Distinct relapse pattern across molecular ependymoma types.

Background: Ependymoma (EPN) is not a uniform disease but represents different disease types with biological and clinical heterogeneity. However, the pattern of when and where different types of EPN relapse is not yet comprehensively described.

Methods: We assembled 269 relapsed intracranial EPN from pediatric (n = 233) and adult (n = 36) patients from European and Northern American cohorts and correlated DNA methylation patterns and copy-number alterations with clinical information.

Radiotherapy for Recurrent Medulloblastoma in Children and Adolescents: Survival after Re-Irradiation and First-Time Irradiation.

Background: Radiotherapy (RT) involving craniospinal irradiation (CSI) is important in the initial treatment of medulloblastoma. At recurrence, the re-irradiation options are limited and associated with severe side-effects.

Methods: For pre-irradiated patients, patients with re-irradiation (RT2) were matched by sex, histology, time to recurrence, disease status and treatment at recurrence to patients without RT2.

Pediatric computed tomography doses in Germany from 2016 to 2018 based on large-scale data collection.

Purpose: Accumulating evidence from epidemiological studies that pediatric computed tomography (CT) examinations can be associated with a small but non-zero excess risk for developing leukemia or brain tumor highlights the need to optimize doses of pediatric CT procedures. Mandatory dose reference levels (DRL) can support reduction of collective dose from CT imaging. Regular surveys of applied dose-related parameters are instrumental to decide when technological advances and optimized protocol design allow lower doses without sacrificing image quality.

Local and Systemic Therapy of Recurrent Medulloblastomas in Children and Adolescents: Results of the P-HIT-REZ 2005 Study.

Recurrent medulloblastomas are associated with survival rates <10%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics.

Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies.

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.

Local and systemic therapy of recurrent ependymoma in children and adolescents: short- and long-term results of the E-HIT-REZ 2005 study.

Background: Survival in recurrent ependymomas in children and adolescents mainly depends on the extent of resection. Studies on repeated radiotherapy and chemotherapy at relapse have shown conflicting results.

Methods: Using data from the German multi-center E-HIT-REZ-2005 study, we examined the role of local therapy and the efficacy of chemotherapy with blockwise temozolomide (TMZ) in children and adolescents with recurrent ependymomas.

Biogas yields and composition from oil-extracted halophilic algae residues in conventional biogas plants operated at high salinities.

CO-induced climate change drives the development of renewable processes for industrial products. Algae processes can actively fix and convert CO into value adding products, such as oils. Algae lipids hence counteract climate change and provide access to renewable commodities.

[Risk of iatrogenic neurovascular damage by proximal 3-dimensional intramedullary nailing of the tibia].

Background: The rate of clinically relevant neurovascular injuries after proximal intramedullary nailing of the tibia remains unclear. The anatomical risk of iatrogenic damage to these structures should be estimated in a prospective MRI examination.

Material And Methods: A total of 99 consecutive patients were included in the study cohort.

Reduced hyperalgesia in homozygous carriers of a GTP cyclohydrolase 1 haplotype.

Background: Carriers of a particular haplotype of the GTP cyclohydrolase gene (GCH1) had less pain after surgery for chronic lumbar radiculopathy and a decreased sensitivity to some experimental mechanical pain stimuli. Ex-vivo, GCH1 upregulation and BH4 production after forskolin stimulation were reduced, while baseline BH4 concentrations were not affected. This suggested that the haplotype may mainly exert its modulating function when the GCH1 system is provoked.

GTP cyclohydrolase and tetrahydrobiopterin regulate pain sensitivity and persistence.

We report that GTP cyclohydrolase (GCH1), the rate-limiting enzyme for tetrahydrobiopterin (BH4) synthesis, is a key modulator of peripheral neuropathic and inflammatory pain. BH4 is an essential cofactor for catecholamine, serotonin and nitric oxide production. After axonal injury, concentrations of BH4 rose in primary sensory neurons, owing to upregulation of GCH1.

Benign multicystic mesothelioma: a case report.

Benign multicystic mesothelioma (also known as multilocular peritoneal inclusion cyst) is a rare lesion found on any abdominal peritoneal surface that occurs most frequently in premenopausal women. We report the case of a 36-year- old woman, who presented with a history of generalized abdominal pain, intermittent abdominal bloating, and episodes of loose stools. A pelvic ultrasound revealed a complex cystic mass with fine internal septations.

External radiotherapy of pituitary adenomas.

Purpose: To evaluate therapeutic outcome and side effects of radiotherapy in pituitary adenomas as sole or combined treatment.

Methods And Materials: Retrospective analysis of 138 patients (74 male, 64 female) irradiated for pituitary adenoma from 1972 to 1991 was performed. Mean age was 49.

[Magnetic resonance tomography of the ankle joint].

To define the clinical role of MRI of the ankle joint, a total of 88 patients was investigated. In the evaluation of ligamentous injury, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint.

[The diagnostic reliability of the occipitomental radiograph of the paranasal sinuses. Correlation with magnetic resonance tomography].

100 conventional occipitomental radiographs of the paranasal sinuses were studied independently by five radiologists. Predictive values were determined, based on MRI as the gold standard. Sensitivity and specificity for detection of mucosal thickening in the sinuses were: maxillary sinus: 0.

[A comparison between digital luminescence radiography and conventional myelography].

The potential of digital luminescence radiography in replacing conventional myelography was analyzed using ROC methodology. 95 conventional (CR), digital (DR) and edge enhanced digital (EDR) myelograms (49 disk herniations, 46 normal) were read independently by 5 radiologists; and a ROC analysis was performed. Higher confidence levels were used in making both correct and incorrect diagnoses with DR and EDR than with CR.

[The diagnosis of deep venous thrombosis of the lower extremities using high-resolution real-time and CW-Doppler sonography. Accuracy and limitations].

The combination of high-resolution real time and continuous wave (CW) Doppler sonography is particularly valuable for the detection of venous thrombosis in the lower limbs. A total of 235 venous sonograms were prospectively compared with phlebography (gold standard) and indicated a sensitivity and specificity of 93%-100% and 96%-99%, respectively, depending on the thrombosis site. The positive and negative predictive values ranged between 90% and 97% and 97% and 100%, respectively.

[Conventional diagnosis of carpal luxation and instability].

The recognition of ligament disruption in carpal dislocation and the early diagnosis of carpal instability have had implications for the therapy since the evolution of differentiated surgical treatment concepts including ligament reconstruction. Plain radiography and the carpal instability series are helpful in the detection of ligament disruption. The radiological analysis is based on the configuration and arrangement of the carpals, the setting of their axes, and the detection of intercarpal gaps.

Evaluation of flu-like symptoms in workers handling xanthan gum powder.

A study was performed to determine the relationship between the handling of xanthan gum powder and reported symptoms. Nose and throat irritation was the most prevalent symptom, and the group with the greatest exposure reported the highest prevalence of nose and throat irritation as well as work-related illness. Employees who reported illness as a result of exposure to materials at work did not show a decrease in pulmonary function over the first day of the workday or workweek.

[Hemophilic osteoarthropathy with special reference to the elbow joint].

Hemophilia is a rare disorder, whereby recurrent bleedings into the joint can result in osteoarthropathy. Radiological changes consist of osteoporosis, enlargement of the epiphyses, irregularity of the subchondral bone surface, narrowing of the joint space, cysts, erosions, joint incongruence and joint deformity. The earlier and the more frequent bleedings have occurred that have not been treated adequately, the more of the changes mentioned above are present.

[The radiotherapeutic effect on bone metastases in relation to the frequency of metastases, sites of metastases and histology of the primary tumor].

In a retrospective study on 239 patients irradiated for osseous metastases in 578 different skeletal areas, the therapy effect was evaluated in dependence on the frequency of metastases, the sites of metastases, and the histology of the primary tumors. Furthermore the duration of improved findings was verified. The primary tumor was a mammary carcinoma in 186 patients, a bronchial carcinoma in 21 patients, a renal cell carcinoma in 20 patients, and a prostatic carcinoma in 12 patients.

[Radiologic diagnosis of bone metastases].

The diagnostic relevance of the various radiological examination methods - skeleton scintigraphy, conventional x-ray film, computed tomography, sonography and magnetic resonance - was analysed on the basis of an examination of 4765 clinically or scintigraphically suspect skeleton segments in order to arrive at an effective but also economically justifiable diagnostic approach. Conventional skeleton scintigraphy should be employed as the first method of choice, since it has a sensitivity of 93% and is hence very suitable as a searching tool. To differentiate benign and malignant lesions it is absolutely imperative to conduct at the same time a x-ray control of any abnormal accumulation of nuclides, or of parts of the skeleton that display signs or symptoms.

[Accelerated irradiation of bone metastases].

In a prospective study, accelerated irradiation was performed over 60 portals in 34 tumor patients with peripheral bone metastases. During a period of three days, three daily fractions of 3 Gy each were applied with intervals of four hours, resulting in a total dose of 27 Gy. Using this fractionation schedule introduced by Ammon, a reduction of metastasis-associated pain was achieved in 90% of cases (54/60).