The REMAR (Rhein-Main-Registry) real-world study: prospective evaluation of the 21-gene breast recurrence score® assay in addition to Ki-67 for adjuvant treatment decisions in early-stage breast cancer.

Purpose: Ki-67 is recommended by international/national guidelines for risk stratification in early breast cancer (EBC), particularly for defining "intermediate risk," despite inter-laboratory/inter-observer variability and cutoff uncertainty. We investigated Ki-67 (> 10%- < 40%, determined locally) as a prognostic marker for intermediate/high risk in EBC, pN0-1 patients.

Methods: This prospective, non-interventional, real-world study included females ≥ 18 years, with pN0/pN1mi/pN1, HR+ , HER2-negative EBC, and locally determined Ki-67 ranging 10%-40%.

Regeneration of older patients after oncologic surgery. A temporal trajectory of geriatric assessment and quality of life parameters.

Aims: The effectiveness of surgery depends on it being carried out safely, which allows patients to return to independent lives. Because gastrointestinal cancers are a major cause of morbidity and mortality in older people, we examined the dynamics of recuperation after elective, curative surgery. As disease parameters alone may not suffice to address geriatric patients' issues after onco-surgical interventions, Comprehensive Geriatric and QOL Assessments (CGA/QOL) were performed at four time points to gain information on clinical, functional, and cognitive aspects.

Early initiation of MARS® dialysis in Amanita phalloides-induced acute liver injury prevents liver transplantation.

 Amanita phalloides is the most relevant mushroom intoxication leading to acute liver failure. The two principal groups of toxins, the amatoxins and the phallotoxins, are small oligopeptides highly resistant to chemical and physical influences. The amatoxins inhibit eukaryotic RNA polymerase II causing transcription arrest affecting mainly metabolically highly active cells like hepatocytes and renal cells.

The obesity paradox in surgical intensive care patients with peritonitis.

Purpose: Although obesity is usually regarded as a risk factor in surgical patients, various observations have revealed a better outcome in the obese. This finding is called the obesity paradox. To which group of patients the paradox applies and even whether it exists at all are matters of controversial discussion.

Improved long-term survival after esophagectomy for esophageal cancer: influence of epidemiologic shift and neoadjuvant therapy.

Background: The study was done to determine long-term outcomes of surgically treated esophageal cancer and to identify trends in epidemiology, oncological therapy, and oncological prognosis over the last two decades.

Methods: Overall survival in 304 patients undergoing esophagectomy was analyzed. Fifty-three percent had squamous cell carcinoma and 46 % had adenocarcinoma (AC).

Ring drape do not protect against surgical site infections in colorectal surgery: a randomised controlled study.

Introduction: Surgical site infections (SSIs) remain a major problem in colorectal surgery.

Method: In this prospective, randomised study, we compared two kinds of wound protection, namely, "plastic ring drape" versus "standard cloth towels". One hundred one patients were randomised to the control group (wet cloth towels) and 98 to the study cohort (ring drape).

Subcutaneous Redon drains do not reduce the incidence of surgical site infections after laparotomy. A randomized controlled trial on 200 patients.

Purpose: Surgical site infections (SSI) cause excess morbidity and mortality in modern surgery. Several different approaches to reduce the incidence of SSI have been investigated with variable results.

Method: This is to our knowledge the first systematic randomized evaluation in patients undergoing laparotomy in visceral surgery to clarify whether widely used subcutaneous drains (Redon) affect wound infection as the primary outcome measure.

Living-donor kidney transplantation: the Freiburg experience.

Background And Aim: The objective of this study was to determine outcome after living-donor kidney transplantation in a single-center institution in Germany.

Materials And Methods: From 1976 to May 2005, a total of 298 living-donor kidney transplants were performed at the University of Freiburg. Most recipients (78.

Effects of creatine supplementation on nutritional status, muscle function and quality of life in patients with colorectal cancer--a double blind randomised controlled trial.

Background & Aim: Nutritional status frequently deteriorates during chemotherapy in cancer. This is associated with a poor outcome. Since creatine supplementation has shown promising results in various diseases, we investigated the effects of creatine on nutritional status in patients with colorectal cancer undergoing chemotherapy.

Nonoperative treatment of 15 benign esophageal perforations with self-expandable covered metal stents.

Background: Spontaneous or iatrogenic esophageal perforations after endoscopic procedures are potentially life-threatening events with a considerable mortality rate. The aim of this study was to demonstrate that a nonoperative endoscopic treatment with self-expanding metal stents may have a lower morbidity and mortality rate compared with surgical treatment.

Methods: A nonrandomized observational study was conducted with 15 consecutive patients between January 1997 and June 2004.

Prediction of axillary lymph node status of breast cancer patients by tumorbiological factors of the primary tumor.

Background And Purpose: The increasing use of systemic adjuvant therapy even in lymph node-negative breast cancer patients and breast cancer screening programs detecting smaller tumors with less probability of metastatic lymph nodes questions the need for routine axillary lymph node dissection. Since morbidity of breast cancer surgery is predominantly related to axillary lymph node dissection, predictive models for lymph node involvement may provide a way to avoid lymph node surgery and its side effects in subgroups of patients.

Patients And Methods: Using a multivariate logistic regression model, tumorbiological parameters such as expression of estrogen and progesterone receptors, Ki-67, p53, cathepsin D, HER2, S-phase fraction, and ploidy were analyzed regarding their ability to predict axillary lymph node involvement in 655 breast cancer patients.

Cytokine expression in colon carcinoma.

Background: Cytokines reflect the activity of the immune system. We analyzed the local expression of characteristic cytokines indicating the level of activity of unspecific inflammatory cells, Th1-cells and Th2-cells in colon cancer.

Materials And Methods: In 25 tumor/ mucosa pairs, IL-1alpha, IL-2, IL-4, IL-5, IL-15, TNF-alpha and IFN-gamma were measured by real-time PCR.

A butterfly's chemical key to various ant forts: intersection-odour or aggregate-odour multi-host mimicry?

Deception is a crucial yet incompletely understood strategy of social parasites. In central Europe, the Mountain Alcon Blue, Maculinea rebeli, a highly endangered butterfly, parasitises several Myrmica ant species. Caterpillars gain access to host nests probably by faking the ants' odour.

The 3alpha-hydroxy-steroid-dehydrogenase-mRNA and -protein are more prevalent in pericentral than in periportal hepatocytes.

Background: Under physiological conditions, de-novo synthesis and metabolism of bile acids are confined mainly to the pericentral zone of the liver acinus. In the rat, 3alpha-hydroxy-steroid-dehydrogenase (3alpha-HSD) is the major bile acid-binding protein. At the same time, this protein is involved in the de-novo synthesis and metabolism of bile acids.

Repetitive short-term bile duct obstruction and relief causes reproducible and reversible bile acid regurgitation.

Background: Long-term bile duct obstruction causes sinusoidal regurgitation of bile acids, a shift in bile acid metabolism, and alterations of liver histology. In this study we investigated the regurgitation of bile acids during short-term bile duct obstruction and its reversibility and reproducibility. In addition, the biotransformation of taurodeoxycholate and its appearance in bile and perfusate effluent were studied as well as liver histology.

Antisense CD11b integrin inhibits the development of a differentiated monocyte/macrophage phenotype in human leukemia cells.

Macrophage-like development of myeloid leukemia cells which can be induced by agents such as phorbol esters (TPA) is accompanied by integrin expression and cell adhesion. Thus, in differentiating myeloid leukemia cells CD11b is predominantly expressed which can associate with CD18 to form the functional heterodimeric integrin Mac-1. To elucidate the role of cell adhesion during macrophage-like differentiation, we transfected human U937 myeloid leukemia cells with a vector containing the CD11b gene in antisense orientation.