understand the structural basis of recognition of the Runt domain by the aptamer motif, the solution structure of a 22-mer RNA was determined using nuclear magnetic resonance. The motif contains the AH(+)-C mismatch and base triple and adopts an unusual backbone structure. Structural analysis of the aptamer motif indicated that the aptamer binds to the Runt domain by mimicking the RDE sequence and structure. Our data should enhance the understanding of the structural basis of DNA mimicry by RNA molecules.

  14. Exchange Transfusion and Leukapheresis in Pediatric Patients with AML With High Risk of Early Death by Bleeding and Leukostasis.

    Science.gov (United States)

    Creutzig, Ursula; Rössig, Claudia; Dworzak, Michael; Stary, Jan; von Stackelberg, Arend; Wössmann, Wilhelm; Zimmermann, Martin; Reinhardt, Dirk

    2016-04-01

    The risk of early death (ED) by bleeding/leukostasis is high in patients with AML with hyperleukocytosis (>100,000/μl). Within the pediatric AML-BFM (Berlin-Frankfurt-Münster) 98/04 studies, emergency strategies for these children included exchange transfusion (ET) or leukapheresis (LPh). Risk factors for ED and interventions performed were analyzed. Two hundred thirty-eight of 1,251 (19%) patients with AML presented with hyperleukocytosis; 23 of 1,251 (1.8%) patients died of bleeding/leukostasis. ED due to bleeding/leukostasis was highest at white blood cell (WBC) count >200,000/μl (14.3%). ED rates were even higher (20%) in patients with FAB (French-American-British) M4/M5 and hyperleukocytosis >200,000/μl. Patients with WBC >200,000/μl did slightly better with ET/LPh compared to those without ET/LPh (ED rate 7.5% vs. 21.2%, P = 0.055). Multivariate WBC >200,000/μl was of strongest prognostic significance for ED (P(χ(2) ) rate due to bleeding/leukostasis and is recommended at WBC >200,000/μl, and in FAB M4/M5 even at lower WBC. © 2015 Wiley Periodicals, Inc.

  15. MIT wavelength tables. Volume 2. Wavelengths by element

    International Nuclear Information System (INIS)

    Phelps, F.M. III.

    1982-01-01

    This volume is the first stage of a project to expand and update the MIT wavelength tables first compiled in the 1930's. For 109,325 atomic emission lines, arranged by element, it presents wavelength in air, wavelength in vacuum, wave number and intensity. All data are stored on computer-readable magnetic tape

  16. MIT Orients Course Materials Online to K-12

    Science.gov (United States)

    Cavanagh, Sean

    2008-01-01

    Many science and mathematics educators across the country are taking advantage of a Web site created by the Massachusetts Institute of Technology (MIT), the famed research university located in Cambridge, Massachusetts, which offers free video, audio, and print lectures and course material taken straight from the school's classes. Those resources…

  17. MIT Mints a Valuable New Form of Academic Currency

    Science.gov (United States)

    Carey, Kevin

    2012-01-01

    The Massachusetts Institute of Technology (MIT) has invented or improved many world-changing things--radar, information theory, and synthetic self-replicating molecules, to name a few. Last month the university announced, to mild fanfare, an invention that could be similarly transformative, this time for higher education itself. It is called MITx.…

  18. Possibilities of transport with monorails; Moeglichkeiten des Transports mit Einschienenhaengebahnen

    Energy Technology Data Exchange (ETDEWEB)

    Bolz, P. [Deutsche Montan Technologie GmbH, Bochum (Germany)

    2001-08-02

    The safety limits of transport by monorails were determined within the framework of a test project. The safety-related components of the system, in particular the rail system with its suspensions and the drive and braking system, were investigated for normal and heavy load transport. In addition to operational measurements for actual stressing of the components tests were conducted on test benches to determine the dynamic strength. The concept of a new forward-looking monorail system with greater safety was subsequently developed with the aid of the results obtained. The compatibility with the previous components was ensured. Compared to the determined load capacity limits a development requirement for monorail suspension anchor bolts, diesel- and battery-operated trolleys as well as braking trolleys for ropeways were derived. The other components are already adequately dimensioned. (orig.) [German] Im Rahmen eines Untersuchungsvorhabens wurden die sicherheitlichen Grenzen des Transports mit EHB ermittelt. Die sicherheitsrelevanten Bauteile des Systems, insbesondere das Schienensystem mit seinen Aufhaengungen sowie das Antriebs- und Bremssystem, wurden fuer den Normal- und den Schwerlasttransport untersucht. Neben Betriebsmessungen zur tatsaechlichen Beanspruchung der Bauteile erfolgten Pruefstandsuntersuchungen zur dynamischen Festigkeit. Mit Hilfe der gewonnenen Ergebnisse wurde anschliessend das Konzept fuer ein neues, zukunftsorientiertes EHB-System mit erhoehter Sicherheit erarbeitet. Die Kompatibilitaet zu den bisherigen Bauteilen wurde dabei gewaehrleistet. Im Vergleich zu den ermittelten Belastbarkeitsgrenzen wurde daraus ein Entwicklungsbedarf bei EHB-Aufhaengeankern, Diesel- und Batteriekatzen sowie Bremskatzen fuer Seilbahnen abgeleitet. Die uebrigen Bauteile sind bereits jetzt ausreichend bemessen. (orig.)

  19. Interaktion mit virtuellen Agenten? Zur Aneignung eines ungewohnten Artefakts

    DEFF Research Database (Denmark)

    Krummheuer, Antonia Lina

    sprechen, schließt der soziologische Interaktionsbegriff nichtmenschliche Gesprächspartner aus. Es stellt sich daher die Frage, mit welchen Konzepten die Soziologie dieses neue Phänomen fassen kann. Vor dem Hintergrund der techniksoziologischen Debatte um die Handlungsträgerschaft von Artefakten werden die...

  20. Collimator optimization studies for the new MIT epithermal neutron beam

    International Nuclear Information System (INIS)

    Riley, K.J.; Ali, S.J.; Harling, O.K.

    2000-01-01

    A patient collimator has been designed for the epithermal neutron facility now being commissioned at MIT. Collimator performance both in and out of field was evaluated using the Monte Carlo code MCNP. A two piece design that can accommodate different circular field sizes will be manufactured using a composite lead, epoxy, boron and lithium mixture. (author)

  1. Interaktion mit RFID Ausleih- und Rückgabeautomaten

    DEFF Research Database (Denmark)

    Greifeneder, Elke; Heyroth, Melanie; Klingbeil, Karin

    2011-01-01

    Der Artikel untersucht mittels Beobachtung die Interaktion zwischen RFID-Ausleih- und Rückgabeautomaten sowie Bibliotheksbenutzern in vier deutschen Bibliotheken. Die Ergebnisse belegen, dass die Interaktion grundsätzlich funktioniert. Die Benutzer zeigten Gelassenheit und Routine im Umgang mit den...

  2. The TEL-AML1 fusion protein of acute lymphoblastic leukemia modulates IRF3 activity during early B-cell differentiation.

    Science.gov (United States)

    de Laurentiis, A; Hiscott, J; Alcalay, M

    2015-12-03

    The t(12;21) translocation is the most common genetic rearrangement in childhood acute lymphoblastic leukemia (ALL) and gives rise to the TEL-AML1 fusion gene. Many studies on TEL-AML1 describe specific properties of the fusion protein, but a thorough understanding of its function is lacking. We exploited a pluripotent hematopoietic stem/progenitor cell line, EML1, and generated a cell line (EML-TA) stably expressing the TEL-AML1 fusion protein. EML1 cells differentiate to mature B-cells following treatment with IL7; whereas EML-TA display an impaired differentiation capacity and remain blocked at an early stage of maturation. Global gene expression profiling of EML1 cells at different stages of B-lymphoid differentiation, compared with EML-TA, identified the interferon (IFN)α/β pathway as a primary target of repression by TEL-AML1. In particular, expression and phosphorylation of interferon-regulatory factor 3 (IRF3) was decreased in EML-TA cells; strikingly, stable expression of IRF3 restored the capacity of EML-TA cells to differentiate into mature B-cells. Similarly, IRF3 silencing in EML1 cells by siRNA was sufficient to block B-lymphoid differentiation. The ability of TEL-AML1 to block B-cell differentiation and downregulate the IRF3-IFNα/β pathway was confirmed in mouse and human primary hematopoietic precursor cells (Lin- and CD34+ cells, respectively), and in a patient-derived cell line expressing TEL-AML1 (REH). Furthermore, treatment of TEL-AML1 expressing cells with IFNα/β was sufficient to overcome the maturation block. Our data provide new insight on TEL-AML1 function and may offer a new therapeutic opportunity for B-ALL.

  3. SGN-CD33A: a novel CD33-targeting antibody-drug conjugate using a pyrrolobenzodiazepine dimer is active in models of drug-resistant AML.

    Science.gov (United States)

    Kung Sutherland, May S; Walter, Roland B; Jeffrey, Scott C; Burke, Patrick J; Yu, Changpu; Kostner, Heather; Stone, Ivan; Ryan, Maureen C; Sussman, Django; Lyon, Robert P; Zeng, Weiping; Harrington, Kimberly H; Klussman, Kerry; Westendorf, Lori; Meyer, David; Bernstein, Irwin D; Senter, Peter D; Benjamin, Dennis R; Drachman, Jonathan G; McEarchern, Julie A

    2013-08-22

    Outcomes in acute myeloid leukemia (AML) remain unsatisfactory, and novel treatments are urgently needed. One strategy explores antibodies and their drug conjugates, particularly those targeting CD33. Emerging data with gemtuzumab ozogamicin (GO) demonstrate target validity and activity in some patients with AML, but efficacy is limited by heterogeneous drug conjugation, linker instability, and a high incidence of multidrug resistance. We describe here the development of SGN-CD33A, a humanized anti-CD33 antibody with engineered cysteines conjugated to a highly potent, synthetic DNA cross-linking pyrrolobenzodiazepine dimer via a protease-cleavable linker. The use of engineered cysteine residues at the sites of drug linker attachment results in a drug loading of approximately 2 pyrrolobenzodiazepine dimers per antibody. In preclinical testing, SGN-CD33A is more potent than GO against a panel of AML cell lines and primary AML cells in vitro and in xenotransplantation studies in mice. Unlike GO, antileukemic activity is observed with SGN-CD33A in AML models with the multidrug-resistant phenotype. Mechanistic studies indicate that the cytotoxic effects of SGN-CD33A involve DNA damage with ensuing cell cycle arrest and apoptotic cell death. Together, these data suggest that SGN-CD33A has CD33-directed antitumor activity and support clinical testing of this novel therapeutic in patients with AML.

  4. A review of therapy-related myelodysplastic syndromes and acute myeloid leukaemia (t-MDS/AML) in Irish patients: a single centre experience.

    Science.gov (United States)

    Maung, Su W; Burke, Cathie; Hayde, Jennifer; Walshe, Janice; McDermott, Ray; Desmond, Ronan; McHugh, Johnny; Enright, Helen

    2017-07-01

    To demonstrate the incidence, characteristics, treatment and outcomes of patients with therapy-related myelodysplastic syndromes and therapy-related acute myeloid leukaemia (t-MDS/AML) in a tertiary referral centre. Patients meeting the diagnostic criteria for t-MDS/AML from 2003 to 2014 were reviewed to analyse their diagnostic features, details of antecedent disorder and treatment, approach to management and survival. 39 patients who developed t-MDS/AML were identified with incidence of 8.7%. Median age and gender distribution were similar to de novo MDS but t-MDS/AML patients had greater degree of cytopenia and adverse karyotypes. Time to development of t-MDS/AML was shortest for patients with antecedent haematological malignancy compared to solid tumours and autoimmune disorders (46, 85 and 109 months). Patients with prior acute leukaemia had the shortest latency and poor overall survival. Treatment options included best supportive care (56%), Azacitidine (31%) or intensive chemotherapy/allogeneic transplant (13%). Median OS of all patients was 14 months. Survival declined markedly after two years and 5-year OS was 13.8%. Longer survival was associated with blast count MDS/AML patients showed unique characteristics which influenced their treatment and outcomes. IPSS-R may be useful in risk-adapted treatment approaches and can predict outcomes. Survival remains poor but improved outcomes were seen with allogeneic transplantation. Azacitidine may be effective in patients unfit for intensive therapies.

  5. Expression and prognostic value of hemopoietic cytokine receptors in acute myeloid leukemia (AML): implications for future therapeutical strategies.

    Science.gov (United States)

    Graf, Michaela; Hecht, Karin; Reif, Susanne; Pelka-Fleischer, Renate; Pfister, Karin; Schmetzer, Helga

    2004-02-01

    Hemopoietic cytokines regulate hemopoietic cell functions via specific cell surface receptors. There is evidence to suggest, that those receptors (R) could play a role in leukemia with respect to cell differentiations and its regulation, prognosis, and pathobiology. Knowledge of individual cytokine receptor (CKR) profiles could provide new discoveries about CKR-supported therapeutic considerations. We have studied the expression of CKR on mononuclear bone marrow (BM) cells of 89 patients with acute myeloid leukemia (AML) at first diagnosis, three patients at relapse or with persisting AML and eight healthy probands by fluorescence-activated cell sorting (FACS) analysis using directly fluorescein-conjugated antibodies: CD114 (hG-CSF-R), CD116 (hGM-CSF-R), CD117 (hSCF-R), CD123 (hIL-3-R), CD130 (gp130subunit), CD135 (hFL-R). A case was defined as positive, if more than 20% of the cells expressed the regarding CKR. All investigated CKR were more frequently expressed in AML-samples than in healthy BM-samples, except CD130, which was only expressed on 5-6% of AML-blasts in all and with only one healthy BM-sample being CD130(+). Within the French-American-British (FAB) types we observed a maturation- and lineage (granulocytic/monocytic)-committed expression profile. Monocytic subtypes (FAB-type M4/M5) showed significantly more GM-CSF-R(+) (P = 0.001) and FL-R(+) (P = 0.001) and significantly less stem cell factor-R (SCF-R(+)) (P = 0.02) cases. Highest proportions of G-CSF-R(+) blasts were observed in FAB-type M3. In undifferentiated leukemias (FAB-type M1, M2) high amounts of SCF-R(+), IL-3-R(+), and FL-R(+) blasts could be detected. FL-R was the only CKR, which was positive in FAB-type M0 (n = 2). No differences in CKR-expression were detected between primary (p) and secondary (s). Separating our patient cohorts in cytogenetic risk groups we could detect a significant higher proportion of G-CSF-R(+) blasts in the cytogenetic good risk group than in the bad risk group (P

  6. Azelainsäure 20 % Creme: Auswirkung auf Lebensqualität und Krankheitsaktivität bei erwachsenen Patientinnen mit Acne vulgaris.

    Science.gov (United States)

    Kainz, Julius Thomas; Berghammer, Gabriele; Auer-Grumbach, Piet; Lackner, Verena; Perl-Convalexius, Sylvia; Popa, Rodica; Wolfesberger, Barbara

    2016-12-01

    Zur Wirksamkeit von Aknetherapien und deren Auswirkungen auf die Lebensqualität erwachsener Patienten liegen kaum Daten vor. ZIEL: Erhebung der Wirkung von Azelainsäure 20 % Creme (Skinoren ® ) auf Akne-Schweregrad und krankheitsbedingte Lebensqualität. Nichtinterventionelle Studie bei erwachsenen Patientinnen mit leichter bis mittelschwerer Akne. Wirksamkeitsparameter waren DLQI sowie Akne-Schweregrad im Gesicht, am Dekolleté sowie am Rücken im Gesamturteil des Prüfarztes (IGA-Skala: Grad 1 = annähernd reine Haut; 2 = leichte Akne; 3 = mittelschwere Akne). Visiten waren zu Studienbeginn sowie nach 4-8 und zwölf Wochen geplant. Von den 251 eingeschlossenen Patientinnen lag zu Studienbeginn bei 59 %, 31 % bzw. 10 % ein IGA-Grad von 1, 2 bzw. 3 vor; die am häufigsten betroffene Hautpartie war das Gesicht (IGA-Grad 2 oder 3: 79 %). Nach zwölf Behandlungswochen war eine signifikante Besserung der Acne vulgaris im Gesicht (IGA-Grad 0 oder 1: 82 %) sowie auf Dekolleté und Rücken feststellbar. Der mediane DLQI-Wert sank von neun zu Studienbeginn auf fünf nach zwölf Behandlungswochen. Neunzig Prozent der behandelnden Ärzte und Patientinnen beurteilten die Verträglichkeit der Behandlung als sehr gut oder gut. Die Anwendung von 20%iger Azelainsäure-Creme führt bei erwachsenen Frauen zu einer signifikanten Besserung der Acne vulgaris und der krankheitsbedingten Lebensqualität. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  7. Eine Extraktkombination aus Cranberry, Brunnenkresse und Meerrettich in der Anwendung bei Frauen mit unkompliziertem Harnwegsinfekt // A Complex Preparation of Cranberry, Horseradish and Watercress in the Treatment of Non-Severe Lower Urinary Tract Infect

    Directory of Open Access Journals (Sweden)

    Thiel I

    2016-01-01

    -Resistenzen besteht für die Behandlung von unkomplizierten unteren Harnwegsinfektionen (Urethritis, Zystitis, Urethrozystitis ein dringender Bedarf an alternativen pflanzlichen Arzneimitteln. Vaccinium macrocarpon, die amerikanische Cranberry, wirkt durch verschiedene Mechanismen, ohne Resistenzen auszulösen. Aus diesem Grund wurde eine Anwendungsbeobachtung (n = 48 mit einer Zubereitung eines standardisierten Cranberry-Extraktes (67 mg Proanthocyanidine, kombiniert mit senfölglykosidischen Extrakten aus Brunnenkresse (Nasturtium officinale und Meerrettich (Armoracia rusticana, durchgeführt.br iPatienten:/i Frauen (≥ 18 Jahre mit einem Leukozytenanstieg im Harn und klinischen Symptomen typisch für Harnwegsinfektionen wie Dysurie, Harndrang, neu auftretende Inkontinenz und Schmerzen über dem Schambein erhielten in der ersten Woche eine Tablette mit der Extraktkombination zweimal täglich und eine Tablette pro Tag für die folgenden 4 Wochen. Nach 14 Tagen (t1 und nach 35 Tagen (t2 wurde eine weitere Erhebung und Kontrolluntersuchung mit einem Urin-Test durchgeführt. Patientinnen mit anhaltenden klinischen Symptomen bekamen ein Antibiotikum verschrieben, bei den anderen wurde die Einnahme der Extrakte aus Cranberry, Brunnenkresse und Meerrettich fortgesetzt.briErgebnisse:/i 34 Patientinnen (70,8 % konnten innerhalb der ersten 14 Tage (t1 auf die Einnahme eines Antibiotikums verzichten und 32 Patientinnen (66,7 % benötigten auch nach 35 Tagen (t2 kein Antibiotikum. 28 Patientinnen (87,5 % waren zum Zeitpunkt (t2 ohne Symptome. Es wurden keine Nebenwirkungen beobachtet.briSchlussfolgerung:/i Diese Anwendungsbeobachtung ist die erste Studie mit einem entsprechenden Kombinationsextrakt (Cranberry, Brunnenkresse, Meerrettich, die darüber hinaus das Konzept des Einsatzes alternativer Therapeutika zur Behandlung von unkomplizierten unteren HWIs unterstützt.

  8. VIBE with parallel acquisition technique - a novel approach to dynamic contrast-enhanced MR imaging of the liver; VIBE mit paralleler Akquisitionstechnik - eine neue Moeglichkeit der dynamischen kontrastverstaerkten MRT der Leber

    Energy Technology Data Exchange (ETDEWEB)

    Dobritz, M.; Radkow, T.; Bautz, W.; Fellner, F.A. [Inst. fuer Diagnostische Radiologie, Friedrich-Alexander-Univ. Erlangen-Nuernberg (Germany); Nittka, M. [Siemens Medical Solutions, Erlangen (Germany)

    2002-06-01

    Leberlaesionen zu sammeln. Material und Methoden: 10 konsekutive Patienten mit verschiedenen pathologischen Befunden (HCC, Haemangiome, Metastasen, Zysten, Adenome) wurden an einem 1.5 T MRT-System untersucht. Zur Anwendung kamen folgende Sequenzen: T{sub 2} TSE und T{sub 1} FLASH nativ, nach Gadolinium-Gabe 6 VIBE-Sequenzen mit iPAT (TR/TE/Matrix/Partitionsdicke/Akquisitionszeit: 6.2 ms/3.2 ms/256 x 192/4 mm/13 s) sowie T{sub 1} FLASH mit Fettsaettigung. Zwei Untersucher beurteilten im Konsensus die einzelnen Sequenzen hinsichtlich Anzahl und Dignitiaet der Laesionen. Ergebnisse: Die VIBE-Sequenz zeigte sich ueberlegen in der Detektion arteriell hyperperfundierter Laesionen mit insgesamt 33 erkannten Herden. In der T{sub 2}-gewichteten TSE-Sequenz wurden 21 und in der nativen T{sub 1}-gewichteten GRE-Sequenz 20 Herde gefunden. Die diagnostische Sicherheit stieg in der VIBE-Sequenz gegenueber den anderen Sequenzen deutlich an. Zusammenfassung: Die VIBE-Sequenz mit iPAT ermoeglicht eine MRT der Leber in hoher oertlicher und zeitlicher Aufloesung, wodurch dynamische Kontrastinformationen ueber das gesamte Organ ermoeglicht werden. Dadurch koennte eine Verbesserung der Detektion fokaler Laesionen erreicht werden. (orig.)

  9. Indirect MR venography: contrast medium protocols, postprocessing and combination in diagnosing pulmonary emboli with MRI; Indirekte MR-Phlebografie: Kontrastmittelprotokolle, Nachverarbeitung und Kombination mit Lungenemboliediagnostik in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Kluge, A.; Bachmann, G. [Diagnostische Radiologie, Kerckhoff-Klinik, Bad Nauheim (Germany); Rominger, M. [Diagnostische Radiologie, Phillips-Univ. Marburg (Germany); Schoenburg, M. [Herzchirurgie, Kerckhoff-Klinik, Bad Nauheim (Germany)

    2004-07-01

    Purpose: Integration of MR venography in a comprehensive MR imaging protocol in patients with suspected pulmonary embolism (PE) and evaluation of contrast media dosage, timing and postprocessing for diagnostic accuracy. Materials and Methods: Fortyeight consecutive inpatients with suspected PE or deep vein thrombosis were examined by MR venography according to one of the following protocols: protocol I: MR venography only, 0.25 mmol/kg bodyweight (BW) Gadopentate dimeglumine(Gd-DTPA) as single dose, bolus timing; protocol II: MR angiography of pulmonary arteries with a cumulative dosage of 0.25 mmol/kg contrast media, modification of coil setting for MR venography without further contrast media application; protocol III: as protocol II but with 0.125 mmol/kg BW, followed by MR venography. Signal-to-noise ratio, contrast-to-noise ratio, number of definable vascular segments and image quality were evaluated. The results were compared to conventional bilateral venography. Results: All MR venography examinations were of diagnostic quality and the examination time was below 10 min. MR venography could be performed in all 48 patients comparted to 43 of 48 patients for conventional venography. Significantly more superficial and deep veins of the leg could be visualized by MR venography (94% compared to 83% for conventional venography). Sensitivity and specificity were 100% and 92%, respectively. Quality differed significantly between 0.125 mmol/kg (protocol III) and 0.25 mmol/kg Gd-DTPA (protocols I and II) while timing did not influence quality (protocol I vs. II). (orig.) [German] Ziel: Integration der MR-Phlebografie in ein umfassendes Konzept der MRT-Diagnostik bei Verdacht auf Lungenembolie (LE). Untersuchung des Einflusses von Kontrastmittelmenge, -bolusform und Verzoegerungszeit sowie der Nachverarbeitung auf die diagnostische Qualitaet von MR-Phlebografien. Material und Methode: Bei 48 konsekutiven stationaeren Patienten mit Verdacht auf Beinvenenthrombose (TVT

  10. MIT-Skywalker: Evaluating comfort of bicycle/saddle seat.

    Science.gov (United States)

    Goncalves, Rogerio S; Hamilton, Taya; Daher, Ali R; Hirai, Hiroaki; Krebs, Hermano I

    2017-07-01

    The MIT-Skywalker is a robotic device developed for the rehabilitation of gait and balance after a neurological injury. This device has been designed based on the concept of a passive walker and provides three distinct training modes: discrete movement, rhythmic movement, and balance training. In this paper, we present our efforts to evaluate the comfort of a bicycle/saddle seat design for the system's novel actuated body weight support device. We employed different bicycle and saddle seats and evaluated comfort using objective and subjective measures. Here we will summarize the results obtained from a study of fifteen healthy subjects and one stroke patient that led to the selection of a saddle seat design for the MIT-Skywalker.

  11. MIT LMFBR blanket research project. Final summary report

    International Nuclear Information System (INIS)

    Driscoll, M.J.

    1983-08-01

    This is a final summary report on an experimental and analytical program for the investigation of LMFBR blanket characteristics carried out at MIT in the period 1969 to 1983. During this span of time, work was carried out on a wide range of subtasks, ranging from neutronic and photonic measurements in mockups of blankets using the Blanket Test Facility at the MIT Research Reactor, to analytic/numerical investigations of blanket design and economics. The main function of this report is to serve as a resource document which will permit ready reference to the more detailed topical reports and theses issued over the years on the various aspects of project activities. In addition, one aspect of work completed during the final year of the project, on doubly-heterogeneous blanket configurations, is documented for the record

  12. Endokrinologische Behandlung der Geschlechtsdysphorie bei Menschen mit Geschlechtsinkongruenz

    Directory of Open Access Journals (Sweden)

    Flütsch N

    2015-01-01

    Full Text Available Es gibt Menschen, die die innere Gewissheit besitzen, dass ihre Geschlechtsidentität nicht zu ihrem biologischen Ursprungsgeschlecht passt. Durch die Entwicklungen in der Medizin in den letzten hundert Jahren ist es möglich geworden, die körperlichen Geschlechtsmerkmale an das innerlich erlebte Geschlecht anzupassen. Die Zahl der Hilfesuchenden in den ärztlichen Ambulanzen und Privatpraxen hat in den vergangenen Jahren deutlich zugenommen. Das Vorgehen bei der Diagnostik und Therapieeinleitung erlebt zurzeit eine deutliche Veränderung hin zu mehr Patientenzentriertheit und Individualisierung des Transitionsprozesses. Dabei bildet die geschlechtsangleichende Hormontherapie ein wesentliches Standbein in der körperlichen Angleichung an das Gegengeschlecht. Unter Beachtung von bestimmten Sicherheitsaspekten ist eine Hormontherapie mit Sexualhormonen sicher und einfach durchzuführen. Regelmäßige Verlaufskontrollen sowie der offene und affirmative Umgang mit den Betroffenen tragen zudem wesentlich zur Sicherheit in der Behandlung bei.

  13. Are the N and Δ deformed MIT bags

    International Nuclear Information System (INIS)

    Clement, G.; Maamache, M.

    1985-01-01

    The influence of the one-gluon exchange interaction, zero-point energy, and centre-of-mass correction, on the deformation of the nucleon and Δ bags, is studied in the MIT bag model. If the sharp MIT boundary conditions are taken seriously, the strong dependence of the zero-point energy on the deformation leads to the collapse of the N and Δ bags for realistic values of the strong fine structure constant α/sub S/. If on the other hand the zero-point energy is ignored altogether, then the nucleon, spherical for α/sub S/ 3.25, while the Δ is always prolate. The various predictions of the model are, for α/sub S/> or approx. =3.25, consistent with experiment, except for the proton magnetic moment which is only about 40% of the experimental value

  14. Properties of hybrid stars in an extended MIT bag model

    International Nuclear Information System (INIS)

    Bao Tmurbagan; Liu Guangzhou; Zhu Mingfeng

    2009-01-01

    The properties of hybrid stars are investigated in the framework of the relativistic mean field theory (RMFT) and an MIT bag model with density-dependent bag constant to describe the hadron phase (HP) and quark phase (QP), respectively. We find that the density-dependent B(ρ) decreases with baryon density ρ; this decrement makes the strange quark matter become more energetically favorable than ever; which makes the threshold densities of the hadron-quark phase transition lower than those of the original bag constant case. In this case, the hyperon degrees of freedom can not be considered. As a result, the equations of state of a star in the mixed phase (MP) become softer whereas those in the QP become stiffer, and the radii of the star obviously decrease. This indicates that the extended MIT bag model is more suitable to describe hybrid stars with small radii. (authors)

  15. Elektrochemisches Verhalten von Lithium-Schwefel-Zellen mit unterschiedlicher Kathodenstruktur

    OpenAIRE

    Scherr, Christopher

    2014-01-01

    Die elektrochemische Energiespeicherung ist in der Elektromobilität und dezentralen Energieversorgung einer der wichtigsten Bausteine. Der Lithium-Schwefel-Akkumulator mit seinen hohen theoretischen Kennwerte hat das Potential in Zukunft, hierbei eine gewichtige Rolle zu spielen. Je nach Zusammensetzung und Herstellung der Kathode variieren die Kennwerte jedoch sehr stark. In dieser Arbeit wurde der Einfluss der Kathodenstruktur und -zusammensetzung auf die Kapazität und Lebensdauer untersuch...

  16. Quark matter revisited with non-extensive MIT bag model

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Pedro H.G.; Nunes da Silva, Tiago; Menezes, Debora P. [Universidade Federal de Santa Catarina, Departamento de Fisica, CFM, Florianopolis (Brazil); Deppman, Airton [Instituto de Fisica da Universidade de Sao Paulo, Sao Paulo (Brazil)

    2017-10-15

    In this work we revisit the MIT bag model to describe quark matter within both the usual Fermi-Dirac and the Tsallis statistics. We verify the effects of the non-additivity of the latter by analysing two different pictures: the first order phase transition of the QCD phase diagram and stellar matter properties. While the QCD phase diagram is visually affected by the Tsallis statistics, the resulting effects on quark star macroscopic properties are barely noticed. (orig.)

  17. Configuration management plan for Machine Interface Test System (MITS)

    International Nuclear Information System (INIS)

    O'Neill, C.K.

    1980-01-01

    The discipline required by this plan will apply from the establishment of a configuration baseline until completion of the final test in the MITS. The plan applies to configured items of hardware and software as well as to the specifications and drawings for these items. The plan encompasses establishment of the facility baseline, interface definition, classes of change, change control, change paper, organizational responsibilities and relationships, test configuration (as opposed to facility), and configuration data retention

  18. Optische Bildgebung der Autoimmunarthritis mit DiD markierten Leukozyten

    OpenAIRE

    Kau, Julia

    2008-01-01

    Zielsetzung: Ziel der vorliegenden Studie war es, zu untersuchen, ob die Optische Bildgebung nach Injektion von ex vivo DiD markierten Leukozyten, in der Lage ist, eine Entzündung der Synovialmembran in Ratten mit einer Antigen-induzierten Monoarthritis des rechten Kniegelenkes aufzudecken. Die Optische Bildgebung wurde auf ihre Fähigkeit zur Unterscheidung zwischen arthritischen und gesunden Kniegelenken und zwischen nichttherapierten und Kortison-therapierten Kniegelenken unt...

  19. Psychologie - Fachdatenbank mit europäischem Fokus

    OpenAIRE

    Schön, Dana

    2010-01-01

    Die Sichtbarkeit von europäischer Wissenschaftsliteratur ist notwendige Voraussetzung für deren Rezeption im internationalen Kontext. Ein bibliographisches Nachweissystem psychologischer Fachliteratur auf der Basis moderner Suchtechnologie mit Fokus auf europäischen Werken kann einen wichtigen Beitrag dazu leisten. Mehrere europäische Institute stellen ihre bibliographischen Datenbestände zum Aufbau einer umfassenden europäischen Fachdatenbank für die Psychologie zur Verfügung. Die Bereitstel...

  20. Qanti-QG hermaphrodite mesons in the MIT bag model

    International Nuclear Information System (INIS)

    Barnes, T.; Close, F.E.; Viron, F. de

    1982-10-01

    It is suggested that hermaphrodite (qanti-qg) mesons could exist with rather light masses. The spectrum of the ground state nonets, Jsup(PC) = (0, 1, 2) -+ ; 1 -- is calculated in the MIT bag model including 0(αsub(s)) energy shifts. Hadronic transitions among these states are discussed, considering their possible production at LEAR and SPEAR and indicating some interesting decay signatures. (author)

  1. Strategien zur HLA-Typisierung mit PyrosequencingTM

    OpenAIRE

    Entz, Patricia

    2006-01-01

    Der Haupthistokompatibilitätskomplex ist durch seine biologische Funktion eine für die Diagnostik und Forschung äußerst wichtige Region im humanen Genom. Die Untersuchung von HLA-Genorten stellt ein wichtiges Instrument in der molekulargenetischen Praxis dar. Die Pyrosequencing-Technik ist gut geeignet, um kurze DNA-Abschnitte mit weitgehend bekannter Sequenz schnell und effizient zu untersuchen. Ziel dieser Arbeit war die Entwicklung von Pyrosequencing-basierten Methoden zur HLA-Typisierung....

  2. Cost accounting in Kernforschungsanlage Juelich Gesellschaft mit beschraenkter Haftung (KFA)

    International Nuclear Information System (INIS)

    Seidel, G.; Schilling, H.

    1979-01-01

    The paper gives an overview about the organization and the research program of the Kernforschungsanalage Juelich Gesellschaft mit beschraenkter Haftung (KFA). The cost accounting system is discussed in detail, cost categories, cost centers, units of production and the data flow of the cost accounting are described. The distribution of the resulting management accounting reports and all sorts of EDP-result listings of the cost accounting system is described. (A.N.)

  3. Kundenorientierte Produktentwicklung mit Hilfe von Quality Function Deployment (QFD)

    OpenAIRE

    Schloske, Alexander

    2011-01-01

    Die Produktentwicklung von heute muss in immer kürzeren Zeiträumen kunden- und kostenorientierte Produkte entwickeln. Zur systematischen Unterstützung dieser Aufgabe im Rahmen der Produktentwicklung wird die Methode Quality Function Deployment (QFD) eingesetzt. Die konsequente Umsetzung der Stimme des Kunden in die Sprache des Unternehmens gelingt mit Quality Function Deployment (QFD). Die Methode wertet systematisch Kundenanforderungen an Produkte aus und führt zu innovativen Lösungen, die s...

  4. Phylogenetic relationships of the Gomphales based on nuc-25S-rDNA, mit-12S-rDNA, and mit-atp6-DNA combined sequences

    Science.gov (United States)

    Admir J. Giachini; Kentaro Hosaka; Eduardo Nouhra; Joseph Spatafora; James M. Trappe

    2010-01-01

    Phylogenetic relationships among Geastrales, Gomphales, Hysterangiales, and Phallales were estimated via combined sequences: nuclear large subunit ribosomal DNA (nuc-25S-rDNA), mitochondrial small subunit ribosomal DNA (mit-12S-rDNA), and mitochondrial atp6 DNA (mit-atp6-DNA). Eighty-one taxa comprising 19 genera and 58 species...

  5. Characterization of children with FLT3-ITD acute myeloid leukemia: a report from the AIEOP AML-2002 study group.

    Science.gov (United States)

    Manara, E; Basso, G; Zampini, M; Buldini, B; Tregnago, C; Rondelli, R; Masetti, R; Bisio, V; Frison, M; Polato, K; Cazzaniga, G; Menna, G; Fagioli, F; Merli, P; Biondi, A; Pession, A; Locatelli, F; Pigazzi, M

    2017-01-01

    Recurrent molecular markers have been routinely used in acute myeloid leukemia (AML) for risk assessment at diagnosis, whereas their post-induction monitoring still represents a debated issue. We evaluated the prognostic value and biological impact of minimal residual disease (MRD) and of the allelic ratio (AR) of FLT3-internal-tandem duplication (ITD) in childhood AML. We retrospectively screened 494 children with de novo AML for FLT3-ITD mutation, identifying 54 harboring the mutation; 51% of them presented high ITD-AR at diagnosis and had worse event-free survival (EFS, 19.2 versus 63.5% for low ITD-AR, <0.05). Forty-one percent of children with high levels of MRD after the 1st induction course, measured by a patient-specific real-time-PCR, had worse EFS (22.2 versus 59.4% in low-MRD patients, P<0.05). Next, we correlated these parameters with gene expression, showing that patients with high ITD-AR or persistent MRD had characteristic expression profiles with deregulated genes involved in methylation and acetylation. Moreover, patients with high CyclinA1 expression presented an unfavorable EFS (20.3 versus 51.2% in low CyclinA1 group, P<0.01). Our results suggest that ITD-AR levels and molecular MRD should be considered in planning clinical management of FLT3-ITD patients. Different transcriptional activation of epigenetic and oncogenic profiles may explain variability in outcome among these patients, for whom novel therapeutic approaches are desirable.

  6. A clinical trial of supervised exercise for adult inpatients with acute myeloid leukemia (AML) undergoing induction chemotherapy☆

    Science.gov (United States)

    Alibhai, Shabbir M.H.; O’Neill, Sara; Fisher-Schlombs, Karla; Breunis, Henriette; Brandwein, Joseph M.; Timilshina, Narhari; Tomlinson, George A.; Klepin, Heidi D.; Culos-Reed, S. Nicole

    2013-01-01

    Patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC) were enrolled in a supervised exercise intervention to determine safety, feasibility, and efficacy. Physical fitness measures, quality of life (QOL) and fatigue were assessed using standardized measures at baseline, post-induction, and post first consolidation. Retention was excellent, the intervention was safe, and efficacy estimates suggested benefits in physical fitness and QOL outcomes. Exercise is a safe, promising intervention for improving fitness and QOL in this patient population. These results provide a foundation for a randomized trial to better understand the impact of exercise during IC on clinically important outcomes. PMID:22726923

  7. A clinical trial of supervised exercise for adult inpatients with acute myeloid leukemia (AML) undergoing induction chemotherapy.

    Science.gov (United States)

    Alibhai, Shabbir M H; O'Neill, Sara; Fisher-Schlombs, Karla; Breunis, Henriette; Brandwein, Joseph M; Timilshina, Narhari; Tomlinson, George A; Klepin, Heidi D; Culos-Reed, S Nicole

    2012-10-01

    Patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC) were enrolled in a supervised exercise intervention to determine safety, feasibility, and efficacy. Physical fitness measures, quality of life (QOL) and fatigue were assessed using standardized measures at baseline, post-induction, and post first consolidation. Retention was excellent, the intervention was safe, and efficacy estimates suggested benefits in physical fitness and QOL outcomes. Exercise is a safe, promising intervention for improving fitness and QOL in this patient population. These results provide a foundation for a randomized trial to better understand the impact of exercise during IC on clinically important outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. A randomized comparison of daunorubicin 90 mg/m2 vs 60 mg/m2 in AML induction

    DEFF Research Database (Denmark)

    Burnett, A. K.; Russell, N. H.; Hills, R. K.

    2015-01-01

    Modifying induction therapy in acute myeloid leukemia (AML) may improve the remission rate and reduce the risk of relapse, thereby improving survival. Escalation of the daunorubicin dose to 90 mg/m(2) has shown benefit for some patient subgroups when compared with a dose of 45 mg/m(2), and has been...... = .15). In an exploratory subgroup analysis, there was no subgroup that showed significant benefit, although there was a significant interaction by FLT3 ITD mutation. This trial is registered at http://www.isrctn.com as #ISRCTN55675535....

  9. Azacitidine in combination with intensive induction chemotherapy in older patients with acute myeloid leukemia: The AML-AZA trial of the Study Alliance Leukemia.

    Science.gov (United States)

    Müller-Tidow, C; Tschanter, P; Röllig, C; Thiede, C; Koschmieder, A; Stelljes, M; Koschmieder, S; Dugas, M; Gerss, J; Butterfaß-Bahloul, T; Wagner, R; Eveslage, M; Thiem, U; Krause, S W; Kaiser, U; Kunzmann, V; Steffen, B; Noppeney, R; Herr, W; Baldus, C D; Schmitz, N; Götze, K; Reichle, A; Kaufmann, M; Neubauer, A; Schäfer-Eckart, K; Hänel, M; Peceny, R; Frickhofen, N; Kiehl, M; Giagounidis, A; Görner, M; Repp, R; Link, H; Kiani, A; Naumann, R; Brümmendorf, T H; Serve, H; Ehninger, G; Berdel, W E; Krug, U

    2016-03-01

    DNA methylation changes are a constant feature of acute myeloid leukemia. Hypomethylating drugs such as azacitidine are active in acute myeloid leukemia (AML) as monotherapy. Azacitidine monotherapy is not curative. The AML-AZA trial tested the hypothesis that DNA methyltransferase inhibitors such as azacitidine can improve chemotherapy outcome in AML. This randomized, controlled trial compared the efficacy of azacitidine applied before each cycle of intensive chemotherapy with chemotherapy alone in older patients with untreated AML. Event-free survival (EFS) was the primary end point. In total, 214 patients with a median age of 70 years were randomized to azacitidine/chemotherapy (arm-A) or chemotherapy (arm-B). More arm-A patients (39/105; 37%) than arm-B (25/109; 23%) showed adverse cytogenetics (P=0.057). Adverse events were more frequent in arm-A (15.44) versus 13.52 in arm-B, (P=0.26), but early death rates did not differ significantly (30-day mortality: 6% versus 5%, P=0.76). Median EFS was 6 months in both arms (P=0.96). Median overall survival was 15 months for patients in arm-A compared with 21 months in arm-B (P=0.35). Azacitidine added to standard chemotherapy increases toxicity in older patients with AML, but provides no additional benefit for unselected patients.

  10. Infectious Complications in Children With Acute Myeloid Leukemia and Down Syndrome: Analysis of the Prospective Multicenter Trial AML-BFM 2004.

    Science.gov (United States)

    Hassler, Angela; Bochennek, Konrad; Gilfert, Julia; Perner, Corinna; Schöning, Stefan; Creutzig, Ursula; Reinhardt, Dirk; Lehrnbecher, Thomas

    2016-06-01

    Children with acute myeloid leukemia (AML) and Down syndrome have high survival rates with intensity-reduced chemotherapeutic regimens, although the optimal balance between dose intensity and treatment toxicity has not been determined. We, therefore, characterized infectious complications in children with AML and Down syndrome treated according to AML-BFM 2004 study (ClinicalTrials.gov NCT00111345; amended 2006 for Down syndrome with reduced intensity). Data on infectious complications were gathered from the medical records in the hospital where the patient was treated. Infectious complications were categorized as fever without identifiable source (FUO), or as microbiologically or clinically documented infections. A total of 157 infections occurred in 61 patients (60.5% FUO, 9.6% and 29.9% clinically and microbiologically documented infections, respectively). Almost 90% of the pathogens isolated from the bloodstream were Gram-positive bacteria, and approximately half of them were viridans group streptococci. All seven microbiologically documented episodes of pneumonia were caused by viruses. Infection-related mortality was 4.9%, and all three patients died due to viral infection. Our data demonstrate that a reduced-intensity chemotherapeutic regimen in children with AML and Down syndrome is still associated with high morbidity. Although no patient died due to bacteria or fungi, viruses were responsible for all lethal events. Future studies, therefore, have to focus on the impact of viruses on morbidity and mortality of patients with AML and Down syndrome. © 2016 Wiley Periodicals, Inc.

  11. Determination of the cerebral dopamine-D2-receptor density by [sup 123]I-IBZM-SPECT in patients with Parkinson's disease. Bestimmung der zerebralen Dopamin-(D2)-Rezeptoren-Dichte mit Hilfe der [sup 123]Jod-IBZM-SPECT bei Patienten mit Morbus Parkinson

    Energy Technology Data Exchange (ETDEWEB)

    Hierholzer, J; Cordes, M; Barzen, G; Keske, U; Felix, R [Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Berlin (Germany); Schelosky, L; Poewe, H [Neurologische Klinik und Poliklinik, Klinikum Rudolf Virchow, Berlin (Germany); Henkes, H [Inst. fuer Neuroradiologie, Univ. des Saarlandes, Homburg/Saar (Germany); Horowski, R [Schering AG, Berlin (Germany)

    1992-10-01

    An alteration of the dopaminergic nigrostriatal system is believed to be the main pathogenetic factor of Parkinson's disease (PD). We report on our initial results on the determination of the post-synapticdopamine-D2-receptor binding of [sup 123]I-IBZM in patients with PD. Drug-native patients showed a significantly higher IBZM binding in the basal ganglia as compared to patients on specific dopaminergic medication. We conclude that [sup 123]I-IBZM-SPECT is an extremely usuful tool for the evaluation of the functional state of cerebraldopamine-D2-receptors. (orig./DG).

  12. Acute myeloblastic leukemia with minimal myeloid differentiation (FAB AML-M0): a study of eleven cases.

    Science.gov (United States)

    Sempere, A; Jarque, I; Guinot, M; Palau, J; García, R; Sanz, G F; Gomis, F; Pérez-Sirvent, M L; Senent, L; Sanz, M A

    1993-12-01

    The main clinical, morphological, cytochemical, immunological features and therapy results of eleven patients diagnosed as acute myeloblastic leukemia M0 (AML-M0) are reported here. There were no clinical characteristics, abnormalities on physical examination or initial laboratory parameters that distinguished these eleven patients. Bone marrow aspirates were hypocellular in four patients. The leukemic cells were undifferentiated by light microscopy and myeloperoxidase (MPO) and/or Sudan Black B (SBB) stains were negative in all cases. Myeloid differentiation antigens were present on the leukemic cells of all eleven patients, whereas B and T cell markers were clearly negative except for CD4 and CD7 antigens. Whatever the treatment employed survival was very short. Eight of the eleven patients were treated and two achieved complete remission (CR) but only one of them is alive in continuous CR. Our results like those previously reported, suggest that AML-M0 patients have a very poor prognosis with standard induction therapies and should perhaps be considered for experimental therapeutic approaches.

  13. Treatment strategies in patients with AML or high-risk myelodysplastic syndrome relapsed after Allo-SCT.

    Science.gov (United States)

    Sauer, T; Silling, G; Groth, C; Rosenow, F; Krug, U; Görlich, D; Evers, G; Albring, J; Besoke, R; Mesters, R M; Müller-Tidow, C; Kessler, T; Büchner, T; Berdel, W E; Stelljes, M

    2015-04-01

    Non-relapse mortality after Allo-SCT has significantly decreased over the last years. Nevertheless, relapse remains a major cause for post SCT mortality in patients with AML and high-risk myelodysplastic syndrome (MDS). In this retrospective single-center analysis, we have analyzed the treatment outcomes of 108 patients with AML or MDS, who relapsed after Allo-SCT. Seventy of these patients (65%) were treated with salvage therapies containing chemotherapy alone, allogeneic cell-based treatment or the combination of both. Thirty-eight patients (35%) received palliative treatment. Median OS after diagnosis of relapse was 130 days. Compared with patients who received chemotherapy alone, response to salvage therapy was significantly improved in patients treated with a combination of chemo- and allogeneic cell-based therapy (CR rate 57% vs 13%, P=0.002). Among risk factors concerning pretreatment characteristics, disease status before first Allo-SCT, and details of transplantation, only the time interval from Allo-SCT to relapse was an independent predictor of response to salvage therapy and OS. These data confirmed that time to relapse after transplantation is an important prognostic factor. Up to now, only patients eligible for treatment regimens containing allogeneic cell-based interventions achieved relevant response rates.

  14. Geotourism and Sustainability: The Kızılcahamam – Çamlıdere Geopark Case

    Directory of Open Access Journals (Sweden)

    M. Sercan Gürsay

    2014-12-01

    Full Text Available Today, geotourism is one of the popular types of special interest tourism. On the other hand, poorly managed tourism can have some negative economic, environmental and socio-cultural impacts on destinations. Therefore, all types of tourism should be managed with a sustainable approach. The concept of sustainability, which had been first introduced in 1987, in the Report entitled “Our Common Future” as a fundamental of development, and has three dimensions of social, economic and environmental aspects. The purpose of this study is to evaluate sustainable tourism practices in Kızılcahamam - Çamlıdere Geopark. In this context, local stakeholders’ opinion on the importance of sustainable tourism in the management of the geopark area is determined. The qualitative method was used in this study. Data were collected through review of the related literature, observation and in-depth interviews. As a result of the study, physical and legal deficiencies in the protection and the management of the geopark area were identified. The lack of trained and qualified work force, sustainable financial resources, local participation, and education are the other major issues in terms of sustaining geotourismin Kızılcahamam - Çamlıdere Geopark. These deficiencies can be corrected under the UNESCO GGN (Global Geopark Network criteria.

  15. Physikalische Grundlagen von chemischen Raman-Sensoren mit Schwerpunkt auf faseroptischen SERS-Sonden

    OpenAIRE

    Viets, Carmen

    2001-01-01

    Faseroptische SERS-Sensoren wurden durch die Beschichtung der Endflächen von optischen Fasern mit rauhen Metallfilmen erzeugt. Zu den verschiedenen Präparationstechniken, die angewendet und verglichen wurden, gehörten das langsame Aufdampfen von Metall-Inselfilmen und das Bedampfen von Nanopartikeln, aufgerauhten oder elektronenlithographisch strukturierten Oberflächen mit Metallfilmen. Der Einfluß der Laserleistung auf die Messungen mit SERS-Sensoren wurde untersucht, und es wurden maximale ...

  16. Quantitative Datenanalyse: Arbeiten mit SPSS Statistics : Eine Einführung

    OpenAIRE

    Hoidn, Sabine

    2012-01-01

    Bei diesem Buch handelt es sich um eine verständliche Einführung in das Arbeiten mit dem quantitativen Datenanalyseprogramm SPSS Statistics. Die Studierenden setzen sich mit den Grundlagen zum Arbeiten mit SPSS Statistics auseinander, können selbständig eine SPSS Statistics-Datei erstellen, Daten einlesen, zusammenfügen und modifizieren, erfasste Daten managen und die gebräuchlichsten tabellarischen und grafischen Grundauswertungen sowie Analyseverfahren durchführen und interpretieren. Au...

  17. The development of form two mathematics i-Think module (Mi-T2)

    Science.gov (United States)

    Yao, Foo Jing; Abdullah, Mohd Faizal Nizam Lee; Tien, Lee Tien

    2017-05-01

    This study aims to develop a training module i-THINK Mathematics Form Two (Mi-T2) to increase the higher-order thinking skills of students. The Mi-T2 training module was built based on the Sidek Module Development Model (2001). Constructivist learning theory, cognitive learning theory, i-THINK map and higher order thinking skills were the building blocks of the module development. In this study, researcher determined the validity and reliability of Mi-T2 module. The design being used in this study was descriptive study. To determine the needs of Mi-T2 module, questionnaires and literature review were used to collect data. When the need of the module was determined, the module was built and a pilot study was conducted to test the reliability of the Mi-T2 module. The pilot study was conducted at a secondary school in North Kinta, Perak. A Form Two class was selected to be the sample study through clustered random sampling. The pilot study was conducted for two months and one topic had been studied. The Mi-T2 module was evaluated by five expert panels to determine the content validity of the module. The instruments being used in the study were questionnaires about the necessity of the Mi-T2 module for guidance, questionnaires about the validity of the module and questionnaires concerning the reliability of the module. Statistical analysis was conducted to determine the validity and reliability coefficients of the Mi-T2 module. The content validity of Mi-T2 module was determined by Cohen's Kappa's (1968) agreement coefficient and the reliability of Mi-T2 module was determined by Cronbach Alpha's value scale. The content validity of Mi-T2 module was 0.89 and the Cronbach Alpha's value of Mi-T2 module was 0.911.

  18. Der Ritter mit dem Hemd : drei Fassungen einer mittelalterlichen Erzählung

    OpenAIRE

    Dunphy, Graeme

    2011-01-01

    Unter den zahlreichen Motiven, die in der mittelalterlichen Literatur mit Frauendienst verbunden sind, gehört das vom Ritter mit dem Hemd zu den besonders interessanten. Es erscheint zunächst in dem ersten von fünf Fabliaux aus einer verlorenen Turiner Handschrift, die dem sonst unbekannten altfranzösischen Dichter Jacques de Baisieux zugeschrieben werden, einer heiteren Kurzgeschichte mit dem Titel "Des trois chevaliers et del chainse". In der vorliegenden Untersuchung gilt es, der Frage der...

  19. Evaluation of percutaneous vertebroplasty in osteoporotic vertebral fractures using a combination of CT fluoroscopy and conventional lateral fluoroscopy; Perkutane Vertebroplastie osteoporosebedingter Wirbelkoerperfrakturen: Erfahrungen mit der CT-Fluoroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, M.B.; Schneider, J.; Brecher, B.; Herber, S.; Mohr, W.; Thelen, M. [Klinik fuer Radiologie, Universitaetskliniken Mainz (Germany); Drees, P.; Eckardt, A.; Heine, J. [Klinik fuer Orthopaedie, Universitaetskliniken Mainz (Germany)

    2004-07-01

    cannulation of the vertebra had been changed before cement application resulting in a hole in the dorsolateral vertebral wall. However, all patients were discharged without evidence of neurologic complications. Multiplanar reconstructions of CT scans were used for the detection of extraosseous cement leaks: The incidence of extraosseous cement leaks was 4.1% in epidural veins, 6.5% in paravertebral vessels (6 veins, 2 arteries), and 17.9 and 11.4% respectively, for upper or lower and plates. At discharge, 25 patients (43.1%) were free of pain and 28 (48,3%) significantly improved with a considerable reduction of analgetic drugs. Significant complaints persisted in 5 patients (8.6%) with concomitant degenerative disease in four and vasculitis in one case. (orig.) [German] Zielsetzung: Klinisch-radiologische Pruefung der Vertebroplastie mittels CT-Fluoroskopie und seitlicher Durchleuchtung bei Patienten mit osteoporosebedingten Wirbelkoerperfrakturen. Material und Methoden: 58 Patienten (23 Maenner und 35 Frauen, Alter 69,7 {+-} 10,2 Jahre) mit schmerzhaften, osteoporosebedingten Wirbelkoerperfrakturen wurden mittels Vertebroplastie behandelt. Praeinterventionell erfolgte eine Spiral-CT mit sagittaler Rekonstruktion zur Befunddokumentation. Die Eingriffe erfolgten in Analgosedierung. Die Platzierung der Vertebroplastiekanuele und die Applikation des Knochenzementes erfolgten unter CT-Fluoroskopie und seitlicher Durchleuchtung. Bei unguenstiger Zementausbreitung wurde die Applikation fuer 30-60 s unterbrochen. Nach Polymerisation des Zementes an dieser Lokalisation wurde die Injektion bis zur ausreichenden Wirbelkoerperfuellung fortgesetzt. Das Ergebnis wurde mittels Spiral-CT mit sagittaler Rekonstruktion des behandelten Wirbelsaeulenabschnittes dokumentiert. Ergebnisse: Insgesamt wurden 123 Wirbelkoerper behandelt, 39 Brustwirbel- und 84 Lendenwirbelkoerper. Alle Eingriffe konnten in Analgosedierung und Lokalanaesthesie durchgefuehrt werden. Im Mittel wurden 2,1 {+-} 1,3 (1

  20. A non-canonical Flt3ITD/NF-κB signaling pathway represses DAPK1 in acute myeloid leukemia (AML)

    Science.gov (United States)

    Shanmugam, Rajasubramaniam; Sayar, Hamid; Suvannasankha, Attaya; Goswami, Chirayu; Li, Lang; Gupta, Sushil; Cardoso, Angelo A.; Baghdadi, Tareq Al; Sargent, Katie J.; Cripe, Larry D.; Kalvakolanu, Dhananjaya V.; Boswell, H. Scott

    2014-01-01

    Purpose DAPK1, a tumor suppressor, is a rate-limiting effector in an ER stress-dependent apoptotic pathway. Its expression is epigenetically suppressed in several tumors. A mechanistic basis for epigenetic/transcriptional repression of DAPK1 was investigated in certain forms of AML with poor prognosis, which lacked ER stress-induced apoptosis. Experimental Design Heterogeneous primary AMLs were screened to identify a subgroup with Flt3ITD in which repression of DAPK1, among NF-κB- and c- jun-responsive genes, was studied. RNAi knockdown studies were performed in Flt3ITD+ve cell line, MV-4-11, to establish genetic epistasis in the pathway Flt3ITD-TAK1-DAPK1 repression, and chromatin immunoprecipitations were performed to identify proximate effector proteins, including TAK1-activated p52NF-κB, at the DAPK1 locus. Results AMLs characterized by normal karyotype with Flt3ITD were found to have 10-100-fold lower DAPK1 transcripts normalized to the expression of c-jun, a transcriptional activator of DAPK1, as compared to a heterogeneous cytogenetic category. Meis1, a c-jun-responsive adverse AML prognostic gene signature was also measured as control. These Flt3ITD+ve AMLs over-express relB, a transcriptional repressor, which forms active heterodimers with p52NF-κB. Chromatin immunoprecipitation assays identified p52NF-κB binding to the DAPK1 promoter along with HDAC2 and HDAC6 in the Flt3ITD+ve human AML cell line MV-4-11. Knockdown of p52NF-κB or its upstream regulator, NIK, de-repressed DAPK1. DAPK1-repressed primary Flt3ITD+ve AMLs had selective nuclear activation of p52NF-κB. Conclusions Flt3ITD promotes a non-canonical pathway via TAK1 and p52NF-κB to suppress DAPK1 in association with HDACs, which explains DAPK1 repression in Flt3ITD+ve AML. PMID:22096027

  1. Downregulation but lack of promoter hypermethylation or somatic mutations of the potential tumor suppressor CXXC5 in MDS and AML with deletion 5q

    DEFF Research Database (Denmark)

    Treppendahl, Marianne Bach; Möllgård, L; Hellström-Lindberg, E

    2013-01-01

    During recent years mutations in epigenetic modulators have been identified in several human cancers, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)[1]. CXXC5 has been found to be necessary for retinoic acid induced differentiation of myelocytic leukemia cells, identify......During recent years mutations in epigenetic modulators have been identified in several human cancers, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)[1]. CXXC5 has been found to be necessary for retinoic acid induced differentiation of myelocytic leukemia cells...

  2. Comments on the MIT Assessment of the Mars One Plan

    Science.gov (United States)

    Jones, Harry W.

    2015-01-01

    The MIT assessment of the Mars One mission plan reveals design assumptions that would cause significant difficulties. Growing crops in the crew chamber produces excessive oxygen levels. The assumed in-situ resource utilization (ISRU) equipment has too low a Technology Readiness Level (TRL). The required spare parts cause a large and increasing launch mass logistics burden. The assumed International Space Station (ISS) Environmental Control and Life Support (ECLS) technologies were developed for microgravity and therefore are not suitable for Mars gravity. Growing food requires more mass than sending food from Earth. The large number of spares is due to the relatively low reliability of ECLS and the low TRL of ISRU. The Mars One habitat design is similar to past concepts but does not incorporate current knowledge. The MIT architecture analysis tool for long-term settlements on the Martian surface includes an ECLS system simulation, an ISRU sizing model, and an analysis of required spares. The MIT tool showed the need for separate crop and crew chambers, the large spare parts logistics, that crops require more mass than Earth food, and that more spares are needed if reliability is lower. That ISRU has low TRL and ISS ECLS was designed for microgravity are well known. Interestingly, the results produced by the architecture analysis tool - separate crop chamber, large spares mass, large crop chamber mass, and low reliability requiring more spares - were also well known. A common approach to ECLS architecture analysis is to build a complex model that is intended to be all-inclusive and is hoped will help solve all design problems. Such models can struggle to replicate obvious and well-known results and are often unable to answer unanticipated new questions. A better approach would be to survey the literature for background knowledge and then directly analyze the important problems.

  3. Elastolysen und Hauterkrankungen mit Verlust der elastischen Fasern.

    Science.gov (United States)

    Tronnier, Michael

    2018-02-01

    Die elastischen Fasern sind neben den kollagenen Fasern der wichtigste Bestandteil des Bindegewebsgerüstes der Haut. Eine Verminderung oder ein Verlust der elastischen Fasern ist bei einer Vielzahl von klinisch sich unterschiedlich präsentierenden Erkrankungen, hereditär oder erworben, beschrieben. Bei den Erkrankungen, die mit einer Entzündung einhergehen ist die Elastophagozytose ein wichtiges histologisches Merkmal. Die Therapie der Erkrankungen dieser Gruppe ist grundsätzlich schwierig. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. Innovative facades with photovoltaics; Innovative Fassaden mit Photovoltaik

    Energy Technology Data Exchange (ETDEWEB)

    Eicker, U. [Hochschule fuer Technik, Stuttgart (Germany)

    1999-10-01

    Having grown at a rate of 15% since the middle of the 1980s the photovoltaic market today commands an annual module production of more than 100 MW{sub p}. In Germany altogether 10,000 PV systems with a total power output of 10 MW{sub p} were newly installed in 1997 alone. In 1990 the market was boosted by the heavily subsidised 1000 roofs programme, under which in the end more than 2,000 systems were installed on the roofs of mostly one-family houses. With power ratings ranging from 1 to 5 kW these decentral plants require roof surface areas between 10 and 50 m-2. On average they generate 800 kWh of electricity per kW of installed power. According to a number of studies carried out in the early 1990s the total surface area on buildings available for photovoltaics amounts to an enormous potential of 1,000 km-2, which is equivalent to an electricity generating potential of 130 TWh (100 TWh on roofs and 30 TWh on facades), or 25% of Germany`s total electricity demand. The degree to which this potential will be realised in the long term will notably depend on whether convincing architectural solutions are found for integrating photovoltaic plants in roofs and facades. [Deutsch] Der Photovoltaikmarkt waechst weltweit seit Mitte der 80er Jahre um durchschnittlich 15% und liegt heute bei einer Jahresmodulproduktion ueber 100 MW{sub p}. In Deutschland wurden alleine 1997 etwa 10.000 PV-Systeme mit einer Gesamtleistung von 10 MW{sub p} installiert. Die Marktentwicklung wurde 1990 mit dem stark subventionierten 1000-Daecher Programm angestossen, in welchem schliesslich mehr als 2000 Systeme meist auf Daechern von Einfamilienhaeusern installiert wurden. Diese dezentralen Anlagen mit Leistungen zwischen 1 und 5 kW erfordern Dachflaechen zwischen 10 und 50 m{sup 2} und erzeugen im Schnitt 800 kWh Strom pro kW installierter Leistung. Das verfuegbare Flaechenpotential von Gebaeuden wurde Anfang der 90er Jahre in einer Reihe von Studien ermittelt und stellt mit etwa 1000 km{sup 2

  5. Die Behandlung des Akustikusneurinoms mit dem Gamma-Knife

    OpenAIRE

    Hempel, Elizabeta

    2005-01-01

    Das Akustikusneurinom ist mit ca. 6% der häufigste intrakranielle Tumor und hat eine jährliche Inzidenz von 1:100000. Die durchschnittliche Wachstumsrate beträgt 2 mm pro Jahr, wobei es auch Akustikusneurinome gibt, die sehr viel schneller wachsen können. Bei der Behandlung des Schwannoms stehen uns zwei Modalitäten zur Verfügung. Die konventionelle Chirurgie und die stereotaktische Radiochirurgie, zu der die Gamma-Knife Therapie und der Linearbeschleuniger zählen. Sorgfältig ausgesuchte P...

  6. Content Management von Leittexten mit XML Topic Maps

    Directory of Open Access Journals (Sweden)

    Johannes Busse

    2003-07-01

    Full Text Available Die Autoren definieren den Umgang mit internet- basierten Informations- und Kommunikationstechnologien als Schlüsselqualifikation für Studierende aller Fachrichtungen. Im vorliegenden Aufsatz beschreiben sie ein Projekt, das der Fachbereich Erziehungswissenschaften der Universität Heidelberg seit 2001 durchführt. Hier werden Studierende der Geistes- und Sozialwissenschaften zu "Lernberatern" ausgebildet, die als Multiplikatoren die notwendigen Kenntnisse erwerben. Die Teilnehmenden erarbeiten nach der "Leittextmethode" selbstgesteuert xml-basierte Contents. Dies setzt den Erwerb von informationstechnischen Kenntnissen voraus, der neben dem Aufbau eines (sowohl technischen als auch sozialen Netzwerks einen Schwerpunkt bildet.

  7. Automatic control and monitoring of the MIT fission converter beam

    International Nuclear Information System (INIS)

    Wilson, B.A.; Riley, K.J.; Harling, O.K.

    2000-01-01

    An automated control and monitoring system for the new MIT high intensity epithermal neutron irradiation facility has been designed and constructed. The neutron beam is monitored with fission counters located at the periphery of the beam near the patient position. Control of the beam is accomplished with redundant Programmable Logic Controllers (PLCs). These industrial controllers open and close the three shutters of the Fission Converter Beam. The control system uses a series of robust components to assure that the prescribed fluence is delivered. This paper discusses the design and implementation of this system. (author)

  8. M1-transitions in the MIT bag model

    International Nuclear Information System (INIS)

    Hackman, R.H.; Deshpande, N.G.; Dicus, D.A.; Teplitz, V.L.

    1977-03-01

    In the MIT bag model, the M1-transitions of low lying hadrons are investigated. The following calculations are performed: 32 hadron masses are recomputed with a choice of bag parameters designed to give the correct values for the proton magnetic moment, μ/sub p/, and several masses, M/sub rho/ M/sub ω/ M/sub Δ/ M/sub Ω/, and M/sub D/; (2) eta, eta', eta/sub c/ mixing is computed in an untrustworthy approximation; and the widths for 38 M1-transitions are computed

  9. Recent work at MIT on uranium recovery from seawater

    International Nuclear Information System (INIS)

    Driscoll, M.J.

    1984-01-01

    Recent work at MIT has confirmed the superiority of fiber-form ion exchange media for uranium recovery from seawater, subject to demonstration of the ability to control fouling by suspended particulate matter. Calculations and laboratory experiments indicate loading rates of several hundred ppm U/day: an order of magnitude faster than for bead-type sorbers in fixed or fluidized beds. A high performance, modular, sorber cartridge/seawater contactor system capable of a lifetime-levelized cost of product in the range 100-150 $/1b U 3 O 8 has been designed. (author)

  10. Cerebrospinal fluid leakage. Indications, technique and results of treatment with a blood patch; Liquorverlustsyndrom. Indikation, Technik und Ergebnisse der Behandlung mit ''blood patch''

    Energy Technology Data Exchange (ETDEWEB)

    Gottschalk, A. [Krankenhaus Nordwest, Abteilung Neuroradiologie, Frankfurt am Main (Germany)

    2015-06-15

    of several months, even though patients are already free of symptoms. In total, blood patch therapy is a safe and technically relative simple method with a high success rate. Therefore, it represents the therapy of choice in patients with spontaneous cerebrospinal fluid leakage as well as in cases of post-lumbar puncture syndrome refractory to conservative therapy. (orig.) [German] In den meisten Faellen ist ein Liquorverlustsyndrom iatrogen durch Lumbalpunktionen, Periduralanaesthesien oder operative Eingriffe an der Wirbelsaeule bedingt. Durch verbesserte diagnostische Moeglichkeiten werden jedoch auch spontane Liquorverlustsyndrome mit zunehmender Haeufigkeit diagnostiziert, deren Ursache oft nicht eindeutig zu klaeren ist. Zur radiologischen Diagnosesicherung und zur Lokalisierung des Liquorlecks stehen mit der Postmyelo-CT, der {sup 111}Indium-Radioisotopenzisternographie und der (Myelo-)MRT mehrere Verfahren mit unterschiedlichen Sensitivitaeten zur Verfuegung. Nach unserer eigenen Erfahrung ist eine primaer nativdiagnostische MRT mit fettsaturierten T2-Sequenzen in vielen Faellen bereits diagnostisch ausreichend, um das Liquorleck und seine Lokalisation zu sichern. In den uebrigen Faellen ist die Durchfuehrung einer ergaenzenden Postmyelo-CT oder alternativ einer Myelo-MRT empfehlenswert. Bei manchen Patienten mit spontanem Liquorverlustsyndrom finden sich dabei mehrere Liquorlecks auf unterschiedlichen Hoehen. Leitsymptom ist in den meisten Faellen ein lageabhaengiger orthostatischer Kopfschmerz. Waehrend das postpunktionelle Syndrom unter Bettruhe und medikamentoeser Therapie oft selbstlimitierend ist, bedarf es beim spontanen Liquorverlustsyndrom meist einer Blood-patch-Therapie. Der lumbale ''blood patch'' kann in der Regel problemlos unter Durchleuchtungskontrolle erfolgen. Bei einem ''blood patch'' an der HWS oder BWS wird aus Sicherheitsgruenden eine CT-gesteuerte Durchfuehrung empfohlen, um eine streng epidurale

  11. Helicobacter sp. MIT 01-6451 infection during fetal and neonatal life in laboratory mice.

    Science.gov (United States)

    Yamanaka, Hitoki; Nakanishi, Tai; Takagi, Toshikazu; Ohsawa, Makiko; Kubo, Noriaki; Yamamoto, Naoto; Takemoto, Takahira; Ohsawa, Kazutaka

    2015-01-01

    Helicobacter sp. MIT 01-6451 has been detected in SPF mice kept in Japan. To characterize strain MIT 01-6451, its infection route during fetal and neonatal life and effects on pregnancy were investigated using immunocompetent and immunodeficient mouse strains (BALB/c, C57BL/6, and SCID). MIT 01-6451 was detected in the uterus, vagina, and mammary glands of 50% of infected SCID mice, whereas these tissues were all negative in immunocompetent mice. No fetal infections with MIT 01-6451 were detected at 16-18 days after pregnancy in any mouse strain. In newborn mice, MIT 01-6451 was detected in intestinal tissue of C57BL/6 and SCID mice at 9-11 days after birth, but not in BALB/c mice. The IgA and IgG titers to MIT 01-6451 in sera of C57BL/6 female mice were significantly lower than those of BALB/c mice. Although no significant differences in the number of newborns per litter were observed between MIT 01-6451-infected and MIT 01-6451-free dams, the birth rate was lower in infected SCID mice than in control SCID mice. The present results indicated that MIT 01-6451 infects newborn mice after birth rather than by vertical transmission to the fetus via the placenta and that MIT 01-6451 infection shows opportunistically negative effects on the birth rate. In addition, the maternal immune response may affect infection of newborn mice with MIT 01-6451 through breast milk.

  12. Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation

    International Nuclear Information System (INIS)

    Buchmann, I.

    2008-01-01

    Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. 90 Y, 188 Re and 131 I are the most frequently used β - -particles. Of these, 90 Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate 90 Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The 90 Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow 90 Y-anti-CD45-mAb YAML568 are 6.4 ± 1.2 (bone marrow), 3.9 ± 1.4 (liver) and 1.1 ± 0.4 (kidneys). CD45 is expressed also on the extramedullar clonogenic myeloma progenitor cell that circulates in the peripheral blood. Thus, the conditioning of

  13. OSI-211, a novel liposomal topoisomerase I inhibitor, is active in SCID mouse models of human AML and ALL.

    Science.gov (United States)

    Tomkinson, Blake; Bendele, Ray; Giles, Francis J; Brown, Eric; Gray, Atherton; Hart, Karen; LeRay, Jeremy D; Meyer, Denny; Pelanne, Michelle; Emerson, David L

    2003-11-01

    OSI-211 (liposomal lurtotecan), was evaluated using several different dose schedules (1mg/kg, d1-5, 1.75 mg/kg d1, 3, 5 and 6 mg/kg d1, 8) in severe combined immunodeficient (SCID) mouse models of acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL) with early treatment (ET, days 6-8) or late treatment (LT, days 15-19), examining early and advanced disease, respectively. Due to the aggressive nature of the Molt-4 model, the ET and LT were accelerated to day 3 or 4 and day 8 post-implant, respectively. For each model, 2 x 10(7) (KBM-3B) or 1 x 10(7) (Molt-4, HL-60 and CEM) leukemia cells were injected intravenously into the tail vein. Each control and test group consisted of eight animals. All three schedules (1mg/kg qd1-5, 1.75 mg/kg d1, 3, 5 and 6 mg/kg d1, 8) increased the life span of OSI-211 treated animals in each model, with a tendency toward improved efficacy with the 6 mg/kg d1, 8 schedule. As a result, the activity of the 6 mg/kg d1, 8 schedule is detailed for each model. ET significantly (Pmodel with 86% long-term survivors (LTS). Using PRC analysis, human beta-globin gene sequences in one or several tissues were amplified in all but 3 LTS, suggesting minimal residual disease in 26 of the 29 LTS. LT also significantly (Pmodel, with an average ILS=196+/-11% and one LTS. Treatment of HL-60 leukemia animals significantly (Pmodel tested, significantly (Pmodel, ET resulted in a significantly (POSI-211, treatment with DaunoXome, the liposomal formulation of daunorubicin, a drug with clinical efficacy in AML and ALL, had no effect on survival in the KBM-3B, nor Molt-4 A4 leukemia models when administered at its maximum or near maximum tolerated doses of 3mg/kg d1, 8. These data demonstrate that OSI-211 has potent antileukemia activity in preclinical SCID mouse AML and ALL leukemia models, supporting the clinical investigation of OSI-211 for hematological malignancies.

  14. Material Identification Technology (MIT) concept technical feasibility study

    International Nuclear Information System (INIS)

    Jones, J.L.; Harker, Y.D.; Yoon, W.Y.; Johnson, L.O.

    1993-09-01

    The Idaho National Engineering Laboratory (INEL) has initiated the design and development of a novel pulsed accelerator-based, active interrogation concept. The proposed concept, referred to as the Material Identification Technology (MIT), enables rapid (between accelerator pulses), non-destructive, elemental composition analysis of both nuclear and non-nuclear materials. Applications of this technique include material monitoring in support of counter-proliferation activities, such as export controls (at domestic and international inspection locations), SNM controls, nuclear weapon dismantlement, and chemical weapon verification. Material Identification Technology combines a pulsed, X-ray source (an electron accelerator) and a gamma detection system. The accelerator must maximize neutron production (pulse width, beam current, beam energy, and repetition rate) and minimize photon dose to the object. Current available accelerator technology can meet these requirements. The detection system must include detectors which provide adequate gamma energy resolution capability, rapid recovery after the initial X-ray interrogation pulse, and multiple single gamma event detection between accelerator pulses. Further research is required to develop the detection system. This report provides the initial feasibility assessment of the MIT concept

  15. MIT nuclear reactor laboratory high school teaching program

    International Nuclear Information System (INIS)

    Olmez, I.

    1991-01-01

    For the last 6 years, the Massachusetts Institute of Technology (MIT) Nuclear Reactor Laboratory's academic and scientific staff a have been conducting evening seminars for precollege science teachers, parents, and high school students from the New England area. These seminars, as outlined in this paper, are intended to give general information on nuclear technologies with specific emphasis on radiation physics, nuclear medicine, nuclear chemistry, and ongoing research activities at the MIT research reactor. The ultimate goal is to create interest or build on the already existing interest in science and technology by, for example, special student projects. Several small projects have already been completed ranging from environmental research to biological reactions with direct student involvement. Another outcome of these seminars was the change in attitudes of science teachers toward nuclear technology. Numerous letters have been received from the teachers and parents stating their previous lack of knowledge on the beneficial aspects of nuclear technologies and the subsequent inclusion of programs in their curriculum for educating students so that they may also develop a more positive attitude toward nuclear power

  16. Status of the MIT-Bates South Hall Ring commissioning

    International Nuclear Information System (INIS)

    Flanz, J.B.; Jacobs, K.D.; McAllister, B.; Averill, R.; Bradley, S.; Carter, A.; Dow, K.; Farkondeh, M.; Ihloff, E.; Kowalski, S.

    1993-01-01

    The MIT-Bates South Hall Ring construction project is now nearly complete. At this time the Energy Compression System, the SHR Injection Line and the South Hall Ring itself are complete. The SHR Extraction Line is complete but has not been connected to the ring. Commissioning with beam of the completed beam lines has been started. The MIT-Bates South Hall Ring (SHR) is an electron storage ring used with the 1 GeV Bates electron accelerator to increase the effective duty factor and luminosity. A beam can be stored for use with an internal target, thus allowing for high duty factor, high luminosity experiments. External beams with high duty factor can be obtained using resonant extraction. The new systems associated with the SHR include the Energy Compression System (ECS), the Injection line, and the Extraction line. The authors have commissioned the ECS, the new injection line and the SHR without RF. This includes transporting beam, measuring beam phase space parameters using critical injection elements including a high voltage electrostatic septum, a fast beam kicker, and storing a beam in the SHR

  17. Gene expression profiling of acute myeloid leukemia samples from adult patients with AML-M1 and -M2 through boutique microarrays, real-time PCR and droplet digital PCR.

    Science.gov (United States)

    Handschuh, Luiza; Kaźmierczak, Maciej; Milewski, Marek C; Góralski, Michał; Łuczak, Magdalena; Wojtaszewska, Marzena; Uszczyńska-Ratajczak, Barbara; Lewandowski, Krzysztof; Komarnicki, Mieczysław; Figlerowicz, Marek

    2018-03-01

    Acute myeloid leukemia (AML) is the most common and severe form of acute leukemia diagnosed in adults. Owing to its heterogeneity, AML is divided into classes associated with different treatment outcomes and specific gene expression profiles. Based on previous studies on AML, in this study, we designed and generated an AML-array containing 900 oligonucleotide probes complementary to human genes implicated in hematopoietic cell differentiation and maturation, proliferation, apoptosis and leukemic transformation. The AML-array was used to hybridize 118 samples from 33 patients with AML of the M1 and M2 subtypes of the French-American‑British (FAB) classification and 15 healthy volunteers (HV). Rigorous analysis of the microarray data revealed that 83 genes were differentially expressed between the patients with AML and the HV, including genes not yet discussed in the context of AML pathogenesis. The most overexpressed genes in AML were STMN1, KITLG, CDK6, MCM5, KRAS, CEBPA, MYC, ANGPT1, SRGN, RPLP0, ENO1 and SET, whereas the most underexpressed genes were IFITM1, LTB, FCN1, BIRC3, LYZ, ADD3, S100A9, FCER1G, PTRPE, CD74 and TMSB4X. The overexpression of the CPA3 gene was specific for AML with mutated NPM1 and FLT3. Although the microarray-based method was insufficient to differentiate between any other AML subgroups, quantitative PCR approaches enabled us to identify 3 genes (ANXA3, S100A9 and WT1) whose expression can be used to discriminate between the 2 studied AML FAB subtypes. The expression levels of the ANXA3 and S100A9 genes were increased, whereas those of WT1 were decreased in the AML-M2 compared to the AML-M1 group. We also examined the association between the STMN1, CAT and ABL1 genes, and the FLT3 and NPM1 mutation status. FLT3+/NPM1- AML was associated with the highest expression of STMN1, and ABL1 was upregulated in FLT3+ AML and CAT in FLT3- AML, irrespectively of the NPM1 mutation status. Moreover, our results indicated that CAT and WT1

  18. Clonal evolution of AML on novel FMS-like tyrosine kinase-3 (FLT3 inhibitor therapy with evolving actionable targets

    Directory of Open Access Journals (Sweden)

    Pashtoon M. Kasi

    2016-01-01

    Full Text Available For acute myeloid leukemia (AML, identification of activating mutations in the FMS-like tyrosine kinase-3 (FLT3 has led to the development of several FLT3-inhibitors. Here we present clinical and next generation sequencing data at the time of progression of a patient on a novel FLT3-inhibitor clinical trial (ASP2215 to show that employing therapeutic interventions with these novel targeted therapies can lead to consequences secondary to selective pressure and clonal evolution of cancer. We describe novel findings alongside data on treatment directed towards actionable aberrations acquired during the process. (Clinical Trial: NCT02014558; registered at: 〈https://clinicaltrials.gov/ct2/show/NCT02014558〉

  19. A case of AML with preceding hypoplastic stage after oophoro-hysterectomy and 60Co-irradiation

    International Nuclear Information System (INIS)

    Yoshida, Takashi; Nakamura, Shinobu; Hattori, Kenichi; Tanimoto, Kazuo.

    1975-01-01

    A case of AML (preceded by a hypoplastic stage) which developed after oophoro-hysterectomy and 60 Co-irradiation is presented, and related literature concerning irradiation-induced leukemia and the early diagnosis of leukemia and/or preleukemia are discussed. The patient, a 47 year old female had had surgery and irradiation with a subsequent normachromic anemia necessitating transfusions 11 years prior to her presenting herself at our hospital because of anemia. Her pancytopenic peripheral blood picture combined with a relatively hypererythroid marron led to a diagnosis of atypical hypoplastic anemia. Two years after this she suddenly developed a high fever, general fatigue and a severe anemia. Hematological studies revealed acute myeloblastic leukemia. A combination therapy consisting of DM, 6MP, prednisolon and blood transfusions was given with no effect and 3 months after the onset, the patient died of asphyxia resulting from gross hemoptysis. Autopsy revealed pulmonary hemorrhage secondary to the leukemia. (J. Evans)

  20. Mobile-IT Education (MIT.EDU): M-Learning Applications for Classroom Settings

    Science.gov (United States)

    Sung, M.; Gips, J.; Eagle, N.; Madan, A.; Caneel, R.; DeVaul, R.; Bonsen, J.; Pentland, A.

    2005-01-01

    In this paper, we describe the Mobile-IT Education (MIT.EDU) system, which demonstrates the potential of using a distributed mobile device architecture for rapid prototyping of wireless mobile multi-user applications for use in classroom settings. MIT.EDU is a stable, accessible system that combines inexpensive, commodity hardware, a flexible…

  1. MIT domain of Vps4 is a Ca2+-dependent phosphoinositide-binding domain.

    Science.gov (United States)

    Iwaya, Naoko; Takasu, Hirotoshi; Goda, Natsuko; Shirakawa, Masahiro; Tanaka, Toshiki; Hamada, Daizo; Hiroaki, Hidekazu

    2013-05-01

    The microtubule interacting and trafficking (MIT) domain is a small protein module that is conserved in proteins of diverged function, such as Vps4, spastin and sorting nexin 15 (SNX15). The molecular function of the MIT domain is protein-protein interaction, in which the domain recognizes peptides containing MIT-interacting motifs. Recently, we identified an evolutionarily related domain, 'variant' MIT domain at the N-terminal region of the microtubule severing enzyme katanin p60. We found that the domain was responsible for binding to microtubules and Ca(2+). Here, we have examined whether the authentic MIT domains also bind Ca(2+). We found that the loop between the first and second α-helices of the MIT domain binds a Ca(2+) ion. Furthermore, the MIT domains derived from Vps4b and SNX15a showed phosphoinositide-binding activities in a Ca(2+)-dependent manner. We propose that the MIT domain is a novel membrane-associating domain involved in endosomal trafficking.

  2. Scratch that: MIT's Mitchel Resnick Says Kids Should Do It for Themselves

    Science.gov (United States)

    Traylor, Scott

    2008-01-01

    Mitchel Resnick is a researcher, inventor, and professor at MIT's Media Laboratory in Cambridge, MA, and the founder of the Lifelong Kindergarten Group at MIT. He is the lead innovator behind many cutting-edge learning technologies and projects for children, including the Computer Clubhouse, PicoCrickets, and the wildly successful consumer…

  3. Assessing International Product Design and Development Graduate Courses: The MIT-Portugal Program

    Science.gov (United States)

    Dori, Yehudit Judy; Silva, Arlindo

    2010-01-01

    The Product Design and Development (PDD) course is part of the graduate curriculum in the Engineering Design and Advanced Manufacturing (EDAM) study in the MIT-Portugal Program. The research participants included about 110 students from MIT, EDAM, and two universities in Portugal, Instituto Superior Técnico-Universidade Técnica de Lisboa (IST) and…

  4. Analyse von Kunststoffadditiven mittels Laserablation gekoppelt mit induktiv gekoppelter Plasma Massenspektrometrie

    OpenAIRE

    Börno, Fabian

    2016-01-01

    Die Laserablation gekoppelt mit der Massenspektrometrie mit induktiv gekoppeltem Plasma ist eine vielversprechende direkte Feststofftechnik, die sich jedoch bei der Analyse von Kunststoffen wegen des Mangels an matrixangepassten zertifizierten Referenzmaterialien nicht durchsetzen konnte. Vorherige Arbeiten belegen polymerabhängige Abtragsraten. Das oft als interner Standard verwendete Intensitätssignal des Kohlenstoffisotopes 13C zur Korrektur dieser Unterschiede wird in der Literatur kritis...

  5. Der Entwurf einer Musterwohnung für ältere Menschen mit Demenz

    NARCIS (Netherlands)

    Joost van Hoof

    2014-01-01

    Einführung Ältere Menschen mit Demenz brauchen Wohnungen, die sowohl altersgemäß ausgestattet sind als auch die erforderliche Pflege im Haus anbieten. Traditionelle Änderungen und entsprechende Technologien bieten in erster Linie Lösungen für Personen mit eingeschränkter Mobilität. Dies bedeutet,

  6. Klinische Ergebnisse in der Behandlung der rezidivierenden respiratorischen Papillomatose mit Microdebrider, intraläsionaler Cidofovir-Injektion und Impfung mit Gardasil

    OpenAIRE

    Schäfer, Fabian Axel

    2013-01-01

    Die Rekurrierende Respiratorische Papillomatose (RRP) ist eine seltene Erkrankung, die Kinder, aber auch Erwachsene betrifft. Sie ist charakterisiert durch eine Proliferation benigner Plattenepithel-Papillome innerhalb des Aerodigestiv-Traktes mit dem Larynx als Prädilektionsstelle. Hervorgerufen wird die RRP durch eine orale Infektion mit Humanen Papillomviren (HPV) der Typen 6 oder 11. Bei aggressiven Verlaufsformen, die eine Vielzahl von Papillomabtragungen im Abstand von wenigen Monaten o...

  7. Pevonedistat, a first-in-class NEDD8-activating enzyme inhibitor, combined with azacitidine in patients with AML.

    Science.gov (United States)

    Swords, Ronan T; Coutre, Steven; Maris, Michael B; Zeidner, Joshua F; Foran, James M; Cruz, Jose; Erba, Harry P; Berdeja, Jesus G; Tam, Wayne; Vardhanabhuti, Saran; Pawlikowska-Dobler, Iwona; Faessel, Hélène M; Dash, Ajeeta B; Sedarati, Farhad; Dezube, Bruce J; Faller, Douglas V; Savona, Michael R

    2018-03-29

    Pevonedistat (TAK-924/MLN4924) is a novel inhibitor of NEDD8-activating enzyme (NAE) with single-agent activity in relapsed/refractory acute myeloid leukemia (AML). We performed a phase 1b study of pevonedistat (PEV) with azacitidine (AZA) based on synergistic activity seen preclinically. Primary objectives included safety and tolerability, and secondary objectives included pharmacokinetics (PK) and disease response. Patients ≥60 years with treatment-naive AML (unfit for standard induction therapy) received PEV 20 or 30 mg/m 2 IV on days 1, 3, and 5 combined with fixed-dose AZA (75 mg/m 2 IV/subcutaneously) on days 1 to 5, 8, and 9, every 28 days. The most common treatment-emergent adverse events were constipation (48%), nausea (42%), fatigue (42%), and anemia (39%). In total, 11 deaths were observed and considered unrelated to study therapy by the investigators. Transient elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were dose limiting. The recommended phase 2 dose (RP2D) of PEV in this combination is 20 mg/m 2 PEV PK was not altered by the addition of AZA. Overall response rate (ORR) based on an intent-to-treat analysis was 50% (20 complete remissions [CRs], 5 complete remission with incomplete peripheral count recovery, 7 partial remissions [PRs]), with an 8.3-month median duration of remission. In patients receiving ≥6 cycles of therapy (n = 23, 44%), ORR was 83%. In patients with TP53 mutations, the composite CR/PR rate was 80% (4/5). Two of these patients stayed on study for >10 cycles. Baseline bone marrow blast percentage or cytogenetic/molecular risk did not influence ORR. This study was registered at www.clinicaltrials.gov as #NCT01814826. © 2018 by The American Society of Hematology.

  8. Identification of the Molecular Mechanisms Responsible for the Inhibition of Homing of AML Cells Triggered by CD44-Ligation

    KAUST Repository

    Al-Jifri, Ablah

    2011-08-03

    Acute Myeloid Leukemia (AML) is a cancerous disease that is defined by the inability to produce functional and mature blood cells, as well as the uncontrolled proliferation due to failure to undergo apoptosis of abnormal cells. The most common therapy for Leukemia, chemotherapy, has proven only to be partially efficient since it does not target the leukemic stem cells (LSCs) that have a high self-renewal and repopulation capacity and result in remission of the disease. Therefore targeting LSCs will provide more efficient therapy. One way to achieve this would be to inhibit their homing capability to the bone marrow. It has recently been shown that CD44, an adhesive molecule, plays a crucial role in cell trafficking and lodgement of both normal and leukemic stem cells. More importantly anti-CD44 monoclonal antibodies, along with its ability to induce differentiation of leukemic blasts, it inhibits specifically the homing capacity of LSCs to their micro-environmental niches. However, these molecular mechanisms that underlie the inhibition of homing have yet to be determined. To address these questions we conducted in vitro adhesion and blot-rolling assays to analyze the adherence and rolling capacity of these LSCs before and after treatment with anti-CD44 monoclonal antibody (mAb). Since glycosyltransferases play a crucial role in post translational carbohydrate decoration on adhesion molecules, we analyzed the expression (using quantitative PCR) of the different glycosyltransferases expressed in LSC\\'s before and after CD44 ligation (mAb treatment). Furthermore, we analyzed differentiation by flow cytometric analysis of treated and non-treated LSC\\'s. We anticipate that our results will set forth new insights into targeted therapies for AML.

  9. Transformation from refractory anemia with excess of blasts (RAEB) into acute myeloid leukemia (AML) obserbed in a heavily exposed atomic bomb survivor

    Energy Technology Data Exchange (ETDEWEB)

    Iwato, Koji; Kawano, Michio; Kimura, Akiro; Kuramoto, Atsushi; Tanaka, Kimio; Kamada, Nanao

    1987-01-01

    A heavily exposed atomic bomb survivor, 59-year-old man presented refractory anemia with excess of blasts (RAEB) terminating in acute myeloid leukemia (AML) 38 years after exposure. When he manifested AML, combination chemotherapy was started. But complete remission was not obtained even by B-DOMP regimen. Cytogenetic studies were performed, and their relation to the clinical course was analyzed. Peripheral blood T lymphocytes had 41.9 % non-clonal chromosomal abnormalities suggesting over 400 rad exposure. Bone marrow cells at RAEB exhibited a presence of mosaic clones of normal and abnormal chromosomal pattern, which supported the clinical diagnosis of RAEB and corresponded to the clinical features such as steady state and a low percentage of myeloblasts. At transformation into AML, clonal chromosomal abnormality was seen in bone marrow cells. It may explain a rapid increase of abnormal cells. This abnormal clone showed a little different karyotype seen at RAEB. But it was suspected to derive from a clone at RAEB, because of the same persistent chromosomal abnormalities. Then it aquired an additional chromosomal abnormalities at clinically drug-resistant phase of AML. In vivo selection assay of these leukemic cells revealed that transforming gene took part in this leukemogenesis. These data shown in this paper contribute to investigate a mechanism of leukemogenesis in atomic bomb survivors and establishment of new therapy.

  10. Detection of TET2, KRAS and CBL variants by Next Generation Sequencing and analysis of their correlation with JAK2 and FLT3 in childhood AML

    Directory of Open Access Journals (Sweden)

    Dilara Fatma Akin

    2016-04-01

    Conclusion: We found novel mutations for TET2, KRAS, and CBL. The detected variants in this article seem to be the first screening results of genes studied by NGS in childhood AML patients. Our results also showed some degree of association between FLT3-ITD and TET2, KRAS, CBL mutations.

  11. Transformation from refractory anemia with excess of blasts (RAEB) into acute myeloid leukemia (AML) obserbed in a heavily exposed atomic bomb survivor

    International Nuclear Information System (INIS)

    Iwato, Koji; Kawano, Michio; Kimura, Akiro; Kuramoto, Atsushi; Tanaka, Kimio; Kamada, Nanao

    1987-01-01

    A heavily exposed atomic bomb survivor, 59-year-old man presented refractory anemia with excess of blasts (RAEB) terminating in acute myeloid leukemia (AML) 38 years after exposure. When he manifested AML, combination chemotherapy was started. But complete remission was not obtained even by B-DOMP regimen. Cytogenetic studies were performed, and their relation to the clinical course was analyzed. Peripheral blood T lymphocytes had 41.9 % non-clonal chromosomal abnormalities suggesting over 400 rad exposure. Bone marrow cells at RAEB exhibited a presence of mosaic clones of normal and abnormal chromosomal pattern, which supported the clinical diagnosis of RAEB and corresponded to the clinical features such as steady state and a low percentage of myeloblasts. At transformation into AML, clonal chromosomal abnormality was seen in bone marrow cells. It may explain a rapid increase of abnormal cells. This abnormal clone showed a little different karyotype seen at RAEB. But it was suspected to derive from a clone at RAEB, because of the same persistent chromosomal abnormalities. Then it aquired an additional chromosomal abnormalities at clinically drug-resistant phase of AML. In vivo selection assay of these leukemic cells revealed that transforming gene took part in this leukemogenesis. These data shown in this paper contribute to investigate a mechanism of leukemogenesis in atomic bomb survivors and establishment of new therapy. (author)

  12. The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

    DEFF Research Database (Denmark)

    Giebel, S; Labopin, M; Mohty, M

    2013-01-01

    Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

  13. The thrombopoietin/MPL/Bcl-xL pathway is essential for survival and self-renewal in human preleukemia induced by AML1-ETO

    Science.gov (United States)

    Chou, Fu-Sheng; Griesinger, Andrea; Wunderlich, Mark; Lin, Shan; Link, Kevin A.; Shrestha, Mahesh; Goyama, Susumu; Mizukawa, Benjamin; Shen, Shuhong; Marcucci, Guido

    2012-01-01

    AML1-ETO (AE) is a fusion product of translocation (8;21) that accounts for 40% of M2 type acute myeloid leukemia (AML). In addition to its role in promoting preleukemic hematopoietic cell self-renewal, AE represses DNA repair genes, which leads to DNA damage and increased mutation frequency. Although this latter function may promote leukemogenesis, concurrent p53 activation also leads to an increased baseline apoptotic rate. It is unclear how AE expression is able to counterbalance this intrinsic apoptotic conditioning by p53 to promote survival and self-renewal. In this report, we show that Bcl-xL is up-regulated in AE cells and plays an essential role in their survival and self-renewal. Further investigation revealed that Bcl-xL expression is regulated by thrombopoietin (THPO)/MPL-signaling induced by AE expression. THPO/MPL-signaling also controls cell cycle reentry and mediates AE-induced self-renewal. Analysis of primary AML patient samples revealed a correlation between MPL and Bcl-xL expression specifically in t(8;21) blasts. Taken together, we propose that survival signaling through Bcl-xL is a critical and intrinsic component of a broader self-renewal signaling pathway downstream of AML1-ETO–induced MPL. PMID:22337712

  14. Gemtuzumab ozogamicin as postremission treatment in AML at 60 years of age or more : results of a multicenter phase 3 study

    NARCIS (Netherlands)

    Lowenberg, Bob; Beck, Joachim; Graux, Carlos; van Putten, Wim; Schouten, Harry C.; Verdonck, Leo F.; Ferrant, Augustin; Sonneveld, Pieter; Jongen-Lavrencic, Mojca; von Lilienfeld-Toal, Marie; Biemond, Bart J.; Vellenga, Edo; Breems, Dimitri; de Muijnck, Hilde; Schaafsma, Ron; Verhoef, Gregor; Doehner, Hartmut; Gratwohl, Alois; Pabst, Thomas; Ossenkoppele, Gert J.; Maertens, Johan

    2010-01-01

    In older patients with acute myeloid leukemia (AML), the prevention of relapse has remained one of the major therapeutic challenges, with more than 75% relapses after complete remission. The anti-CD33 immunotoxin conjugate gemtuzumab ozogamicin (GO) has shown antileukemic remission induction

  15. Parallelization Experience with Four Canonical Econometric Models Using ParMitISEM

    Directory of Open Access Journals (Sweden)

    Nalan Baştürk

    2016-03-01

    Full Text Available This paper presents the parallel computing implementation of the MitISEM algorithm, labeled Parallel MitISEM. The basic MitISEM algorithm provides an automatic and flexible method to approximate a non-elliptical target density using adaptive mixtures of Student-t densities, where only a kernel of the target density is required. The approximation can be used as a candidate density in Importance Sampling or Metropolis Hastings methods for Bayesian inference on model parameters and probabilities. We present and discuss four canonical econometric models using a Graphics Processing Unit and a multi-core Central Processing Unit version of the MitISEM algorithm. The results show that the parallelization of the MitISEM algorithm on Graphics Processing Units and multi-core Central Processing Units is straightforward and fast to program using MATLAB. Moreover the speed performance of the Graphics Processing Unit version is much higher than the Central Processing Unit one.

  16. ASXL2 mutations are frequently found in pediatric AML patients with t(8;21)/ RUNX1-RUNX1T1 and associated with a better prognosis.

    Science.gov (United States)

    Yamato, Genki; Shiba, Norio; Yoshida, Kenichi; Shiraishi, Yuichi; Hara, Yusuke; Ohki, Kentaro; Okubo, Jun; Okuno, Haruna; Chiba, Kenichi; Tanaka, Hiroko; Kinoshita, Akitoshi; Moritake, Hiroshi; Kiyokawa, Nobutaka; Tomizawa, Daisuke; Park, Myoung-Ja; Sotomatsu, Manabu; Taga, Takashi; Adachi, Souichi; Tawa, Akio; Horibe, Keizo; Arakawa, Hirokazu; Miyano, Satoru; Ogawa, Seishi; Hayashi, Yasuhide

    2017-05-01

    ASXL2 is an epigenetic regulator involved in polycomb repressive complex regulation or recruitment. Clinical features of pediatric acute myeloid leukemia (AML) patients with ASXL2 mutations remain unclear. Thus, we investigated frequencies of ASXL1 and ASXL2 mutations, clinical features of patients with these mutations, correlations of these mutations with other genetic alterations including BCOR/BCORL1 and cohesin complex component genes, and prognostic impact of these mutations in 369 pediatric patients with de novo AML (0-17 years). We identified 9 (2.4%) ASXL1 and 17 (4.6%) ASXL2 mutations in 25 patients. These mutations were more common in patients with t(8;21)(q22;q22)/RUNX1-RUNX1T1 (ASXL1, 6/9, 67%, P = 0.02; ASXL2, 10/17, 59%, P = 0.01). Among these 25 patients, 4 (27%) of 15 patients with t(8;21) and 6 (60%) of 10 patients without t(8;21) relapsed. However, most patients with relapse were rescued using stem cell transplantation irrespective of t(8;21). The overall survival (OS) and event-free survival (EFS) rates showed no differences among pediatric AML patients with t(8;21) and ASXL1 or ASXL2 mutations and ASXL wild-type (5-year OS, 75% vs. 100% vs. 91% and 5-year EFS, 67% vs. 80% vs. 67%). In 106 patients with t(8;21) AML, the coexistence of mutations in tyrosine kinase pathways and chromatin modifiers and/or cohesin complex component genes had no effect on prognosis. These results suggest that ASXL1 and ASXL2 mutations play key roles as cooperating mutations that induce leukemogenesis, particularly in pediatric AML patients with t(8;21), and these mutations might be associated with a better prognosis than that reported previously. © 2017 Wiley Periodicals, Inc.

  17. Novel BET protein proteolysis-targeting chimera exerts superior lethal activity than bromodomain inhibitor (BETi) against post-myeloproliferative neoplasm secondary (s) AML cells.

    Science.gov (United States)

    Saenz, D T; Fiskus, W; Qian, Y; Manshouri, T; Rajapakshe, K; Raina, K; Coleman, K G; Crew, A P; Shen, A; Mill, C P; Sun, B; Qiu, P; Kadia, T M; Pemmaraju, N; DiNardo, C; Kim, M-S; Nowak, A J; Coarfa, C; Crews, C M; Verstovsek, S; Bhalla, K N

    2017-09-01

    The PROTAC (proteolysis-targeting chimera) ARV-825 recruits bromodomain and extraterminal (BET) proteins to the E3 ubiquitin ligase cereblon, leading to degradation of BET proteins, including BRD4. Although the BET-protein inhibitor (BETi) OTX015 caused accumulation of BRD4, treatment with equimolar concentrations of ARV-825 caused sustained and profound depletion (>90%) of BRD4 and induced significantly more apoptosis in cultured and patient-derived (PD) CD34+ post-MPN sAML cells, while relatively sparing the CD34+ normal hematopoietic progenitor cells. RNA-Seq, Reverse Phase Protein Array and mass cytometry 'CyTOF' analyses demonstrated that ARV-825 caused greater perturbations in messenger RNA (mRNA) and protein expressions than OTX015 in sAML cells. Specifically, compared with OTX015, ARV-825 treatment caused more robust and sustained depletion of c-Myc, CDK4/6, JAK2, p-STAT3/5, PIM1 and Bcl-xL, while increasing the levels of p21 and p27. Compared with OTX015, PROTAC ARV-771 treatment caused greater reduction in leukemia burden and further improved survival of NSG mice engrafted with luciferase-expressing HEL92.1.7 cells. Co-treatment with ARV-825 and JAK inhibitor ruxolitinib was synergistically lethal against established and PD CD34+ sAML cells. Notably, ARV-825 induced high levels of apoptosis in the in vitro generated ruxolitinib-persister or ruxolitinib-resistant sAML cells. These findings strongly support the in vivo testing of the BRD4-PROTAC based combinations against post-MPN sAML.

  18. [Dexamethasone and vorinostat cooperatively promote differentiation and apoptosis in Kasumi-1 leukemia cells through ubiquitination and degradation of AML1-ETO].

    Science.gov (United States)

    Chen, Li-ping; Zhang, Jian-wei; Xu, Fa-mei; Xing, Hai-yan; Tian, Zheng; Wang, Min; Wang, Jian-xiang

    2013-09-01

    To probe the effects of dexamethasone (DEX) combined with histone deacetylase (HDAC) inhibitor vorinostat on inhibiting proliferation and inducing differentiation and apoptosis in Kasumi-1 leukemia cells, and its possible mechanisms in order to provide a theoretical basis for the treatment of AML1-ETO positive AML. The cell survival, differentiation and apoptosis rates were tested by MTT or flow cytometry analysis after Kasumi-1 cells were treated by DMSO, DEX (20 nmol/L), vorinostat (1 μmol/L) or DEX (20 nmol/L) in combination with vorinostat (1 μmol/L). WB and IP-WB were performed to detect AML1-ETO and its ubiquitination. Treatment with the combination of DEX and vorinostat for 48 h led to statistically significant differences of inhibited proliferation [(42.06±8.20)%], increased differentiation [(52.83±8.97)%] and apoptosis [(52.92±2.53)%] of Kasumi-1 cells when compared with vorinostat [(33.82±9.41)%, (43.93±9.04)% and (42.98±3.01)%, respectively], DEX [(17.30±3.49)%, (22.53±4.51)% and (19.57±2.17)%, respectively] or control [(6.96±0.39)%, (21.73±2.03)% and (6.96±0.39)%, respectively]. Also significant ubiquitination and decreased AML1-ETO protein in Kasumi-1 cells after the combination treatment over single agent or control were observed. The results indicated that DEX and vorinostat could synergistically inhibit the Kasumi-1 cells proliferation, induce Kasumi-1 cells differentiation and apoptosis through ubiquitination and degradation of AML1-ETO.

  19. DHX15 is associated with poor prognosis in acute myeloid leukemia (AML) and regulates cell apoptosis via the NF-kB signaling pathway.

    Science.gov (United States)

    Pan, Lili; Li, Yang; Zhang, Hai-Ying; Zheng, Yi; Liu, Xiao-Li; Hu, Zheng; Wang, Yi; Wang, Jing; Cai, Yuan-Hua; Liu, Qiao; Chen, Wan-Ling; Guo, Ying; Huang, Yuan-Mao; Qian, Feng; Jin, Li; Wang, Jiucun; Wang, Shao-Yuan

    2017-10-27

    The role of DHX15 , a newly identified DEAH-box RNA helicase, in leukemogenesis remains elusive. Here, we identified a recurrent mutation in DHX15 (NM_001358:c.664C>G: p.(R222G)) in one familial AML patient and 4/240 sporadic AML patients. Additionally, DHX15 was commonly overexpressed in AML patients and associated with poor overall survival (OS) (P=0.019) and relapse-free survival (RFS) (P=0.032). In addition, we found a distinct expression pattern of DHX15 . DHX15 was highly expressed in hematopoietic stem cells and leukemia cells but was lowly expressed in mature blood cells. DHX15 was down-regulated when AML patients achieved disease remission or when leukemia cell lines were induced to differentiate. DHX15 silencing greatly inhibited leukemia cell proliferation and induced cell apoptosis and G1-phase arrest. In contrast, the restoration of DHX15 expression rescued cell viability and reduced cell apoptosis. In addition, we found that DHX15 was down-regulated when cell apoptosis was induced by ATO (arsenic trioxide); overexpression of DHX15 caused dramatic resistance to ATO-induced cell apoptosis, suggesting an important role for DHX15 in cell apoptosis. We further explored the mechanism of DHX15 in apoptosis and found that overexpression of DHX15 activated NF-kB transcription. Knockdown of DHX15 inhibited the nuclear translocation and activation of the NF-kB subunit P65 in leukemia cells. Several downstream targets of the NF-kB pathway were also down-regulated, and apoptosis-associated genes CASP3 and PARP were activated. In conclusion, this study represents the first demonstration that DHX15 plays an important role in leukemogenesis via the NF-kB signaling pathway and may serve as an independent prognostic marker for AML.

  20. [R]MIT Research Centre at Delft University of Technology: A Bridge between Research, Education, Society and Profession

    Science.gov (United States)

    Zijlstra, Hielkje

    2009-01-01

    In 2006, we launched the [R]MIT Research Centre (Modification, Intervention Transformation) at the Faculty of Architecture at Delft University of Technology. [R]MIT was founded to respond to the need for an integrated, multi-disciplinary approach to the transformation of the built environment. [R]MIT aims to bring momentum to the renewal of…

  1. Predicting material failure using mathematics; Mit Mathematik Materialversagen vorhersagen

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Christian [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany)

    2016-06-15

    Numerical simulations provide insights into materials, technical procedures or processes that are hardly possible by means of measurement technology, or require a lot of effort. In BAM's ConDrop research project (Numerical Drop Test Analyses of Steel Sheet Containers for the Konrad Repository), scientists are developing a method to predict the deformation and failure behaviour of containers for low- and intermediate- level radioactive waste for the Konrad repository. [German] Numerische Simulationen erlauben Einblicke in Materialien, technische Verfahren oder Prozesse, die mit Mitteln der Messtechnik kaum oder nur unter grossem Aufwand moeglich sind. Im BAM-Forschungsvorhaben ConDrop entwickeln Wissenschaftlerinnen und Wissenschaftler damit eine Methode, um das Verformungs- und Versagensverhalten von Behaeltern fuer schwach- und mittelradioaktive Abfaelle fuer das Endlager Konrad vorherzusagen.

  2. Operating experience with innovative environmental technologies; Betriebserfahrungen mit innovativen Umwelttechnologien

    Energy Technology Data Exchange (ETDEWEB)

    Spindler, H.; Bauermeister, U.; Kliche, H.; Seiffarth, K. (comps.)

    2000-03-01

    The MUT '99 (Merseburger Umwelt-Tag) discussed modern processes, technologies and plants for treatment and utilisation of waste. The conference was attended by industrial organisations and scientific institutions. [German] Der 9. Merseburger Umwelt-Tag MUT '99 steht unter dem Motto 'Betriebserfahrungen mit innovativen Umwelttechnologien - Moderne wirtschaftliche Verfahren, Technologien und Anlagen zur Behandlung/Verwertung nichtvermeidbaren Abfalls', wobei der Begriff 'Abfall' sich letztlich auf alle Umweltmedien bezieht. Entsprechend dem Motto dieser Tagung stellen Unternehmen, Betriebe und wissenschaftliche Einrichtungen ihre Erfahrungen auf dem Gebiet der Umwelttechnologien vor, um Entwicklungen auf diesem Gebiet einer breiten Diskussion zu eroeffnen. Dabei soll es insbesondere um die Behandlung nicht vermeidbarer Abfaelle und Abwaesser gehen. (orig.)

  3. LLIMAS: Revolutionizing integrating modeling and analysis at MIT Lincoln Laboratory

    Science.gov (United States)

    Doyle, Keith B.; Stoeckel, Gerhard P.; Rey, Justin J.; Bury, Mark E.

    2017-08-01

    MIT Lincoln Laboratory's Integrated Modeling and Analysis Software (LLIMAS) enables the development of novel engineering solutions for advanced prototype systems through unique insights into engineering performance and interdisciplinary behavior to meet challenging size, weight, power, environmental, and performance requirements. LLIMAS is a multidisciplinary design optimization tool that wraps numerical optimization algorithms around an integrated framework of structural, thermal, optical, stray light, and computational fluid dynamics analysis capabilities. LLIMAS software is highly extensible and has developed organically across a variety of technologies including laser communications, directed energy, photometric detectors, chemical sensing, laser radar, and imaging systems. The custom software architecture leverages the capabilities of existing industry standard commercial software and supports the incorporation of internally developed tools. Recent advances in LLIMAS's Structural-Thermal-Optical Performance (STOP), aeromechanical, and aero-optical capabilities as applied to Lincoln prototypes are presented.

  4. Mitä uutta Oulun ravintolatarjontaan? : markkinatutkimus uutta ravintolaa ajatellen

    OpenAIRE

    Korhonen, Kerttu

    2014-01-01

    Tämä opinnäytetyö käsittelee Oulun alueelle tehtävää markkinatutkimusta nuorten ravintolakäyttäytymisestä ja – toiveista. Tutkimuskysymys kuuluu: ”Millaista uutta ravintolaa nuoret kaipaavat Oulun ravintolamaailmaan?”. Tutkimus on tehty ajatellen uuden ravintolan perustamista. Markkinatutkimuksella selvitetään opiskelevien nuorten toiveita siitä, mitä hyvä ravintola pitää sisällään. Tutkimuksen avulla selvitetään myös kuinka paljon nuoret käyttävät rahaa ravintolakäynneillään sekä sitä, kuink...

  5. Plattenepithelkarzinom in Verbindung mit einer roten Tätowierung.

    Science.gov (United States)

    Schmitz, Inge; Prymak, Oleg; Epple, Matthias; Ernert, Carsten; Tannapfel, Andrea

    2016-06-01

    Obwohl Tätowierungen in den letzten Jahren außerordentlich beliebt geworden sind, wurde in der Literatur bisher nur über wenige Fälle schwerer Reaktionen berichtet, die zu einer malignen Transformation führten. Dies steht im Kontrast zu der praktisch unüberschaubaren Zahl an Tätowierungen weltweit. Die Zusammensetzung der für Tätowierungen verwendeten Farbstoffe variiert stark, und selbst gleiche Farbtöne können unterschiedliche Komponenten enthalten. Das Ziel unserer Studie war es zu untersuchen, auf welche Weise Tätowierungen möglicherweise Hautkrebs auslösen können. Wir berichten über den seltenen Fall einer 24-jährigen Frau, bei der sich sieben Monate nachdem sie eine Tätowierung auf dem Fußrücken erhalten hatte in unmittelbarer Nähe des verwendeten roten Farbstoffs ein Plattenepithelkarzinom entwickelte. Die Komplikationen begannen mit einer unspezifischen Schwellung. Die Läsion wurde histologisch untersucht. Die Zusammensetzung des inkorporierten Farbstoffs wurde mittels Rasterelektronenmikroskopie in Kombination mit energiedispersiver Elementanalyse analysiert. Zur weiteren Charakterisierung wurden Thermogravimetrie und Pulverdiffraktometrie eingesetzt. Der Tätowierungsfarbstoff enthielt hauptsächlich Bariumsulfat; Spuren von Al, S, Ti, P, Mg und Cl ließen sich ebenfalls nachweisen. Bei der Analyse zeigten sich Pigmentgranula unterschiedlicher Größe. In seltenen Fällen kann Tätowierungstinte karzinogene Effekte haben, die multifaktoriell zu sein scheinen. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  6. MiT family translocation renal cell carcinoma.

    Science.gov (United States)

    Argani, Pedram

    2015-03-01

    The MiT subfamily of transcription factors includes TFE3, TFEB, TFC, and MiTF. Gene fusions involving two of these transcription factors have been identified in renal cell carcinoma (RCC). The Xp11 translocation RCCs were first officially recognized in the 2004 WHO renal tumor classification, and harbor gene fusions involving TFE3. The t(6;11) RCCs harbor a specific Alpha-TFEB gene fusion and were first officially recognized in the 2013 International Society of Urologic Pathology (ISUP) Vancouver classification of renal neoplasia. These two subtypes of translocation RCC have many similarities. Both were initially described in and disproportionately involve young patients, though adult translocation RCC may overall outnumber pediatric cases. Both often have unusual and distinctive morphologies; the Xp11 translocation RCCs frequently have clear cells with papillary architecture and abundant psammomatous bodies, while the t(6;11) RCCs frequently have a biphasic appearance with both large and small epithelioid cells and nodules of basement membrane material. However, the morphology of these two neoplasms can overlap, with one mimicking the other. Both of these RCCs underexpress epithelial immunohistochemical markers like cytokeratin and epithelial membrane antigen (EMA) relative to most other RCCs. Unlike other RCCs, both frequently express the cysteine protease cathepsin k and often express melanocytic markers like HMB45 and Melan A. Finally, TFE3 and TFEB have overlapping functional activity as these two transcription factors frequently heterodimerize and bind to the same targets. Therefore, on the basis of clinical, morphologic, immunohistochemical, and genetic similarities, the 2013 ISUP Vancouver classification of renal neoplasia grouped these two neoplasms together under the heading of "MiT family translocation RCC." This review summarizes our current knowledge of these recently described RCCs. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Evaluation of the MIT RMID 1000 system for the identification of Listeria species.

    Science.gov (United States)

    Ricardi, John; Haavig, David; Cruz, Lasaunta; Paoli, George; Gehring, Andrew

    2010-01-01

    The Micro Imaging Technology (MIT) 1000 Rapid Microbial Identification (RMID) System is a device that uses the principles of light scattering coupled with proprietary algorithms to identify bacteria after being cultured and placed in a vial of filtered water. This specific method is for pure culture identification of Listeria spp. A total of 81 microorganisms (55 isolates) were tested by the MIT 1000 System, of which 25 were Listeria spp. and 30 a variety of other bacterial species. In addition, a total of 406 tests over seven different ruggedness parameters were tested by the MIT 1000 System to determine its flexibility to the specifications stated in the MIT 1000 System User Guide in areas where they might be deviated by a user to shorten the test cycle. Overall, MIT concluded that the MIT 1000 System had an accuracy performance that should certify this Performance Test Method for the identification of Listeria spp. This report discusses the tests performed, results achieved, and conclusions, along with several reference documents to enable a higher understanding of the technology used by the MIT 1000 System.

  8. Computed tomography after extracorporal shock wave lithotripsy of the kidney. Pt. 3; Prospective CT study in 105 patients and three year follow-up in 23 patients by CT and [sup 99m]Tc MAG3 clearance. Computertomographie nach extrakorporaler Stosswellenlithotripsie (ESWL) der Nieren. T. 3; Prospektive CT-Untersuchung bei 105 Patienten und Drei-Jahres-Kontrolle bei 23 Patienten mit CT und seitengetrennter [sup 99m]Tc-MAG3-Clearance

    Energy Technology Data Exchange (ETDEWEB)

    Schaub, T. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Radiologie); Schweden, F. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Radiologie); Witsch, U. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Urologie); El-Damanhoury, H. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Urologie); Schild, H. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Radiologie); Thelen, M. (Mainz Univ. (Germany). Klinik mit Poliklinik fuer Radiologie)

    1993-02-01

    In 105 patients CT studies were done prospectively after renal ESWL with a second generation lithotripter. 33 (31%) of the patients had renal oedema (n=8), renal (n=20) or extrarenal (n=31) bleeding. Three of the 23 patients who had a three year follow-up had chronic renal changes, 10 had renal stones. As blunt renal trauma can be the cause of renal hypertension a longterm follow-up is necessary in ESWL patients, particularly if there was renal bleeding after treatment. Further studies are needed to determine the exact risk of renal hypertension after ESWL. (orig.)

  9. Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI; Funktionelle MRT bei Schizophreniepatienten. Diagnostik und Therapiemonitoring kognitiver Defizite schizophrener Patienten mittels funktioneller MRT

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Sachs, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Psychiatrie und Psychotherapie, Wien (Austria)

    2010-02-15

    Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [German] Kognitive Defizite sind ein zentraler Bestandteil der Symptomatik schizophrener Patienten. Diese Defizite betreffen v. a. die Aufmerksamkeit, exekutive Funktionen sowie das Gedaechtnis. Der vorliegende Beitrag zeigt den Stellenwert der funktionellen Magnetresonanztomographie (fMRT) in Hinblick auf Diagnostik und Therapiemonitoring der unterschiedlichen kognitiven Teilbereiche auf. Darueber hinaus werden die Unterschiede in Bezug auf die Aktivierung der einzelnen Gehirnareale zwischen schizophrenen Patienten und gesunden Kontrollpersonen dargestellt. Diese Informationen sollen helfen, in der Praxis ein Profil der kognitiven Leistungsreduktionen sowie ein darauf angepasstes Therapiekonzept zu erstellen. (orig.)

  10. [Combination of busulfan with increased-dose of fludarabine as conditioning regimen for MDS and MDS-AML patients with allo-HSCT].

    Science.gov (United States)

    Yuan, Jing; Ren, Hanyun; Qiu, Zhixiang; Li, Yuan; Wang, Mangju; Liu, Wei; Xu, Weilin; Sun, Yuhua; Wang, Lihong; Liang, Zeyin; Dong, Yujun; Ou, Jinping; Wang, Wensheng; Yin, Yue; Cen, Xinan; Wang, Qian

    2015-06-01

    To investigate the safety and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndrome (MDS) and secondary acute myelogenous leukemia (MDS-AML) using conditioning regimen with busulfan (Bu) and increased-dose of fludarabine (ID-Flu). A total of 49 patients with MDS or MDS-AML were treated by allo-HSCT, the clinical data was analyzed retrospectively. All patients achieved hematopoietic reconstitution. Neutrophil engraftment was at 10 - 22 days (median 13 days), and platelet engraftment was at 8 - 66 days (median 16 days). The cumulative incidences of Ⅱ-Ⅳ degree acute graft-versus-host disease (GVHD), hemorrhagic cystitis (HC), and hepatic venous occlusive disease (VOD) were 28.6%, 14.3% and 2.0%, respectively. The transplant-related mortality (TRM) was only 4.1% at 100d and 8.2% at 1-92 months of followed-up (median 14 months) period. Overall survival (OS) and disease free survival (DFS) was 75.5%, 73.5%, respectively. Kaplan-Meier curve showed that 3-year OS and 3-year DFS was (71.1 ± 7.8)%, (66.7 ± 8.3)%, respectively, with a relapse incidence (RI) 16.3%. OS for MDS and MDS-AML was 81.5% and 68.2%, and RI in two settings was 3.7%, 31.8%, respectively. OS for MDS-AML at complete remission (CR) and non-CR subgroup was 83.3% and 50.0%, respectively, while cumulative RR was 16.7% and 50.0%, respectively. OS and RI except for non-CR subgroup were 82.1% and 7.7%. Univariate analysis showed that pre-HSCT disease status had correlation with OS (P=0.031), but age, decitabine in conditioning regimen, stem cell source, HLA matching, patient-donor gender, dose of mononuclear cells and GVHD had no correlation with OS. Bu/ID-Flu conditioning regimen for MDS and MDS-AML has high efficiency, fewer complications, lower toxicity and TRM. The OS and DFS were higher and RI was lower except for refractory MDS-AML patients. The regimen is valuable for clinical application.

  11. Skiing and snowboarding center at Bottrop; Mit Ski oder Snowboard runter von der Halde

    Energy Technology Data Exchange (ETDEWEB)

    Matthesius, M. [Lenze GmbH und Co KG, Hameln (Germany)

    2001-09-01

    The 'Alpincenter' at Bottrop is the biggest indoor winter sports center of the world. Its ventilation systems were equipped with specially selected frequency inverters. [German] Skifahren im Hochsommer? Mit dem Snowboard im Ruhrgebiet den Hang hinunter? Beste Wintersportverhaeltnisse an 365 Tagen im Jahr? Und das in Deutschland? Kein Problem. Seit Anfang des Jahres kommen in Bottrop Wintersportfreunde voll auf ihre Kosten. Nach einem halben Jahr Bauzeit hat das Alpincenter seine Pforten geoeffnet. Die Wintersporthalle ist die laengste Anlage auf der Welt. Die gesamte Belueftung wurde mit speziell auf die Klimatechnik (mit Drehzahl geregelten Ventilatoren) abgestimmten Frequenzumrichtern ausgeruestet. (orig./AKF)

  12. RIP Input Tables From WAPDEG for LA Design Selection: Repository Horizon Elevation - 2-Level AML 50% and Near Maximum

    International Nuclear Information System (INIS)

    B.E. Bullard

    1999-01-01

    The purpose of this calculation is to document the WAPDEG version 3.09 (CRWMS M and O 1998b). Software Routine Report for WAPDEG (Version 3.09) simulations used to analyze waste package degradation and failure under the repository exposure conditions characterized by a two-tier thermal loading repository design. Also documented is the post-processing of these results into tables of waste-package-degradation-time histories suitable for use as input into the Integrated Probabilistic Simulator for Environmental Systems (RIP) version 5.19.01 (Golder Associates 1998) computer program. Specifically, the WAPDEG simulations discussed in this calculation correspond to waste package emplacement conditions (repository environment and design) as defined in the Total System Performance Assessment-Viability Assessment (CRWMS M and O 1998a). Total System Performance Assessment-Viability Assessment (TSPA-VA) Analyses Technical Basis Document--Chapter 5, Waste Package Degradation Modeling And Abstraction, pp. 5-27 to 5-29, with the exception that a two-tier thermal loading design feature as specified in the License Application Design Selection (LADS) study was analyzed. The particular design feature evaluated in this report is a modification of the repository horizon elevation and layout within the Topopah Springs Member of Yucca Mountain. Specifically, the modification consists of adding a second level, 50-m above the base case repository layout. Two options were considered, representing two variations in thermal loading. In Design Feature 25e (designated DF25e), each level has an Areal Mass Loading (AML) of 42.5 MTU/acre (i.e., half the VA base case). In Design Feature 25f (designated DF25), each level has an AML of 64MTU/acre. As a result of the change in waste package placement relative to the TSPA-VA base-case design, different temperature and relative humidity time histories at the waste package surface are calculated (input to the WAPDEG simulations), and consequently

  13. Faruk Nafiz Çamlıbel’in Suda Halkalar Adlı Eserinde Su İmajları ve Benzetmeler Water Images and Metaphors in Suda Halkalar Which Faruk Nafiz Çamlıbel’s Work

    Directory of Open Access Journals (Sweden)

    Hüseyin DOĞRAMACIOĞLU

    2012-09-01

    Full Text Available Suda Halkalar (Circles in Water which the poetry book of Faruk Nafiz Çamlıbel, has not been translated into the Latin alphabet to the present day. The images of the water and metaphors which used in this work brought new connotations and approaches to the Turkish poetry. The images of the water in the poetry book are used instead of the poet's soul and dreams sometimes. These images are thought with poet’s darling and sometimes are used as a background. The poetformed the images of the water in his poem sadly. There are the poetand his darling in these tables. The images of the water and thedreams of the poet form the background of the poem. The backgroundsin this poem are repeated as a leitmotiv. Visuality and individualitybecomes important feature in these tables created by the poet. Themetaphors in the work created differently from classical Turkish poetry.These metaphors brought a new meaning to the poem. The poem basedon the intellectual grounds via metaphors. This can be considered asone of the significant achievements of Turkish poetry. We can see thatthe past remembered and desired both in poetry and metaphors bypessimistic feeling. In this respect the past affects the poet's dreamscombining with a sense of mourning, water images and metaphors inpoetry. The metaphors can be grouped as imaginary, visual andstrongly poetic ground. The feelings of pessimism and sadness arepredominant in these metaphors. The images and metaphors used bythe poet can be considered as an improvement for Turkish poetry. It isthe first research done on Suda Halkalar (Circles in Water will help tobetter understand and identify Çamlıbel’s aspect of poetry and literaryline. Faruk Nafiz Çamlıbel’in Suda Halkalar adlı şiir kitabı günümüze kadar Latin harflerine aktarılmamıştır. Bu eserde kullanılan su imajları ve benzetmeler Türk şiirine yeni yaklaşımlar ve çağrışımlar getirmiştir. Eserdeki su imajları bazen şairin ruhu ve hayalleri

  14. Radiografi med patienten i centrum?

    DEFF Research Database (Denmark)

    Møller, Louise

    2016-01-01

    This dissertations aim is to look, how radiography is performed so the patient is in center in radiological examinations, as the Danish definition of radiography prescribes. The method used in the project is an ANT analysis of actors present and of how radiography is performed in practice, combined...... whit an analysis based on Foucault’s theory of power, to answer why the examinations are build of these particular actions. This project argues that there is no center in radiography in the simple sense but instead several centers are present formed by actions and all actors must contribute...

  15. Çamlıbel - Ulubey (Uşak) Beyaz Mermerinin Jeolojik ve Fiziko-Mekanik Özelliklerinin Araştırılması

    OpenAIRE

    ÇELİK, Mustafa Yavuz; KIRILIVEREN, Sabri

    2012-01-01

    Menderes Masifinde yer alan Uşak bölgesi önemli bir mermer potansiyeline sahiptir. Bölgede Karahallı, Sivaslı ve Ulubey ilçeleri civarında mermer blok üretimi yapılmaktadır. Bu makalede, Çamlıbel-Ulubey (Uşak) beyaz mermerinin, mermer olarak kullanılabilirliği irdelenmiş ve yöre mermerleriyle karşılaştırılmaları yapılmıştır. Çamlıbel-Ulubey (Uşak) beyaz mermerinin özelliklerini belirlemek amacıyla yapılan deneylerde özgül kütle 2,73 g/cm3, kütlece su emme oranı % 0,06, doluluk oranı % 99,3, b...

  16. MIT/Draper Technology Development Partnership Project: Systems Analysis and On-Station Propulsion Subsystem Design

    National Research Council Canada - National Science Library

    Conklin, Theodore

    1998-01-01

    The objective of this thesis is to describe the process for, and the overall design that resulted from the MIT/Draper Project from August, 1996 to May, 1997, including the specific design of the on...

  17. Entwicklung und Anwendung neuer NMR-Methoden: Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern und Metabonomics

    OpenAIRE

    Büchler, Silke

    2014-01-01

    Das Ziel dieser Arbeit war die Entwicklung und Anwendung neuer Orientierungsmedien zur Strukturbestimmung mit anisotropen Parametern, sowie die Etablierung von Metabonomics-Studien an Flüssigzellkulturen und Reispflanzen.

  18. Evaluation of injuries of the upper cervical spine in a postmortem study with digital radiography, CT and MRI; Evaluation experimentell erzeugter Verletzungen der oberen Halswirbelsaeule mit digitaler Roentgentechnik, Computertomographie und Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Obenauer, S.; Herold, T.; Fischer, U.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik; Fadjasch, G.; Saternus, K.S. [Goettingen Univ. (Germany). Abt. fuer Rechtsmedizin; Koebke, J. [Koeln Univ. (Germany). Anatomisches Inst.

    1999-12-01

    obere Halswirbelsaeulen-Praeparate wurden nach definiertem Rotationstrauma sowie nach Praeparation mittels digitaler Roentgentechnik (DIMA Soft P41, Fa. Feinfokus), mittels CT (CTi, High Speed, GE) in konventioneller und in Spiraltechnik (Kollimation 1 mm, Pitch 1.0) sowie mit Hilfe der MRT (Magnetom Vision Siemens) in 2D- und 3D-Technik untersucht. Ergebnisse: Die Praeparation zeigte 6 Wirbelkoerperfrakturen, 5 Densfrakturen, 1 Fraktur des vorderen Atlasbogens, 4 knoecherne Ausrisse an den okzipitalen Kondylen und 6 Laesionen der Ligg. alaria. Die digitale Praeparateradiographie dokumentierte alle Frakturen und die 4 knoechernen Ausrissfrakturen am Condylus occipitalis. In der CT konnten alle Frakturen und ligamentaeren Verletzungen erkannt werden. Die 2D MRT wies 9 Frakturen sicher und 3 fraglich nach; die 3D MRT zeigte 7 Frakturen sicher und 5 fraglich. Von den 4 Ausrissfrakturen konnten 2 mit der 2D MRT und 1 mit der 3D MRT nachgewiesen werden. Ligamentaere Verletzungen waren sicher in der 2D MRT in 2/6 Faellen und in der 3D MRT in 1 Fall zu erkennen. Diskussion: In postmortalen Studien zeigt die CT gegenueber der digitalen Radiographie und der MRT in der Detektion von Frakturen und ligamentaeren Verletzungen der oberen Halswirbelsaeule eine Ueberlegenheit, wobei diese Ergebnisse nur bedingt auf Patienten nach Hochgeschwindigkeitstrauma uebertragbar sind. (orig.)

  19. Dendritic cells (DCs) can be successfully generated from leukemic blasts in individual patients with AML or MDS: an evaluation of different methods.

    Science.gov (United States)

    Kremser, Andreas; Dressig, Julia; Grabrucker, Christine; Liepert, Anja; Kroell, Tanja; Scholl, Nina; Schmid, Christoph; Tischer, Johanna; Kufner, Stefanie; Salih, Helmut; Kolb, Hans Jochem; Schmetzer, Helga

    2010-01-01

    Myeloid-leukemic cells (AML, MDS, CML) can be differentiated to leukemia-derived dendritic cell [DC (DCleu)] potentially presenting the whole leukemic antigen repertoire without knowledge of distinct leukemia antigens and are regarded as promising candidates for a vaccination strategy. We studied the capability of 6 serum-free DC culture methods, chosen according to different mechanisms, to induce DC differentiation in 137 cases of AML and 52 cases of MDS. DC-stimulating substances were cytokines ("standard-medium", "MCM-Mimic", "cytokine-method"), bacterial lysates ("Picibanil"), double-stranded RNA ["Poly (I:C)"] or a cytokine bypass method ("Ca-ionophore"). The quality/quantity of DC generated was estimated by flow cytometry studying (co) expressions of "DC"antigens, costimulatory, maturation, and blast-antigens. Comparing these methods on average 15% to 32% DC, depending on methods used, could be obtained from blast-containing mononuclear cells (MNC) in AML/MDS cases with a DC viability of more than 60%. In all, 39% to 64% of these DC were mature; 31% to 52% of leukemic blasts could be converted to DCleu and DCleu-proportions in the suspension were 2% to 70% (13%). Average results of all culture methods tested were comparable, however not every given case of AML could be differentiated to DC with 1 selected method. However performing a pre-analysis with 3 DC-generating methods (MCM-Mimic, Picibanil, Ca-ionophore) we could generate DC in any given case. Functional analyses provided proof, that DC primed T cells to antileukemia-directed cytotoxic cells, although an anti-leukemic reaction was not achieved in every case. In summary our data show that a successful, quantitative DC/DCleu generation is possible with the best of 3 previously tested methods in any given case. Reasons for different functional behaviors of DC-primed T cells must be evaluated to design a practicable DC-based vaccination strategy.

  20. Prognostic Markers in Core-Binding Factor AML and Improved Survival with Multiple Consolidation Cycles of Intermediate/High-dose Cytarabine.

    Science.gov (United States)

    Prabahran, Ashvind; Tacey, Mark; Fleming, Shaun; Wei, Andrew; Tate, Courtney; Marlton, Paula; Wight, Joel; Grigg, Andrew; Tuckfield, Annabel; Szer, Jeff; Ritchie, David; Chee, Lynette

    2018-05-02

    Core-binding factor acute myeloid leukaemia (CBF AML) defined by t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22) has a favourable prognosis, however 30-40% of patients still relapse after chemotherapy. We sought to evaluate risk factors for relapse in a de novo CBF AML cohort. A retrospective review of patients from 4 Australian tertiary centres from 2001-2012, comprising 40 t(8;21) and 30 inv(16) AMLs. Multivariate analysis identified age (p=0.032) and WCC>40 (p=0.025) as significant predictors for inferior OS and relapse respectively. Relapse risk was higher in the inv(16) group vs the t(8;21) group (57% vs 18%, HR 4.31, 95% CI: 1.78-10.42, p=0.001). Induction therapy had no bearing on OS or relapse free survival (RFS) however, consolidation treatment with >3 cycles of intermediate/high dose cytarabine improved OS (p=0.035) and relapse-free survival (RFS) (p=0.063). 5 patients demonstrated post-treatment stable q PCR positivity without relapse. (1)>3 consolidation cycles of intermediate/ high-dose cytarabine improves patient outcomes. (2)Age and inv(16) CBF AML subtype are predictors of inferior OS and RFS respectively. (3)Stable low-level MRD by qPCR does not predict relapse. (4)Similar OS in the inv(16) cohort compared to the t(8;21) cohort, despite a higher relapse rate, confirms salvageability of relapsed disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. "Drugwatch": Forschung mit Schlüsselprofessionellen und illegalen Drogenusern zur Identifikation von Drogentrends

    OpenAIRE

    Mason, Mark; Baker, Oswin; Hardy, Rebecca

    2007-01-01

    Die revidierte "United Kingdom Anti-Drugs Strategy" hat Lücken im Wissen über Drogen verdeutlicht: Insbesondere die Dynamiken, die mit der Entstehung regionalen Drogentrends einhergehen, erwiesen sich trotz mehrjährigem Bemühen als schwer fassbar, und einige hierzu in Großbritannien durchgeführte Studien waren mit erheblichen Problemen behaftet. Deshalb wurde vom "Drugs Analysis and Research Programme" und von "Market and Opinion Research International" (MORI) ein nationales Entwicklungsproje...

  2. Azacitidine for Front-Line Therapy of Patients with AML: Reproducible Efficacy Established by Direct Comparison of International Phase 3 Trial Data with Registry Data from the Austrian Azacitidine Registry of the AGMT Study Group

    Directory of Open Access Journals (Sweden)

    Lisa Pleyer

    2017-02-01

    Full Text Available We recently published a clinically-meaningful improvement in median overall survival (OS for patients with acute myeloid leukaemia (AML, >30% bone marrow (BM blasts and white blood cell (WBC count ≤15 G/L, treated with front-line azacitidine versus conventional care regimens within a phase 3 clinical trial (AZA-AML-001; NCT01074047; registered: February 2010. As results obtained in clinical trials are facing increased pressure to be confirmed by real-world data, we aimed to test whether data obtained in the AZA-AML-001 trial accurately represent observations made in routine clinical practice by analysing additional AML patients treated with azacitidine front-line within the Austrian Azacitidine Registry (AAR; NCT01595295; registered: May 2012 and directly comparing patient-level data of both cohorts. We assessed the efficacy of front-line azacitidine in a total of 407 patients with newly-diagnosed AML. Firstly, we compared data from AML patients with WBC ≤ 15 G/L and >30% BM blasts included within the AZA-AML-001 trial treated with azacitidine (“AML-001” cohort; n = 214 with AAR patients meeting the same inclusion criteria (“AAR (001-like” cohort; n = 95. The current analysis thus represents a new sub-analysis of the AML-001 trial, which is directly compared with a new sub-analysis of the AAR. Baseline characteristics, azacitidine application, response rates and OS were comparable between all patient cohorts within the trial or registry setting. Median OS was 9.9 versus 10.8 months (p = 0.616 for “AML-001” versus “AAR (001-like” cohorts, respectively. Secondly, we pooled data from both cohorts (n = 309 and assessed the outcome. Median OS of the pooled cohorts was 10.3 (95% confidence interval: 8.7, 12.6 months, and the one-year survival rate was 45.8%. Thirdly, we compared data from AAR patients meeting AZA-AML-001 trial inclusion criteria (n = 95 versus all AAR patients with World Health Organization (WHO-defined AML (

  3. Consecutive epigenetically-active agent combinations act in ID1-RUNX3-TET2 and HOXA pathways for Flt3ITD+ve AML.

    Science.gov (United States)

    Sayar, Hamid; Liu, Yan; Gao, Rui; Zaid, Mohammad Abu; Cripe, Larry D; Weisenbach, Jill; Sargent, Katie J; Nassiri, Mehdi; Li, Lang; Konig, Heiko; Suvannasankha, Attaya; Pan, Feng; Shanmugam, Rajasubramaniam; Goswami, Chirayu; Kapur, Reuben; Xu, Mingjiang; Boswell, H Scott

    2018-01-19

    Co-occurrence of Flt3ITD and TET2 mutations provoke an animal model of AML by epigenetic repression of Wnt pathway antagonists, including RUNX3, and by hyperexpression of ID1, encoding Wnt agonist. These affect HOXA over-expression and treatment resistance. A comparable epigenetic phenotype was identified among adult AML patients needing novel intervention. We chose combinations of targeted agents acting on distinct effectors, at the levels of both signal transduction and chromatin remodeling, in relapsed/refractory AML's, including Flt3ITD+ve, described with a signature of repressed tumor suppressor genes, involving Wnt antagonist RUNX3 , occurring along with ID1 and HOXA over-expressions. We tracked patient response to combination of Flt3/Raf inhibitor, Sorafenib, and Vorinostat, pan-histone deacetylase inhibitor, without or with added Bortezomib, in consecutive phase I trials. A striking association of rapid objective remissions (near-complete, complete responses) was noted to accompany induced early pharmacodynamic changes within patient blasts in situ, involving these effectors, significantly linking RUNX3 /Wnt antagonist de-repression (80%) and ID1 downregulation (85%), to a response, also preceded by profound HOXA9 repression. Response occurred in context of concurrent TET2 mutation/hypomorphy and Flt3ITD+ve mutation (83% of complete responses). Addition of Bortezomib to the combination was vital to attainment of complete response in Flt3ITD+ve cases exhibiting such Wnt pathway dysregulation.

  4. Outcome of children with high-risk acute myeloid leukemia given autologous or allogeneic hematopoietic cell transplantation in the aieop AML-2002/01 study.

    Science.gov (United States)

    Locatelli, F; Masetti, R; Rondelli, R; Zecca, M; Fagioli, F; Rovelli, A; Messina, C; Lanino, E; Bertaina, A; Favre, C; Giorgiani, G; Ripaldi, M; Ziino, O; Palumbo, G; Pillon, M; Pession, A; Rutella, S; Prete, A

    2015-02-01

    We analyzed the outcome of 243 children with high-risk (HR) AML in first CR1 enrolled in the AIEOP-2002/01 protocol, who were given either allogeneic (ALLO; n=141) or autologous (AUTO; n=102) hematopoietic SCT (HSCT), depending on the availability of a HLA-compatible sibling. Infants, patients with AML-M7, or complex karyotype or those with FLT3-ITD, were eligible to be transplanted also from alternative donors. All patients received a myeloablative regimen combining busulfan, cyclophosphamide and melphalan; [corrected] AUTO-HSCT patients received BM cells in most cases, while in children given ALLO-HSCT stem cell source was BM in 96, peripheral blood in 19 and cord blood in 26. With a median follow-up of 57 months (range 12-130), the probability of disease-free survival (DFS) was 73% and 63% in patients given either ALLO- or AUTO-HSCT, respectively (P=NS). Although the cumulative incidence (CI) of relapse was lower in ALLO- than in AUTO-HSCT recipients (17% vs 28%, respectively; P=0.043), the CI of TRM was 7% in both groups. Patients transplanted with unrelated donor cord blood had a remarkable 92.3% 8-year DFS probability. Altogether, these data confirm that HSCT is a suitable option for preventing leukemia recurrence in HR children with CR1 AML.

  5. Advanced modularity design for the MIT pebble bed reactor

    Energy Technology Data Exchange (ETDEWEB)

    Kadak, Andrew C. [Department of Nuclear Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 24-202 Cambridge, MA 02139-4307 (United States)]. E-mail: kadak@mit.edu; Berte, Marc V. [Department of Nuclear Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 24-202 Cambridge, MA 02139-4307 (United States)]. E-mail: mvberte@yahoo.com

    2006-03-15

    The future of all reactors will depend on whether they can be economically built and operated. One of the major impediments to new nuclear construction is the capital cost due in large part to the length of construction time and complexity of the plant. Pebble bed reactors offer the opportunity to reduce the complexity of the plant because the number of safety systems required is significantly reduced due to the inherent safety of the technology. However, because of its small size, the capital cost per kilowatt is likely to be large if traditional construction approaches are followed. This strongly suggests the need for innovative construction concepts to reduce the construction time and cost. MIT has proposed a modularity approach in which the plant is pre-built in space-frame type modules which are built in factories. These space frames would contain all the equipment contained in a given volume. Once equipment in the space frame is installed, the space frame would then be shipped to the site and assembled 'lego-style.' Studies presently underway have demonstrated the feasibility of the concept. Thermal stress analysis has been performed and an integrated design with the space frames has been developed. It is expected that this modularity approach will significantly shorten construction time and expense. This paper proposes a concept for further development, not a final design for the entire plant.

  6. Advanced modularity design for the MIT pebble bed reactor

    International Nuclear Information System (INIS)

    Kadak, Andrew C.; Berte, Marc V.

    2006-01-01

    The future of all reactors will depend on whether they can be economically built and operated. One of the major impediments to new nuclear construction is the capital cost due in large part to the length of construction time and complexity of the plant. Pebble bed reactors offer the opportunity to reduce the complexity of the plant because the number of safety systems required is significantly reduced due to the inherent safety of the technology. However, because of its small size, the capital cost per kilowatt is likely to be large if traditional construction approaches are followed. This strongly suggests the need for innovative construction concepts to reduce the construction time and cost. MIT has proposed a modularity approach in which the plant is pre-built in space-frame type modules which are built in factories. These space frames would contain all the equipment contained in a given volume. Once equipment in the space frame is installed, the space frame would then be shipped to the site and assembled 'lego-style.' Studies presently underway have demonstrated the feasibility of the concept. Thermal stress analysis has been performed and an integrated design with the space frames has been developed. It is expected that this modularity approach will significantly shorten construction time and expense. This paper proposes a concept for further development, not a final design for the entire plant

  7. Lessons learned from the MIT Tara control and data system

    International Nuclear Information System (INIS)

    Gaudreau, M.P.J.; Sullivan, J.D.; Fredian, T.W.; Irby, J.H.; Karcher, C.A.; Rameriz, R.A.; Sevillano, E.; Stillerman, J.A.; Thomas, P.

    1987-10-01

    The control and data system of the MIT Tara Tandem Mirror has worked successfully throughout the lifetime of the experiment (1983 through 1987). As the Tara project winds down, it is appropriate to summarize the lessons learned from the implementation and operation of the control and data system over the years and in its final form. The control system handled ∼2400 I/0 points in real time throughout the 5 to 10 minute shot cycle while the data system, in near real time, handled ∼1000 signals with a total of 5 to 7 Mbytes of data each shot. The implementation depended upon a consistent approach based on separating physics and engineering functions and on detailed functional diagrams with narrowly defined cross communication. This paper is a comprehensive treatment of the principal successes, residual problems, and dilemmas that arose from the beginning until the final hardware and software implementation. Suggestions for future systems of either similar size or of larger scale such as CIT are made in the conclusion. 11 refs., 1 fig

  8. Pediatric acute myeloid leukemia with t(8;16)(p11;p13), a distinct clinical and biological entity: a collaborative study by the International-Berlin-Frankfurt-Münster AML-study group

    Science.gov (United States)

    Coenen, Eva A.; Zwaan, C. Michel; Reinhardt, Dirk; Harrison, Christine J.; Haas, Oskar A.; de Haas, Valerie; Mihál, Vladimir; De Moerloose, Barbara; Jeison, Marta; Rubnitz, Jeffrey E.; Tomizawa, Daisuke; Johnston, Donna; Alonzo, Todd A.; Hasle, Henrik; Auvrignon, Anne; Dworzak, Michael; Pession, Andrea; van der Velden, Vincent H. J.; Swansbury, John; Wong, Kit-fai; Terui, Kiminori; Savasan, Sureyya; Winstanley, Mark; Vaitkeviciene, Goda; Zimmermann, Martin; Pieters, Rob; van den Heuvel-Eibrink, Marry M.

    2013-01-01

    In pediatric acute myeloid leukemia (AML), cytogenetic abnormalities are strong indicators of prognosis. Some recurrent cytogenetic abnormalities, such as t(8;16)(p11;p13), are so rare that collaborative studies are required to define their prognostic impact. We collected the clinical characteristics, morphology, and immunophenotypes of 62 pediatric AML patients with t(8;16)(p11;p13) from 18 countries participating in the International Berlin-Frankfurt-Münster (I-BFM) AML study group. We used the AML-BFM cohort diagnosed from 1995-2005 (n = 543) as a reference cohort. Median age of the pediatric t(8;16)(p11;p13) AML patients was significantly lower (1.2 years). The majority (97%) had M4-M5 French-American-British type, significantly different from the reference cohort. Erythrophagocytosis (70%), leukemia cutis (58%), and disseminated intravascular coagulation (39%) occurred frequently. Strikingly, spontaneous remissions occurred in 7 neonates with t(8;16)(p11;p13), of whom 3 remain in continuous remission. The 5-year overall survival of patients diagnosed after 1993 was 59%, similar to the reference cohort (P = .14). Gene expression profiles of t(8;16)(p11;p13) pediatric AML cases clustered close to, but distinct from, MLL-rearranged AML. Highly expressed genes included HOXA11, HOXA10, RET, PERP, and GGA2. In conclusion, pediatric t(8;16)(p11;p13) AML is a rare entity defined by a unique gene expression signature and distinct clinical features in whom spontaneous remissions occur in a subset of neonatal cases. PMID:23974201

  9. CD4(+)and CD8(+)T-cell reactions against leukemia-associated- or minor-histocompatibility-antigens in AML-patients after allogeneic SCT.

    Science.gov (United States)

    Steger, Brigitte; Milosevic, Slavoljub; Doessinger, Georg; Reuther, Susanne; Liepert, Anja; Braeu, Marion; Schick, Julia; Vogt, Valentin; Schuster, Friedhelm; Kroell, Tanja; Busch, Dirk H; Borkhardt, Arndt; Kolb, Hans-Jochem; Tischer, Johanna; Buhmann, Raymund; Schmetzer, Helga

    2014-04-01

    T-cells play an important role in the remission-maintenance in AML-patients (pts) after SCT, however the role of LAA- (WT1, PR1, PRAME) or minor-histocompatibility (mHag, HA1) antigen-specific CD4(+) and CD8(+)T-cells is not defined. A LAA/HA1-peptide/protein stimulation, cloning and monitoring strategy for specific CD8(+)/CD4(+)T-cells in AML-pts after SCT is given. Our results show that (1) LAA-peptide-specific CD8+T-cells are detectable in every AML-pt after SCT. CD8(+)T-cells, recognizing two different antigens detectable in 5 of 7 cases correlate with long-lasting remissions. Clonal TCR-Vβ-restriction exemplarily proven by spectratyping in PRAME-specific CD8(+)T-cells; high PRAME-peptide-reactivity was CD4(+)-associated, as shown by IFN-γ-release. (2) Two types of antigen-presenting cells (APCs) were tested for presentation of LAA/HA1-proteins to CD4(+)T-cells: miniEBV-transduced lymphoblastoid cells (B-cell-source) and CD4-depleted MNC (source for B-cell/monocyte/DC). We provide a refined cloning-system for proliferating, CD40L(+)CD4(+)T-cells after LAA/HA1-stimulation. CD4(+)T-cells produced cytokines (GM-CSF, IFN-γ) upon exposure to LAA/HA1-stimulation until after at least 7 restimulations and demonstrated cytotoxic activity against naive blasts, but not fibroblasts. Antileukemic activity of unstimulated, stimulated or cloned CD4(+)T-cells correlated with defined T-cell-subtypes and the clinical course of the disease. In conclusion we provide immunological tools to enrich and monitor LAA/HA1-CD4(+)- and CD8(+)T-cells in AML-pts after SCT and generate data with relevant prognostic value. We were able to demonstrate the presence of LAA-peptide-specific CD8(+)T-cell clones in AML-pts after SCT. In addition, we were also able to enrich specific antileukemic reactive CD4(+)T-cells without GvH-reactivity upon repeated LAA/HA1-protein stimulation and limiting dilution cloning. Copyright © 2013 Elsevier GmbH. All rights reserved.

  10. Erste Erfahrungen mit RDA an wissenschaftlichen Universalbibliotheken in Deutschland - Ergebnisse aus Fokusgruppengesprächen mit Katalogisierenden

    Directory of Open Access Journals (Sweden)

    Heidrun Wiesenmüller

    2017-04-01

    Full Text Available Einige Monate nach dem Umstieg auf das neue Regelwerk "Resource Description and Access" (RDA wurden an 18 großen deutschen wissenschaftlichen Universalbibliotheken Fokusgruppengespräche mit Katalogisierererinnen und Katalogisierern durchgeführt. Die Katalogisierenden wurden u.a. befragt, wie sicher sie sich bei der Anwendung von RDA fühlen, was sie am neuen Regelwerk gut oder schlecht finden, wie sie den Aufwand im Vergleich zum früheren Regelwerk RAK einschätzen, welche Informations- und Hilfsmittel sie verwenden und wie sie zu den regelmäßigen Änderungen im Standard stehen. Der vorliegende Aufsatz dokumentiert die Ergebnisse der Gespräche.   Several months after the introduction of the new cataloging standard "Resource Description and Access" (RDA, focus-group interviews with catalogers were conducted at 18 large academic and state libraries in Germany. Among other things, the catalogers were asked how confident they feel in applying RDA, which aspects of the new cataloging code they like or do not like, how they estimate the expenditure of time in comparison to the former cataloging code RAK, which sources they use to get help or information, and what they think about the frequent changes to the new standard. The paper presents the results of these interviews.

  11. Beyond Brooding on Oncometabolic Havoc in IDH-Mutant Gliomas and AML: Current and Future Therapeutic Strategies

    Directory of Open Access Journals (Sweden)

    Hanumantha Rao Madala

    2018-02-01

    Full Text Available Isocitrate dehydrogenases 1 and 2 (IDH1,2, the key Krebs cycle enzy