5 research outputs found
Beeinflussung kardialer Umbauprozesse (kardiales Remodeling) nach einem Herzinfarkt durch Insulin-like growth factor 1 (IGF-1)
No full textPerioperative outcomes in an age-adapted analysis of the German StuDoQ|Pancreas registry for PDAC
No full textAbstract Background Pancreatic ductal adenocarcinoma (PDAC) typically occurs in an older patient population. Yet, early-onset pancreatic cancer (EOPC) has one of the fastest growing incidence rates. This study investigated the influence of age and tumor location on postoperative morbidity and mortality in a large, real-world dataset. Methods Patients with confirmed PDAC undergoing pancreatic surgery between 01/01/2014 and 31/12/2019 were identified from the German StuDoQ|Pancreas registry. After categorization into early- (EOPC; 70 years), and stratification into pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), differences in morbidity and mortality as well as clinicopathologic parameters were analyzed. Results In total, 3011 patients were identified. No difference in the occurrence of postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH) or delayed gastric emptying (DGE) between different age groups and resection techniques was detected. However, in patients undergoing PD, major complications (Clavien-Dindo ≥ 3a) were observed more frequently in LOPC (30,7%) than in MOPC (26,2%) and EOPC (16,9%; p < 0,01). Mortality almost tripled from EOPC (2,4%) to MOPC (3,6%) to LOPC (6,6%, p < 0,01) and significantly higher failure to rescue (FTR) rates could be observed (EOPC 14,3%, MOPC 13,6%; LOPC 21,6%; p < 0,05). In centers with DGAV certification for pancreatic surgery, the risk of complications was significantly decreased in PD (OR 0,79; 95% CI 0,65–0,94; p = 0,010). Conclusion Age has a pronounced impact on the perioperative outcomes after pancreatic resections of PDAC. This effect is more prevalent in PD compared to DP. Pancreatic surgery-specific complications, such as POPF, DGE or PPH do not occur more frequently in the elderly. Overall, the risk of major complications and mortality increases in elderly patients mainly secondary to higher FTR rates.Bavarian Centre for Cancer ResearchMunich Clinician Scientist Program (MCSP) FoeFoLe+German Cancer Consortium http://dx.doi.org/10.13039/501100012353Klinikum der Universität Münche
TGFβ signalling pathway impacts brain metastases profiles in locally advanced colorectal cancer
No full text<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Rationale</jats:title>
<jats:p>Colorectal Cancer (CRC) represents the third most common type of cancer in Germany and the second most common cancer-related cause of death worldwide. Distant metastases are still the main limit for patient survival. While liver metastases as well as peritoneal carcinomatosis can often either be resected or treated with systemic therapy, little options remain for brain metastases. Additionally, a number of studies has already investigated hepatic, peritoneal, pulmonary as well as continuing distant metastases in colorectal cancer. Yet, with respect to tumor biology and brain metastases, little is known so far.</jats:p>
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<jats:title>Material and methods</jats:title>
<jats:p>Two cohorts, M0 without distant spread and BRA with brain metastases were build. RNA was isolated from paraffin embedded specimen. Gene expression was performed by an RNA NanoString-Analysis using the nCounter® PanCancer Progression Panel by NanoString-Technologies (Hamburg, Germany). Results were analysed by principal component analysis, gene expression and pathway analysis using commonly available databases such as KEGG as benchmark for comparison.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>We were able to determine a gene signature that provides a sophisticated group separation between M0 and BRA using principal component analysis. All genes with strong loading characteristics on principal component 1 were cross-referenced with the subsequently performed accurate gene set enrichment analysis (GSEA). The GSEA revealed a clear dysregulation of the TGFβ pathway in compared cohorts M0 and BRA. Interestingly, the targeted pathways analysis of the identified genes confirmed that in fact almost all strong loading genes of PC1 play a role in the TGFβ pathway.</jats:p>
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<jats:title>Conclusion</jats:title>
<jats:p>Our results suggest the TGFβ pathway as a crucial player in the development of brain metastases in primary CRC. In some types of colorectal cancer, downregulation of the TGFβ pathway might hinder primary colorectal cancer to metastasize to the nervous system. While the paradoxical functioning of the TGFβ pathway is still not fully understood, these shed light on yet another clinical implication of this complex pathway.</jats:p>
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Constitutional Duties of the Man and the Citizen in the Focus of Doctrine
No full textThe aim of this article is to present the results of a number of doctrinal perspectives of the study of the constitutional duties of man and citizen which determined general and special approaches to the interpretation of constitutional duties; their author interpretation is proposed. The duties of a citizen arise from the relation of an individual in a state. Citizens, unlike other persons residing in the state territory, are affected not only by the territorial supremacy of the state, but also by their personal supremacy. It applies to citizens when they are outside the territory of their state.El objetivo de este artículo es presentar los resultados de una serie de perspectivas doctrinales del estudio de los deberes constitucionales del hombre y el ciudadano que determinaron enfoques generales y especiales para la interpretación de los deberes constitucionales; se propone la interpretación de su autor. Los deberes de un ciudadano surgen de la relación de un individuo en un estado. Los ciudadanos, a diferencia de otras personas que residen en el territorio estatal, se ven afectados no solo por la supremacía territorial del estado, sino también por su supremacía personal. Se aplica a los ciudadanos cuando se encuentran fuera del territorio de su estado
Validation of body composition parameters extracted via deep learning-based segmentation from routine computed tomographies
No full textAbstract Sarcopenia and body composition metrics are strongly associated with patient outcomes. In this study, we developed and validated a flexible, open-access pipeline integrating available deep learning-based segmentation models with pre- and postprocessing steps to extract body composition measures from routine computed tomography (CT) scans. In 337 surgical oncology patients, total skeletal muscle tissue (SMtotal), psoas muscle tissue (SMpsoas), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were quantified both manually and using the pipeline. Automated and manual measurements showed strong correlations (SMpsoas: r = 0.776, VAT: r = 0.993, SAT: r = 0.984; all P < 0.001). Measurement discrepancies primarily resulted from segmentation errors, anatomical anomalies or image irregularities. SMpsoas measurements showed substantial variability depending on slice selection, whereas SMtotal, averaged across all L3 levels, provided greater measurement stability. Overall, SMtotal performed comparably to SMpsoas in predicting overall survival (OS). In summary, body composition measures derived from the pipeline strongly correlated with manual measurements and were prognostic for OS. The increased stability of SMtotal across vertebral levels suggests it may serve as a more reliable alternative to psoas-based assessments. Future studies should address the identified areas of improvement to enhance the accuracy of automated segmentation models
