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Biomedical subjects

Christoph von Schilling

Publications and source records attributed to Christoph von Schilling.

8 recordsLinked to original sources

Acupuncture and acupressure for the prevention of chemotherapy-induced nausea--a randomised cross-over pilot study.

OBJECTIVE: To investigate whether a combination of acupuncture and acupressure is effective for reducing chemotherapy-induced nausea and vomiting. PATIENTS AND METHODS: In a randomised cross-over trial, 28 patients receiving moderately or highly emetogenic chemotherapy and conventional standard antiemesis were treated for one chemotherapy cycle with a combination of acupuncture and acupressure at point P6 and for one cycle at a close sham point. The main outcome measure was a nausea score derived from daily intensity rating. RESULTS: There was no difference between combined acupuncture and acupressure treatment at P6 and at the sham point for the nausea score, but the level of nausea was very low in both phases. The mean nausea score was 6.2 (standard deviation 9.0) for treatment at P6 and 6.3 (9.1) for treatment at the sham point (mean difference -0.1, 95% confidence interval -3.9 to 3.7; p=0.96). Seventeen of 21 participants completing the study would desire acupuncture and acupressure for future chemotherapy cycles, but there was no clear preference for either point. CONCLUSION: In this small pilot study a significant difference between treatment at P6 and a close sham point could not be detected. However, it cannot be ruled out that an existing difference was missed due to the small sample size.

Acupressure↗

Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis.

Pathomorphological examination of trephine biopsies of the bone marrow (BM) represents a standard method for the diagnosis and staging of hematologic neoplasms and other disorders involving the BM. The increasing knowledge about the genetic basis and biology of hematologic neoplasms, as well as the recently proposed WHO classification system, provide the framework for an accurate diagnosis. Although conventional morphology remains the gold standard for paraffin-embedded BM trephines, immunohistochemical stainings have become an integral part of the diagnostic workup. Antibodies suitable for paraffin sections are generally applicable to BM trephines, but modifications of staining protocols may be necessary due to the alternative fixatives and decalcification procedures used for BM biopsies. The indications for immunostainings range from confirmation and classification of lymphoma involvement, subclassification of acute leukemias, and estimating blast counts in myelodysplastic and myeloproliferative syndromes to characterization of BM involvement in nonhematologic neoplasms. Although subtyping of NHL in the BM is more difficult from the point of morphology, classification of the entities that frequently involve the BM, especially the small B-cell lymphomas, can easily be achieved with the help of immunohistochemistry. In this review, we try to summarize the current state of the art in BM immunohistochemistry for the diagnosis of hematologic disorders. Moreover, diagnostic algorithms and useful antibody panels are proposed for a rational and cost-effective approach.

Algorithms↗

Determination of individual S-values for 131I using segmented CT data and the EGS4 Monte Carlo code.

In individual voxel phantoms, which were segmented from whole-body computed tomography (CT) scans, S-values were calculated for (131)I using the EGS4 Monte Carlo code and compared to Medical Internal Radiation Dose (MIRD) S-values, which were derived from transport calculations in idealized mathematical phantoms. The individually calculated S-values agree very well with the MIRD values for organs, which are source and target simultaneously, when individual organ-mass corrections are applied to the MIRD values. For different source-target combinations, large deviations up to 184% were found. The contribution of the gamma-absorbed fractions to the total dose, however, is small ( approximately 4%). We conclude, therefore, that individual transport calculations in radionuclide-targeted therapies are not necessary for macroscopic dose estimates. Reliable dosimetry is reduced to the problem of accurate activity determination in vivo.

Bone Marrow↗

The oncogenic fusion protein nucleophosmin-anaplastic lymphoma kinase (NPM-ALK) induces two distinct malignant phenotypes in a murine retroviral transplantation model.

A t(2;5) (p23;q35) chromosomal translocation can be found in a high percentage of anaplastic large-cell lymphomas (ALCL). This genetic abnormality leads to the expression of the NPM-ALK fusion protein, which encodes a constitutively active tyrosine kinase that plays a causative role in lymphomagenesis. Employing a modified infection/transplantation protocol utilizing an MSCV-based vector, we were able to reproducibly induce two phenotypically different lymphoma-like diseases dependent on the retroviral titers used. The first phenotype presented as a polyclonal histiocytic malignancy of myeloid/macrophage origin with a short latency period of 3-4 weeks. Clinically, the diseased mice showed rapidly progressive wasting, lymphadenopathy and pancytopenia. Mice displaying the second phenotype developed monoclonal B-lymphoid tumors with a longer latency of approximately 12-16 weeks, primarily involving the spleen and the bone marrow, with less extensive lymph node but also histologically evident extranodal organ infiltration by large immature plasmoblastic cells. The described retroviral mouse model will be useful to analyse the role of NPM-ALK in lymphomagenesis in vivo and may contribute to the development of new treatment options for NPM-ALK induced malignancies.

Animals↗

Detailed analysis of five mutations in dihydropyrimidine dehydrogenase detected in cancer patients with 5-fluorouracil-related side effects.

Complete or partial loss of dihydropyrimidine dehydrogenase (DPD or DYPD) function has been described in cancer patients experiencing severe side effects upon administration of the fluoropyrimidine anticancer drug 5-fluorouracil (5-FU). To investigate a genetic predisposition for 5-FU intolerance due to inherited DPD defects, we established a mutation detection assay based on denaturing HPLC. Analyzing four individuals with symptoms of 5-FU-related toxicity, we detected six distinct sequence variants in the dihydropyrimidine dehydrogenase gene (DPYD): one novel mutation, c.775A>G (K259E); four known missense mutations, c.85T>C (C29R), c.496A>G (M166V), c.1601G>A (S534N), c.1627A>G (I543V); and one silent mutation c.1896T>C affecting the codon for F632. One cancer patient possessing a total of four gene mutations resulting in four amino acid substitutions (C29R, M166V, S534N, I543V) displayed significantly reduced DPD activity. The rare combination of the highly conserved mutation sites M166V and S534N was additionally found in one of the other patients. DPD enzyme activity was low, but yet within normal range. The K259E mutation did not provoke a decrease in DPD function in a heterozygous individual. Based on the protein structure of crystalline pig DPD and the deduced homology models, we have additionally investigated the amino acid positions in their three-dimensional network which correspond to the five missense mutations discovered in the patients.

Antimetabolites, Antineoplastic↗

Immunotherapy with anti-CD20 compounds.

The B-cell surface antigen CD20 is currently the prime target for near-selective treatment of mature B-cell malignancies and a range of reactive B-cell associated disorders (including virus-associated lymphoproliferation or autoimmune conditions). CD20 is strongly and homogeneously expressed on the majority of mature B-cell neoplasms except chronic lymphocytic leukaemia cells, and on all mature reactive B-cells. This review will summarise the modes of action of various reagents targeting CD20. Treatment results following their use in single and combination therapy for B-cell disorders are reviewed.

Animals↗

[Structured patient education in oncology. A prospective study for implementing and effectiveness of interdisciplinary psycho-educational group intervention at a German university clinic].

AIM: To identify the target group for a structured educational group intervention in an acute cancer care setting, and to prove its effectiveness. PATIENTS AND METHODS: Cancer patients were given an opportunity to join an educational group intervention lasting 3 weeks (consisting of six times 1 hour). The intervention consisted of two major components: health education and coping skills. Participating patients (intervention group; n = 51) and nonparticipants (control group; n = 57) were evaluated at the beginning, then 2 months and 4 months later by means of standardized questionnaires (EORTC QLQ-C30, TSK, HADS, Henrich's FTP). RESULTS: Lower social and educational status, nonurban residency, males, and unfavorable prognoses together with palliative treatment intention were found less frequently (p < 0.05) in the intervention group. In comparison to the control group, the intervention group patients were characterized by a significantly greater desire for information and by more treatment-related fear. Improvements in disease-specific knowledge, certain quality of life elements, and in coping occurred only in the intervention group. Increases in the incidence of depression were found only in the control group. CONCLUSION: Patients with a more favorable prognosis, and a higher social and educational status, are more likely to get structured educational group intervention in an acute cancer care setting. For this subset of patients this intervention proves effective. Its importance for the standard care of cancer should be further investigated.

Adaptation, Psychological↗