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3. Organprotektive Intensivtherapie und Simulatortraining

Author

S. Welschehold, T. Ott, Christian Werner, P.R. Galle, D. Bösebeck, and J.W. Rey

Subjects
Transplantation, Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, medicine, General Medicine, Patient simulation, business
Abstract

Die Bereitschaft zur Organspende ist in Deutschland nach wie vor unzureichend. Bei Weitem nicht alle Patienten auf den Wartelisten erhalten rechtzeitig ein geeignetes Spenderorgan. Die adaquate intensivmedizinische Versorgung des Organspenders ist bislang in Losungsansatzen dieses Problems wenig beachtet worden. Bei zunehmendem Alter und zunehmender Komorbiditat ist eine adaquate intensivmedizinische Therapie des Spenders fur den Erfolg der moglichen Transplantationen unabdingbar. Randomisierte klinische Studien zur organprotektiven Therapie sind jedoch nicht ausreichend verfugbar. Die vorliegende Ubersicht fasst die aktuelle wissenschaftliche Literatur zusammen und gibt einen Ausblick auf Losungsansatze. Dabei konnten die Durchfuhrung multizentrischer Studien sowie die intensivierte Aus- und Weiterbildung von arztlichem und pflegerischem Intensivpersonal erste wesentliche Schritte sein, diesen Zustand zu verbessern. Auch die Weiterentwicklung und Etablierung curricularer Fortbildungen an Simulatoren ist ein vielversprechender Ansatz zur quantitativen und qualitativen Steigerung der Organspende.

Published
2012
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4. Treatment of Metachronous and Simultaneous Liver Metastases of Pancreatic Cancer

Author

L. Will, G. Otto, Theodor Junginger, C. von Langsdorf, P.R. Galle, C.F. Vahl, F. Dünschede, and M. Möhler

Subjects
Adult, Male, Oncology, Antimetabolites, Antineoplastic, medicine.medical_specialty, Time Factors, medicine.medical_treatment, MEDLINE, Kaplan-Meier Estimate, Deoxycytidine, Pancreatic cancer, Internal medicine, medicine, Hepatectomy, Humans, Selection (genetic algorithm), Aged, Retrospective Studies, R0 resection, business.industry, Liver Neoplasms, Retrospective cohort study, Middle Aged, medicine.disease, Gemcitabine, Pancreatic Neoplasms, Female, Surgery, business
Abstract

Aim: Patients were analyzed who underwent treatment of liver metastases from pancreatic cancer. Methods: Selection criteria were the possibility of R0 resection of the primary and/or the liver metastases, no other sites of metastases, and the presentation of liver metastases. A comparison of treatment by surgery versus chemotherapy regarding overall survival and disease-free interval was performed. Results: Between 1996 and 2008, a total number of 23 patients were retrospectively identified from a prospective database of 193 cases of pancreatic cancer. In 14 cases, liver metastases were found simultaneously, and in 9 cases metachronously, fulfilling the abovementioned selection criteria. Of these, 13 patients underwent surgery and 10 were treated by gemcitabine. There were no differences in survival in patients with synchronous liver metastases of pancreatic cancer treated by resection of the primary combined with partial hepatectomy versus treatment by gemcitabine (8 vs. 11 months). In patients with metachronous liver metastases, the median survival was increased after liver resection compared to patients who were treated with gemcitabine (31 vs. 11 months). Conclusions: Simultaneous resection of pancreatic cancer and liver metastases cannot be recommended. Resection of metachronous liver metastases of pancreatic cancer seems to improve survival in highly selected patients.

Published
2010
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5. Contents Vol. 44, 2010

Author

Y. Kulahci, B. Erovic, F. Zor, G. Mazzarol, L. Voltolini, Y. Wang, J. Chen, O. Gunhan, S. Frantal, G. Heiduschka, M. Brunner, J. Pammer, Z. Wang, M. Yang, F. Dünschede, F. Saudek, M. Mosconi, P.R. Galle, Jie-qun Li, W. Hang, P. Paladini, O. Kollmar, C. von Langsdorf, B. Celasun, G. Preissler, M. Rastrelli, M. Möhler, M. Guden, H. Ohyanagi, L. Will, T. Junginger, H. Shiozaki, M.K. Schilling, F. Jiang, G. Gotti, F. Granato, S. Tenconi, G. Trifirò, R. Yin, J. Sperling, F. Qiang, J. Tang, D. Thurnher, M. Bozkurt, Yi-ning Li, G. Otto, M.S. Gallazzi, G.C. Vitali, Hai-zhi Qi, M. Zonta, K. Kamei, S. Richter, K. Zacharovova, H. Winter, M. Sengezer, Zhi-jun He, M.E. Eichhorn, S. Schneider, L. Luzzi, T. Marada, H. Waldner, K. Messmer, M.D. Menger, Y. Takeyama, W. Fu, A. Testori, S. Massberg, T. Yasuda, J. Jonas, J. Soteldo, H. Duman, F. Loehe, Z. Jing, Wei Hu, L. Xu, Zhong-zhou Si, C.F. Vahl, and T. Ueda

Subjects
Gerontology, business.industry, Library science, Medicine, Surgery, business
Published
2010
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6. Dynamic in vivo Imaging of Microvasculature and Perfusion by Miniaturized Confocal Laser Microscopy

Author

S. Thomas, Axel Heimann, Oliver Kempski, Martin Goetz, Peter G. Delaney, M. Relle, R. Kiesslich, Constantin Schneider, A. Schwarting, M.F. Neurath, and P.R. Galle

Subjects
Male, Mice, Inbred MRL lpr, Pathology, medicine.medical_specialty, Materials science, Laser scanning, Dynamic imaging, Confocal, Cell Communication, law.invention, Mice, Imaging, Three-Dimensional, In vivo, Confocal microscopy, law, Microscopy, Leukocytes, medicine, Animals, Fluorescent Dyes, Inflammation, Microscopy, Confocal, Miniaturization, Microcirculation, Brain, Endothelial Cells, Thrombosis, Lupus Nephritis, Mice, Inbred C57BL, Disease Models, Animal, Microvessels, Female, Surgery, Intracranial Thrombosis, Gerbillinae, Perfusion, Blood Flow Velocity, Preclinical imaging, Biomedical engineering
Abstract

Introduction: Microvasculature and associated pathologies mandate dynamic imaging. We evaluated a novel miniaturized confocal laser scanning probe for in vivo visualization of blood vessels, blood flow, cell tracking and perfusion in both healthy rodents and disease models. Methods: The hand-held confocal microscopy system allowed a 500- to 2,400-fold magnification at a dynamically variable imaging depth. Different intravital stains were used alone or in combination for tissue, nuclear, plasma and vascular endothelial cell staining and for blood flow visualization, and targeted staining for individual cell populations. Results: Precision optical sectioning yielded high-resolution images in vivo. Leucocyte-endothelium interactions in brain microvasculature were followed in serial sections. A microthrombosis was identified after sequential injection of FITC-labelled erythrocytes, FITC-dextran and acriflavine. Glomerular alterations were visualized in the MRL/lprmouse model of lupus nephritis. Discussion: Intravital confocal microscopy with a miniaturized hand-held probe combines high-resolution subsurface imaging in real time for dynamic visualization of vessels, cells, blood flow and associated pathologies, permitting a truly comprehensive vascular imaging in vivo at the cellular level.

Published
2008
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10. Autorenverzeichnis

Author

W. Domschke, M. Berger, W. Hohenberger, T. Meinertz, C. Vogelmeier, T. Sauerbruch, H.J. Kramer, S.C. Müller, H. Serve, M.M. Weber, B. Göke, J.R. Kalden, B. Manger, W. Rascher, B. Appenrodt, J. Atta, C. Auernhammer, I.B. Autenrieth, W. Avenhaus, M. Backmund, C. Bausewein, J. Behr, A. Behrens, R. Berner, F. Berr, N. Blank, E. Blind, M. Bockhorn, D. Bokemeyer, M. Böhm, G. Bönner, G.D. Borasio, K. Bork, J. Braun, H.-P. Bruch, T.H. Brümmendorf, U. Brunnberg, M. Brüwer, M.W. Büchler, C. Detter, S. Diederich, C. Diehm, J. Distler, D. Domagk, T. Dörner, H.-G. Dörr, H. Dralle, M. Dreyling, I. Ehlebracht-König, C. Ell, W. Enzensberger, H.-J. Epple, M. Fassnacht, H. Feußner, P. Fiegel, C. Fisang, D. Filipas, W. Fischbach, C.H. Flamme, J. Floege, U.R. Fölsch, C. Fottner, W. Frank, N. Frey, K. Friese, A. Frilling, M. Fröhner, P. Frühmorgen, P.R. Galle, S. Geidel, E. Genth, A. Gingelmaier, F.-D. Goebel, N. Gökbuget, R. Göke, K. Grabitz, M. Grünke, S. Hahner, W. Handrick, C. Hasslacher, E. Heidbreder, W. Heindel, V. Heinemann, J. Heitmann, H.W. Heiß, H. Hof, L. Hering, E. Hiller, A. Hirner, W.-K. Hofmann, E. Holler, A.H. Hölscher, G. Holtmann, J. Hölzen, J. Honegger, S. Hörle, K. Hörmann, R. Hörmann, I. Hornke, R.M. Huber, J. Hübner, R. Hummel, S. Irmscher, T. Jelinek, S. Jonas, E. Jost, H.H. Jung, G.J. Kahaly, M. Karaus, S. Katsoulis, H. Katus, H.P. Kessler, K. Kiehne, W. Kiess, M. Kindermann, Y. von Kodolitsch, H. Köhler, L. Köhler, M. Köhler, E. Kohne, H.-J. Kolb, J. Köninger, K. Koop, R. Köster, I. Kötter, H.J.J. Kramer, B. Kremer, P. Kroll, J.G. Kuipers, F. Lammert, M. Langer, M. Laukötter, H. Lehnert, B. Lembcke, M.M. Lerch, S. Liebe, A. Lieber, R. Loddenkemper, M. Löhr, H.-M. Lorenz, J. Lorenz, T. Löscher, M. Luster, G. Lux, K. Mann, J. Mayerle, U. Merle, H.-J. Meyer, C. Möbius, M. Moehler, H. Mönnikes, J. Mössner, S.A. Müller, T.J. Musholt, J. Nattermann, M. Neubrand, P. Neuhaus, B. Neundörfer, T. Nicolai, J. Nolde, H. Olschewski, J. Ostermeyer, C. Ott, S. Pahernik, U. Pankratius, K.G. Parhofer, B. Passlick, O. Pech, B. Pfaffenbach, T. Pfeiffer, A. Pilatz, T. Pohle, A. Pohl-Koppe, Katharina A. Ponto, H. Prange, A. Pruß, J. Rädle, B. Rauch, F. Raue, C. Reichel, C. Reindl, C. Reißfelder, Dipl.-Phys. J. Rendl, E. Rietschel, E. Rijcken, R. Roos, G. Rudofsky†, W. Samtleben, W. Sandmann, G. Sauter, K.P. Schaal, J.R. Schaefer, U. Schäfer-Graf, W. Schepp, M. Schlemmer, S. Schliep, H. Schmidt, B. Schmied, W. Schmiegel, A. Schießl, A. Schmid, A. Schneider, T. Schneider, J. Schölmerich, H. Scholz, U. Schönermarck, J. Schopohl, H. Schrezenmeier, H. Schulze-Koops, D. Schuppan, V. Schuster, G. Schüßler, O. Schwandner, T.F. Schwarz, R. Secknus, N. Senninger, O. Sezer, B.R. Simmen, U. Spengler, U. Stabenow-Lohbauer, R. Stebler, D. Steven, M. Sticherling, U. Strauch, C. Stremmel, W. Stremmel, B.A. Stuck, H. Stürz, C. Taube, O. Thulesius, K. Thurau, J.W. Thüroff, C. Tomiak, W. Uhl, D. Vallböhmer, T. Vogel, P. von den Driesch, F.M.E. Wagenlehner, A. Wagner, U. Wagner, K. Weber, W. Weidner, T. Weinke, B.T. Weis-Müller, M. Weiß, S. Willems, U. Wintergerst, M. Wirth, G.W. Wolkersdörfer, and M. Zeitz

Published
2011
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12. Autorenverzeichnis

Author

V. Andresen, J. Angenendt, C. Anthoni, B. Appenrodt, M. Arbogast, G. Arco, J. Atta, M. Auer, C. Auernhammer, I.B. Autenrieth, W. Avenhaus, R. Bachem, M. Backmund, D. Bänsch, A. Ballauff, J. Baltzer, J. Barth, A. Batra, M.A. Bazarra-Castro, S. Beck, K. Becker, Karsten Becker, J. Behr, A. Behrens, O. Belyaev, Ch. Bender-Götze, J. Bengel, M. Benz, von Haunerschen, J. Berberich, M. Berger, R. Berner, F. Berr, null S.C., N. Blank, C. Bleh, Eberhard Blind, H.E. Blum, N. Bock, M. Bockhorn, J. Böhler, M. Böhm, D. Bokemeyer, G. Bönner, K. Bork, G. Born, Thomas Brandt, J. Braun, H.-P. Bruch, T.H. Brümmendorf, M. Brüwer, U. Brunnberg, M. Buchfelder, G. Buchkremer, M.W. Büchler, H.-D. Carl, S. Castell, C. Daniels, S. Daum, C. Detter, G. Deuschl, E. Dieckmann, S. Diederich, C. Diehm, T. Diemer, H.C. Diener, H. Diepolder, J. Distler, T. Dörner, null Prof. Dr., D. Domagk, W. Domschke, A. Dragu, H. Dralle, M. Dreyling, P. van, T. Dürk, D. Ebert, I. Ehlebracht-König, C.E. Elger, C. Ell, J. Ellinger, G. Emons, O. Engel, W. Enzensberger, H.-J. Epple, R. Erbel, M. Fassnacht, Hubertus Feußner, M. Fichter, P. Fiegel, D. Filipas, C. Fisang, M. Fisch, W. Fischbach, N. Fischer, M. Fischer, C.H. Flamme, K. Fleckenstein, J. Floege, G. Fluhr, U.R. Fölsch, M. Forsting, C. Fottner, W. Frank, N. Frey, H. Freyberger, K. Friese, A. Frilling, PD. Dr. habil, U. Frommberger, P. Frühmorgen, Johannes Fuss, R. Gätje, P.R. Galle, S. Geidel, H.-Ch. Geiß, Ekkehard Genth, J.M. Gilsbach, A. Gingelmaier, F.-D. Goebel, J. Göhl, N. Gökbuget, R. Gold, M.A. Gonzalez-Carmona, F. Gossé, K. Grabitz, M. Greetfeld, F.A. Gries, I. Grosch-Wörner, N. Grüner, M. Grünke, A. Grüters-Kieslich, V. Gülberg, T. Haak, R. Häfner, M. Härter, T. Hagenacker, S. Hahn, S. Hahner, G. Haidl, M. Hammer, F. Hammersen, W. Handrick, F. Hanisch, M.P. Hansen, Sara Hanke, J. Haschka, C. Hasslacher, Th. Hauer, A. Hauptmann, M. Heckmann, E. Heidbreder, U. Heim, W. Heindel, J. Heitmann, U. Hegenbart, W. Hermann, J.M. Herrmann, B. Herpertz-Dahlmann, B. Heßlinger, D. Heuß, P. Heußner, E. Hiller, A. Hirner, A.H. Hölscher, J. Hölzen, W.H. Hörl†, S. Hörle, H. Hof, W.-K. Hofmann, W. Hohenberger, U. Hohenfellner, E. Holler, G. Holtmann, J. Honegger, H.C. Hopf, R.E. Horch, I. Hornke, T. Hornung, R.M. Huber, A. Hueber, J. Hübner, R. Hummel, S. Irmscher, O.E. Janßen, T. Jelinek, K.A. Jendrissek, S. Jonas, E. Jost, H.H. Jung, G.J. Kahaly, J.R. Kalden, J. Kalff, T. Kapellen, M. Karaus, O. Kastrup, S. Katsoulis, H. Katus, C.P. Kaudel, R. Kaulitz, C. Keck, F. Keller, S. Kellnar, K. Kiehne, W. Kiess, M. Kindermann, A. Kirschbaum, M. Klein, A. Kleindienst, C. Kneitz, Y. von Kodolitsch, D. Köhler, H.P. Kessler, G. Köhler, H. Köhler, L. Köhler, M. Köhler, M. Köhnke, C. Königs, J. Köninger, D. Könsgen-Mustea, R. Köster, I. Kötter, E. Kohne, H.-J. Kolb, S. Koletzko, R. Kollmar, S. Konstantinidis, K. Koop, H.G. Kopp, T. Koschinsky, H.J. Kramer, J. Krauss, M.E. Kreis, B. Kremer, H.K. Kroemer, B. Kröner-Herwig, P. Kroll, A.K. Külz, H. Kuhl, J.G. Kuipers, M. Laaser, U. Lamla, F. Lammert, M. Langer, M. Laß, M. Laukötter, P. Layer, M. Leffler, H. Lehnert, M. Lehrke, B. Lembcke, M.M. Lerch, S. Liebe, A. Lieber, V. Limmroth, H. Lochs, R. Loddenkemper, J.-M. Löhr, T. Löscher, A. Loh, H.-M. Lorenz, J. Lorenz, N. Lügering, M. Luster, G. Lux, O. Luzar, A. Maercker, K. Magdorf, P. Mallmann, T. Marth, K. May, J. Mayerle, T. Meinertz, V. Melichar, U. Merle, H.J. Meyer, Th. Meyer, H. Meyer-Lehnert, A. Meyer-Marcotty, H. Michels, C. Möbius, G. Möddel, M. Möhler, H. Mönnikes, J. Mössner, M.G. Mohaupt, S.C. Müller, S.A. Müller, S. Müller-Lissner, J. Müller-Quernheim, A. Muntau, T.J. Musholt, W. Nacimiento, J. Nattermann, G. Nelles, M. Neubrand, C. Neuhäuser, P. Neuhaus, P.-A. Neumann, B. Neundörfer, T. Nicolai, W.-B. Niebling, T. Niehues, G. Nilius, J. Nolde, J. Noth, H. Olschewski, J. Ostermeyer, C. Ott, S. Pahernik, D. Palmes, U. Pankratius, K. Parhofer, R. Paschke, B. Passlick, O. Pech, F.W. Pelster, E.E. Petersen, E. Petri, B. Pfaffenbach, M. Pfeifer, T. Pfeiffer, H.W. Pfister, null Diplom-Gesundheitswirt, J. Pickel, A. Pilatz, M. Pirlich, E. Polykandriotis, B. Pontz, K. Possinger, A. Pohl-Koppe, T. Pohle, H. Prange, A. Prasse, A. Pruß, J. Rädle, K. Raile, W. Randerath, W. Rascher, B. Rauch, F. Raue, B. Raziorruh, J. Rech, A.C. Regierer, C. Reichel, C. Reindl, D. Reinhardt, C. Reißfelder, J. Rendl, M. Reuss-Borst, P. Rieckmann, C. Riedner, E. Rietschel, E. Rijcken, M. Rister, K. Rödder, S. Rogenhofer, F.C. Roos, R. Roos, D. Rosskopf, S. Rudnik-Schöneborn, G. Rudofsky†, M. Ruhnke, M. Ruß, C.F. Rust, F. Saborowski, M. Sailer, M. Sedigh Salakdeh, Walter Samtleben, W. Sandmann, T. Sauerbruch, K.P. Schaal, G. Schackert, U. Schäfer-Graf, M. Schäfers, A. Schalhorn, W. Schepp, J. Schetelig, M. Schifferdecker, J. Schipper, A. Schießl, U. Schlegel, S. Schliep, A. Schmid, P. Schmid, F. Schmidt, B. Schmied, W. Schmiegel, A. Schneider, T. Schneider, C. Schneider-Gold, H.-G. Schnürch, J. Schölmerich, U. Schönermarck, B. Schönhofer, S. Schönland, H. Scholz, J. Schopohl, G. Schott, J. Schrader, A. Schraml, H. Schrezenmeier, A. Schuchert, G. Schüßler, H. Schulze-Koops, D. Schuppan, V. Schuster, S. Schwab, O. Schwandner, C.H.M. Schwarz, T.F. Schwarz, K.W. Schweppe, R. Secknus, S.E. Segerer, N. Senninger, H. Serve, U. Seybold, O. Sezer, B. Siegmund, W. Siegmund, G. Siemon, B.R. Simmen, G. Simonetti, C. Sommer, U. Spengler, H. Sprott, U. Stabenow-Lohbauer, M. Stahl, G. Stalla, A. Stallmach, T. Stammschulte, R. Stebler, R. Stein, D. Steven, M. Sticherling, M. Stöhr, U. Strauch, A. Strauss, H.-G. Strauß, C. Stremmel, W. Stremmel, M. Strupp, E. Stüber, H. Stürz, U. Sure, B. Swoboda, C. Taube, K. Thiel, C. Thomssen, K. Thurau, J. Thöne, J. Thüroff, C. Tomiak, K.V. Toyka, H. Tröger, R.M. Trüeb, M. Tryba, W. Uhl, H. Ullerich, L. Unger, D. Vallböhmer, D. van Calker, T. Vloet, U. Voderholzer, Thomas M.K. Völkl, T. Vogel, P. Vogt, F.E.M. Wagenlehner, A. Wagner, U. Wagner, V. Wahn, C.W. Wallesch, F. Watzka, K. Weber, L. Weber, M.M. Weber, T. Wehrmann, W. Weidner, T. Weinke, M. Weiß, B.T. Weis-Müller, Michael Weller, F. Wenz, K. Werdan, M. Wettstein, M. Wick, I. Wiegratz, S. Willems, H. Wilke, U. Wintergerst, M. Wirth, G.W. Wolkersdörfer, C. Wüster, F. Zabel, H. Zeidler, M. Zeitz, K. Zerres, G. Ziemer, S. Zierz, T. Zimmermann, and J. Zwerina

Published
2007
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13. Subject Index Vol. 44, 2010

Author

F. Zor, G.C. Vitali, S. Tenconi, O. Gunhan, S. Frantal, S. Richter, Z. Jing, Wei Hu, M. Yang, T. Marada, P. Paladini, M. Guden, H. Winter, B. Celasun, M. Mosconi, P.R. Galle, F. Granato, Yi-ning Li, M.S. Gallazzi, T. Ueda, H. Ohyanagi, T. Junginger, J. Jonas, Y. Kulahci, F. Loehe, Zhi-jun He, A. Testori, M.E. Eichhorn, S. Schneider, G. Otto, K. Kamei, J. Tang, L. Voltolini, B. Erovic, G. Gotti, C. von Langsdorf, G. Heiduschka, L. Xu, M. Sengezer, Z. Wang, Y. Wang, Jie-qun Li, G. Preissler, J. Chen, L. Will, G. Trifirò, M. Möhler, F. Jiang, R. Yin, H. Shiozaki, J. Sperling, F. Qiang, H. Duman, J. Soteldo, M. Rastrelli, M. Bozkurt, L. Luzzi, H. Waldner, M.D. Menger, M.K. Schilling, Zhong-zhou Si, G. Mazzarol, J. Pammer, K. Messmer, F. Saudek, M. Brunner, Y. Takeyama, F. Dünschede, O. Kollmar, C.F. Vahl, W. Fu, K. Zacharovova, S. Massberg, T. Yasuda, Hai-zhi Qi, M. Zonta, W. Hang, and D. Thurnher

Subjects
Gerontology, Index (economics), Surgery, Subject (documents), Psychology
Published
2010
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14. 6579 Cetuximab with Irinotecan/Folinic Acid/5-FU as first-line treatment in advanced gastric cancer: a prospective multi-center phase II study and additional biomarkers of the Arbeitsgemeinschaft Internistische Onkologie

Author

S. Kanzler, S. Kubicka, Florian Lordick, Tanja Trarbach, Markus Möhler, Annett Mueller, P.R. Galle, M. Geissler, T. Seufferlein, and S. Daum

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Cetuximab, business.industry, Phases of clinical research, Advanced gastric cancer, First line treatment, Irinotecan, Folinic acid, Internal medicine, medicine, business, medicine.drug
Published
2009
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15. Cetuximab with irinotecan/folinic acid/5-FU as first-line treatment in advanced gastric cancer: A nonrandomized multicenter AIO phase II study

Author

F. Lordick, P.R. Galle, S. Kanzler, T. Seufferlein, M. Geissler, M. Moehler, S. Kubicka, S. Daum, T Trarbach, and German Arbeitsgemeinschaft Internistische Onkologie

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Cetuximab, business.industry, Colorectal cancer, Phases of clinical research, Advanced gastric cancer, medicine.disease, First line treatment, Irinotecan, Folinic acid, Internal medicine, Medicine, business, medicine.drug
Abstract

4534 Background: Cetuximab has demonstrated high efficacy in combination with irinotecan-based therapies in metastatic colorectal cancer and irinotecan/folinic acid/5-FU (IF) may be an effective alternative to cisplatin-based regimens in advanced gastric cancer. We therefore conducted a phase II AIO study to evaluate the tolerability and efficacy of cetuximab combined with IF as first-line treatment in patients with advanced gastric cancer. Methods: Patients (pts) were eligible with untreated adenocarcinoma of the stomach or oesophagogastric junction, with ECOG performance status (PS) < 2, measurable lesions and adequate organ functions. Pts received weekly cetuximab (first dose 400 mg/m2, subsequent doses 250 mg/m2) combined with chemotherapy consisting of irinotecan (80 mg/m2) plus 24 hours continuous infusion of sodium folinic acid (Na-FA: 200 mg/m2) and 5-FU (1500 mg/m2) on days 1, 8, 15, 22, 29 and 36 of a 50-day cycle. Treatment was continued until tumor progression and tumor assessments were performed every 2nd cycle. Results: Between Aug 2006 and Sep 2007, 49 pts were enrolled: 71% were males, median age was 63 years (range 33–77), median PS was 0 (65% pts), and 69% of pts and 31% of pts had gastric and oesophagogastric junction carcinomas, respectively. The median treatment time was 15.2 weeks (range 1.1–69.1). Grade 3/4 toxicities were diarrhoea (17% pts), skin reactions (13% pts), anorexia (9% pts), anaemia and fatigue (7%pts), allergic reactions, leucopoenia and neutropenia (4% pts each). Among 48 response-evaluable pts, the overall response rate (CR + PR) was 42% (CR 4%/PR 38%) and the tumour control rate was 73%. Median progression-free and overall survival times were 8.5 months (36.6 weeks; 95% CI 30.1; 48.1) and 16.6 months (71.1 weeks; 95% CI 50; 93.4), respectively. Conclusions: Cetuximab plus IF was well tolerated and encouraging survival data were observed. Cetuximab combined with chemotherapy in advanced or metastatic gastric cancer is under further investigation in an ongoing phase III trial. No significant financial relationships to disclose.

Published
2009
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16. CO.39 L’endomicroscopie confocale permet la mise en évidence in vivo de bactéries dans la muqueuse colique, augmentées en cas de MICI

Author

Driffa Moussata, Annabel Gloeckner, M. Kerner, P.R. Galle, Bernard Flourié, R. Kiesslich, A. Hoffman, Jean-Christophe Saurin, M. Goetz, M.F. Neurath, A. Watson, and Stefan Biesterfeld

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, medicine, General Medicine, business
Abstract

Introduction Apres injection intra-veineuse de fluorosceine (10 %), l’endomicroscopie confocal (EMC) permet l’etude in vivo de la muqueuse intestinale de 0 a 250 μm au cours d’une endoscopie standard. La fluorosceine, diffusant des vaisseaux jusqu’a la lumiere intestinale, est absorbee par les bacteries localisees dans l’epithelium et dans la lamina propria. De nombreux travaux ont mis en evidence l’implication des bacteries intestinales dans la pathogenie des maladies inflammatoires chroniques de l’intestin (maladie de Crohn (MC), rectocolite hemorragique (RCH)). But Le but de notre etude etait d’identifier par EMC les bacteries au sein de la muqueuse intestinale in vivo et de les quantifier dans les differents segments coliques. Patients et methodes Il s’agit d’une etude retrospective realisee chez des patients atteints de RCH, MC, colites infectieuses (CI) et des patients controles (PC). Dans tous les cas, l’EMC, Pentax EC3870K (Pentax, Tokyo ; Japon) etait utilise. La presence ou l’absence de bacteries etait confirmee par la technique fluorescente d’hybridation in situ a partir de biopsies coliques dont les images etaient comparees a celles obtenues par EMC. Les bacteries ont ainsi pu etre analysees (taille, forme, localisation au sein de la muqueuse colique) et denombrees sur les differents segments coliques. Resultats Cent soixante-quinze patients (102 hommes, 73 femmes) ont ete inclus (RCH : 84 ; MC : 29 ; CI : 12 ; PC : 50). Le nombre moyen d’images par patients (moy ± DS) analysees etait de 162 ± 94, 160 ± 68, 131 ± 54 et 143 ± 78 pour la RCH, MC, CI et PC respectivement. Le nombre moyen d’images par segment etait de 66 ± 52, 85 ± 60, 64 ± 43 et 87 ± 58 pour la RCH, MC, CI et PC respectivement (p > 0,05). Les bacteries etaient observees chez 60 % (50/84), 65 % (19/29) et 58 % (7/12) des patients porteurs de RCH, MC et CI respectivement comparativement a 14 % (7/50) des PC (p Conclusion Chez les patients porteurs de colites (maladies inflammatoires et infectieuses), l’EMC montre la presence plus importante de bacteries dans la muqueuse colique ce qui pourrait aider a la comprehension du role pathogene des bacteries dans ces pathologies. L’absence de bacterie dans l’ileon pourrait permettre de distinguer les colites inflammatoires des colites infectieuses. Remerciements, financements, autres Ce travail a ete realise au cours d’une annee post-doctorale financee par une bourse d’etude de l’Association Francaise Aupetit (AFA) que nous remercions chaleureusement.

Published
2009
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18. 3518 POSTER Cetuximab with Irinotecan/FA/5-FU as first-line treatment in advanced gastric cancer: Preliminary results of a non-randomized multicenter AIO phase II study

Author

T. Hoehler, S. Daum, Tanja Trarbach, Florian Lordick, P.R. Galle, Markus Moehler, T. Seufferlein, S. Kanzler, M. Geissler, and S. Kubicka

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Cetuximab, business.industry, Phases of clinical research, Advanced gastric cancer, First line treatment, Irinotecan, Internal medicine, Medicine, business, medicine.drug
Published
2007
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19. 214 Safety and efficacy of CPT11/FA/5-FU (ILF) versus ELF in previously untreated advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction

Author

A. Wein, Michael Heike, J. Siebler, J. Janssen, T Geer, M. Möhler, D. Flieger, T. Hoehler, M Menges, and P.R. Galle

Subjects
Oncology, Cancer Research, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Stomach, Internal medicine, Metastatic adenocarcinoma, medicine, business, Gastroesophageal Junction, Gastroenterology
Published
2003
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20. Addendum

Author

M.F Neurath, S Finotto, I Fuss, M Boirivant, and P.R Galle

Subjects
Immunology, Immunology and Allergy
Published
2001
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21. Minimal Change Esophagitis: Prospective Comparison of Endoscopic and Histological Markers between Patients with Non-Erosive Reflux Disease and Normal Controls Using Magnifying Endoscopy.

Author

R. Kiesslich, S. Kanzler, M. Vieth, M. Moehler, J. Neidig, B.J. Thanka Nadar, D. Schilling, J. Burg, B. Nafe, M.F. Neurath, and P.R. Galle

Subjects
GASTROESOPHAGEAL reflux, ESOPHAGUS diseases, PATIENTS, ESOMEPRAZOLE, ENDOSCOPY
Abstract

Introduction: More than half the patients with gastroesophageal reflux disease (GERD) show no endoscopic abnormality or minimal change esophagitis (non-erosive reflux disease, NERD). We investigated the value of endoscopic and histological markers for the prediction of NERD before and after treatment with 20 mg esomeprazole. Methods: Between July and October 2002, consecutive patients presenting for upper endoscopy were stratified into GERD and non-reflux patients (control group) with the help of a questionnaire. The endoscopist was blind to the presence of reflux symptoms. Using magnifying endoscopes minimal change esophagitis was defined by the presence of vascular injection or vascular spots above the Z-line, villous mucosal surface and islands of squamous cell epithelium below the Z-line. Targeted and random biopsies were taken below and above the Z-line. Patients with endoscopically visible classical signs of esophagitis (Los Angeles A–D) or histologically proven Barrett’s esophagus were not further investigated in the study (drop out). The esophageal specimens were histologically evaluated for erosions, infiltration with leukocytes, hyperplasia of basal cells and length of papillae. Patients with NERD were treated with 20 mg esomeprazole/day for 4 weeks and reevaluated by endoscopy as described before. Results: 39 patients with heartburn and 39 patients without reflux symptoms (controls) were finally included in the analysis (per protocol). Patients with NERD significantly (p = 0.005) more often showed endoscopic signs of minimal change esophagitis (27/39) than the control group (8/39). An increased length of papillae (14/39 versus 2/39; p = 0.005) and basal cell hyperplasia (17/39 versus 4/39; p = 0.009) were significantly more common in the heartburn group. After treatment with esomeprazole, no significant endoscopic or histological differences between the NERD and control group could be observed. Conclusions: Minimal change esophagitis can be seen with high resolution magnifying endoscopy. By combining endoscopic and histological markers NERD can be predicted with a sensitivity of 62% and a specificity of 74%. Treatment with esomeprazole for 4 weeks reverses the slight alterations to normal.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2004
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22. Chromoendoscopy and Magnifying Endoscopy in Patients with Gastroesophageal Reflux Disease.

Author

R. Kiesslich, M.F. Neurath, and P.R. Galle

Subjects
GASTROESOPHAGEAL reflux, ESOPHAGEAL cancer, ENDOSCOPY, ADENOCARCINOMA, DIAGNOSIS
Abstract

Gastroesophageal reflux disease (GERD) is common in the Western world. Upper endoscopy is needed to characterize the disease. Barrett’s esophagus as a complication of GERD is an established precancerous condition which can lead to adenocarcinoma in the distal esophagus. This review summarizes recent advances in the endoscopic characterization of Barrett’s esophagus using magnification endoscopy and chromoendoscopy. Methylene blue, indigo carmine and acetic acid are commonly used dyes to facilitate diagnosis of Barrett’s esophagus. Methylene blue is absorbed in the specialized columnar epithelium, which is pathognomonic for Barrett’s esophagus. Indigo carmine and acetic acid are used as contrast stains to highlight the surface architecture. Currently, different dyes are used in conjunction with magnifying endoscopes to characterize specific surface patterns of Barrett’s epithelium. However, the current proposed classifications are too complex relative to their clinical value. Nevertheless, simplification of these systems will occur over time with increased use of magnifying chromoendoscopy. The value of magnifying chromoendoscopy for clinical practice is not determined yet and currently under investigation. However, these techniques have significant potential to improve diagnostic accuracy in patients with Barrett’s esophagus.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2004
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23. Comparison of a 48-Hour Infusion of 5-Fluorouracil without Folinic Acid with 24-Hour Folinic Acid/5-Fluorouracil in Patients with Metastatic Colorectal Cancer Refractory to Bolus Folinic Acid/5-Fluorouracil.

Author

M. Moehler, F. Gutzler, S. Steinmann, M. Boehme, U. Raeth, W. Stremmel, P.R. Galle, and J. Rudi

Subjects
FLUOROURACIL, FOLINIC acid, COLON cancer, BODY weight, TUMORS
Abstract

AbstractBackground: Out of various high-dose 5-fluorouracil (5-FU) regimens given with or without folinic acid (FA), the optimal 5-FU schedule has still to be defined as treatment for metastatic colorectal cancer (CRC). Consequently, we compared toxicity, response and survival following two FA/5-FU regimens in 55 CRC patients refractory to bolus FA/5-FU. Methods: Twenty-eight patients (group A) received 5-FU (60 mg/kg body weight) for 48 h, and 27 (group B) received 2-hour infusions of FA (500 mg/m2) and 24-hour infusions of 5-FU (2,600 mg/m2) until disease progression. Results: Both groups were adequately matched with respect to patient characteristics. While overall toxicities were rare, hand-foot syndrome was more common in A. Tumor control was achieved in 57 and 44%, for A and B, respectively. Survival times were 16 months in A and 9 months in B. Conclusions: Since both 5-FU infusion protocols showed equivalent palliative effects, FA may be questioned in second-line 5-FU regimens.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2003
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24. Diagnostic Value of Optical Spectral Transmission in Rheumatoid Arthritis: Associations with Clinical Characteristics and Comparison with Joint Ultrasonography.

Author

Triantafyllias K, Heller C, de Blasi M, Galle PR, and Schwarting A

Subjects
Female, Humans, Male, Severity of Illness Index, Ultrasonography, Ultrasonography, Doppler, Wrist Joint diagnostic imaging, Arthritis, Rheumatoid diagnostic imaging, Synovitis
Abstract

Objective: To examine the value of optical spectral transmission (OST) in detecting joint inflammation in patients with rheumatoid arthritis (RA) and to evaluate whether OST correlates with certain patient characteristics., Methods: OST measurements were performed in the metacarpophalangeal, proximal intraphalangeal, and wrist joints of 168 patients with RA and 114 controls. OST difference between the 2 groups was statistically examined and subsequently controlled for the effect of possible confounding factors. Diagnostic OST performance was tested by receiver-operating characteristics. Moreover, associations of OST with clinical and serological activity markers (patient group), joint ultrasound (US; patient subgroup) and various anthropometric and epidemiologic parameters (patient and control group) were evaluated by Spearman correlation coefficient and a generalized linear statistical adjustment model., Results: OST was significantly higher in the RA group than in the control group, even after adjustment for confounding factors (1.89; 95% CI 0.709-3.070, p adj = 0.002). Taking US as a reference, area under the curve for all 1251 joints simultaneously was 0.67 (95% CI 0.631-0.709). In the patient group, correlation and adjustment analyses showed associations of OST with various disease activity markers [28-joint count Disease Activity Score (rho 0.313), swollen joint counts (rho 0.361), C-reactive protein (rho 0.389); all, p adj = 0.001], age (rho 0.276, p < 0.001), and osteoarthritis (p = 0.022). Moreover, OST associated with a power Doppler US score (rho 0.442; p = 0.001) and a greyscale US score (rho 0.591; p < 0.001). In both groups males had significantly higher OST values than females and OST associated moderately weakly with body mass index (rho patients 0.316, rho controls 0.24; all, p < 0.001)., Conclusion: Patients with RA showed higher OST values in comparison to controls. Moreover, OST associated with clinical, US, and laboratory disease activity markers.

Published
2020
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