TY - THES A1 - Haake, Monika T1 - Belastungen durch Passivrauchen im Kindesalter T1 - The damage to children's health caused by environmental tobacco smoke N2 - Hintergrund: Passivrauchen ist nicht nur als kanzerogen für den Menschen eingestuft, sondern verursacht auch verschiedene andere Erkrankungen. Oft wird dabei der Passivrauchbelastung von Kindern im häuslichen Bereich zu wenig Beachtung geschenkt. In dieser Arbeit wurde deswegen der Zusammenhang zwischen Passivrauchen auf der einen Seite und atopischen Erkrankungen, Erkrankungen der oberen Atemwege und Gentoxizität auf der anderen Seite untersucht. Methoden: Die Daten von über 100 Kindern zwischen 1 und 15 Jahren wurden mit Hilfe eines Fragebogens erhoben und zusammen mit den Krankenakten ausgewertet. Zur Prüfung der Gentoxizität wurden Mikrokernraten und Schwesterchromatidenaustausche in peripheren Lymphozyten bestimmt. Der Erfassung der inneren Exposition dienten Hämoglobinaddukte von 4-Aminobiphenyl, welches in Zigarettenrauch vorkommt und als krebserzeugend für den Menschen eingestuft ist. Ergebnisse: Bei Untersuchung der Mikrokernraten zeigten die rauchbelasteten Kinder höhere Mikrokernraten (Mittelwert: 12,7/1000 zweikernige Lymphozyten) als die unbelasteten (Mittelwert: 11,7 Mikrokerne/1000 zweikernige Lymphozyten). Der Unterschied war aber nicht signifikant (p = 0,344). Außerdem hatten die Vorschulkinder mit rauchenden Eltern signifikant höhere Mikrokernraten (Mittelwert: 14,2/1000 zweikernige Lymphozyten) als die Schulkinder (Mittelwert: 9,2/1000 zweikernige Lymphozyten; p = 0,031). Die Analyse der 4-Aminobiphenyl-Hämoglobinaddukte der 1,25- bis 4,0-Jährigen ergab leicht höhere Werte für Kinder mit rauchenden Eltern (Mittelwert: 66,52 pg/g Hb) als für Kinder, deren Eltern nicht zu Hause rauchten, und deren Werte (Mittelwert: 56,18 pg/g Hb) waren höher als die der unbelasteten Kinder (Mittelwert: 49,60 pg/g Hb). Der Unterschied war nicht signifikant. Bei Betrachtung der atopischen Erkrankungen war der Anteil der Atopiker bei der rauchexponierten Gruppe höher (31,3 %) als bei der nicht exponierten (16,3 %), obwohl die genetische Vorbelastung in der rauchbelasteten Gruppe etwas geringer war als in der unbelasteten. Bei den Kindern mit Erkrankungen der oberen Atemwege zeigte sich ein höherer Anteil rauchexponierter Kinder (61,3 %) als in der Gruppe der Kinder mit Erkrankungen, die wahrscheinlich nicht mit postnataler Passivrauchexposition in Zusammenhang stehen (44,8 %). Schlussfolgerung: Diese Arbeit unterstreicht die Bedeutung von Passivrauchen im Hinblick auf atopische Erkrankungen und Erkrankungen der oberen Atemwege bei Kindern. Gerade die häusliche Passivrauch-Belastung im Vorschulalter und ihre Auswirkung auf das Erbgut sollten hinsichtlich der erhöhten Mikrokernraten mehr Beachtung finden. N2 - Background: Passive smoking is not only classified as carcinogenic in humans, but also causes different other diseases. In this context the exposure of children to environmental tobacco smoke (ETS) at home is often not considered well enough. Therefore the correlation between passive smoking on the one hand and atopic diseases, diseases of the upper airways and genotoxicity on the other hand has been analysed in this dissertation. Methods: The data of more than 100 children from 1 to 15 years of age were collected with the help of a questionnaire and analysed together with the children’s medical files. To test genotoxicity, micronucleus frequencies and sister chromatid exchanges were determined in peripheral lymphocytes. Hemoglobin adducts of 4-aminobiphenyl, which is contained in tobacco smoke and classified as carcinogenic in humans, were used to measure the internal exposure. Results: The examination of the micronucleus frequencies has shown that the ETS-exposed children had higher micronucleus frequencies (mean: 12,7/1000 binucleate lymphocytes) than the non-exposed children (mean: 11,7/1000 binucleate lymphocytes). However, the difference was not significant (p = 0,344). In addition to that, preschool-children with smoking parents had significantly higher micronucleus frequencies (mean: 14,2/1000 binucleate lymphocytes) than school-children (mean: 9,2/1000 binucleate lymphocytes; p = 0,031). The analysis of the 4-aminobiphenyl-hemoglobin adducts of the children from 1,25 to 4 years of age showed results a bit higher for the children with smoking parents (mean: 66,52 pg/g Hb) than for the children whose parents did not smoke at home. The results for these children (mean: 56,18 pg/g Hb) were higher than for those not exposed to environmental tobacco smoke (mean: 49,60 pg/g Hb). The difference was not significant. In regard to the atopic diseases the share of the atopic children in the ETS-exposed group was higher (31,3%) than in the non-exposed one (16,3 %) although the genetic disadvantage in the ETS-exposed group was less serious than in the non-exposed one. Looking at the children with diseases of the upper airways the share of ETS-exposed children was higher (61,3 %) than in the group of children with diseases probably not connected to postnatal exposure to ETS (44,8 %). Conclusion: This dissertation underlines the importance of passive smoking as far as atopic diseases and diseases of the upper airways of children are concerned. Especially the ETS exposure of preschool-children at home and its effects on the genom should be considered more than it is because of the increased micronucleus frequencies. KW - Passivrauchen KW - Kinder KW - Mikrokerne KW - Schwesterchromatidenaustausche KW - 4-Aminobiphenyl KW - Hämoglobinaddukte KW - Gentoxizität KW - atopische Erkrankungen KW - passive smoking KW - environm. tobacco smoke KW - children KW - micronuclei KW - sister chromatid exch. KW - 4-aminobiphenyl KW - hemoglobin adducts KW - genotoxicity Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-13952 ER - TY - JOUR A1 - Trudzinski, Franziska C. A1 - Minko, Peter A1 - Rapp, Daniel A1 - Fähndrich, Sebastian A1 - Haake, Hendrik A1 - Haab, Myriam A1 - Bohle, Rainer M. A1 - Flaig, Monika A1 - Kaestner, Franziska A1 - Bals, Robert A1 - Wilkens, Heinrike A1 - Muellenbach, Ralf M. A1 - Link, Andreas A1 - Groesdonk, Heinrich V. A1 - Lensch, Christian A1 - Langer, Frank A1 - Lepper, Philipp M. T1 - Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: a retrospective analysis JF - Annals of Intensive Care N2 - Background Even though bleeding and thromboembolic events are major complications of extracorporeal membrane oxygenation (ECMO), data on the incidence of venous thrombosis (VT) and thromboembolism (VTE) under ECMO are scarce. This study analyzes the incidence and predictors of VTE in patients treated with ECMO due to respiratory failure. Methods Retrospective analysis of patients treated on ECMO in our center from 04/2010 to 11/2015. Patients with thromboembolic events prior to admission were excluded. Diagnosis was made by imaging in survivors and postmortem examination in deceased patients. Results Out of 102 screened cases, 42 survivors and 21 autopsy cases [mean age 46.0 ± 14.4 years; 37 (58.7 %) males] fulfilling the above-mentioned criteria were included. Thirty-four patients (54.0 %) underwent ECMO therapy due to ARDS, and 29 patients (46.0 %) with chronic organ failure were bridged to lung transplantation. Despite systemic anticoagulation at a mean PTT of 50.6 ± 12.8 s, [VT/VTE 47.0 ± 12.3 s and no VT/VTE 53.63 ± 12.51 s (p = 0.037)], VT and/or VTE was observed in 29 cases (46.1 %). The rate of V. cava thrombosis was 15/29 (51.7 %). Diagnosis of pulmonary embolism prevailed in deceased patients [5/21 (23.8 %) vs. 2/42 (4.8 %) (p = 0.036)]. In a multivariable analysis, only aPTT and time on ECMO predicted VT/VTE. There was no difference in the incidence of clinically diagnosed VT in ECMO survivors and autopsy findings. Conclusions Venous thrombosis and thromboembolism following ECMO therapy are frequent. Quality of anticoagulation and ECMO runtime predicted thromboembolic events. " KW - Pulmonary Embolism KW - Inferior Vena Cava KW - Venous Thrombosis KW - Fresh Freeze Plasma KW - Extracorporeal Membrane Oxygenation Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164455 VL - 6 ER - TY - JOUR A1 - Loeffler-Wirth, Henry A1 - Kreuz, Markus A1 - Hopp, Lydia A1 - Arakelyan, Arsen A1 - Haake, Andrea A1 - Cogliatti, Sergio B. A1 - Feller, Alfred C. A1 - Hansmann, Martin-Leo A1 - Lenze, Dido A1 - Möller, Peter A1 - Müller-Hermelink, Hans Konrad A1 - Fortenbacher, Erik A1 - Willscher, Edith A1 - Ott, German A1 - Rosenwald, Andreas A1 - Pott, Christiane A1 - Schwaenen, Carsten A1 - Trautmann, Heiko A1 - Wessendorf, Swen A1 - Stein, Harald A1 - Szczepanowski, Monika A1 - Trümper, Lorenz A1 - Hummel, Michael A1 - Klapper, Wolfram A1 - Siebert, Reiner A1 - Loeffler, Markus A1 - Binder, Hans T1 - A modular transcriptome map of mature B cell lymphomas JF - Genome Medicine N2 - Background Germinal center-derived B cell lymphomas are tumors of the lymphoid tissues representing one of the most heterogeneous malignancies. Here we characterize the variety of transcriptomic phenotypes of this disease based on 873 biopsy specimens collected in the German Cancer Aid MMML (Molecular Mechanisms in Malignant Lymphoma) consortium. They include diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), Burkitt’s lymphoma, mixed FL/DLBCL lymphomas, primary mediastinal large B cell lymphoma, multiple myeloma, IRF4-rearranged large cell lymphoma, MYC-negative Burkitt-like lymphoma with chr. 11q aberration and mantle cell lymphoma. Methods We apply self-organizing map (SOM) machine learning to microarray-derived expression data to generate a holistic view on the transcriptome landscape of lymphomas, to describe the multidimensional nature of gene regulation and to pursue a modular view on co-expression. Expression data were complemented by pathological, genetic and clinical characteristics. Results We present a transcriptome map of B cell lymphomas that allows visual comparison between the SOM portraits of different lymphoma strata and individual cases. It decomposes into one dozen modules of co-expressed genes related to different functional categories, to genetic defects and to the pathogenesis of lymphomas. On a molecular level, this disease rather forms a continuum of expression states than clearly separated phenotypes. We introduced the concept of combinatorial pattern types (PATs) that stratifies the lymphomas into nine PAT groups and, on a coarser level, into five prominent cancer hallmark types with proliferation, inflammation and stroma signatures. Inflammation signatures in combination with healthy B cell and tonsil characteristics associate with better overall survival rates, while proliferation in combination with inflammation and plasma cell characteristics worsens it. A phenotypic similarity tree is presented that reveals possible progression paths along the transcriptional dimensions. Our analysis provided a novel look on the transition range between FL and DLBCL, on DLBCL with poor prognosis showing expression patterns resembling that of Burkitt’s lymphoma and particularly on ‘double-hit’ MYC and BCL2 transformed lymphomas. Conclusions The transcriptome map provides a tool that aggregates, refines and visualizes the data collected in the MMML study and interprets them in the light of previous knowledge to provide orientation and support in current and future studies on lymphomas and on other cancer entities. KW - tumor heterogeneity KW - B cell malignancies KW - gene regulation KW - molecular subtypes KW - machine learning Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237262 VL - 11 ER - 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 -