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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC); 20070426-20070429; Leipzig; DOCFR.09.06 /20070411/
    Publication Date: 2007-04-04
    Keywords: Stammzelleigenschaften ; Glioblastom ; etablierte Zelllinien ; stem cell characteristics ; glioblastoma ; established cell lines ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
    Publication Date: 2010-02-11
    Description: Targeted monitoring of analgesia, sedation and delirium, as well as their appropriate management in critically ill patients is a standard of care in intensive care medicine. With the undisputed advantages of goal-oriented therapy established, there was a need to develop our own guidelines on analgesia and sedation in intensive care in Germany and these were published as 2nd Generation Guidelines in 2005. Through the dissemination of these guidelines in 2006, use of monitoring was shown to have improved from 8 to 51% and the use of protocol-based approaches increased to 46% (from 21%). Between 2006-2009, the existing guidelines from the DGAI (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) were developed into 3rd Generation Guidelines for the securing and optimization of quality of analgesia, sedation and delirium management in the intensive care unit (ICU). In collaboration with another 10 professional societies, the literature has been reviewed using the criteria of the Oxford Center of Evidence Based Medicine. Using data from 671 reference works, text, diagrams and recommendations were drawn up. In the recommendations, Grade "A" (very strong recommendation), Grade "B" (strong recommendation) and Grade "0" (open recommendation) were agreed. As a result of this process we now have an interdisciplinary and consensus-based set of 3rd Generation Guidelines that take into account all critically illness patient populations. The use of protocols for analgesia, sedation and treatment of delirium are repeatedly demonstrated. These guidelines offer treatment recommendations for the ICU team. The implementation of scores and protocols into routine ICU practice is necessary for their success.
    Description: Ein gezieltes Monitoring von Analgesie, Sedierung und Delir sowie das adäquate therapeutische Management bei kritisch kranken Patienten auf Intensivstationen ist eine Basismaßnahme jeder intensivmedizinischen Behandlung. Aus den unumstrittenen Vorteilen einer leitlinienorientierten Therapie ergab sich die Notwendigkeit der Entwicklung von eigenen Leitlinien zur Analgesie und Sedierung in der Intensivmedizin für Deutschland, die als S2 Leitlinie 2005 veröffentlicht wurde. Durch die Verbreitung dieser Leitlinie wurde 2006 eine Verbesserung des Monitorings von 8 auf 51% und eine Steigerung von protokollbasiertem Vorgehen von 21 auf 46% festgestellt werden.Von 2006-2009 wurde die bestehende S2 Leitlinie von der DGAI (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin) und der DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) unter Bündelung aller verfügbaren Kräfte zur Sicherung und Verbesserung der Qualität der Analgesie und Sedierung sowie zur Delirbehandlung auf der Intensivstation auf eine S3-LL erweitert. In Zusammenarbeit mit weiteren 10 Fachgesellschaften wurde die Literatur nach Kriterien des Oxford Centre of Evidence Based Medicine bewertet. Unter Berücksichtigung von 671 Literaturstellen wurden Volltext, Schemata und Empfehlungen erstellt. In den Empfehlungen wurden die Grade "A" (sehr starke Empfehlung), "B" (starke Empfehlung) und "0" (offene Empfehlung) gewählt.Als Ergebnis dieses Prozesses liegt nun eine interdisziplinär erarbeitete evidenz- und konsensbasierte Stufe 3 Leitlinie vor, die alle kritisch kranken Patientengruppen berücksichtigt.Der Nutzen von Protokollen in der Analgosedierung und bei der Delirbehandlung wurde vielfach gezeigt. Diese Leitlinie bietet eine Handlungsempfehlung für das intensivmedizinische Team. Für die Umsetzung ist die Implementierung von Scores und Protokollen in den klinischen Alltag in der Intensivmedizin erforderlich.
    Keywords: guideline ; evidence ; analgesia ; sedation ; delirium ; monitoring ; treatment ; intensive care ; Leitlinie ; Analgesie ; Sedierung ; Delir ; Monitoring ; Therapie ; Intensivmedizin ; ddc: 610
    Type: article
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC); 20130526-20130529; Düsseldorf; DOCP 134 /20130521/
    Publication Date: 2013-05-22
    Keywords: actute brain injury ; metabolism ; microdialysis ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC); 20130526-20130529; Düsseldorf; DOCDI.10.11 /20130521/
    Publication Date: 2013-05-22
    Keywords: 5-ALA ; iMRI ; resection guidance ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS); 20120613-20120616; Leipzig; DOCFR.01.07 /20120604/
    Publication Date: 2012-06-05
    Keywords: neural stem cell markers ; subventricular zone ; glioblastoma ; neurale Stammzellmarker ; subventrikuläre Zone ; Glioblastome ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien; 20090524-20090527; Münster; DOCDI.08-05 /20090520/
    Publication Date: 2009-06-30
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 7
    Keywords: ANGIOGENESIS ; CANCER ; CELLS ; GROWTH ; IN-VITRO ; proliferation ; tumor ; TUMOR-CELLS ; CELL ; ENDOTHELIAL GROWTH-FACTOR ; Germany ; IN-VIVO ; MICROSCOPY ; MODEL ; THERAPY ; VITRO ; VIVO ; POPULATION ; GENE-EXPRESSION ; DIFFERENTIATION ; cytokines ; ACID ; TARGET ; DESIGN ; resistance ; EFFICACY ; STEM-CELLS ; PPAR-GAMMA ; RETINOIC ACID ; PHASE-II ; chemoresistance ; TRANS-RETINOIC ACID ; CYTOKINE ; ONCOLOGY ; secretion ; GLIOMA ; GLIOMA-CELLS ; MALIGNANT GLIOMAS ; TUMORIGENICITY ; MOTILITY ; GLIOBLASTOMA ; STEM ; TUMOR-INITIATING CELLS ; MARKER CD133
    Abstract: Purpose: Stem-like tumor cells comprise a highly tumorigenic and therapy-resistant tumor subpopulation, which is believed to substantially influence tumor initiation and therapy resistance in glioma. Currently, therapeutic, drug-induced differentiation is considered as a promising approach to eradicate this tumor-driving cell population; retinoic acid is well known as a potent modulator of differentiation and proliferation in normal stem cells. In glioma, knowledge about the efficacy of retinoic acid-induced differentiation to target the stem-like tumor cell pool could have therapeutic implications. Experimental Design: Stem-like glioma cells (SLGC) were differentiated with all-trans retinoic acid-containing medium to study the effect of differentiation on angiogenesis, invasive growth, as well as radioresistance and chemoresistance of SLGCs. In vivo effects were studied using live microscopy in a cranial window model. Results: Our data suggest that in vitro differentiation of SLGCs induces therapy-sensitizing effects, impairs the secretion of angiogenic cytokines, and disrupts SLGCs motility. Further, ex vivo differentiation reduces tumorigenicity of SLGCs. Finally, we show that all-trans retinoic acid treatment alone can induce antitumor effects in vivo. Conclusions: Altogether, these results highlight the potential of differentiation treatment to target the stem-like cell population in glioblastoma. Clin Cancer Res; 16(10); 2715-28. (C) 2010 AACR
    Type of Publication: Journal article published
    PubMed ID: 20442299
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  • 8
    Keywords: ANGIOGENESIS ; EXPRESSION ; GROWTH-FACTOR ; INVASION ; IN-VIVO ; IMMUNE-RESPONSES ; MALIGNANT GLIOMA ; PROGNOSTIC-FACTOR ; BLOOD-BRAIN-BARRIER ; LYMPHOCYTE
    Abstract: Purpose: In glioma-in contrast to various other cancers-the impact of T-lymphocytes on clinical outcome is not clear. We investigated the clinical relevance and regulation of T-cell infiltration in glioma. Experimental Design: T-cell subpopulations from entire sections of 93 WHO degrees II-IV gliomas were computationally identified using markers CD3, CD8, and Foxp3; survival analysis was then done on primary glioblastomas (pGBM). Endothelial cells expressing cellular adhesion molecules (CAM) were similarly computationally quantified from the same glioma tissues. Influence of prominent cytokines (as measured by ELISA from 53 WHO degrees II-IV glioma lysates) on CAM-expression in GBM-isolated endothelial cells was determined using flow cytometry. The functional relevance of the cytokine-mediated CAM regulation was tested in a transmigration assay using GBM-derived endothelial cells and autologous T-cells. Results: Infiltration of all T-cell subsets increased in high-grade tumors. Most strikingly, within pGBM, elevated numbers of intratumoral effector T cells (T(eff), cytotoxic and helper) significantly correlated with a better survival; regulatory T cells were infrequently present and not associated with GBM patient outcome. Interestingly, increased infiltration of T(eff) cells was related to the expression of ICAM-1 on the vessel surface. Transmigration of autologous T cells in vitro was markedly reduced in the presence of CAM-blocking antibodies. We found that TGF-beta molecules impeded transmigration and downregulated CAM-expression on GBM-isolated endothelial cells; blocking TGF-beta receptor signaling increased transmigration. Conclusions: This study provides comprehensive and novel insights into occurrence and regulation of T-cell infiltration in glioma. Specifically, targeting TGF-beta 1 and TGF-beta 2 might improve intratumoral T-cell infiltration and thus enhance effectiveness of immunotherapeutic approaches.
    Type of Publication: Journal article published
    PubMed ID: 21478334
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  • 9
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC); 20130526-20130529; Düsseldorf; DOCMI.16.07 /20130521/
    Publication Date: 2013-05-22
    Keywords: iMRI ; extent of resection ; resection guidance ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 10
    Keywords: SURVIVAL ; tumor ; THERAPY ; FOLLOW-UP ; LONG-TERM ; SURGERY ; PATIENT ; IMPACT ; RESECTION ; GLIOMAS ; MANAGEMENT ; ADULT ; REGRESSION ; THERAPIES ; GLIOMA ; methods ; LONG ; LOW-GRADE GLIOMA ; multivariate analysis ; EXTENT ; surgical resection ; LOW-GRADE ; PROGRESSION-FREE SURVIVAL ; outcome ; Low grade gliomas ; A ; randomized studies
    Abstract: Purpose: The appropriate management of low-grade gliomas is still a matter of debate. So far, there are no randomized studies that analyze the impact of surgical resection on patient outcome. The value of the data obtained from the few retrospective reports available is often limited. Patients and methods: In the present study, we performed an analysis on data of 130 adult low-grade glioma patients. Extent of the resection was evaluated in correlation to the overall survival (OS) and progression-free survival (PFS) using Cox regression multivariate analysis. Results: Extended surgery was shown to prolong OS and PFS significantly. Re-surgery in the case of a tumor relapse has a significant impact on OS and PFS, too. Conclusions: In summary, we could retrospectively evaluate a large case series of well-defined low-grade gliomas patients with a long follow-up period showing that extended surgery would be the most effective therapy for low-grade glioma patients even in recurrent diseases.
    Type of Publication: Journal article published
    PubMed ID: 19730773
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