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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  20. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI); 20120419-20120421; Mannheim; DOC12dgpi43 /20120322/
    Publication Date: 2012-03-23
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie; 73. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 95. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 50. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20091021-20091024; Berlin; DOCPO19-1633 /20091015/
    Publication Date: 2009-10-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    Keywords: RECEPTOR ; Germany ; DENSITY ; HISTORY ; PATIENT ; tumour ; treatment ; MAGNETIC-RESONANCE ; hormone ; REGION ; REGIONS ; LOCALIZATION ; SCINTIGRAPHY ; PAIN ; SERUM ; ADULT ; ADULTS ; normalization ; PARATHYROID-HORMONE ; TESTS ; LOSSES ; PHOSPHATASE ; TUMOR-INDUCED OSTEOMALACIA
    Abstract: History and clinical findings: A 49-year-old woman presented with increased bone and muscle pain of the left thigh and also of the left ribs since 1 1/2 year. 2 osteolytic regions on the left proximal femur were punctured but no tumour-like changes were found. Investigations: Laboratory tests showed a severe hypophosphataemia (0.33 mmol/l), increased serum alkaline phosphatase activity and moderate elevated parathyroid hormone. Renal loss of phosphate was measured under phosphate substitution. The bone mineral density (DXA) was decreased. With octreotid scintigraphy a somatostatine receptor positive tumour was detected on the right proximal thigh and magnetic resonance scanning confirmed localization of the tumour. Treatment and course: Treatment with oral phosphate and calcitriol improved the complaints presently. After total removal of a mesenchymal tumour, normalization of serum phosphate occurred and the patient did not require any medicine and did not have complaints anymore. Conclusion: In a case of uncertain hypophosphataemic osteomalacia in adults it is essential to search for a tumour after exclusion of the rare differential diagnoses to enable a causal treatment of a potentially oncogenic osteomalacia
    Type of Publication: Journal article published
    PubMed ID: 15678388
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  • 4
    Keywords: APOPTOSIS ; CANCER ; CELLS ; GROWTH ; INHIBITOR ; SURVIVAL ; tumor ; TUMOR-CELLS ; CELL ; Germany ; KINASE ; THERAPY ; GENE-EXPRESSION ; DIFFERENTIATION ; ACTIVATION ; primary ; prognosis ; CELL-CYCLE ; ANTITUMOR-ACTIVITY ; TARGET ; NERVOUS-SYSTEM ; BONE-MARROW-TRANSPLANTATION ; STRATEGIES ; CHILDREN ; REPRESSION ; RETINOIC ACID ; 13-CIS-RETINOIC ACID ; INHIBITORS ; ONCOLOGY ; RE ; TUMOR-SUPPRESSOR ; THERAPIES ; LEVEL ; SUPPRESSOR ; USA ; BREAST-CANCER CELLS ; cell cycle arrest ; E2F-1 regulated genes ; epigenetic therapy ; HC-TOXIN ; HUMAN NEURO-BLASTOMA ; RB tumor suppressor network
    Abstract: The survival rate of children with advanced neuroblastoma (NB) is dismal despite intensive multimodal therapy. The limited efficacy and the frequent and serious side effects of currently used therapeutic regimens necessitate the development of new, less toxic treatment strategies. This study shows that the histone deacetylase inhibitor Helminthosporium carbonum (HC)-toxin suppresses the malignant phenotype of both established NB cell lines and primary NB cells with and without amplified MYCN at dosages lower than 20 nM. HC-toxin induces cell cycle arrest and apoptosis as well as neuronal differentiation and diminishes both colony formation and invasive growth. These cellular changes are accompanied by the transcriptional repression of cell cycle regulators of the retinoblastoma (RB) tumor suppressor network found at high levels in NBs with poor prognosis, like E2F-1 and its targets Skp2, N-myc, Mad2 and survivin. The levels of the hypophosphorylated active form of RB, and of cyclin-dependent kinase inhibitors including P15(INK4b), p16(INK4a), p21(cip1/waf-1) and p27(kip1) are increased. In conclusion, nanomolar doses of the HDACI HC-toxin cause a shift to a differentiated and benign phenotype of NB cells that is associated with an activation of the RB tumor suppressor network. (c) 2007 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 18074352
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  • 5
    Keywords: carcinoma ; Germany ; INHIBITION ; PROTEIN ; ACTIVATION ; antibody ; immunohistochemistry ; MUTATION ; MELANOMA ; SIGNALING PATHWAY ; THYROID-CARCINOMA ; SARCOMA ; B-RAF ; BRAF ; HIGH-FREQUENCY ; KRAS MUTATIONS ; biomarker ; monoclonal antibody ; NRAS ; IDH1 ANTIBODY ; Papillary thyroid carcinoma ; V600E
    Abstract: Activating mutations of the serine threonine kinase v-RAF murine sarcoma viral oncogene homolog B1 (BRAF) are frequent in benign and malignant human tumors and are emerging as an important biomarker. Over 95% of BRAF mutations are of the V600E type and specific small molecular inhibitors are currently under preclinical or clinical investigation. BRAF mutation status is determined by DNA-based methods, most commonly by sequencing. Here we describe the development of a monoclonal BRAF V600E mutation-specific antibody that can differentiate BRAF V600E and wild type protein in routinely processed formalin-fixed and paraffin-embedded tissue. A total of 47 intracerebral melanoma metastases and 21 primary papillary thyroid carcinomas were evaluated by direct sequencing of BRAF and by immunohistochemistry using the BRAF V600E mutation-specific antibody clone VE1. Correlation of VE1 immunohistochemistry and BRAF sequencing revealed a perfect match for both papillary thyroid carcinomas and melanoma metastases. The staining intensity in BRAF V600E mutated tumor samples ranged from weak to strong. The generally homogenous VE1 staining patterns argue against a clonal heterogeneity of the tumors investigated. Caution is essential when only poorly preserved tissue is available for VE1 immunohistochemical analysis or when tissues with only little total BRAF protein are analyzed. Immunohistochemistry using antibody VE1 may substantially facilitate molecular analysis of BRAF V600E status for diagnostic, prognostic, and predictive purposes
    Type of Publication: Journal article published
    PubMed ID: 21638088
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  • 6
    Keywords: CANCER ; radiotherapy ; RISK ; TISSUE ; RADIATION-THERAPY ; METASTASIS ; CLINICAL-TRIALS ; PROGNOSTIC-FACTORS ; LOCALIZATION ; POSITRON-EMISSION-TOMOGRAPHY ; ADULT PATIENTS ; EUROPEAN-ORGANIZATION ; ADJUVANT CHEMOTHERAPY ; HIGH-GRADE ; NEOADJUVANT CHEMOTHERAPY ; REGIONAL HYPERTHERMIA
    Abstract: Background: The role of chemotherapy in high-risk soft tissue sarcoma is controversial. Though many patients undergo initial curative resection, distant metastasis is a frequent event, resulting in 5-year overall survival rates of only 50-60%. Neo-adjuvant and adjuvant chemotherapy (CTX) has been applied to achieve pre-operative cytoreduction, assess chemosensitivity, and to eliminate occult metastasis. Here we report on the results of our non-randomized phase II study on neo-adjuvant treatment for high-risk STS. Method: Patients with potentially curative high-risk STS (size 〉= 5 cm, deep/extracompartimental localization, tumor grades II-III [FNCLCC]) were included. The protocol comprised 4 cycles of neo-adjuvant chemotherapy (EIA, etoposide 125 mg/m(2) iv days 1 and 4, ifosfamide 1500 mg/m(2) iv days 1 - 4, doxorubicin 50 mg/m(2) day 1, pegfilgrastim 6 mg sc day 5), definitive surgery with intra-operative radiotherapy, adjuvant radiotherapy and 4 adjuvant cycles of EIA. Result: Between 06/2005 and 03/2010 a total of 50 subjects (male = 33, female = 17, median age 50.1 years) were enrolled. Median follow-up was 30.5 months. The majority of primary tumors were located in the extremities or trunk (92%), 6% originated in the abdomen/retroperitoneum. Response by RECIST criteria to neo-adjuvant CTX was 6% CR (n = 3), 24% PR (n = 12), 62% SD (n = 31) and 8% PD (n = 4). Local recurrence occurred in 3 subjects (6%). Distant metastasis was observed in 12 patients (24%). Overall survival (OS) and disease-free survival (DFS) at 2 years was 83% and 68%, respectively. Multivariate analysis failed to prove influence of resection status or grade of histological necrosis on OS or DFS. Severe toxicities included neutropenic fever (4/50), cardiac toxicity (2/50), and CNS toxicity (4/50) leading to CTX dose reductions in 4 subjects. No cases of secondary leukemias were observed so far. Conclusion: The current protocol is feasible for achieving local control rates, as well as OS and DFS comparable to previously published data on neo-/adjuvant chemotherapy in this setting. However, the definitive role of chemotherapy remains unclear in the absence of large, randomized trials. Therefore, the current regimen can only be recommended within a clinical study, and a possibly increased risk of secondary leukemias has to be taken into account
    Type of Publication: Journal article published
    PubMed ID: 22152120
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  • 7
  • 8
    Keywords: GENE ; TYPE-1 ; DELETION ; MUTATIONS ; GERMLINE ; SUPPRESSOR ; SPECTRUM ; soft-tissue sarcoma ; NF1 ; MEK INHIBITION
    Abstract: Malignant peripheral nerve sheath tumors (MPNST) derive from the Schwann cell or perineurial cell lineage and occur either sporadically or in association with the tumor syndrome neurofibromatosis type 1 (NF1). MPNST often pose a diagnostic challenge due to their frequent lack of pathognomonic morphological or immunohistochemical features. Mutations in the NF1 tumor suppressor gene are found in all NF1-associated and many sporadic MPNST. The presence of NF1 mutation may have the potential to differentiate MPNST from several morphologically similar neoplasms; however, mutation detection is hampered by the size of the gene and the lack of mutational hot spots. Here we describe a newly developed monoclonal antibody binding to the C-terminus of neurofibromin (clone NFC) which was selected for optimal performance in routinely processed formalin-fixed and paraffin-embedded tissue. NFC immunohistochemistry revealed loss of neurofibromin in 22/25 (88 %) of NF1-associated and 26/61 (43 %) of sporadic MPNST. There was a strong association of neurofibromin loss with deletions affecting the NF1 gene (P 〈 0.01). In a series of 256 soft tissue tumors of different histotypes NFC staining showed loss of neurofibromin in 2/8 myxofibrosarcomas, 2/12 (16 %) pleomorphic liposarcomas, 1/16 (6 %) leiomyosarcomas, and 4/28 (14 %) unclassified undifferentiated pleomorphic sarcomas. However, loss of neurofibromin was not observed in 22 synovial sarcomas, 27 schwannomas, 23 solitary fibrous tumors, 14 low-grade fibromyxoid sarcomas, 50 dedifferentiated liposarcomas, 27 myxoid liposarcomas, 13 angiosarcomas, 9 extraskeletal myxoid chondrosarcomas, and 7 epitheloid sarcomas. Immunohistochemistry using antibody NFC may substantially facilitate sarcoma research and diagnostics.
    Type of Publication: Journal article published
    PubMed ID: 24464231
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  • 9
    Keywords: PROGNOSTIC-FACTORS ; HIGH-RISK ; PHASE-II ; EXTERNAL-BEAM RADIOTHERAPY ; ADJUVANT CHEMOTHERAPY ; NEOADJUVANT CHEMOTHERAPY ; soft-tissue sarcoma ; intraoperative radiotherapy ; RADIATION RECALL DERMATITIS ; COMBINED-MODALITY TREATMENT
    Abstract: BACKGROUND: To report the results of a subgroup analysis of a prospective phase II trial focussing on radiation therapy and outcome in patients with extremity soft tissue sarcomas (STS). METHODS: Between 2005 and 2010, 50 patients (pts) with high risk STS (size 〉/= 5 cm, deep/extracompartimental location, grade II-III (FNCLCC)) were enrolled. The protocol comprised 4 cycles of neoadjuvant chemotherapy with EIA (etoposide, ifosfamide and doxorubicin), definitive surgery with IOERT, postoperative EBRT and 4 adjuvant cycles of EIA. 34 pts, who suffered from extremity tumors and received radiation therapy after limb-sparing surgery, formed the basis of this subgroup analysis. RESULTS: Median follow-up from inclusion was 48 months in survivors. Margin status was R0 in 30 pts (88%) and R1 in 4 pts (12%). IOERT was performed as planned in 31 pts (91%) with a median dose of 15 Gy, a median electron energy of 6 MeV and a median cone size of 9 cm. All patients received postoperative EBRT with a median dose of 46 Gy after IOERT or 60 Gy without IOERT. Median time from surgery to EBRT and median EBRT duration was 36 days, respectively. One patient developed a local recurrence while 11 patients showed nodal or distant failures. The estimated 5-year rates of local control, distant control and overall survival were 97%, 66% and 79%, respectively. Postoperative wound complications were found in 7 pts (20%), resulting in delayed EBRT (〉60 day interval) in 3 pts. Acute radiation toxicity mainly consisted of radiation dermatitis (grade II: 24%, no grade III reactions). 4 pts developed grade I/II radiation recall dermatitis during adjuvant chemotherapy, which resolved during the following cycles. Severe late toxicity was observed in 6 pts (18%). Long-term limb preservation was achieved in 32 pts (94%) with good functional outcome in 81%. CONCLUSION: Multimodal therapy including IOERT and postoperative EBRT resulted in excellent local control and good overall survival in patients with high risk STS of the extremities with acceptable acute and late radiation side effects. Limb preservation with good functional outcome was achieved in the majority of patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT01382030, EudraCT 2004-002501-72, 17.06.2011.
    Type of Publication: Journal article published
    PubMed ID: 24885755
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  • 10
    Keywords: EXPRESSION ; PHENOTYPES ; HOMEOBOX GENE ; DEFICIENCY ; TURNER-SYNDROME ; IDIOPATHIC SHORT STATURE ; LERI-WEILL DYSCHONDROSTEOSIS ; CHONDROCYTE PROLIFERATION ; BONE-DEVELOPMENT ; GROWTH-PLATE
    Abstract: Deficiency of the human short stature homeobox-containing gene (SHOX) has been identified in several disorders characterized by reduced height and skeletal anomalies such as Turner syndrome, Leri-Weill dyschondrosteosis and Langer mesomelic dysplasia as well as isolated short stature. SHOX acts as a transcription factor during limb development and is expressed in chondrocytes of the growth plates. Although highly conserved in vertebrates, rodents lack a SHOX orthologue. This offers the unique opportunity to analyze the effects of human SHOX expression in transgenic mice. We have generated a mouse expressing the human SHOXa cDNA under the control of a murine Col2a1 promoter and enhancer (Tg(Col2a1-SHOX)). SHOX and marker gene expression as well as skeletal phenotypes were characterized in two transgenic lines. No significant skeletal anomalies were found in transgenic compared to wildtype mice. Quantitative and in situ hybridization analyses revealed that Tg(Col2a1-SHOX), however, affected extracellular matrix gene expression during early limb development, suggesting a role for SHOX in growth plate assembly and extracellular matrix composition during long bone development. For instance, we could show that the connective tissue growth factor gene Ctgf, a gene involved in chondrogenic and angiogenic differentiation, is transcriptionally regulated by SHOX in transgenic mice. This finding was confirmed in human NHDF and U2OS cells and chicken micromass culture, demonstrating the value of the SHOX-transgenic mouse for the characterization of SHOX-dependent genes and pathways in early limb development.
    Type of Publication: Journal article published
    PubMed ID: 24887312
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