TY  - JOUR
A1  - López, Cristina
A1  - Kleinheinz, Kortine
A1  - Aukema, Sietse M.
A1  - Rohde, Marius
A1  - Bernhart, Stephan H.
A1  - Hübschmann, Daniel
A1  - Wagener, Rabea
A1  - Toprak, Umut H.
A1  - Raimondi, Francesco
A1  - Kreuz, Markus
A1  - Waszak, Sebastian M.
A1  - Huang, Zhiqin
A1  - Sieverling, Lina
A1  - Paramasivam, Nagarajan
A1  - Seufert, Julian
A1  - Sungalee, Stephanie
A1  - Russell, Robert B.
A1  - Bausinger, Julia
A1  - Kretzmer, Helene
A1  - Ammerpohl, Ole
A1  - Bergmann, Anke K.
A1  - Binder, Hans
A1  - Borkhardt, Arndt
A1  - Brors, Benedikt
A1  - Claviez, Alexander
A1  - Doose, Gero
A1  - Feuerbach, Lars
A1  - Haake, Andrea
A1  - Hansmann, Martin-Leo
A1  - Hoell, Jessica
A1  - Hummel, Michael
A1  - Korbel, Jan O.
A1  - Lawerenz, Chris
A1  - Lenze, Dido
A1  - Radlwimmer, Bernhard
A1  - Richter, Julia
A1  - Rosenstiel, Philip
A1  - Rosenwald, Andreas
A1  - Schilhabel, Markus B.
A1  - Stein, Harald
A1  - Stilgenbauer, Stephan
A1  - Stadler, Peter F.
A1  - Szczepanowski, Monika
A1  - Weniger, Marc A.
A1  - Zapatka, Marc
A1  - Eils, Roland
A1  - Lichter, Peter
A1  - Loeffler, Markus
A1  - Möller, Peter
A1  - Trümper, Lorenz
A1  - Klapper, Wolfram
A1  - Hoffmann, Steve
A1  - Küppers, Ralf
A1  - Burkhardt, Birgit
A1  - Schlesner, Matthias
A1  - Siebert, Reiner
T1  - Genomic and transcriptomic changes complement each other in the pathogenesis of sporadic Burkitt lymphoma
JF  - Nature Communications
N2  - Burkitt lymphoma (BL) is the most common B-cell lymphoma in children. Within the International Cancer Genome Consortium (ICGC), we performed whole genome and transcriptome sequencing of 39 sporadic BL. Here, we unravel interaction of structural, mutational, and transcriptional changes, which contribute to MYC oncogene dysregulation together with the pathognomonic IG-MYC translocation. Moreover, by mapping IGH translocation breakpoints, we provide evidence that the precursor of at least a subset of BL is a B-cell poised to express IGHA. We describe the landscape of mutations, structural variants, and mutational processes, and identified a series of driver genes in the pathogenesis of BL, which can be targeted by various mechanisms, including IG-non MYC translocations, germline and somatic mutations, fusion transcripts, and alternative splicing.
KW  - cancer genomics
KW  - lymphocytes
KW  - lymphoid tissues
KW  - oncology
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237281
VL  - 10
ER  - 
TY  - JOUR
A1  - Mitchell, Jonathan S.
A1  - Li, Ni
A1  - Weinhold, Niels
A1  - Försti, Asta
A1  - Ali, Mina
A1  - van Duin, Mark
A1  - Thorleifsson, Gudmar
A1  - Johnson, David C.
A1  - Chen, Bowang
A1  - Halvarsson, Britt-Marie
A1  - Gudbjartsson, Daniel F.
A1  - Kuiper, Rowan
A1  - Stephens, Owen W.
A1  - Bertsch, Uta
A1  - Broderick, Peter
A1  - Campo, Chiara
A1  - Einsele, Hermann
A1  - Gregory, Walter A.
A1  - Gullberg, Urban
A1  - Henrion, Marc
A1  - Hillengass, Jens
A1  - Hoffmann, Per
A1  - Jackson, Graham H.
A1  - Johnsson, Ellinor
A1  - Jöud, Magnus
A1  - Kristinsson, Sigurdur Y.
A1  - Lenhoff, Stig
A1  - Lenive, Oleg
A1  - Mellqvist, Ulf-Henrik
A1  - Migliorini, Gabriele
A1  - Nahi, Hareth
A1  - Nelander, Sven
A1  - Nickel, Jolanta
A1  - Nöthen, Markus M.
A1  - Rafnar, Thorunn
A1  - Ross, Fiona M.
A1  - da Silva Filho, Miguel Inacio
A1  - Swaminathan, Bhairavi
A1  - Thomsen, Hauke
A1  - Turesson, Ingemar
A1  - Vangsted, Annette
A1  - Vogel, Ulla
A1  - Waage, Anders
A1  - Walker, Brian A.
A1  - Wihlborg, Anna-Karin
A1  - Broyl, Annemiek
A1  - Davies, Faith E.
A1  - Thorsteinsdottir, Unnur
A1  - Langer, Christian
A1  - Hansson, Markus
A1  - Kaiser, Martin
A1  - Sonneveld, Pieter
A1  - Stefansson, Kari
A1  - Morgan, Gareth J.
A1  - Goldschmidt, Hartmut
A1  - Hemminki, Kari
A1  - Nilsson, Björn
A1  - Houlston, Richard S.
T1  - Genome-wide association study identifies multiple susceptibility loci for multiple myeloma
JF  - Nature Communications
N2  - Multiple myeloma (MM) is a plasma cell malignancy with a significant heritable basis. Genome-wide association studies have transformed our understanding of MM predisposition, but individual studies have had limited power to discover risk loci. Here we perform a meta-analysis of these GWAS, add a new GWAS and perform replication analyses resulting in 9,866 cases and 239,188 controls. We confirm all nine known risk loci and discover eight new loci at 6p22.3 (rs34229995, P=1.31 × 10−8), 6q21 (rs9372120, P=9.09 × 10−15), 7q36.1 (rs7781265, P=9.71 × 10−9), 8q24.21 (rs1948915, P=4.20 × 10−11), 9p21.3 (rs2811710, P=1.72 × 10−13), 10p12.1 (rs2790457, P=1.77 × 10−8), 16q23.1 (rs7193541, P=5.00 × 10−12) and 20q13.13 (rs6066835, P=1.36 × 10−13), which localize in or near to JARID2, ATG5, SMARCD3, CCAT1, CDKN2A, WAC, RFWD3 and PREX1. These findings provide additional support for a polygenic model of MM and insight into the biological basis of tumour development.
KW  - Cancer genetics
KW  - Genome-wide association studies
KW  - Myeloma
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-165983
VL  - 7
ER  - 
TY  - JOUR
A1  - Went, Molly
A1  - Sud, Amit
A1  - Speedy, Helen
A1  - Sunter, Nicola J.
A1  - Försti, Asta
A1  - Law, Philip J.
A1  - Johnson, David C.
A1  - Mirabella, Fabio
A1  - Holroyd, Amy
A1  - Li, Ni
A1  - Orlando, Giulia
A1  - Weinhold, Niels
A1  - van Duin, Mark
A1  - Chen, Bowang
A1  - Mitchell, Jonathan S.
A1  - Mansouri, Larry
A1  - Juliusson, Gunnar
A1  - Smedby, Karin E
A1  - Jayne, Sandrine
A1  - Majid, Aneela
A1  - Dearden, Claire
A1  - Allsup, David J.
A1  - Bailey, James R.
A1  - Pratt, Guy
A1  - Pepper, Chris
A1  - Fegan, Chris
A1  - Rosenquist, Richard
A1  - Kuiper, Rowan
A1  - Stephens, Owen W.
A1  - Bertsch, Uta
A1  - Broderick, Peter
A1  - Einsele, Hermann
A1  - Gregory, Walter M.
A1  - Hillengass, Jens
A1  - Hoffmann, Per
A1  - Jackson, Graham H.
A1  - Jöckel, Karl-Heinz
A1  - Nickel, Jolanta
A1  - Nöthen, Markus M.
A1  - da Silva Filho, Miguel Inacio
A1  - Thomsen, Hauke
A1  - Walker, Brian A.
A1  - Broyl, Annemiek
A1  - Davies, Faith E.
A1  - Hansson, Markus
A1  - Goldschmidt, Hartmut
A1  - Dyer, Martin J. S.
A1  - Kaiser, Martin
A1  - Sonneveld, Pieter
A1  - Morgan, Gareth J.
A1  - Hemminki, Kari
A1  - Nilsson, Björn
A1  - Catovsky, Daniel
A1  - Allan, James M.
A1  - Houlston, Richard S.
T1  - Genetic correlation between multiple myeloma and chronic lymphocytic leukaemia provides evidence for shared aetiology
JF  - Blood Cancer Journal
N2  - The clustering of different types of B-cell malignancies in families raises the possibility of shared aetiology. To examine this, we performed cross-trait linkage disequilibrium (LD)-score regression of multiple myeloma (MM) and chronic lymphocytic leukaemia (CLL) genome-wide association study (GWAS) data sets, totalling 11,734 cases and 29,468 controls. A significant genetic correlation between these two B-cell malignancies was shown (Rg = 0.4, P = 0.0046). Furthermore, four of the 45 known CLL risk loci were shown to associate with MM risk and five of the 23 known MM risk loci associate with CLL risk. By integrating eQTL, Hi-C and ChIP-seq data, we show that these pleiotropic risk loci are enriched for B-cell regulatory elements and implicate B-cell developmental genes. These data identify shared biological pathways influencing the development of CLL and, MM and further our understanding of the aetiological basis of these B-cell malignancies.
KW  - cancer genetics
KW  - myeloma
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-233627
VL  - 9
ER  - 
TY  - THES
A1  - Hoffmann, Markus Fritz Heinrich
T1  - Induktion von Sekundärstrukturen durch den Einbau von Alanyl-PNA in Peptide und Proteine
T1  - Induction of secondary structures in peptides and proteines by incorporation of alanyl-PNA
N2  - Die Aktivität von Biooligomeren wird wesentlich beeinflusst von deren molekularer Struktur bzw. Konformation. Eine Einflussnahme auf die Struktur sollte deswegen auch mit einer Aktivitätsveränderung einhergehen, ein „Schalten“ von Struktur somit ein „Schalten“ von Aktivität nach sich ziehen. Alanyl-PNA ist ein Oligopeptid alternierender Konfiguration mit Nukleobasen in β-Position der Alanyl-Einheiten, das durch Wasserstoffbrückenbildung und π-Stacking mit einem komplementären Strang Paarungsduplexe mit β-faltblattartiger linearer Struktur eingeht. Der Einbau eines Alanyl-PNA-Stranges in ein Peptid oder Protein und Zugabe des korrespondierenden Gegenstranges sollte zu einer lokalen Induktion eines β-Faltblattes führen und strukturelle Veränderungen im Gesamtpeptid hervorrufen. Es kann dann von einem molekularen Schalter gesprochen werden. Im Rahmen dieser Arbeit wurde eine vom cyclischen Peptidantibiotikum Gramicidin S abgeleitete 18mer-Peptid-Alanyl-PNA-Chimäre 20 mit eingebautem Alanyl-PNA-Pentamer dargestellt. Es konnte mittels temperaturabhängiger UV-Spektroskopie gezeigt werden, dass sich bei Zugabe des komplementären Gegenstranges nichtkovalente Duplexe bilden. CD-spektroskopische Untersuchungen dieses Dimers lieferten keine eindeutigen Beweise für das vorliegen eines β-Faltblattes. Es konnte anhand des humanen Interleukins 8 gezeigt werden, dass der Einbau von Alanyl-PNA durch die Technik der native chemical ligation in größere Peptide möglich ist. Hierfür wurde der N-terminale Thioester 31 des humanen Interleukins hIL8(1-55) durch Expression des Fusionsproteines in E.coli und Expressed Protein Ligation dargestellt. Nach Umsetzung des Thioesters 31 mit einem Alanyl-PNA-Peptid-Hybrid 29, das N-terminal mit einem freien Cystein substituiert ist, wurde durch native chemical ligation ein von dem humanen Interleukin 8 abgeleitetes 77 Aminosäuren enthaltendes Peptid 30 mit eingebauter Alanyl-PNA erhalten. Darüber hinaus wurden mit keinem, einem oder zwei Lysinen substituierte Alanyl-PNA-Hexamere dargestellt und Strukturuntersuchungen unterworfen. Es konnte mittels temperaturabhängiger UV-Spektroskopie gezeigt werden, dass der Einbau zweier Lysine sowohl die Löslichkeit als auch die Bildungskinetik verändert, die Stabilität (Tm-Wert) der Duplexe jedoch unverändert lässt. Diese Hexamere wurden Kristallisationsversuchen unterworfen, bisher konnten noch keine Kristalle erhalten werden. Basierend auf den im Rahmen dieser Arbeit erhaltenen Ergebnissen sollte es in Zukunft darüber hinaus möglich sein, genaueren Aufschluss über die Struktur von Alanyl-PNA zu erhalten. Die Erhöhung der Löslichkeit von Alanyl-PNA durch Einbau zweier Lysine ermöglicht nicht nur weitere Kristallisationsversuche, sondern man gelangt auch in Konzentrationsbereiche, in denen NMR-Untersuchungen an Alanyl-PNA möglich werden, die bisher aufgrund zu schlechter Löslichkeit zu keinen zufrieden stellenden Ergebnissen geführt haben. Durch weitere Optimierung der native chemical ligation und Bereitstellung größerer Mengen von Interleukin 8 Derivaten mit eingebauter Alanyl-PNA sollte es in Zukunft möglich sein, den Einfluss des komplementären Alanyl-PNA-Stranges auf die Struktur des Gesamtsystems und dessen biologischer Aktivität zu untersuchen. Durch Variation und Optimierung der Sequenz und des örtlichen Einbaus der Alanyl-PNA kann so vielleicht das Fernziel eines molekularen strukturellen Schalters für Peptide bzw. Proteine erreicht werden. Ebenso ist es denkbar, dass durch den Einbau von Alanyl-PNA in zwei verschiedene Peptide bzw. Proteine nichtkovalente Protein-Protein-Komplexe erhalten werden können.
N2  - Activity and properties of biooligomers depend mainly on their molecular structure and conformation. Changing structure causes also a change of activity. Therefore, “switching” structure results in “switching” activity. Alanyl-PNA is an oligopeptide consisting of amino acids with alternating configuration with nucleobases attached to the β-position of an alanyl unit. Addition of a complementary peptide strand induces a β-sheet like conformation in the backbone of the duplex by hydrogen bonding and π-stacking . Incorporation of alanyl-PNA into a peptide or protein and addition of a complementary sequence should induce a β-sheet like structure and produce structural changes in the entire system. For this effect the term molecular switch can be used. In this work a peptide-alanyl-PNA chimera 20 consisting of a sequence of 18 amino acids, which was derived from the cyclic antibiotic Gramicidin S, has been synthesized. It contained a terminal alanyl-PNA pentamere. Using temperature dependent UV-spectroscopy it could be proven that addition of the complementary strand led to noncovalent duplexes. Investigations by CD-spectroscopy did not give clear evidence for the existence of a β-sheet. To accomplish the incorporation of alanyl-PNA into larger peptides the techique native chemical ligation has been applied. Alanyl-PNA has been incorporated into the 77 amino acids containing peptide human interleukine 8 (hIL8). The N-terminal thioester hIL8(1-55) 31 was expressed by a fusion-protein in E.coli and worked up by Expressed Protein Ligation. After reaction of the thioester 31 with an alanyl-PNA-peptide hybrid 29, N-terminally substituted with a free cysteine, a new analogue 30 of hIL-8 could be obtained by native chemical ligation. Furthermore, alanyl-PNA hexamers containing up to two lysines have been synthesized and subjected to structural examinations. Using temperature dependent UV-spectroscopy it could be shown that the incorporation of two lysines not only increased the solubility of the oligomers substantially but also had strong influence on the kinetics of the duplex formation, whereas the stability of the pairing complex (defined by the Tm value) did not change. Attempts to crystallize these hexamers have not been successful up to the present. On the basis of these results it should be possible to obtain in the future more detailed information about the structure of alanyl-PNA. Due to the poor solubility, previous NMR examinations did not give satisfying results. The increase in solubility by addition of a second lysine to alanyl-PNA will allow in future further crystallisation experiments and more promising NMR investigations. By optimization of the native chemical ligation and supply of larger amounts of interleukine 8 derivatives with incorporated alanyl-PNA it should be possible to examine the influence of a complementary alanyl-PNA strand on the structure of the entire system and its biological activity. By variation and optimization of the sequence and the local incorporation of alanyl-PNA moieties the objective of a molecular switch for peptides and proteins might be reached. The incorporation of alanyl-PNA into two different peptides or proteins might also result in the formation of noncovalent protein-protein-complexes mediated by hydrogen bonding.
KW  - Peptide
KW  - Proteine
KW  - Sekundärstruktur
KW  - Peptide
KW  - molekularer Schalter
KW  - PNA
KW  - Sekundärstrukturen
KW  - peptides
KW  - molecular switches
KW  - PNA
KW  - secondary structures
Y1  - 2003
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-6308
ER  - 
TY  - JOUR
A1  - Wester, Hans Jürgen
A1  - Keller, Ulrich
A1  - Schottelius, Margret
A1  - Beer, Ambros
A1  - Philipp-Abbrederis, Kathrin
A1  - Hoffmann, Frauke
A1  - Šimeček, Jakub
A1  - Gerngross, Carlos
A1  - Lassmann, Michael
A1  - Herrmann, Ken
A1  - Pellegata, Natalia
A1  - Rudelius, Martina
A1  - Kessler, Horst
A1  - Schwaiger, Markus
T1  - Disclosing the CXCR4 expression in lymphoproliferative diseases by targeted molecular imaging
JF  - Theranostics
N2  - Chemokine ligand-receptor interactions play a pivotal role in cell attraction and cellular trafficking, both in normal tissue homeostasis and in disease. In cancer, chemokine receptor-4 (CXCR4) expression is an adverse prognostic factor. Early clinical studies suggest that targeting CXCR4 with suitable high-affinity antagonists might be a novel means for therapy. In addition to the preclinical evaluation of [\(^{68}\)Ga]Pentixafor in mice bearing human lymphoma xenografts as an exemplary CXCR4-expressing tumor entity, we report on the first clinical applications of [\(^{68}\)Ga]Pentixafor-Positron Emission Tomography as a powerful method for CXCR4 imaging in cancer patients. [\(^{68}\)Ga]Pentixafor binds with high affinity and selectivity to human CXCR4 and exhibits a favorable dosimetry. [\(^{68}\)Ga]Pentixafor-PET provides images with excellent specificity and contrast. This non-invasive imaging technology for quantitative assessment of CXCR4 expression allows to further elucidate the role of CXCR4/CXCL12 ligand interaction in the pathogenesis and treatment of cancer, cardiovascular diseases and autoimmune and inflammatory disorders.
KW  - acute myeloid leukemia
KW  - prognostic value
KW  - therapeutic target
KW  - chemokine receptor
KW  - CXCR4
KW  - lymphoma
KW  - in vivo imaging
KW  - positron emission tomography
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-144537
VL  - 5
IS  - 6
ER  - 
TY  - JOUR
A1  - Lewerentz, Anne
A1  - Hoffmann, Markus
A1  - Sarmento Cabral, Juliano
T1  - Depth diversity gradients of macrophytes: Shape, drivers, and recent shifts
JF  - Ecology and Evolution
N2  - Investigating diversity gradients helps to understand biodiversity drivers and threats. However, one diversity gradient is rarely assessed, namely how plant species distribute along the depth gradient of lakes. Here, we provide the first comprehensive characterization of depth diversity gradient (DDG) of alpha, beta, and gamma species richness of submerged macrophytes across multiple lakes. We characterize the DDG for additive richness components (alpha, beta, gamma), assess environmental drivers, and address temporal change over recent years. We take advantage of yet the largest dataset of macrophyte occurrence along lake depth (274 depth transects across 28 deep lakes) as well as of physiochemical measurements (12 deep lakes from 2006 to 2017 across Bavaria), provided publicly online by the Bavarian State Office for the Environment. We found a high variability in DDG shapes across the study lakes. The DDGs for alpha and gamma richness are predominantly hump-shaped, while beta richness shows a decreasing DDG. Generalized additive mixed-effect models indicate that the depth of the maximum richness (Dmax) is influenced by light quality, light quantity, and layering depth, whereas the respective maximum alpha richness within the depth gradient (Rmax) is significantly influenced by lake area only. Most observed DDGs seem generally stable over recent years. However, for single lakes we found significant linear trends for Rmax and Dmax going into different directions. The observed hump-shaped DDGs agree with three competing hypotheses: the mid-domain effect, the mean–disturbance hypothesis, and the mean–productivity hypothesis. The DDG amplitude seems driven by lake area (thus following known species–area relationships), whereas skewness depends on physiochemical factors, mainly water transparency and layering depth. Our results provide insights for conservation strategies and for mechanistic frameworks to disentangle competing explanatory hypotheses for the DDG.
KW  - aquatic plants
KW  - biodiversity gradients
KW  - biodiversity hypotheses
KW  - deep lakes
KW  - Germany
KW  - Water Framework Directive
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-260280
VL  - 11
IS  - 20
ER  - 
TY  - JOUR
A1  - Schulz, Herbert
A1  - Ruppert, Ann-Kathrin
A1  - Herms, Stefan
A1  - Wolf, Christiane
A1  - Mirza-Schreiber, Nazanin
A1  - Stegle, Oliver
A1  - Czamara, Darina
A1  - Forstner, Andreas J.
A1  - Sivalingam, Sugirthan
A1  - Schoch, Susanne
A1  - Moebus, Susanne
A1  - Pütz, Benno
A1  - Hillmer, Axel
A1  - Fricker, Nadine
A1  - Vatter, Hartmut
A1  - Müller-Myhsok, Bertram
A1  - Nöthen, Markus M.
A1  - Becker, Albert J.
A1  - Hoffmann, Per
A1  - Sander, Thomas
A1  - Cichon, Sven
T1  - Genome-wide mapping of genetic determinants influencing DNA methylation and gene expression in human hippocampus
JF  - Nature Communications
N2  - Emerging evidence emphasizes the strong impact of regulatory genomic elements in neurodevelopmental processes and the complex pathways of brain disorders. The present genome-wide quantitative trait loci analyses explore the \(cis\)-regulatory effects of single-nucleotide polymorphisms (SNPs) on DNA methylation (meQTL) and gene expression (eQTL) in 110 human hippocampal biopsies. We identify \(cis\)-meQTLs at 14,118 CpG methylation sites and \(cis\)-eQTLs for 302 3′-mRNA transcripts of 288 genes. Hippocampal \(cis\)-meQTL-CpGs are enriched in flanking regions of active promoters, CpG island shores, binding sites of the transcription factor CTCF and brain eQTLs. \(Cis\)-acting SNPs of hippocampal meQTLs and eQTLs significantly overlap schizophrenia-associated SNPs. Correlations of CpG methylation and RNA expression are found for 34 genes. Our comprehensive maps of \(cis\)-acting hippocampal meQTLs and eQTLs provide a link between disease-associated SNPs and the regulatory genome that will improve the functional interpretation of non-coding genetic variants in the molecular genetic dissection of brain disorders.
KW  - psychiatry
KW  - epigenetics in the nervous system
KW  - epigenomics
KW  - gene expression
KW  - neurological disorders
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-173168
VL  - 8
ER  - 
TY  - JOUR
A1  - Fehske, Kai
A1  - Berninger, Markus T.
A1  - Alm, Lena
A1  - Hoffmann, Reinhard
A1  - Zellner, Johannes
A1  - Kösters, Clemens
A1  - Barzen, Stefan
A1  - Raschke, Michael J.
A1  - Izadpanah, Kaywan
A1  - Herbst, Elmar
A1  - Domnick, Christoph
A1  - Schüttrumpf, Jan Philipp
A1  - Krause, Matthias
T1  - Aktueller Versorgungsstandard von Patellafrakturen in Deutschland
JF  - Der Unfallchirurg
N2  - Hintergrund
Die Versorgung von Patellafrakturen ist technisch anspruchsvoll. Auch wenn die radiologischen Ergebnisse zumeist zufriedenstellend sind, deckt sich dies häufig nicht mit der subjektiven Einschätzung der Patienten. Die klassische Versorgung mittels Drahtzuggurtung weist einige Komplikationen auf. Die winkelstabile Plattenosteosynthese hat sich in den letzten Jahren biomechanisch als vorteilhaft erwiesen.

Fragestellung
Von wem werden Patellafrakturen in Deutschland versorgt? Wie sieht der aktuelle Versorgungsstandard aus? Haben sich „moderne“ Osteosyntheseformen durchgesetzt? Was sind die häufigsten Komplikationen?

Material und Methoden
Die Mitglieder der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie sowie der Deutschen Kniegesellschaft wurden aufgefordert, an einer Onlinebefragung teilzunehmen.

Ergebnisse
Insgesamt wurden 511 komplett ausgefüllte Fragebogen ausgewertet. Die Befragten sind zum größten Teil auf Unfallchirurgie spezialisiert (51,5 %) und verfügen über langjährige Berufserfahrung in Traumazentren. Die Hälfte der Operateure versorgt ≤5 Patellafrakturen jährlich. In knapp 40 % der Fälle wird die präoperative Bildgebung um eine Computertomographie ergänzt. Die klassische Zuggurtung ist noch die bevorzugte Osteosyntheseform bei allen Frakturtypen (Querfraktur 52 %, Mehrfragmentfrakturen 40 %). Bei Mehrfragmentfrakturen entscheiden sich 30 % der Operateure für eine winkelstabile Plattenosteosynthese. Bei Beteiligung des kaudalen Pols dient als zusätzliche Sicherung die McLaughlin-Schlinge (60 %).

Diskussion
Der Versorgungsstandard von Patellafrakturen in Deutschland entspricht weitgehend der aktualisierten S2e-Leitlinie. Nach wie vor wird die klassische Zuggurtungsosteosynthese als Verfahren der Wahl genutzt. Weitere klinische (Langzeit‑)Studien werden benötigt, um die Vorteile der winkelstabilen Plattenosteosynthese zu verifizieren.
N2  - Background
The treatment of patella fractures is technically demanding. Although the radiological results are mostly satisfactory, this often does not correspond to the subjective assessment of the patients. The classical treatment with tension band wiring with K‑wires has several complications. Fixed-angle plate osteosynthesis seems to be biomechanically advantageous.

Objective
Who is treating patella fractures in Germany? What is the current standard of treatment? Have modern forms of osteosynthesis become established? What are the most important complications?

Material and methods
The members of the German Society for Orthopedics and Trauma Surgery and the German Knee Society were asked to participate in an online survey.

Results
A total of 511 completed questionnaires were evaluated. Most of the respondents are specialized in trauma surgery (51.5%), have many years of professional experience and work in trauma centers. Of the surgeons 50% treat ≤5 patella fractures annually. In almost 40% of the cases preoperative imaging is supplemented by computed tomography. The classical tension band wiring with K‑wires is still the preferred form of osteosynthesis for all types of fractures (transverse fractures 52%, comminuted fractures 40%). In the case of comminuted fractures 30% of the surgeons choose fixed-angle plate osteosynthesis. If the inferior pole is involved a McLaughlin cerclage is used for additional protection in 60% of the cases.

Discussion
The standard of care for patella fractures in Germany largely corresponds to the updated S2e guidelines. Tension band wiring is still the treatment of choice. Further (long-term) clinical studies are needed to verify the advantages of fixed-angle plates.
T2  - Current treatment standard for patella fractures in Germany
KW  - Kniegelenk
KW  - Winkelstabile Platte
KW  - Klassische Zuggurtung
KW  - Versorgungsstrategien
KW  - Umfrage
KW  - knee joint
KW  - fixed-angle plate
KW  - tension band wiring
KW  - treatment strategy
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235047
SN  - 0177-5537
VL  - 124
ER  - 
TY  - JOUR
A1  - Potreck, Arne
A1  - Mutke, Matthias A.
A1  - Weyland, Charlotte S.
A1  - Pfaff, Johannes A. R.
A1  - Ringleb, Peter A.
A1  - Mundiyanapurath, Sibu
A1  - Möhlenbruch, Markus A.
A1  - Heiland, Sabine
A1  - Pham, Mirko
A1  - Bendszus, Martin
A1  - Hoffmann, Angelika
T1  - Combined Perfusion and Permeability Imaging Reveals Different Pathophysiologic Tissue Responses After Successful Thrombectomy
JF  - Translational Stroke Research
N2  - 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.
KW  - permeability imaging
KW  - perfusion imaging
KW  - mechanical thrombectomy
KW  - secondary stroke injury
KW  - hyperperfusion
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308946
SN  - 1868-4483
SN  - 1868-601X
VL  - 12
IS  - 5
ER  -