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  • 1
    Online Resource
    Online Resource
    Wiley ; 2019
    In:  Journal of Biomedical Materials Research Part B: Applied Biomaterials Vol. 107, No. 6 ( 2019-08), p. 1772-1778
    In: Journal of Biomedical Materials Research Part B: Applied Biomaterials, Wiley, Vol. 107, No. 6 ( 2019-08), p. 1772-1778
    Abstract: The biocompatibility of a textile implant is determined by various parameters, such as material composition and surface chemistry. However, little is known about the influence of geometry of sutures on biocompatibility. To elucidate this factor we focused on geometry‐modification resulting in ultrafine polyethylene terephthalate (UFPET) suture and a snowflake like shaped polyvenylidenfluorid (PVDF) suture. Forty‐eight rats were divided into two observation periods. In each rat 3 out of 4 sutures (profiled UFPET, snowflake‐like profiled PVDF, reference Prolene and Mersilene suture) were randomly placed into the subcutaneous tissue. Rats were euthanized after 7 and 21 days and samples were explanted. Foreign body granuloma was measured and expression of CD68, TUNEL, Ki‐67 and Collagen I/III ratio were determined. The profiled (snowflake) suture showed a significantly smaller FBG in comparison to standard sutures ( p 〈 0.001). Both modified sutures showed a significant lower tissue remodeling by Ki‐67 and TUNEL expression ( p 〈 0.03). Furthermore, profiled sutures caused a lower inflammatory reaction expressed in a significant lower amount of CD68 positive macrophages after 21 days ( p 〈 0.001). Modifications of suture geometry alter the foreign body granuloma and the inflammatory reaction. Therefore, profiled sutures might be a promising approach to improve biocompatibility of textile mesh prosthesis. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1772–1778, 2019.
    Type of Medium: Online Resource
    ISSN: 1552-4973 , 1552-4981
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 2
    In: Cancer Discovery, American Association for Cancer Research (AACR), Vol. 11, No. 11 ( 2021-11-01), p. 2780-2795
    Abstract: The clinical relevance of comprehensive molecular analysis in rare cancers is not established. We analyzed the molecular profiles and clinical outcomes of 1,310 patients (rare cancers, 75.5%) enrolled in a prospective observational study by the German Cancer Consortium that applies whole-genome/exome and RNA sequencing to inform the care of adults with incurable cancers. On the basis of 472 single and six composite biomarkers, a cross-institutional molecular tumor board provided evidence-based management recommendations, including diagnostic reevaluation, genetic counseling, and experimental treatment, in 88% of cases. Recommended therapies were administered in 362 of 1,138 patients (31.8%) and resulted in significantly improved overall response and disease control rates (23.9% and 55.3%) compared with previous therapies, translating into a progression-free survival ratio & gt;1.3 in 35.7% of patients. These data demonstrate the benefit of molecular stratification in rare cancers and represent a resource that may promote clinical trial access and drug approvals in this underserved patient population. Significance: Rare cancers are difficult to treat; in particular, molecular pathogenesis–oriented medical therapies are often lacking. This study shows that whole-genome/exome and RNA sequencing enables molecularly informed treatments that lead to clinical benefit in a substantial proportion of patients with advanced rare cancers and paves the way for future clinical trials. See related commentary by Eggermont et al., p. 2677. This article is highlighted in the In This Issue feature, p. 2659
    Type of Medium: Online Resource
    ISSN: 2159-8274 , 2159-8290
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
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  • 3
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 9 ( 2020-07-21), p. e301-e302
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 4
    In: BMC Surgery, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Patients with inflammatory bowel disease (IBD) have a high-life time risk undergoing abdominal surgery and are prone to develop incisional hernias (IH) in the postoperative course. Therefore, we investigated the role of IBD as perioperative risk factor in open ventral hernia repair (OVHR) as well as the impact of IBD on hernia recurrence during postoperative follow-up. Methods The postoperative course of 223 patients (Non-IBD (n = 199) and IBD (n = 34)) who underwent OVHR were compared by means of extensive group comparisons and binary logistic regressions. Hernia recurrence was investigated in the IBD group according to the Kaplan–Meier method and risk factors for recurrence determined by Cox regressions. Results General complications (≥ Clavien-Dindo I) occurred in 30.9% (72/233) and major complications (≥ Clavien-Dindo IIIb) in 7.7% (18/233) of the overall cohort with IBD being the single independent risk-factor for major complications (OR = 4.2, p = 0.007). Further, IBD patients displayed a recurrence rate of 26.5% (9/34) after a median follow-up of 36 months. Multivariable analysis revealed higher rates of recurrence in patients with ulcerative colitis (UC, 8/15, HR = 11.7) compared to patients with Crohn’s disease (CD, 1/19, HR = 1.0, p = 0.021). Conclusion IBD is a significant risk factor for major postoperative morbidity after OVHR. In addition, individuals with IBD show high rates of hernia recurrence over time with UC patients being more prone to recurrence than patients with CD.
    Type of Medium: Online Resource
    ISSN: 1471-2482
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 5
    In: The FASEB Journal, Wiley, Vol. 33, No. 8 ( 2019-08), p. 9235-9249
    Type of Medium: Online Resource
    ISSN: 0892-6638 , 1530-6860
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 6
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 9 ( 2020-9-24), p. e0239959-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2020
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  • 7
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 13_Supplement ( 2017-07-01), p. 3391-3391
    Abstract: More than 35% of pheochromocytomas and paragangliomas (PPGL) are thought to occur due to an underlying genetic predisposition. 18 susceptibility genes have been identified for PPGL, which explain app. 30% of familial cases. Further PPGL predisposition genes, however, remain to be discovered. In addition, identification of biomarkers for malignancy also remains a current challenge since histologic assessment does not suffice discrimination of malignant PPGLs. Personalized screening protocols, risk stratification measures and surveillance guidelines are needed for PPGL patients and their family members at risk. We performed panel sequencing for 94 tumor predisposition syndrome (TPS) genes and identified 12 pathogenic germline mutations in 60 PPGL patients. Two of these patients were identified with NF1-mutations although they did not meet the diagnostic criteria for Neurofibromatosis. Thus, TPS gene panel sequencing proved superior to routine Sanger sequencing since mutations were identified in genes that would have routinely been excluded from analysis. Combining results of immunohistochemistry as well as biochemical profiling by measuring Krebs-cycle metabolites and genetic analyses of tumors we were able to reclassify variants of uncertain significance (VUS) as either pathogenic mutations or polymorphisms in several patients. Three incidentally found pathogenic mutations in CHEK2 and MSH2 prompted further analyses such as testing for microsatellite instability in order to evaluate possible effects on PPGL development. For patients in whom no underlying mutation could be detected we performed custom candidate gene panel sequencing of tumor derived-DNA. Whole exome sequencing (WES) was carried out in 15 cases highly suspicious for a genetic background in order to identify new candidate predisposition genes that will further be evaluated in the patient cohort and in functional studies. We will also present guidelines for diagnostics, surveillance and prevention of PPGL for patients and their family members. Citation Format: Laura Gieldon, Susan Richter, Andreas Rump, Karl Hackmann, Andreas Tzschach, Graeme Eisenhofer, Mariola Pęczkowska, Aleksander Prejbisz, Evelin Schröck, Barbara Klink. Next generation sequencing paves the way for personalized medicine in pheochromocytoma and paraganglioma patients and their families [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3391. doi:10.1158/1538-7445.AM2017-3391
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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  • 8
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 78, No. 13_Supplement ( 2018-07-01), p. 1410-1410
    Abstract: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer death in western countries, although lifetime risk is estimated at only 1.3% in the general population. BRCA2 mutations, however, have been attributed with a lifetime risk for PDAC development of 5-10%, while the risk for PDAC development in BRCA1 mutation carriers has been the subject of an ongoing scientific discussion, with current estimates of an increased PDAC risk of only 2-4-fold. We retrospectively analyzed 180 pedigrees for occurrence of PDAC. All families were counselled for hereditary breast and ovarian cancer (HBOC) within three years (2015 to 2017) at the Center for Hereditary Breast and Ovarian Cancer in Dresden. The pedigrees of 111 families with a pathogenic BRCA1 germline mutation and of 69 families with a pathogenic BRCA2 germline mutation were available for analysis. Whenever possible genetic testing (NGS or targeted sequencing) was performed using blood and/or tumor tissue of affected individuals. 14 “BRCA1 families” were identified to have at least one family member affected by PDAC (12.6% of families). Three of the patients were available for testing and carrier status could be confirmed in all of them. According to formal genetic risk calculation 6 of the PDAC patients had a mutation carrier risk of 50%, 5 of 25% and 1 of 12.5%. Age of onset (AO) of the disease was known in 13 of the families and the mean AO, calculated for these patients, was 58.7 years. Interestingly, two female Mutation carriers had both breast- and pancreatic cancer and one family with a BRCA1 mutation presented with two sisters with PDAC. Tumor tissue was available from one of them and sequencing indicated loss-of-heterozygosity, supporting the assumption that the BRCA1 mutation might have been causative for tumorigenesis. Of the “BRCA2 families” 10 (14,5%) were identified to have one family member each with PDAC. To date, however, none of them was available for genetic testing. 3 of the patients had a mutation carrier risk calculated at 50%, 5 at 25%, 1 at 12.5% and 1 at 6.25%. The mean AO was calculated to be 60.1 years. One female PDAC patient additionally had breast cancer and one of the male patients also suffered from prostate cancer. While the number of families represented in this retrospective study is limited, our observations indicate that BRCA1 mutations might be underdiagnosed in PDAC, especially in patients with an earlier AO. Extensive genetic analyses of PDAC patients will be necessary in order to elucidate this presumption and could also indicate whether additional genetic risk modifiers play a role in PAC development in BRCA1/2 families. Citation Format: Evelin Schrock, Karl Hackmann, Franziska Kuhlee, Arne Jahn, Johannes Wagner, Anne-Karin Kahlert, Joseph Porrmann, Andreas Tzschach, Daniela Aust, Gustavo Baretton, Karin Kast, Pauline Wimberger, Michael Laniado, Christoph Kahlert, Thilo Welsch, Jürgen Weitz, Barbara Klink, Andreas Rump, Laura Gieldon. Pedigree analysis equally identifies cases of pancreatic cancer in families with BRCA1 and BRCA2 mutations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1410.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
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  • 9
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 15_Supplement ( 2015-08-01), p. LB-044-LB-044
    Abstract: Introduction: Breast and ovarian cancer (BC/OC) predisposition is associated with a number of high- and low-penetrance susceptibility genes. Despite comprehensive testing there is still a large portion of high risk cases without mutation in any of the known susceptibility loci. Therefore novel candidate genes need to be identified. Here we report on the results of testing 94 genes in 717 BC/OC patients from Germany and Lithuania. Method: Inclusion criteria for the patients in this study were defined by the German Consortium for Breast and Ovarian Cancer. Next generation sequencing (NGS) was performed on an Illumina MiSeq sequencer, with 150 bp paired end sequencing chemistry and an average base coverage of 300 fold. Target enrichment was performed with the Illumina TruSight cancer panel, which includes 94 genes associated with both common (e.g., breast, colorectal) and rare cancers. Results: In 19.7% of the patients, BRCA1 or BRCA2 variations have been found. These were either clearly pathogenic loss-of-function mutations (43%) or very rare, unclassified missense variations with high probability of a deleterious effect (57%). In 17.9% of the patients we found null-mutations and rare, unclassified missense variants in the acknowledged BC/OC susceptibility genes ATM, CDH1, CHEK2, NBN, PALB2, RAD51C/D and TP53. Analysis of the non-BC/OC genes on the NGS panel identified the “excision repair cross-complementing rodent repair deficiency, complementation group 2” gene (ERCC2 or XPD) as a promising BC/OC predisposition candidate: we found 3 frame-shift mutations and 1 splice-site mutation in four independent BC/OC families. Additionally we found 20 rare, unclassified sequence variations in ERCC2. These variants have a cumulative allele frequency of 2.9% in our BC/OC cohort, which is 14.5-fold overrepresentation compared to the “exome aggregation consortium” (ExAC) cohort (61486 exomes). In all affected families tested so far, the ERCC2 mutations co-segregate with the occurrence of BC and/or OC. Functional assays testing the ERCC2 variants have been initiated. First results show that at least some of the missense variants (e.g. NM_000400.3:p.Val536Met) have lost their DNA repair ability. Conclusion: Deleterious mutations and probably pathogenic missense variations in ERCC2, which are significantly overrepresented in our BC/OC families and co-segregate with the affected individuals, define ERCC2 clearly as a susceptibility gene for BC/OC predisposition. Functional assays will be continued in order to identify missense variations that diminish the DNA-repair capacity of ERCC2. Affected individuals with excluded mutations in the known BC/OC predisposition genes should be tested for mutations in ERCC2. Citation Format: Evelin Schrock, Anna Benet-Pagès, Steffen Schubert, Ramūnas Janavicius, Karl Hackmann, Elitza Betcheva-Krajcir, Luisa Mackenroth, Janin Lehmann, AM Nissen, Janine Altmueller, Holger Thiele, Nataliya Di Donato, Barbara Klink, Jan D. Kuhlmann, Andreas Tzschach, Karin Kast, Pauline Wimberger, Elke Holinski-Feder, Alfons Meindl, Steffen Emmert, Andreas Rump. Germline mutations in patients with hereditary breast and ovarian cancer establish ERCC2 as a cancer susceptibility gene. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-044. doi:10.1158/1538-7445.AM2015-LB-044
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 10
    In: Langenbeck's Archives of Surgery, Springer Science and Business Media LLC, Vol. 407, No. 2 ( 2022-03), p. 789-795
    Abstract: Appendectomy for acute appendicitis is one of the most common operative procedures worldwide in both children and adults. In particular, complicated (perforated) cases show high variability in individual outcomes. Here, we developed and validated a machine learning prediction model for postoperative outcome of perforated appendicitis. Methods Retrospective analyses of patients with clinically and histologically verified perforated appendicitis over 10 years were performed. Demographic and surgical baseline characteristics were used as competing predictors of single-patient outcomes along multiple dimensions via a random forest classifier with stratified subsampling. To assess whether complications could be predicted in new, individual cases, the ensuing models were evaluated using a replicated 10-fold cross-validation. Results A total of 163 patients were included in the study. Sixty-four patients underwent laparoscopic surgery, whereas ninety-nine patients got a primary open procedure. Interval from admission to appendectomy was 9 ± 12 h and duration of the surgery was 74 ± 38 min. Forty-three patients needed intensive care treatment. Overall mortality was 0.6 % and morbidity rate was 15%. Severe complications as assessed by Clavien-Dindo 〉 3 were predictable in new cases with an accuracy of 68%. Need for ICU stay ( 〉 24 h) could be predicted with an accuracy of 88%, whereas prolonged hospitalization (greater than 7–15 days) was predicted by the model with an accuracy of 76%. Conclusion We demonstrate that complications following surgery, and in particular, health care system-related outcomes like intensive care treatment and extended hospitalization, may be well predicted at the individual level from demographic and surgical baseline characteristics through machine learning approaches.
    Type of Medium: Online Resource
    ISSN: 1435-2443 , 1435-2451
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    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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