@article{KouhestaniGeisAlsourietal.2021, author = {Kouhestani, Dina and Geis, Maria and Alsouri, Saed and Bumm, Thomas G. P. and Einsele, Hermann and Sauer, Markus and Stuhler, Gernot}, title = {Variant signaling topology at the cancer cell-T-cell interface induced by a two-component T-cell engager}, series = {Cellular \& Molecular Immunology}, volume = {18}, journal = {Cellular \& Molecular Immunology}, doi = {10.1038/s41423-020-0507-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241189}, pages = {1568-1570}, year = {2021}, abstract = {No abstract available.}, language = {en} } @article{DelgoboHeinrichsHapkeetal.2021, author = {Delgobo, Murilo and Heinrichs, Margarete and Hapke, Nils and Ashour, DiyaaElDin and Appel, Marc and Srivastava, Mugdha and Heckel, Tobias and Spyridopoulos, Ioakim and Hofmann, Ulrich and Frantz, Stefan and Ramos, Gustavo Campos}, title = {Terminally Differentiated CD4\(^+\) T Cells Promote Myocardial Inflammaging}, series = {Frontiers in Immunology}, volume = {12}, journal = {Frontiers in Immunology}, issn = {1664-3224}, doi = {10.3389/fimmu.2021.584538}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229612}, year = {2021}, abstract = {The cardiovascular and immune systems undergo profound and intertwined alterations with aging. Recent studies have reported that an accumulation of memory and terminally differentiated T cells in elderly subjects can fuel myocardial aging and boost the progression of heart diseases. Nevertheless, it remains unclear whether the immunological senescence profile is sufficient to cause age-related cardiac deterioration or merely acts as an amplifier of previous tissue-intrinsic damage. Herein, we sought to decompose the causality in this cardio-immune crosstalk by studying young mice harboring a senescent-like expanded CD4\(^+\) T cell compartment. Thus, immunodeficient NSG-DR1 mice expressing HLA-DRB1*01:01 were transplanted with human CD4\(^+\) T cells purified from matching donors that rapidly engrafted and expanded in the recipients without causing xenograft reactions. In the donor subjects, the CD4\(^+\) T cell compartment was primarily composed of na{\"i}ve cells defined as CCR7\(^+\)CD45RO\(^-\). However, when transplanted into young lymphocyte-deficient mice, CD4\(^+\) T cells underwent homeostatic expansion, upregulated expression of PD-1 receptor and strongly shifted towards effector/memory (CCR7\(^-\) CD45RO\(^+\)) and terminally-differentiated phenotypes (CCR7\(^-\)CD45RO\(^-\)), as typically seen in elderly. Differentiated CD4\(^+\) T cells also infiltrated the myocardium of recipient mice at comparable levels to what is observed during physiological aging. In addition, young mice harboring an expanded CD4\(^+\) T cell compartment showed increased numbers of infiltrating monocytes, macrophages and dendritic cells in the heart. Bulk mRNA sequencing analyses further confirmed that expanding T-cells promote myocardial inflammaging, marked by a distinct age-related transcriptomic signature. Altogether, these data indicate that exaggerated CD4\(^+\) T-cell expansion and differentiation, a hallmark of the aging immune system, is sufficient to promote myocardial alterations compatible with inflammaging in juvenile healthy mice.}, language = {en} } @article{ZetzlRennerPittigetal.2021, author = {Zetzl, Teresa and Renner, Agnes and Pittig, Andre and Jentschke, Elisabeth and Roch, Carmen and van Oorschot, Birgitt}, title = {Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer}, series = {Supportive Care in Cancer}, volume = {29}, journal = {Supportive Care in Cancer}, issn = {0941-4355}, doi = {10.1007/s00520-020-05794-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235415}, pages = {2973-2982}, year = {2021}, abstract = {Purpose Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. Methods A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). Results A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. Conclusion The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. Trial registration German Clinical Trials Register DRKS00016034}, language = {en} } @article{BarlinnWinzerWorthmannetal.2021, author = {Barlinn, J. and Winzer, S. and Worthmann, H. and Urbanek, C. and H{\"a}usler, K. G. and G{\"u}nther, A. and Erdur, H. and G{\"o}rtler, M. and Busetto, L. and Wojciechowski, C. and Schmitt, J. and Shah, Y. and B{\"u}chele, B. and Sokolowski, P. and Kraya, T. and Merkelbach, S. and Rosengarten, B. and Stangenberg-Gliss, K. and Weber, J. and Schlachetzki, F. and Abu-Mugheisib, M. and Petersen, M. and Schwartz, A. and Palm, F. and Jowaed, A. and Volbers, B. and Zickler, P. and Remi, J. and Bardutzky, J. and B{\"o}sel, J. and Audebert, H. J. and Hubert, G. J. and Gumbinger, C.}, title = {Telemedizin in der Schlaganfallversorgung - versorgungsrelevant f{\"u}r Deutschland}, series = {Der Nervenarzt}, volume = {92}, journal = {Der Nervenarzt}, number = {6}, issn = {0028-2804}, doi = {10.1007/s00115-021-01137-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307752}, pages = {593-601}, year = {2021}, abstract = {Hintergrund und Ziel Telemedizinische Schlaganfall-Netzwerke tragen dazu bei, die Schlaganfallversorgung und insbesondere den Zugang zu zeitkritischen Schlaganfalltherapien in vorrangig strukturschwachen, l{\"a}ndlichen Regionen zu gew{\"a}hrleisten. Ziel ist eine Darstellung der Nutzungsfrequenz und regionalen Verteilung dieser Versorgungsstruktur. Methoden Die Kommission „Telemedizinische Schlaganfallversorgung" der Deutschen Schlaganfall-Gesellschaft f{\"u}hrte eine Umfragestudie in allen Schlaganfall-Netzwerken durch. Ergebnisse In Deutschland sind 22 telemedizinische Schlaganfall-Netzwerke aktiv, welche insgesamt 43 Zentren (pro Netzwerk: Median 1,5, Interquartilsabstand [IQA] 1-3) sowie 225 Kooperationskliniken (pro Netzwerk: Median 9, IQA 4-17) umfassen und an einem unmittelbaren Zugang zur Schlaganfallversorgung f{\"u}r 48 Mio. Menschen teilhaben. Im Jahr 2018 wurden 38.211 Telekonsile (pro Netzwerk: Median 1340, IQA 319-2758) durchgef{\"u}hrt. Die Thrombolyserate betrug 14,1 \% (95 \%-Konfidenzintervall 13,6-14,7 \%), eine Verlegung zur Thrombektomie wurde bei 7,9 \% (95 \%-Konfidenzintervall 7,5-8,4 \%) der isch{\"a}mischen Schlaganfallpatienten initiiert. Das Finanzierungssystem ist uneinheitlich mit einem Verg{\"u}tungssystem f{\"u}r die Zentrumsleistungen in nur drei Bundesl{\"a}ndern. Diskussion Etwa jeder 10. Schlaganfallpatient wird telemedizinisch behandelt. Die telemedizinischen Schlaganfall-Netzwerke erreichen vergleichbar hohe Lyseraten und Verlegungen zur Thrombektomie wie neurologische Stroke-Units und tragen zur Sicherstellung einer fl{\"a}chendeckenden Schlaganfallversorgung bei. Eine netzwerk{\"u}bergreifende Sicherstellung der Finanzierung und einheitliche Erhebung von Qualit{\"a}tssicherungsdaten haben das Potenzial diese Versorgungsstruktur zuk{\"u}nftig weiter zu st{\"a}rken.}, language = {de} } @misc{FeketeEgbertsPreissleretal.2021, author = {Fekete, Stefanie and Egberts, K. and Preissler, T. and Wewetzer, C. and Mehler-Wex, C. and Romanos, M. and Gerlach, M.}, title = {Correction to: Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride}, series = {European Journal of Clinical Pharmacology}, volume = {77}, journal = {European Journal of Clinical Pharmacology}, number = {8}, doi = {10.1007/s00228-021-03159-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-329467}, pages = {1257}, year = {2021}, abstract = {Correction to: European Journal of Clinical Pharmacology (2021) 77:163-170 https://doi.org/10.1007/s00228-020-03000-0}, language = {en} } @misc{DietzKudsiGarciaUrenaetal.2021, author = {Dietz, Ulrich A. and Kudsi, O. Yusef and Garcia-Ure{\~n}a, Miguel and Baur, Johannes and Ramser, Michaela and Maksimovic, Sladjana and Keller, Nicola and D{\"o}rfer, J{\"o}rg and Eisner, Lukas and Wiegering, Armin}, title = {Erratum to: Robotic hernia repair III. English version}, series = {Der Chirurg}, volume = {92}, journal = {Der Chirurg}, number = {Suppl 1}, doi = {10.1007/s00104-021-01564-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-329360}, pages = {40}, year = {2021}, abstract = {No abstract available.}, language = {en} } @article{LinzBrandsKertelsetal.2021, author = {Linz, Christian and Brands, Roman C. and Kertels, Olivia and Dierks, Alexander and Brumberg, Joachim and Gerhard-Hartmann, Elena and Hartmann, Stefan and Schirbel, Andreas and Serfling, Sebastian and Zhi, Yingjun and Buck, Andreas K. and K{\"u}bler, Alexander and Hohm, Julian and Lapa, Constantin and Kircher, Malte}, title = {Targeting fibroblast activation protein in newly diagnosed squamous cell carcinoma of the oral cavity - initial experience and comparison to [\(^{18}\)F]FDG PET/CT and MRI}, series = {European Journal of Nuclear Medicine and Molecular Imaging}, volume = {48}, journal = {European Journal of Nuclear Medicine and Molecular Imaging}, number = {12}, issn = {1619-7070}, doi = {10.1007/s00259-021-05422-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307246}, pages = {3951-3960}, year = {2021}, abstract = {Purpose While [\(^{18}\)F]-fluorodeoxyglucose ([\(^{18}\)F]FDG) is the standard for positron emission tomography/computed tomography (PET/CT) imaging of oral squamous cell carcinoma (OSCC), diagnostic specificity is hampered by uptake in inflammatory cells such as neutrophils or macrophages. Recently, molecular imaging probes targeting fibroblast activation protein α (FAP), which is overexpressed in a variety of cancer-associated fibroblasts, have become available and might constitute a feasible alternative to FDG PET/CT. Methods Ten consecutive, treatment-na{\"i}ve patients (8 males, 2 females; mean age, 62 ± 9 years) with biopsy-proven OSCC underwent both whole-body [\(^{18}\)F]FDG and [\(^{68}\)Ga]FAPI-04 (FAP-directed) PET/CT for primary staging prior to tumor resection and cervical lymph node dissection. Detection of the primary tumor, as well as the presence and number of lymph node and distant metastases was analysed. Intensity of tracer accumulation was assessed by means of maximum (SUV\(_{max}\)) and peak (SUV\(_{peak}\) standardized uptake values. Histological work-up including immunohistochemical staining for FAP served as standard of reference. Results [\(^{18}\)F]FDG and FAP-directed PET/CT detected all primary tumors with a SUVmax of 25.5 ± 13.2 (FDG) and 20.5 ± 6.4 (FAP-directed) and a SUVpeak of 16.1 ± 10.3 ([\(^{18}\)F]FDG) and 13.8 ± 3.9 (FAP-directed), respectively. Regarding cervical lymph node metastases, FAP-directed PET/CT demonstrated comparable sensitivity (81.3\% vs. 87.5\%; P = 0.32) and specificity (93.3\% vs. 81.3\%; P = 0.16) to [\(^{18}\)F]FDG PET/CT. FAP expression on the cell surface of cancer-associated fibroblasts in both primary lesions as well as lymph nodes metastases was confirmed in all samples. Conclusion FAP-directed PET/CT in OSCC seems feasible. Future research to investigate its potential to improve patient staging is highly warranted.}, language = {en} } @article{GrosseRueckriegelThomaleetal.2021, author = {Grosse, Frederik and Rueckriegel, Stefan Mark and Thomale, Ulrich-Wilhelm and Hern{\´a}iz Driever, Pablo}, title = {Mapping of long-term cognitive and motor deficits in pediatric cerebellar brain tumor survivors into a cerebellar white matter atlas}, series = {Child's Nervous System}, volume = {37}, journal = {Child's Nervous System}, number = {9}, issn = {0256-7040}, doi = {10.1007/s00381-021-05244-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307416}, pages = {2787-2797}, year = {2021}, abstract = {Purpose Diaschisis of cerebrocerebellar loops contributes to cognitive and motor deficits in pediatric cerebellar brain tumor survivors. We used a cerebellar white matter atlas and hypothesized that lesion symptom mapping may reveal the critical lesions of cerebellar tracts. Methods We examined 31 long-term survivors of pediatric posterior fossa tumors (13 pilocytic astrocytoma, 18 medulloblastoma). Patients underwent neuronal imaging, examination for ataxia, fine motor and cognitive function, planning abilities, and executive function. Individual consolidated cerebellar lesions were drawn manually onto patients' individual MRI and normalized into Montreal Neurologic Institute (MNI) space for further analysis with voxel-based lesion symptom mapping. Results Lesion symptom mapping linked deficits of motor function to the superior cerebellar peduncle (SCP), deep cerebellar nuclei (interposed nucleus (IN), fastigial nucleus (FN), ventromedial dentate nucleus (DN)), and inferior vermis (VIIIa, VIIIb, IX, X). Statistical maps of deficits of intelligence and executive function mapped with minor variations to the same cerebellar structures. Conclusion We identified lesions to the SCP next to deep cerebellar nuclei as critical for limiting both motor and cognitive function in pediatric cerebellar tumor survivors. Future strategies safeguarding motor and cognitive function will have to identify patients preoperatively at risk for damage to these critical structures and adapt multimodal therapeutic options accordingly.}, language = {en} } @article{D'AndreaSoriaGrotenhuisetal.2021, author = {D'Andrea, David and Soria, Francesco and Grotenhuis, Anne J. and Cha, Eugene K. and Malats, Nuria and Di Stasi, Savino and Joniau, Steven and Cai, Tommaso and Rhijn, Bas W. G. van and Irani, Jaques and Karnes, Jeffrey and Varkarakis, John and Baniel, Jack and Palou, Joan and Babjuk, Marek and Spahn, Martin and Ardelt, Peter and Colombo, Renzo and Serretta, Vincenzo and Dalbagni, Guido and Gontero, Paolo and Bartoletti, Riccardo and Larr{\´e}, Stephane and Malmstrom, Per-Uno and Sylvester, Richard and Shariat, Shahrokh F.}, title = {Association of patients' sex with treatment outcomes after intravesical bacillus Calmette-Gu{\´e}rin immunotherapy for T1G3/HG bladder cancer}, series = {World Journal of Urology}, volume = {39}, journal = {World Journal of Urology}, number = {9}, doi = {10.1007/s00345-021-03653-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-344486}, pages = {3337-3344}, year = {2021}, abstract = {Purpose To investigate the association of patients' sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette-Gu{\´e}rin (BCG) for T1G3/HG urinary bladder cancer (UBC). Materials and methods We analyzed the data of 2635 patients treated with adjuvant intravesical BCG for T1 UBC between 1984 and 2019. We accounted for missing data using multiple imputations and adjusted for covariate imbalance between males and females using inverse probability weighting (IPW). Crude and IPW-adjusted Cox regression analyses were used to estimate the hazard ratios (HR) with their 95\% confidence intervals (CI) for the association of patients' sex with HG-recurrence and disease progression. Results A total of 2170 (82\%) males and 465 (18\%) females were available for analysis. Overall, 1090 (50\%) males and 244 (52\%) females experienced recurrence, and 391 (18\%) males and 104 (22\%) females experienced disease progression. On IPW-adjusted Cox regression analyses, female sex was associated with disease progression (HR 1.25, 95\%CI 1.01-1.56, p = 0.04) but not with recurrence (HR 1.06, 95\%CI 0.92-1.22, p = 0.41). A total of 1056 patients were treated with adequate BCG. In these patients, on IPW-adjusted Cox regression analyses, patients' sex was not associated with recurrence (HR 0.99, 95\%CI 0.80-1.24, p = 0.96), HG-recurrence (HR 1.00, 95\%CI 0.78-1.29, p = 0.99) or disease progression (HR 1.12, 95\%CI 0.78-1.60, p = 0.55). Conclusion Our analysis generates the hypothesis of a differential response to BCG between males and females if not adequately treated. Further studies should focus on sex-based differences in innate and adaptive immune system and their association with BCG response.}, language = {en} } @article{GieselKratochwilSchlittenhardtetal.2021, author = {Giesel, Frederik L. and Kratochwil, Clemens and Schlittenhardt, Joel and Dendl, Katharina and Eiber, Matthias and Staudinger, Fabian and Kessler, Lukas and Fendler, Wolfgang P. and Lindner, Thomas and Koerber, Stefan A. and Cardinale, Jens and Sennung, David and Roehrich, Manuel and Debus, Juergen and Sathekge, Mike and Haberkorn, Uwe and Calais, Jeremie and Serfling, Sebastian and Buck, Andreas L.}, title = {Head-to-head intra-individual comparison of biodistribution and tumor uptake of \(^{68}\)Ga-FAPI and \(^{18}\)F-FDG PET/CT in cancer patients}, series = {European Journal of Nuclear Medicine and Molecular Imaging}, volume = {48}, journal = {European Journal of Nuclear Medicine and Molecular Imaging}, number = {13}, issn = {1619-7070}, doi = {10.1007/s00259-021-05307-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307252}, pages = {4377-4385}, year = {2021}, abstract = {Purpose FAPI ligands (fibroblast activation protein inhibitor), a novel class of radiotracers for PET/CT imaging, demonstrated in previous studies rapid and high tumor uptake. The purpose of this study is the head-to-head intra-individual comparison of \(^{68}\)Ga-FAPI versus standard-of-care \(^{18}\)F-FDG in PET/CT in organ biodistribution and tumor uptake in patients with various cancers. Material and Methods This international retrospective multicenter analysis included PET/CT data from 71 patients from 6 centers who underwent both \(^{68}\)Ga-FAPI and \(^{18}\)F-FDG PET/CT within a median time interval of 10 days (range 1-89 days). Volumes of interest (VOIs) were manually drawn in normal organs and tumor lesions to quantify tracer uptake by SUVmax and SUVmean. Furthermore, tumor-to-background ratios (TBR) were generated (SUVmax tumor/ SUVmax organ). Results A total of 71 patients were studied of, which 28 were female and 43 male (median age 60). In 41 of 71 patients, the primary tumor was present. Forty-three of 71 patients exhibited 162 metastatic lesions. \(^{68}\)Ga-FAPI uptake in primary tumors and metastases was comparable to 18F-FDG in most cases. The SUVmax was significantly lower for \(^{68}\)Ga-FAPI than \(^{18}\)F-FDG in background tissues such as the brain, oral mucosa, myocardium, blood pool, liver, pancreas, and colon. Thus, \(^{68}\)Ga-FAPI TBRs were significantly higher than 18F-FDG TBRs in some sites, including liver and bone metastases. Conclusion Quantitative tumor uptake is comparable between \(^{68}\)Ga-FAPI and \(^{18}\)F-FDG, but lower background uptake in most normal organs results in equal or higher TBRs for \(^{68}\)Ga-FAPI. Thus, \(^{68}\)Ga-FAPI PET/CT may yield improved diagnostic information in various cancers and especially in tumor locations with high physiological \(^{18}\)F-FDG uptake.}, language = {en} } @article{FeketeEgbertsPreissleretal.2021, author = {Fekete, Stefanie and Egberts, K. and Preissler, T. and Wewetzer, C. and Mehler-Wex, C. and Romanos, M. and Gerlach, M.}, title = {Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride}, series = {European Journal of Clinical Pharmacology}, volume = {77}, journal = {European Journal of Clinical Pharmacology}, number = {2}, doi = {10.1007/s00228-020-03000-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-279893}, pages = {163-170}, year = {2021}, abstract = {Purpose Tiapride is commonly used in Europe for the treatment of tics. The aim of this study was to examine the relationship between dose and serum concentrations of tiapride and potential influential pharmacokinetic factors in children and adolescents. In addition, a preliminary therapeutic reference range for children and adolescents with tics treated with tiapride was calculated. Methods Children and adolescents treated with tiapride at three university hospitals and two departments of child and adolescents psychiatry in Germany and Austria were included in the study. Patient characteristics, doses, serum concentrations, and therapeutic outcome were assessed during clinical routine care using standardised measures. Results In the 49 paediatric patients (83.7\% male, mean age = 12.5 years), a positive correlation was found between tiapride dose (median 6.9 mg/kg, range 0.97-19.35) and serum concentration with marked inter-individual variability. The variation in dose explained 57\% of the inter-patient variability in tiapride serum concentrations; age, gender, and concomitant medication did not contribute to the variability. The symptoms improved in 83.3\% of the patients. 27.1\% of the patients had mild or moderate ADRs. No patient suffered from severe ADRs. Conclusions This study shows that tiapride treatment was effective and safe in most patients with tics. Compared with the therapeutic concentration range established for adults with Chorea Huntington, our data hinted at a lower lower limit (560 ng/ml) and similar upper limit (2000 ng/ml).}, language = {en} } @article{GuthHueserRothetal.2021, author = {Guth, Sabine and H{\"u}ser, Stephanie and Roth, Angelika and Degen, Gisela and Diel, Patrick and Edlund, Karolina and Eisenbrand, Gerhard and Engel, Karl-Heinz and Epe, Bernd and Grune, Tilman and Heinz, Volker and Henle, Thomas and Humpf, Hans-Ulrich and J{\"a}ger, Henry and Joost, Hans-Georg and Kulling, Sabine E. and Lampen, Alfonso and Mally, Angela and Marchan, Rosemarie and Marko, Doris and M{\"u}hle, Eva and Nitsche, Michael A. and R{\"o}hrdanz, Elke and Stadler, Richard and van Thriel, Christoph and Vieths, Stefan and Vogel, Rudi F. and Wascher, Edmund and Watzl, Carsten and N{\"o}thlings, Ute and Hengstler, Jan G.}, title = {Contribution to the ongoing discussion on fluoride toxicity}, series = {Archives of Toxicology}, volume = {95}, journal = {Archives of Toxicology}, number = {7}, issn = {0340-5761}, doi = {10.1007/s00204-021-03072-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307161}, pages = {2571-2587}, year = {2021}, abstract = {Since the addition of fluoride to drinking water in the 1940s, there have been frequent and sometimes heated discussions regarding its benefits and risks. In a recently published review, we addressed the question if current exposure levels in Europe represent a risk to human health. This review was discussed in an editorial asking why we did not calculate benchmark doses (BMD) of fluoride neurotoxicity for humans. Here, we address the question, why it is problematic to calculate BMDs based on the currently available data. Briefly, the conclusions of the available studies are not homogeneous, reporting negative as well as positive results; moreover, the positive studies lack control of confounding factors such as the influence of well-known neurotoxicants. We also discuss the limitations of several further epidemiological studies that did not meet the inclusion criteria of our review. Finally, it is important to not only focus on epidemiological studies. Rather, risk analysis should consider all available data, including epidemiological, animal, as well as in vitro studies. Despite remaining uncertainties, the totality of evidence does not support the notion that fluoride should be considered a human developmental neurotoxicant at current exposure levels in European countries.}, language = {en} } @article{PinkawaAebersoldBoehmeretal.2021, author = {Pinkawa, Michael and Aebersold, Daniel M. and B{\"o}hmer, Dirk and Flentje, Michael and Ghadjar, Pirus and Schmidt-Hegemann, Nina-Sophie and H{\"o}cht, Stefan and H{\"o}lscher, Tobias and M{\"u}ller, Arndt-Christian and Niehoff, Peter and Sedlmayer, Felix and Wolf, Frank and Zamboglou, Constantinos and Zips, Daniel and Wiegel, Thomas}, title = {Radiotherapy in nodal oligorecurrent prostate cancer}, series = {Strahlentherapie und Onkologie}, volume = {197}, journal = {Strahlentherapie und Onkologie}, number = {7}, issn = {0179-7158}, doi = {10.1007/s00066-021-01778-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307763}, pages = {575-580}, year = {2021}, abstract = {Objective The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer. Materials and methods A literature review focused on studies comparing metastasis-directed stereotactic ablative radiotherapy (SABR) vs. external elective nodal radiotherapy (ENRT) and studies analyzing recurrence patterns after local nodal treatment was performed. The DEGRO Prostate Cancer Expert Panel discussed the results and developed treatment recommendations. Results Metastasis-directed radiotherapy results in high local control (often > 90\% within a follow-up of 1-2 years) and can be used to improve progression-free survival or defer androgen deprivation therapy (ADT) according to prospective randomized phase II data. Distant progression after involved-node SABR only occurs within a few months in the majority of patients. ENRT improves metastases-free survival rates with increased toxicity in comparison to SABR according to retrospective comparative studies. The majority of nodal recurrences after initial local treatment of pelvic nodal metastasis are detected within the true pelvis and common iliac vessels. Conclusion ENRT with or without a boost should be preferred to SABR in pelvic nodal recurrences. In oligometastatic prostate cancer with distant (extrapelvic) nodal recurrences, SABR alone can be performed in selected cases. Application of additional systemic treatments should be based on current guidelines, with ADT as first-line treatment for hormone-sensitive prostate cancer. Only in carefully selected patients can radiotherapy be initially used without additional ADT outside of the current standard recommendations. Results of (randomized) prospective studies are needed for definitive recommendations.}, language = {en} } @article{BarileBerryBlaauboeretal.2021, author = {Barile, Frank A. and Berry, Colin and Blaauboer, Bas and Boobis, Alan and Bolt, Herrmann M. and Borgert, Christopher and Dekant, Wolfgang and Dietrich, Daniel and Domingo, Jose L. and Galli, Corrado L. and Gori, Gio Batta and Greim, Helmut and Hengstler, Jan G. and Heslop-Harrison, Pat and Kacew, Sam and Marquardt, Hans and Mally, Angela and Pelkonen, Olavi and Savolainen, Kai and Testai, Emanuela and Tsatsakis, Aristides and Vermeulen, Nico P.}, title = {The EU chemicals strategy for sustainability: in support of the BfR position}, series = {Archives of Toxicology}, volume = {95}, journal = {Archives of Toxicology}, number = {9}, issn = {0340-5761}, doi = {10.1007/s00204-021-03125-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307154}, pages = {3133-3136}, year = {2021}, abstract = {The EU chemicals strategy for sustainability (CSS) asserts that both human health and the environment are presently threatened and that further regulation is necessary. In a recent Guest Editorial, members of the German competent authority for risk assessment, the BfR, raised concerns about the scientific justification for this strategy. The complexity and interdependence of the networks of regulation of chemical substances have ensured that public health and wellbeing in the EU have continuously improved. A continuous process of improvement in consumer protection is clearly desirable but any initiative directed towards this objective must be based on scientific knowledge. It must not confound risk with other factors in determining policy. This conclusion is fully supported in the present Commentary including the request to improve both, data collection and the time-consuming and bureaucratic procedures that delay the publication of regulations.}, language = {en} } @article{DornHerzberg2021, author = {Dorn, Franziska and Herzberg, Moriz}, title = {Response to Letter to the Editor "Keeping Late Thrombectomy Imaging Protocols Simple to Avoid Analysis Paralysis"}, series = {Clinical Neuroradiology}, volume = {31}, journal = {Clinical Neuroradiology}, number = {3}, issn = {1869-1439}, doi = {10.1007/s00062-021-01091-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307023}, pages = {813-814}, year = {2021}, language = {en} } @article{PennigHoyerKrauskopfetal.2021, author = {Pennig, Lenhard and Hoyer, Ulrike Cornelia Isabel and Krauskopf, Alexandra and Shahzad, Rahil and J{\"u}nger, Stephanie T. and Thiele, Frank and Laukamp, Kai Roman and Grunz, Jan-Peter and Perkuhn, Michael and Schlamann, Marc and Kabbasch, Christoph and Borggrefe, Jan and Goertz, Lukas}, title = {Deep learning assistance increases the detection sensitivity of radiologists for secondary intracranial aneurysms in subarachnoid hemorrhage}, series = {Neuroradiology}, volume = {63}, journal = {Neuroradiology}, number = {12}, issn = {0028-3940}, doi = {10.1007/s00234-021-02697-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308117}, pages = {1985-1994}, year = {2021}, abstract = {Purpose To evaluate whether a deep learning model (DLM) could increase the detection sensitivity of radiologists for intracranial aneurysms on CT angiography (CTA) in aneurysmal subarachnoid hemorrhage (aSAH). Methods Three different DLMs were trained on CTA datasets of 68 aSAH patients with 79 aneurysms with their outputs being combined applying ensemble learning (DLM-Ens). The DLM-Ens was evaluated on an independent test set of 104 aSAH patients with 126 aneuryms (mean volume 129.2 ± 185.4 mm3, 13.0\% at the posterior circulation), which were determined by two radiologists and one neurosurgeon in consensus using CTA and digital subtraction angiography scans. CTA scans of the test set were then presented to three blinded radiologists (reader 1: 13, reader 2: 4, and reader 3: 3 years of experience in diagnostic neuroradiology), who assessed them individually for aneurysms. Detection sensitivities for aneurysms of the readers with and without the assistance of the DLM were compared. Results In the test set, the detection sensitivity of the DLM-Ens (85.7\%) was comparable to the radiologists (reader 1: 91.2\%, reader 2: 86.5\%, and reader 3: 86.5\%; Fleiss κ of 0.502). DLM-assistance significantly increased the detection sensitivity (reader 1: 97.6\%, reader 2: 97.6\%,and reader 3: 96.0\%; overall P=.024; Fleiss κ of 0.878), especially for secondary aneurysms (88.2\% of the additional aneurysms provided by the DLM). Conclusion Deep learning significantly improved the detection sensitivity of radiologists for aneurysms in aSAH, especially for secondary aneurysms. It therefore represents a valuable adjunct for physicians to establish an accurate diagnosis in order to optimize patient treatment.}, language = {en} } @article{PilgramEberweinWilleetal.2021, author = {Pilgram, Lisa and Eberwein, Lukas and Wille, Kai and Koehler, Felix C. and Stecher, Melanie and Rieg, Siegbert and Kielstein, Jan T. and Jakob, Carolin E. M. and R{\"u}thrich, Maria and Burst, Volker and Prasser, Fabian and Borgmann, Stefan and M{\"u}ller, Roman-Ulrich and Lanznaster, Julia and Isberner, Nora and Tometten, Lukas and Dolff, Sebastian}, title = {Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease}, series = {Infection}, volume = {49}, journal = {Infection}, number = {4}, organization = {LEOSS Study group}, issn = {0300-8126}, doi = {10.1007/s15010-021-01597-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308957}, pages = {725-737}, year = {2021}, abstract = {Purpose The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study's aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. Methods We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Results Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9\% versus 354/2391, 14.8\%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95\% CI 1.27-33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95\% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/µl, aOR 11.66, 95\% CI 2.49-54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95\% CI 1.17-8.82, p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95\% CI 1.13-10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95\% CI 0.68-1.93, p = 0.611). Conclusion The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.}, language = {en} } @article{HornKristLiebetal.2021, author = {Horn, A. and Krist, L. and Lieb, W. and Montellano, F. A. and Kohls, M. and Haas, K. and Gelbrich, G. and Bolay-Gehrig, S. J. and Morbach, C. and Reese, J. P. and St{\"o}rk, S. and Fricke, J. and Zoller, T. and Schmidt, S. and Triller, P. and Kretzler, L. and R{\"o}nnefarth, M. and Von Kalle, C. and Willich, S. N. and Kurth, F. and Steinbeis, F. and Witzenrath, M. and Bahmer, T. and Hermes, A. and Krawczak, M. and Reinke, L. and Maetzler, C. and Franzenburg, J. and Enderle, J. and Flinspach, A. and Vehreschild, J. and Schons, M. and Illig, T. and Anton, G. and Ungeth{\"u}m, K. and Finkenberg, B. C. and Gehrig, M. T. and Savaskan, N. and Heuschmann, P. U. and Keil, T. and Schreiber, S.}, title = {Long-term health sequelae and quality of life at least 6 months after infection with SARS-CoV-2: design and rationale of the COVIDOM-study as part of the NAPKON population-based cohort platform (POP)}, series = {Infection}, volume = {49}, journal = {Infection}, number = {6}, issn = {0300-8126}, doi = {10.1007/s15010-021-01707-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308960}, pages = {1277-1287}, year = {2021}, abstract = {Purpose Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany. Methods The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, W{\"u}rzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained. Results As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36\% wished to participate and 1295 have already been examined at least once. Conclusion NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity. Trial registration Registered at the German registry for clinical studies (DRKS00023742).}, language = {en} } @article{DichtlKocForsteretal.2021, author = {Dichtl, Karl and Koc, {\"O}zlem and Forster, Johannes and Scharf, Christina and Suerbaum, Sebastian and Andrassy, Joachim and Wagener, Johannes and Schroeder, Ines}, title = {An invasive infection caused by the thermophilic mold Talaromyces thermophilus}, series = {Infection}, volume = {49}, journal = {Infection}, number = {6}, issn = {0300-8126}, doi = {10.1007/s15010-021-01648-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308970}, pages = {1347-1353}, year = {2021}, abstract = {Background Increasing incidence of invasive infections caused by rare fungi was observed over the recent years. Case Here, we describe the first reported case of an infection caused by the thermophilic mold Talaromyces thermophilus. Cultivation and, hence, identification of this fastidious organism is challenging since standard incubation conditions are not sufficient. Retrospective analysis of patient samples and in vitro experiments demonstrated that testing for fungal antigens, i.e., the cell wall components galactomannan and β-1,3-D-glucan, is a promising tool.}, language = {en} } @article{JockelSchneiderSchlagenhaufPetsosetal.2021, author = {Jockel-Schneider, Yvonne and Schlagenhauf, Ulrich and Petsos, Hari and R{\"u}ttermann, Stefan and Schmidt, Jana and Ziebolz, Dirk and Wehner, Christian and Laky, Markus and Rott, Thea and Noack, Michael and Noack, Barbara and Lorenz, Katrin}, title = {Impact of 0.1\% octenidine mouthwash on plaque re-growth in healthy adults: a multi-center phase 3 randomized clinical trial}, series = {Clinical Oral Investigations}, volume = {25}, journal = {Clinical Oral Investigations}, number = {7}, issn = {1432-6981}, doi = {10.1007/s00784-021-03781-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307629}, pages = {4681-4689}, year = {2021}, abstract = {Objectives To investigate plaque inhibition of 0.1\% octenidine mouthwash (OCT) vs. placebo over 5 days in the absence of mechanical plaque control. Materials and methods For this randomized, placebo-controlled, double-blind, parallel group, multi-center phase 3 study, 201 healthy adults were recruited. After baseline recording of plaque index (PI) and gingival index (GI), collection of salivary samples, and dental prophylaxis, subjects were randomly assigned to OCT or placebo mouthwash in a 3:1 ratio. Rinsing was performed twice daily for 30 s. Colony forming units in saliva were determined before and after the first rinse. At day 5, PI, GI, and tooth discoloration index (DI) were assessed. Non-parametric van Elteren tests were applied with a significance level of p < 0.05. Results Treatment with OCT inhibited plaque formation more than treatment with placebo (PI: 0.36 vs. 1.29; p < 0.0001). OCT reduced GI (0.04 vs. placebo 0.00; p = 0.003) and salivary bacterial counts (2.73 vs. placebo 0.24 lgCFU/ml; p < 0.0001). Tooth discoloration was slightly higher under OCT (DI: 0.25 vs. placebo 0.00; p = 0.0011). Mild tongue staining and dysgeusia occurred. Conclusions OCT 0.1\% mouthwash inhibits plaque formation over 5 days. It therefore can be recommended when regular oral hygiene is temporarily compromised. Clinical relevance When individual plaque control is compromised, rinsing with octenidine mouthwash is recommended to maintain healthy oral conditions while side effects are limited.}, language = {en} } @article{RighessoTerekhovGoetzetal.2021, author = {Righesso, L. A. R. and Terekhov, M. and G{\"o}tz, H. and Ackermann, M. and Emrich, T. and Schreiber, L. M. and M{\"u}ller, W. E. G. and Jung, J. and Rojas, J. P. and Al-Nawas, B.}, title = {Dynamic contrast-enhanced magnetic resonance imaging for monitoring neovascularization during bone regeneration — a randomized in vivo study in rabbits}, series = {Clinical Oral Investigations}, volume = {25}, journal = {Clinical Oral Investigations}, number = {10}, issn = {1432-6981}, doi = {10.1007/s00784-021-03889-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307614}, pages = {5843-5854}, year = {2021}, abstract = {Objectives Micro-computed tomography (μ-CT) and histology, the current gold standard methods for assessing the formation of new bone and blood vessels, are invasive and/or destructive. With that in mind, a more conservative tool, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), was tested for its accuracy and reproducibility in monitoring neovascularization during bone regeneration. Additionally, the suitability of blood perfusion as a surrogate of the efficacy of osteoplastic materials was evaluated. Materials and methods Sixteen rabbits were used and equally divided into four groups, according to the time of euthanasia (2, 3, 4, and 6 weeks after surgery). The animals were submitted to two 8-mm craniotomies that were filled with blood or autogenous bone. Neovascularization was assessed in vivo through DCE-MRI, and bone regeneration, ex vivo, through μ-CT and histology. Results The defects could be consistently identified, and their blood perfusion measured through DCE-MRI, there being statistically significant differences within the blood clot group between 3 and 6 weeks (p = 0.029), and between the former and autogenous bone at six weeks (p = 0.017). Nonetheless, no significant correlations between DCE-MRI findings on neovascularization and μ-CT (r =-0.101, 95\% CI [-0.445; 0.268]) or histology (r = 0.305, 95\% CI [-0.133; 0.644]) findings on bone regeneration were observed. Conclusions These results support the hypothesis that DCE-MRI can be used to monitor neovascularization but contradict the premise that it could predict bone regeneration as well.}, language = {en} } @article{LenzPahlHaucketal.2021, author = {Lenz, Dominic and Pahl, Jens and Hauck, Fabian and Alameer, Seham and Balasubramanian, Meena and Baric, Ivo and Boy, Nikolas and Church, Joseph A. and Crushell, Ellen and Dick, Anke and Distelmaier, Felix and Gujar, Jidnyasa and Indolfi, Giuseppe and Lurz, Eberhard and Peters, Bianca and Schwerd, Tobias and Serranti, Daniele and K{\"o}lker, Stefan and Klein, Christoph and Hoffmann, Georg F. and Prokisch, Holger and Greil, Johann and Cerwenka, Adelheid and Giese, Thomas and Staufner, Christian}, title = {NBAS Variants Are Associated with Quantitative and Qualitative NK and B Cell Deficiency}, series = {Journal of Clinical Immunology}, volume = {41}, journal = {Journal of Clinical Immunology}, number = {8}, issn = {0271-9142}, doi = {10.1007/s10875-021-01110-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308362}, pages = {1781-1793}, year = {2021}, abstract = {Purpose Biallelic pathogenic NBAS variants manifest as a multisystem disorder with heterogeneous clinical phenotypes such as recurrent acute liver failure, growth retardation, and susceptibility to infections. This study explores how NBAS-associated disease affects cells of the innate and adaptive immune system. Methods Clinical and laboratory parameters were combined with functional multi-parametric immunophenotyping methods in fifteen NBAS-deficient patients to discover possible alterations in their immune system. Results Our study revealed reduced absolute numbers of mature CD56dim natural killer (NK) cells. Notably, the residual NK cell population in NBAS-deficient patients exerted a lower potential for activation and degranulation in response to K562 target cells, suggesting an NK cell-intrinsic role for NBAS in the release of cytotoxic granules. NBAS-deficient NK cell activation and degranulation was normalized upon pre-activation by IL-2 in vitro, suggesting that functional impairment was reversible. In addition, we observed a reduced number of na{\"i}ve B cells in the peripheral blood associated with hypogammaglobulinemia. Conclusion In summary, we demonstrate that pathogenic biallelic variants in NBAS are associated with dysfunctional NK cells as well as impaired adaptive humoral immunity.}, language = {en} } @article{HollaenderSchwenderBoehmeetal.2021, author = {Holl{\"a}nder, Olivia and Schwender, Kristina and B{\"o}hme, Petra and Fleckhaus, Jan and Haas, Cordula and Han, Yang and Heidorn, Frank and Klein-Unseld, Rachel and Lichtenwald, Julia and Naue, Jana and Neubauer, Jacqueline and Poetsch, Micaela and Schneider, Peter M. and Wagner, Wolfgang and Vennemann, Marielle}, title = {Forensische DNA-Methylierungsanalyse}, series = {Rechtsmedizin}, volume = {31}, journal = {Rechtsmedizin}, number = {3}, organization = {Arbeitsgemeinschaft Molekulare Alterssch{\"a}tzung der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM)}, issn = {0937-9819}, doi = {10.1007/s00194-021-00492-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307131}, pages = {192-201}, year = {2021}, abstract = {Die quantitative Analyse der relativen DNA-Methylierung gilt als eine der vielversprechendsten Methoden der molekularen Alterssch{\"a}tzung. Viele Studien der letzten Jahre identifizierten geeignete Positionen im Genom, deren DNA-Methylierung sich altersabh{\"a}ngig ver{\"a}ndert. F{\"u}r den Einsatz dieser Methode in der Routine- bzw. Fallarbeit ist es von großer Bedeutung, angewandte Analysetechniken zu validieren. Als ein Teilaspekt dieser Validierung sollte die Vergleichbarkeit der Analyseergebnisse zur DNA-Methylierung mithilfe der Mini- und Pyrosequenzierung zwischen verschiedenen Laboren evaluiert werden. Die Arbeitsgruppe „Molekulare Alterssch{\"a}tzung" der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM) f{\"u}hrte hierzu den ersten, technischen Ringversuch durch, der 4 Positionen in den Genen PDE4C, EDARADD, SST und KLF14 umfasste. Diese Marker waren in vorangegangenen Studien als altersabh{\"a}ngige Biomarker charakterisiert worden. Am Ringversuch nahmen 12 Labore teil, wobei jedes die Wahl zwischen der Minisequenzierung und/oder der Pyrosequenzierung f{\"u}r die quantitative Methylierungsanalyse hatte. Jedem teilnehmenden Labor wurden Blut- und Speichelproben von 3 Personen unterschiedlichen Alters {\"u}bersandt. Die Wahl der Reagenzien f{\"u}r die Probenbearbeitung wurde den Teilnehmern freigestellt. Die Ergebnisse der Minisequenzierung zeigten systematische Abweichungen zwischen den Laboren, die am ehesten auf die Verwendung unterschiedlicher Reagenzien und Analyseplattformen zur{\"u}ckzuf{\"u}hren sein k{\"o}nnen. Die Resultate der Pyrosequenzierung hingegen wiesen nicht auf systematische Abweichungen zwischen den Laboren hin, hier zeigte sich jedoch die Tendenz einer markerabh{\"a}ngigen Abweichung. Dar{\"u}ber hinaus konnten Unterschiede hinsichtlich technischer Probleme zwischen Laboren mit mehr Erfahrung in der jeweiligen Sequenzierungsmethode und Laboren mit weniger Erfahrung festgestellt werden. Sowohl die Beobachtung von systematischen als auch die von markerabh{\"a}ngigen Abweichungen l{\"a}sst den Schluss zu, dass eine {\"U}bertragung von Analysemethoden zwischen Laboren grunds{\"a}tzlich m{\"o}glich ist, eine Anpassung des jeweiligen Modells zur Alterssch{\"a}tzung jedoch notwendig sein kann.}, language = {de} } @article{AdolphFleischhackGaabetal.2021, author = {Adolph, Jonas E. and Fleischhack, Gudrun and Gaab, Christine and Mikasch, Ruth and Mynarek, Martin and Rutkowski, Stefan and Sch{\"u}ller, Ulrich and Pfister, Stefan M. and Pajtler, Kristian W. and Milde, Till and Witt, Olaf and Bison, Brigitte and Warmuth-Metz, Monika and Kortmann, Rolf-Dieter and Dietzsch, Stefan and Pietsch, Torsten and Timmermann, Beate and Tippelt, Stephan}, title = {Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies}, series = {Journal of Neuro-Oncology}, volume = {155}, journal = {Journal of Neuro-Oncology}, number = {2}, organization = {German GPOH HIT-Network}, issn = {0167-594X}, doi = {10.1007/s11060-021-03867-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308302}, pages = {193-202}, year = {2021}, abstract = {Purpose Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN. Methods Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated. Results Median age at first recurrence was 7.6 years (IQR: 4.0-13.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3-20.0) and 36.9 months (CI 29.7-53.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74-1.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50\%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival > 12 months after subtotal/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found. Conclusion No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation.}, language = {en} } @article{DenkSchmidtSchurretal.2021, author = {Denk, S. and Schmidt, S. and Schurr, Y. and Schwarz, G. and Schote, F. and Diefenbacher, M. and Armendariz, C. and Dejure, F. and Eilers, M. and Wiegering, Armin}, title = {CIP2A regulates MYC translation (via its 5′UTR) in colorectal cancer}, series = {International Journal of Colorectal Disease}, volume = {36}, journal = {International Journal of Colorectal Disease}, number = {5}, doi = {10.1007/s00384-020-03772-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-280092}, pages = {911-918}, year = {2021}, abstract = {Background Deregulated expression of MYC is a driver of colorectal carcinogenesis, suggesting that decreasing MYC expression may have significant therapeutic value. CIP2A is an oncogenic factor that regulates MYC expression. CIP2A is overexpressed in colorectal cancer (CRC), and its expression levels are an independent marker for long-term outcome of CRC. Previous studies suggested that CIP2A controls MYC protein expression on a post-transcriptional level. Methods To determine the mechanism by which CIP2A regulates MYC in CRC, we dissected MYC translation and stability dependent on CIP2A in CRC cell lines. Results Knockdown of CIP2A reduced MYC protein levels without influencing MYC stability in CRC cell lines. Interfering with proteasomal degradation of MYC by usage of FBXW7-deficient cells or treatment with the proteasome inhibitor MG132 did not rescue the effect of CIP2A depletion on MYC protein levels. Whereas CIP2A knockdown had marginal influence on global protein synthesis, we could demonstrate that, by using different reporter constructs and cells expressing MYC mRNA with or without flanking UTR, CIP2A regulates MYC translation. This interaction is mainly conducted by the MYC 5′UTR. Conclusions Thus, instead of targeting MYC protein stability as reported for other tissue types before, CIP2A specifically regulates MYC mRNA translation in CRC but has only slight effects on global mRNA translation. In conclusion, we propose as novel mechanism that CIP2A regulates MYC on a translational level rather than affecting MYC protein stability in CRC.}, language = {en} } @article{ReddersenGuellmarTonndorfMartinietal.2021, author = {Reddersen, Kirsten and G{\"u}llmar, Andr{\´e} and Tonndorf-Martini, Silke and Sigusch, Bernd W. and Ewald, Andrea and Dauben, Thomas J. and Martin, Karin and Wiegand, Cornelia}, title = {Critical parameters in cultivation of experimental biofilms using the example of Pseudomonas fluorescens}, series = {Journal of Materials Science: Materials in Medicine}, volume = {32}, journal = {Journal of Materials Science: Materials in Medicine}, number = {9}, issn = {0957-4530}, doi = {10.1007/s10856-021-06568-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-309911}, year = {2021}, abstract = {Formation and treatment of biofilms present a great challenge for health care and industry. About 80\% of human infections are associated with biofilms including biomaterial centered infections, like infections of prosthetic heart valves, central venous catheters, or urinary catheters. Additionally, biofilms can cause food and drinking water contamination. Biofilm research focusses on application of experimental biofilm models to study initial adherence processes, to optimize physico-chemical properties of medical materials for reducing interactions between materials and bacteria, and to investigate biofilm treatment under controlled conditions. Exploring new antimicrobial strategies plays a key role in a variety of scientific disciplines, like medical material research, anti-infectious research, plant engineering, or wastewater treatment. Although a variety of biofilm models exist, there is a lack of standardization for experimental protocols, and designing experimental setups remains a challenge. In this study, a number of experimental parameters critical for material research have been tested that influence formation and stability of an experimental biofilm using the non-pathogenic model strain of Pseudomonas fluorescens. These parameters include experimental time frame, nutrient supply, inoculum concentration, static and dynamic cultivation conditions, material properties, and sample treatment during staining for visualization of the biofilm. It was shown, that all tested parameters critically influence the experimental biofilm formation process. The results obtained in this study shall support material researchers in designing experimental biofilm setups.}, language = {en} } @misc{BaurRamserKelleretal.2021, author = {Baur, Johannes and Ramser, Michaela and Keller, Nicola and Muysoms, Filip and D{\"o}rfer, J{\"o}rg and Wiegering, Armin and Eisner, Lukas and Dietz, Ulrich A.}, title = {Erratum to: Robotic hernia repair II. English version Robotic primary ventral and incisional hernia repair (rv-TAPP and r-Rives or r-TARUP). Video report and results of a series of 118 patients}, series = {Der Chirurg}, volume = {92}, journal = {Der Chirurg}, number = {SUPPL 1}, doi = {10.1007/s00104-021-01563-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-326357}, pages = {S27}, year = {2021}, abstract = {No abstract available.}, language = {en} } @article{NowotnyAhmedBensingetal.2021, author = {Nowotny, Hanna and Ahmed, S. Faisal and Bensing, Sophie and Beun, Johan G. and Br{\"o}samle, Manuela and Chifu, Irina and Claahsen van der Grinten, Hedi and Clemente, Maria and Falhammar, Henrik and Hahner, Stefanie and Husebye, Eystein and Kristensen, Jette and Loli, Paola and Lajic, Svetlana and Reisch, Nicole}, title = {Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis}, series = {Endocrine}, volume = {71}, journal = {Endocrine}, number = {3}, organization = {Endo ERN (MTG1)}, issn = {1355-008X}, doi = {10.1007/s12020-021-02649-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308769}, pages = {586-594}, year = {2021}, abstract = {Adrenal insufficiency (AI) is a life-threatening condition requiring life-long glucocorticoid (GC) substitution therapy, as well as stress adaptation to prevent adrenal crises. The number of individuals with primary and secondary adrenal insufficiency in Europe is estimated to be 20-50/100.000. A growing number of AI cases are due to side effects of GC treatment used in different treatment strategies for cancer and to immunotherapy in cancer treatment. The benefit of hormone replacement therapy is evident but long-term adverse effects may arise due to the non-physiological GC doses and treatment regimens used. Given multiple GC replacement formulations available comprising short-acting, intermediate, long-acting and novel modified-release hydrocortisone as well as subcutaneous formulations, this review offers a concise summary on the latest therapeutic improvements for treatment of AI and prevention of adrenal crises. As availability of various glucocorticoid formulations and access to expert centers across Europe varies widely, European Reference Networks on rare endocrine conditions aim at harmonizing treatment and ensure access to specialized patient care for individual case-by-case treatment decisions. To improve the availability across Europe to cost effective oral and parenteral formulations of hydrocortisone will save lives.}, language = {en} } @article{LiPamporakiFliedneretal.2021, author = {Li, Minghao and Pamporaki, Christina and Fliedner, Stephanie M. J. and Timmers, Henri J. L. M. and N{\"o}lting, Svenja and Beuschlein, Felix and Prejbisz, Aleksander and Remde, Hanna and Robledo, Mercedes and Bornstein, Stefan R. and Lenders, Jacques W. M. and Eisenhofer, Graeme and Bechmann, Nicole}, title = {Metastatic pheochromocytoma and paraganglioma: signs and symptoms related to catecholamine secretion}, series = {Discover Oncology}, volume = {12}, journal = {Discover Oncology}, issn = {2730-6011}, doi = {10.1007/s12672-021-00404-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-309901}, year = {2021}, abstract = {Background The presence or future development of metastatic pheochromocytomas or paragangliomas (mPPGLs) can be difficult to diagnose or predict at initial presentation. Since production of catecholamines from mPPGLs is different from non-metastatic tumors (non-mPPGLs), this study aimed to clarify whether presenting catecholamine-related signs and symptoms (cSS) might also differ. Methods The study included 249 patients, 43 with mPPGL and 206 with non-mPPGL. Clinical data at the time of biochemical diagnosis (i.e. at entry into the study) were used to generate a cumulative score of cSS for each patient. Results Patients with mPPGL were significantly younger (43.3 ± 14 vs. 48.9 ± 16.1 years) and included a lower proportion of females (39.5\% vs. 60.7\%) than patients with non-mPPGLs. Frequencies of signs and symptoms did not differ between the two groups. Patients with mPPGLs had lower (P < 0.001) urinary excretion of epinephrine (3.5 (IQR, 1.9—6.5) µg/day) than those with non-mPPGLs (19.1 (IQR, 4.3—70.2) µg/day). There was no difference in urinary excretion of norepinephrine. In patients with mPPGLs a high cSS score was associated with high urinary excretion of norepinephrine and normetanephrine. In contrast, in patients with non-mPPGLs, a high cSS was associated with high urinary excretion of epinephrine and metanephrine. Conclusion Although presenting signs and symptoms were associated with production of norepinephrine in patients with mPPGLs and of epinephrine in patients with non-mPPGLs, there were no differences in signs and symptoms between the two groups. Therefore, consideration of signs and symptoms does not appear helpful for distinguishing patients with and without mPPGLs.}, language = {en} } @article{MinnerSchreinerSaeger2021, author = {Minner, S. and Schreiner, J. and Saeger, W.}, title = {Adrenal cancer: relevance of different grading systems and subtypes}, series = {Clinical and Translational Oncology}, volume = {23}, journal = {Clinical and Translational Oncology}, number = {7}, issn = {1699-048X}, doi = {10.1007/s12094-020-02524-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308479}, pages = {1350-1357}, year = {2021}, abstract = {Purpose The subclassification of adrenal cancers according to the WHO classification in ordinary, myxoid, oncocytic, and sarcomatoid as well as pediatric types is well established, but the criteria for each subtype are not sufficiently determined and the relative frequency of the different types of adrenal cancers has not been studied in large cohorts. Therefore, our large collection of surgically removed adrenal cancers should be reviewed o establish the criteria for the subtypes and to find out the frequency of the various types. Methods In our series of 521 adrenal cancers the scoring systems of Weiss et al., Hough et al., van Slooten et al. and the new Helsinki score system were used for the ordinary type of cancer (97\% of our series) and the myxoid type (0.8\%). For oncocytic carcinomas (2\%), the scoring system of Bisceglia et al. was applied. Results Discrepancies between benign and malignant diagnoses from the first thee classical scoring systems are not rare (22\% in our series) and could be resolved by the Helsinki score especially by Ki-67 index (more than 8\% unequivocally malignant). Since all our cancer cases are positive in the Helsinki score, this system can replace the three elder systems. For identification of sarcomatoid cancer as rarest type in our series (0.2\%), the scoring systems are not practical but additional immunostainings used for soft tissue tumors and in special cases molecular pathology are necessary to differentiate these cancers from adrenal sarcomas. According to the relative frequencies of the different subtypes of adrenal cancers the main type is the far most frequent (97\%) followed by the oncocytic type (2\%), the myxoid type (0.8\%) and the very rare sarcomatoid type (0.2\%). Conclusions The Helsinki score is the best for differentiating adrenal carcinomas of the main, the oncocytic, and the myxoid type in routine work. Additional scoring systems for these carcinomas are generally not any longer necessary. Signs of proliferation (mitoses and Ki-67 index) and necroses are the most important criteria for diagnosis of malignancy.}, language = {en} } @article{DanyszDekundyScheschonkaetal.2021, author = {Danysz, Wojciech and Dekundy, Andrzej and Scheschonka, Astrid and Riederer, Peter}, title = {Amantadine: reappraisal of the timeless diamond—target updates and novel therapeutic potentials}, series = {Journal of Neural Transmission}, volume = {128}, journal = {Journal of Neural Transmission}, number = {2}, doi = {10.1007/s00702-021-02306-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-330133}, pages = {127-169}, year = {2021}, abstract = {The aim of the current review was to provide a new, in-depth insight into possible pharmacological targets of amantadine to pave the way to extending its therapeutic use to further indications beyond Parkinson's disease symptoms and viral infections. Considering amantadine's affinities in vitro and the expected concentration at targets at therapeutic doses in humans, the following primary targets seem to be most plausible: aromatic amino acids decarboxylase, glial-cell derived neurotrophic factor, sigma-1 receptors, phosphodiesterases, and nicotinic receptors. Further three targets could play a role to a lesser extent: NMDA receptors, 5-HT3 receptors, and potassium channels. Based on published clinical studies, traumatic brain injury, fatigue [e.g., in multiple sclerosis (MS)], and chorea in Huntington's disease should be regarded potential, encouraging indications. Preclinical investigations suggest amantadine's therapeutic potential in several further indications such as: depression, recovery after spinal cord injury, neuroprotection in MS, and cutaneous pain. Query in the database http://www.clinicaltrials.gov reveals research interest in several further indications: cancer, autism, cocaine abuse, MS, diabetes, attention deficit-hyperactivity disorder, obesity, and schizophrenia.}, language = {en} } @article{NauePfeiferAugustinetal.2021, author = {Naue, Jana and Pfeifer, Manuel and Augustin, Christa and Becker, Julia and Fleckhaus, Jan and Grabm{\"u}ller, Melanie and Han, Yang and Heidorn, Frank and Hollaender, Olivia and Klein-Unseld, Rachel and Kulstein, Galina and Lichtenwald, Julia and Neubauer, Jacqueline and Suarez, Philippe and Haas, Cordula and Schneider, Peter M. and Vennemann, Marielle and B{\"o}hme, Petra}, title = {Forensische DNA-Methylierungsanalyse}, series = {Rechtsmedizin}, volume = {31}, journal = {Rechtsmedizin}, number = {3}, organization = {Arbeitsgemeinschaft Molekulare Alterssch{\"a}tzung der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM)}, issn = {0937-9819}, doi = {10.1007/s00194-021-00493-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307129}, pages = {202-216}, year = {2021}, abstract = {Mit der Entdeckung altersabh{\"a}ngiger epigenetischer Ver{\"a}nderungen, der DNA-Methylierung (DNAm), hat sich eine neue M{\"o}glichkeit aufgezeigt, das Alter eines Individuums zu sch{\"a}tzen. Die Methode wurde intensiv erforscht und ihre Anwendung in der forensischen Fallarbeit durch die Aktualisierung des \S 81e der Strafprozessordnung (StPO) in Deutschland reguliert. Zur Untersuchung des DNAm-Grades m{\"u}ssen neue Techniken etabliert und validiert werden. Dies macht die Pr{\"u}fung der Vergleichbarkeit von Messergebnissen aus verschiedenen forensischen Laboren erforderlich. Hierzu f{\"u}hrte die Arbeitsgruppe „Molekulare Alterssch{\"a}tzung" der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM) im Winter 2019/2020 den 2. Ringversuch (RV) zur quantitativen DNAm-Analyse mithilfe der Mini- und der Pyrosequenzierung durch. Dieser basierte auf den Erfahrungen des 1. RV 2018/2019, dessen Ergebnisse in dieser Ausgabe ebenfalls vorgestellt werden. Die aktuelle Studie umfasst Analyseergebnisse aus 12 Laboren (ingesamt 14 teilnehmende Labore), von denen einige beide Methoden angewandt haben. Zus{\"a}tzlich f{\"u}hrten 4 Labore eine Alterssch{\"a}tzung an den RV-Proben mit eigenen Markerkombinationen und Modellen durch. Da diese auf unterschiedlichen Referenzdaten und Markerkombinationen beruhen, erfolgte kein qualitativer Vergleich der Modelle, sondern das grunds{\"a}tzliche Potenzial der Methodik wurde verdeutlicht. Ziele des RV waren die Evaluierung der Vergleichbarkeit der DNAm-Messungen und die Bewertung m{\"o}glicher Einflussfaktoren, wie Extraktionsmethode und verwendetes Ger{\"a}t. Die Ergebnisse zeigen, dass sich die gemessenen DNAm-Werte der untersuchten Marker sowohl zwischen Mini- und Pyrosequenzierung als auch innerhalb der jeweiligen Methode zwischen den Laboren unterscheiden k{\"o}nnen, sodass mit Schwankungen gerechnet werden muss.}, language = {de} } @article{PotreckMutkeWeylandetal.2021, author = {Potreck, Arne and Mutke, Matthias A. and Weyland, Charlotte S. and Pfaff, Johannes A. R. and Ringleb, Peter A. and Mundiyanapurath, Sibu and M{\"o}hlenbruch, Markus A. and Heiland, Sabine and Pham, Mirko and Bendszus, Martin and Hoffmann, Angelika}, title = {Combined Perfusion and Permeability Imaging Reveals Different Pathophysiologic Tissue Responses After Successful Thrombectomy}, series = {Translational Stroke Research}, volume = {12}, journal = {Translational Stroke Research}, number = {5}, issn = {1868-4483}, doi = {10.1007/s12975-020-00885-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308946}, pages = {799-807}, year = {2021}, abstract = {Despite successful recanalization of large-vessel occlusions in acute ischemic stroke, individual patients profit to a varying degree. Dynamic susceptibility-weighted perfusion and dynamic T1-weighted contrast-enhanced blood-brain barrier permeability imaging may help to determine secondary stroke injury and predict clinical outcome. We prospectively performed perfusion and permeability imaging in 38 patients within 24 h after successful mechanical thrombectomy of an occlusion of the middle cerebral artery M1 segment. Perfusion alterations were evaluated on cerebral blood flow maps, blood-brain barrier disruption (BBBD) visually and quantitatively on ktrans maps and hemorrhagic transformation on susceptibility-weighted images. Visual BBBD within the DWI lesion corresponded to a median ktrans elevation (IQR) of 0.77 (0.41-1.4) min-1 and was found in all 7 cases of hypoperfusion (100\%), in 10 of 16 cases of hyperperfusion (63\%), and in only three of 13 cases with unaffected perfusion (23\%). BBBD was significantly associated with hemorrhagic transformation (p < 0.001). While BBBD alone was not a predictor of clinical outcome at 3 months (positive predictive value (PPV) = 0.8 [0.56-0.94]), hypoperfusion occurred more often in patients with unfavorable clinical outcome (PPV = 0.43 [0.10-0.82]) compared to hyperperfusion (PPV = 0.93 [0.68-1.0]) or unaffected perfusion (PPV = 1.0 [0.75-1.0]). We show that combined perfusion and permeability imaging reveals distinct infarct signatures after recanalization, indicating the severity of prior ischemic damage. It assists in predicting clinical outcome and may identify patients at risk of stroke progression.}, language = {en} }