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  • 1
    Online Resource
    Online Resource
    Prediction of Locally Advanced Urothelial Carcinoma of the Bladder Using Clinical Parameters before Radical Cystectomy - A Prospective Multicenter Study
    S. Karger AG ; 2016
    In:  Urologia Internationalis Vol. 96, No. 1 ( 2016), p. 57-64
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 96, No. 1 ( 2016), p. 57-64
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 We aimed at developing and validating a pre-cystectomy nomogram for the prediction of locally advanced urothelial carcinoma of the bladder (UCB) using clinicopathological parameters. 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 Multicenter data from 337 patients who underwent radical cystectomy (RC) for UCB were prospectively collected and eligible for final analysis. Univariate and multivariate logistic regression models were applied to identify significant predictors of locally advanced tumor stage (pT3/4 and/or pN+) at RC. Internal validation was performed by bootstrapping. The decision curve analysis (DCA) was done to evaluate the clinical value. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The distribution of tumor stages pT3/4, pN+ and pT3/4 and/or pN+ at RC was 44.2, 27.6 and 50.4%, respectively. Age (odds ratio (OR) 0.980; p 〈 0.001), advanced clinical tumor stage (cT3 vs. cTa, cTis, cT1; OR 3.367; p 〈 0.001), presence of hydronephrosis (OR 1.844; p = 0.043) and advanced tumor stage T3 and/or N+ at CT imaging (OR 4.378; p 〈 0.001) were independent predictors for pT3/4 and/or pN+ tumor stage. The predictive accuracy of our nomogram for pT3/4 and/or pN+ at RC was 77.5%. DCA for predicting pT3/4 and/or pN+ at RC showed a clinical net benefit across all probability thresholds. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 We developed a nomogram for the prediction of locally advanced tumor stage pT3/4 and/or pN+ before RC using established clinicopathological parameters.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000433606
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1464417-4
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  • 2
    Online Resource
    Online Resource
    Reliability of Carbohydrate-Deficient Transferrin to Detect Chronic Alcohol Misuse in Carcinoma Patients
    S. Karger AG ; 1996
    In:  European Addiction Research Vol. 2, No. 3 ( 1996), p. 156-162
    Details
    In: European Addiction Research, S. Karger AG, Vol. 2, No. 3 ( 1996), p. 156-162
    Type of Medium: Online Resource
    ISSN: 1421-9891 , 1022-6877
    URL: Article
    DOI: 10.1159/000259123
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1996
    detail.hit.zdb_id: 1482231-3
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  • 3
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    Online Resource
    The Prognostic Impact of PD-L2 in Papillary Renal-Cell Carcinoma
    S. Karger AG ; 2022
    In:  Urologia Internationalis Vol. 106, No. 11 ( 2022), p. 1168-1176
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 106, No. 11 ( 2022), p. 1168-1176
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Programmed death-1 ligand (PD-L1) has been often studied in different types of renal-cell carcinoma (RCC). For example, in clear-cell renal carcinoma it is well established that programmed death-1 receptor and PD-L1 are important prognostic markers. In contrast, the role of programmed death-2 ligand (PD-L2) as prognostic marker remains unclear. The aim of this study was to evaluate if PD-L2 expression could play a role as a prognostic marker for papillary RCC (pRCC). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The patients’ sample collection was a joint collaboration of the PANZAR consortium. Patients’ medical history and tumor specimens were collected from 〈 i 〉 n 〈 /i 〉 = 240 and 〈 i 〉 n 〈 /i 〉 = 128 patients with type 1 and 2 pRCC, respectively. Expression of PD-L2 was determined by immunohistochemistry. In total, PD-L2 staining was evaluable in 185 of 240 type 1 and 99 of 128 type 2 pRCC cases. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 PD-L2 staining was positive in 67 (36.2%) of type 1 and in 31 (31.3%) of type 2 pRCC specimens. The prevalence of PD-L2+ cells was significantly higher in high-grade type 1 tumors ( 〈 i 〉 p 〈 /i 〉 = 0.019) and in type 2 patients with metastasis ( 〈 i 〉 p 〈 /i 〉 = 0.002). Kaplan-Meier analysis disclosed significant differences in 5-year overall survival (OS) for patients with PD-L2− compared to PD-L2+ in pRCC type 1 of 88.4% compared to 73.6% ( 〈 i 〉 p 〈 /i 〉 = 0.039) and type 2 of 78.8% compared to 39.1% % ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). However, multivariate analysis did not identify the presence of PD-L2+ cells neither in type 1 nor type 2 pRCC as an independent predictor of poor OS. 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 PD-L2 expression did not qualify as an independent prognostic marker in pRCC. Future studies will have to determine whether anti-PD-L2-targeted treatment may play a role in pRCC and expression can potentially serve as a predictive marker for these therapeutic approaches.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000525016
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1464417-4
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  • 4
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    Online Resource
    Evaluation of Gas 6 as a Prognostic Marker in Papillary Renal Cell Carcinoma
    S. Karger AG ; 2023
    In:  Urologia Internationalis Vol. 107, No. 7 ( 2023), p. 713-722
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 107, No. 7 ( 2023), p. 713-722
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Growth arrest-specific protein 6 (Gas 6) is a ligand that plays a role in proliferation and migration of cells. For several tumor entities, high levels of Gas 6 are associated with poorer survival. We examined the prognostic role of Gas 6 in renal cell carcinoma (RCC), especially in papillary RCC (pRCC), which is still unclear. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The patients’ sample collection is a joint collaboration of the PANZAR consortium. Patients’ medical history and tumor specimens were collected from 〈 i 〉 n 〈 /i 〉 = 240 and 〈 i 〉 n 〈 /i 〉 = 128 patients with type 1 and 2 pRCC, respectively. Expression of Gas 6 was determined by immunohistochemistry. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In total, Gas 6 staining was evaluable in 180 of 240 type 1 and 110 of 128 type 2 pRCC cases. Kaplan-Meier analysis disclosed no significant difference in 5-year overall survival for all pRCC nor either subtype. Also, Gas+ and Gas– groups did not significantly differ in any tumor or patient characteristics. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Gas 6 was not found to be an independent prognostic marker in pRCC. Future studies are warranted to determine if Gas 6 plays a role as prognostic marker or therapeutic target in pRCC.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000529898
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1464417-4
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  • 5
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    Online Resource
    Allogeneic Blood Transfusion and Risk of Postoperative Complications in Patients with Mild and Moderate Anemia of Any Cause? A Retrospective Cohort Study in Total Revision Hip Surgery
    S. Karger AG ; 2023
    In:  Transfusion Medicine and Hemotherapy
    Details
    In: Transfusion Medicine and Hemotherapy, S. Karger AG
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Patients undergoing revision total hip surgery (RTHS) have a high prevalence of mild and moderate preoperative anemia, associated with adverse outcomes. The aim of this study was to investigate the association of perioperative allogeneic blood transfusions (ABT) and postoperative complications in preoperatively mild compared to moderate anemic patients undergoing RTHS who did not receive a diagnostic anemia workup and treatment before surgery. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We included 1,765 patients between 2007 and 2019 at a university hospital. Patients were categorized according to their severity of anemia using the WHO criteria of mild, moderate, and severe anemia in the first Hb level of the case. Patients were grouped as having received no ABT, 1–2 units of ABT, or more than 2 units of ABT. Need for intraoperative ABT was assessed in accordance with institutional standards. Primary endpoint was the compound incidence of postoperative complications. Secondary outcomes included major/minor complications and length of hospital and ICU stay. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 1,765 patients, 31.0% were anemic of any cause before surgery. Transfusion rates were 81% in anemic patients and 41.2% in nonanemic patients. The adjusted risks for compound postoperative complication were significantly higher in patients with moderate anemia (OR 4.88, 95% CI: 1.54–13.15, 〈 i 〉 p 〈 /i 〉 = 0.003) but not for patients with mild anemia (OR 1.93, 95% CI: 0.85–3.94, 〈 i 〉 p 〈 /i 〉 & lt; 0.090). Perioperative ABT was associated with significantly higher risks for complications in nonanemic patients and showed an increased risk for complications in all anemic patients. In RTHS, perioperative ABT as a treatment for moderate preoperative anemia of any cause was associated with a negative compound effect on postoperative complications, compared to anemia or ABT alone. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 ABT is associated with adverse outcomes of patients with moderate preoperative anemia before RTHS. For this reason, medical treatment of moderate preoperative anemia may be considered.
    Type of Medium: Online Resource
    ISSN: 1660-3796 , 1660-3818
    URL: Article
    DOI: 10.1159/000530135
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 2100533-3
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  • 6
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    Online Resource
    Cognitive Development in Benign Focal Epilepsies of Childhood
    S. Karger AG ; 1999
    In:  Developmental Neuroscience Vol. 21, No. 3-5 ( 1999), p. 182-190
    Details
    In: Developmental Neuroscience, S. Karger AG, Vol. 21, No. 3-5 ( 1999), p. 182-190
    Abstract: Benign focal epilepsy of childhood (BFEC) is the most common form of epilepsy, in children from 3 to 12 years. Its prognosis is always favourable as far as the epilepsy is concerned. Nevertheless, recent clinical data suggest that children affected by BFEC are more likely to show learning difficulties and behavioural disturbances than their peers. We report here the preliminary findings of a prospective study of 22 children affected with BFEC. Electroclinical and neuropsychological changes observed during the first 18 months of the follow-up strengthen the conclusion of recent neuropsychological studies stressing the correlation between epilepsy and cognitive performances. The cognitive deficits affecting mainly non-verbal functions were significantly correlated with the frequency of seizures and spike-wave discharges and to the lateralization of the epileptic focus in the right hemisphere, whereas frontal functions like attention control, response organization and fine motor speed, were impaired in the presence of active BFEC independently of the lateralization of the epileptic focus. Our results indicate that maturing cognitive functions subserved by a cortical area distant from the epileptic focus are susceptible to interference with epilepsy.
    Type of Medium: Online Resource
    ISSN: 0378-5866 , 1421-9859
    URL: Article
    DOI: 10.1159/000017397
    RVK:
    XG 8817
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1999
    detail.hit.zdb_id: 1482201-5
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  • 7
    Online Resource
    Online Resource
    The Severity of Ischemia Determines and Predicts Malignant Brain Edema in Patients with Large Middle Cerebral Artery Infarction
    S. Karger AG ; 2012
    In:  Cerebrovascular Diseases Vol. 33, No. 1 ( 2012), p. 1-7
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 33, No. 1 ( 2012), p. 1-7
    Abstract: 〈 i 〉 Background: 〈 /i 〉 In order to determine the impact of the severity of ischemia on malignant edema formation, we investigated various degrees of perfusional deficit by 〈 sup 〉 11 〈 /sup 〉 C-flumazenil PET in patients with large middle cerebral artery (MCA) infarction. 〈 i 〉 Methods: 〈 /i 〉 17 patients with large MCA stroke were included. Cerebral blood flow (CBF) was measured 15.9 ± 6.4 h after the ictus. Patients were divided into a malignant (n = 9) and a benign group (n = 8) as a function of their clinical courses and edema. Edema was measured as maximal midline shift on follow-up CTs. Total hypoperfusion volume was divided into different subvolumes according to the degree of CBF reduction. 〈 i 〉 Results: 〈 /i 〉 Subvolumes of severe ischemia relative to total ischemic area were significantly larger in the malignant group than in the benign group and were significantly correlated with edema formation. The highest correlation and best predictive values for edema formation with a sensitivity, specificity, and a positive and negative predictive value of 100% were found for subvolumes with severe ischemia. Correlation coefficients and prediction decreased for subvolumes with less severe perfusional deficit, pointing to the risk of misclassifying patients when relying on the volume of total perfusional deficit alone. 〈 i 〉 Conclusions: 〈 /i 〉 Malignant MCA infarction seems to be determined more by the volume of severe perfusional deficit than that of total perfusional deficit. Assessment of severely ischemic areas allows prediction of malignant edema formation and might help to select candidates for hemicraniectomy.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000330648
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482069-9
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  • 8
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    Online Resource
    Effects of Optimized Heart Failure Therapy and Anemia Correction with Epoetin β on Left Ventricular Mass in Hemodialysis Patients
    S. Karger AG ; 2005
    In:  American Journal of Nephrology Vol. 25, No. 3 ( 2005), p. 211-220
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 25, No. 3 ( 2005), p. 211-220
    Abstract: 〈 i 〉 Background: 〈 /i 〉 In chronic hemodialysis (HD) patients, the presence and degree of left ventricular hypertrophy (LVH) correlates with mortality. Previous studies have shown that interventions, such as anemia correction or treatment of hypertension and/or chronic heart failure (CHF), can result in moderate regression of LVH. The primary objective of our study was to investigate the effects of a multi-interventional treatment strategy on LVH in HD patients. 〈 i 〉 Methods and Results: 〈 /i 〉 In a series of 202 consecutive HD patients, we combined optimized CHF therapy, including β-blockers (BB), ACE inhibitors and angiotensin receptor blockers (ARBs), to target doses with full anemia correction by epoetin β (hemoglobin (Hb) target males 14.5 g/dl, females 13.5 g/dl). Serial echocardiograms were recorded every 3–6 months. Mean follow-up was 3.4 ± 1.2 years. Mean Hb at baseline was 11.4 ± 1.4 vs. 14.6 ± 1.6 g/dl (p 〈 0.001) at study end. There was a significant reduction in left ventricular mass index (LVMI, 159 ± 65 vs. 132 ± 46 g/m 〈 sup 〉 2 〈 /sup 〉 (p 〈 0.001)), an improvement in left ventricular ejection fraction (LVEF, 60 ± 15 vs. 66 ± 12% (p 〈 0.01)) and in NYHA class (2.8 ± 0.76 vs. 1.96 ± 0.76 (p 〈 0.01)) from baseline to follow-up in the overall study population. In a subgroup of 70 patients, LVMI returned to normal (169 ± 33 vs. 114 ± 14 g/m 〈 sup 〉 2 〈 /sup 〉 (p 〈 0.001)) after 1.4 ± 1 years. 〈 i 〉 Conclusions: 〈 /i 〉 Our study shows that optimized CHF therapy, in combination with anemia correction to normal Hb targets, results in a significant reduction of LVH, an increase in LVEF and an improvement in NYHA class. Moreover, in contrast to previous studies, our data also demonstrate that complete regression and prevention of LVH in HD patients is possible.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000085881
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1468523-1
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  • 9
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    Online Resource
    Intraoperative Bleeding in Stereotactic Biopsies and Its Implication on Postoperative Management: Can We Predict CT Findings?
    S. Karger AG ; 2014
    In:  Stereotactic and Functional Neurosurgery Vol. 92, No. 2 ( 2014), p. 80-85
    Details
    In: Stereotactic and Functional Neurosurgery, S. Karger AG, Vol. 92, No. 2 ( 2014), p. 80-85
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Stereotactic biopsies are procedures with a high diagnostic yield and a low but serious risk of hemorrhage. Postoperative management remains controversial. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 To evaluate the predictive value of intraoperative bleeding and its implication on postoperative management. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Cases of intraoperative bleeding were prospectively documented in a consecutive series comprising 303 patients. Categories were as follows: no bleeding, single drop, ≤10 drops and 〉 10 drops. Incidence, size of hemorrhage and neurological deterioration were noted. Hemorrhage on routine postoperative CT scans was correlated with intraoperative findings, sample size, location and pathology. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 93 patients (30.7%) showed intraoperative bleeding and 68 (22.4%) showed blood on postoperative CT. In 13 patients (4.3%) the diameter was 〉 1 cm; 19 patients (6.3%) experienced neurological worsening, 9 (3.0%) having postoperative hemorrhage and 3 (1.0%) permanent neurological deficits. Bleeding was associated with postoperative hemorrhage (p 〈 0.0001). The negative predictive values to rule out any postoperative hemorrhage or hemorrhages 〉 1 cm were 92 and 100%, respectively. Number of samples, location and pathology had no significant influence on postoperative hemorrhage. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Stereotactic biopsies have a low risk of symptomatic hemorrhages. Intraoperative bleeding is a surveillance parameter of hemorrhage on CT. Therefore, routine postoperative CT may be restricted to patients who show intraoperative bleeding.
    Type of Medium: Online Resource
    ISSN: 1011-6125 , 1423-0372
    URL: Article
    DOI: 10.1159/000355904
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1483576-9
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  • 10
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    Online Resource
    Expression and Characterization of Membrane-Type 4 Matrix Metalloproteinase (MT4-MMP) and its Different Forms in Melanoma
    S. Karger AG ; 2017
    In:  Cellular Physiology and Biochemistry Vol. 42, No. 1 ( 2017), p. 198-210
    Details
    In: Cellular Physiology and Biochemistry, S. Karger AG, Vol. 42, No. 1 ( 2017), p. 198-210
    Abstract: Background/Aims: Membrane-type matrix metalloproteinases (MT-MMPs) are expressed on the cell surface and hydrolyze extracellular matrix components and signaling molecules by which they influence cancer cell migration and metastasis. Two of the six known MT-MMPs are anchored to the plasma membrane via a GPI anchor, one of which is MT4-MMP. Only little is known about MT4-MMP expression, synthesis, regulation and degradation. Methods: We analyzed several human cancer cell lines as well as tissue homogenates using Western blotting and quantitative PCR for the expression of MT4-MMP. Organelles of SK-Mel-28 cells were separated using continuous Iodixanol gradients. Glycosylation of the SK-Mel-28 protein was studied via glucosidases and site directed mutagenesis of the MT4-MMP cDNA prior to transfection. Results: We found the MT4-MMP highly expressed in human melanoma cell lines as well as skin and melanoma tissue samples. Three forms of MT4-MMP with molecular masses of 45 kDa, 58 kDa and 69 kDa were detected. Further, we demonstrate that the 58 kDa form is the mature protein in the cell membrane, while the 69 kDa form is its precursor found in intracellular compartments. The 69 kDa forms are processed by furin cleavage in the Golgi apparatus. Moreover, we identified Asn318 as the single N-glycosylation site of MT4-MMP. Conclusion: We demonstrate the novel expression of MT4-MMP in melanocytic tissues and propose a precursor/product-relationship of the different forms of MT4-MMP in melanoma cells.
    Type of Medium: Online Resource
    ISSN: 1015-8987 , 1421-9778
    URL: Article
    DOI: 10.1159/000477311
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482056-0
    SSG: 12
    SSG: 15,3
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