Peptide receptor radionuclide therapy in a patient with disabling non-functioning pituitary adenoma

Non-functioning pituitary adenoma (NFPA) with higher proliferation index (WHO II) are often a therapeutical challenge. Low somatostatin receptor expression in these tumors usually prevents a treatment with somatostatin analogs. In 1996, a 55-year-old patient was referred due to right-sided headache. A pituitary macroadenoma with infiltration into the right cavernous sinus was diagnosed. There was no visual field deficit and the clinical and biochemical work up was consistent with a NFPA. The patient underwent transsphenoidal surgery. Residual adenoma remained in the right cavernous sinus. Histologically, a null-cell adenoma with a high proliferation index was documented (MIB-1: 11.6%, WHO II). Somatostatin receptor autoradiography was performed in the surgical specimen showing a homogenous expression of sst2 receptors. Radiosurgery was completed with stable disease for 8years. In 2004, the patient was diagnosed with an incomplete palsy of the right oculomotorius nerve and a significant increase in the volume of the adenoma in the right cavernous sinus. After a positive Octreoscan® the patient consented to an experimental therapy approach using Lutetium DOTATOC (3×200mCi). The palsy of the oculomotorius nerve improved and remained stable until today (March 2013), the follow-up MRI scans demonstrated stable disease. This is the first case of a patient with a NFPA (WHO II) in whom PRRT successfully improved the local complications of the tumor for more than 8years after ineffective surgery and gamma knife therapy. The determination of sst2 in vitro using autoradiography and in vivo by Octreoscan was instrumental to administer this therapy in a challenging situation

Boron isotope ratio (delta B-11) measurements in water framework directive monitoring programs: comparison between double focusing sector field ICP and thermal ionization mass spectrometry

International audienceThe aim of our research was to compare delta B-11 measurements performed with thermal ionization mass spectrometry (TIMS) and sector field-inductively coupled plasma-mass spectrometry (SF-ICP-MS) and evaluate the feasibility of implementing stable isotope methods in European water framework directive (WFD) monitoring programs. The comparison was based on delta B-11 measurements of 192 ground-and surface water samples and 15 leachates of nitrate pollution source materials (organic and mineral fertilisers). The precision of delta B-11 measurements attainable with SF-ICP-MS, 2 sigma= +/- 2.6 parts per thousand; (n = 192), is as expected lower than the precision achieved by TIMS, 2 sigma= +/- 0.3 parts per thousand (n=183). However the ease of use, rapidity and availability of SF-ICP-MS on one hand and the observed variability in delta B-11 in ground-and surface water on the other (from -3.4 to +37 parts per thousand), demonstrates that using SF-ICP-MS as an isotopic screening method would promote the use of isotopic methodology for WFD monitoring. Based on the results of the different case studies it is shown that retrieving precise information on the identification of pollution sources from delta B-11 values requires reaching the best analytical precision and accuracy possible. Hence, the superior precision of TIMS advantages tracing of nitrate pollution sources. However for some cases, e. g. trying to decipher contributions between sources with really distinct delta B-11 signatures (e.g. manure and sewage effluent), SF-ICP-MS results lead to the same conclusions and can therefore be used as a first approachable screening method for the determination of delta B-11 in WFD monitoring programs

Identification of biology-based breast cancer types with distinct predictive and prognostic features: role of steroid hormone and HER2 receptor expression in patients treated with neoadjuvant anthracycline/taxane-based chemotherapy

Introduction: Reliable predictive and prognostic markers for routine diagnostic purposes are needed for breast cancer patients treated with neoadjuvant chemotherapy. We evaluated protein biomarkers in a cohort of 116 participants of the GeparDuo study on anthracycline/taxane-based neoadjuvant chemotherapy for operable breast cancer to test for associations with pathological complete response (pCR) and disease-free survival (DFS). Particularly, we evaluated if interactions between hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expression might lead to a different clinical behavior of HR+/HER2+ coexpressing and HR+/HER2- tumors and whether subgroups of triple negative tumors might be identified by the help of Ki67 labeling index, cytokeratin 5/6 (CK5/6), as well as cyclooxygenase-2 (COX-2), and Y-box binding protein 1 (YB-1) expression. Methods: Expression analysis was performed using immunohistochemistry and silver-enhanced in situ hybridization on tissue microarrays (TMAs) of pretherapeutic core biopsies. Results: pCR rates were significantly different between the biology-based tumor types (P = 0.044) with HR+/HER2+ and HR-/HER2- tumors having higher pCR rates than HR+/HER2-tumors. Ki67 labeling index, confirmed as significant predictor of pCR in the whole cohort (P = 0.001), identified HR-/HER- (triple negative) carcinomas with a higher chance for a pCR (P = 0.006). Biology-based tumor type (P = 0.046 for HR+/HER2+vs. HR+/HER2-), Ki67 labeling index (P = 0.028), and treatment arm (P = 0.036) were independent predictors of pCR in a multivariate model. DFS was different in the biology-based tumor types (P < 0.0001) with HR+/HER2- and HR+/HER2+ tumors having the best prognosis and HR-/HER2+ tumors showing the worst outcome. Biology-based tumor type was an independent prognostic factor for DFS in multivariate analysis (P < 0.001). Conclusions: Our data demonstrate that a biology-based breast cancer classification using estrogen receptor (ER), progesterone receptor (PgR), and HER2 bears independent predictive and prognostic potential. The HR+/HER2+ coexpressing carcinomas emerged as a group of tumors with a good response rate to neoadjuvant chemotherapy and a favorable prognosis. HR+/HER2- tumors had a good prognosis irrespective of a pCR, whereas patients with HR-/HER- and HR-/HER+ tumors, especially if they had not achieved a pCR, had an unfavorable prognosis and are in need of additional treatment options. Trial registration ClinicalTrials.gov identifier: NCT0079337

Cross-Cultural Differences Between Poland and Germany in Light of Cultural Dimensions Theory

The paper aims to determine the cultural differences between Poland and Germany on the basis of cultural dimensions theory proposed by Dutch social psychologist Geert Hofstede. The authors conduct an empirical study using a uniform survey questionnaire and compare their findings against the pattern of cultural values established by Hofstede.The research focuses on cultural diversity. The original study conducted by Hofstede at the IBM corporation in the 1960 s and the 1970 s identified four cultural dimensions in several dozen countries, including Germany. The value scores for Poland’s cultural dimensions estimated by Hofstede were based on research carried out by other authors in the 1990 s. Komor and Schumann set out to determine the current cultural dimensions for Poland and Germany with a view to identifying the differences between the two nations. The authors discuss the theoretical and methodological background of their study and provide a detailed explanation of the research problem. They also discuss the procedures underlying their empirical research based on a Cultural Value Scale (CVScale) validated by other researches. The research indicates that there are relatively small differences in terms of cultural dimensions between Poland and Germany, the authors conclude. The greatest differences involve two dimensions: uncertainty avoidance and individualism/collectivism. A comparison of the results of the study with the index scores calculated by Hofstede points to differences in cultural values. According to Komor and Schumann, the results of their study can be used in business practice and future cross-cultural research.Celem artykułu jest określenie cech kulturowych Polaków i Niemców, opierających się na czterech wymiarach kulturowych zaproponowanych przez Geerta Hofstede na podstawie badań empirycznych przeprowadzonych z zastosowaniem tych samych kwestionariuszy badawczych, a następnie identyfikacja różnic kulturowych występujących między tymi narodami oraz porównanie wyników tych badań z wartościami wskaźników wymiarów kultury wyznaczonych przez G. Hofstede. Autorzy artykułu podejmują rozważania dotyczące zróżnicowań międzykulturowych. Pierwotne badania G. Hofstede przeprowadzone w latach 60. i 70. ubiegłego wieku w koncernie IBM pozwoliły na zidentyfikowanie czterech wymiarów kulturowych w kilkudziesięciu krajach, w tym w Niemczech. Z kolei wartości wymiarów dla Polski zostały wyznaczone przez G. Hofstede szacunkowo na podstawie innych badań kulturowych z lat 90. Niniejsze badania podjęto w celu ustalenia obecnych wymiarów kulturowych w Polsce i Niemczech, jak i określenia występujących zróżnicowań między krajami oraz porównania wyników badań z wartościami wymiarów przyjętych przez G. Hofstede. W publikacji przedstawiono teoretyczne podstawy tego projektu oraz szczegółowo wyjaśniono problem badawczy. Następnie zaprezentowano metodykę przeprowadzonych badań empirycznych opartych na potwierdzonej w badaniach innych autorów skali CVSCALE. W kolejnej części artykułu zaprezentowano wyniki oraz odniesiono się do postawionych hipotez. Wyniki wskazują, iż występują relatywnie niewielkie zróżnicowania kulturowe w czterech wymiarach kultury między Polską a Niemcami. Największe zróżnicowania mają miejsce w dwóch wymiarach, tj. w unikaniu niepewności oraz w indywidualizmie versus kolektywizmie. Ponadto porównano wyniki niniejszych badań z wartościami wymiarów kulturowych przyjętych przez G. Hofstede. Stwierdzono, iż występują zróżnicowania, które w zakresie wartości wskaźników kulturowych są znacznie większe w Polsce niż Niemczech. W podsumowaniu opracowania zawarto wnioski autorów oraz wskazano możliwości wykorzystania wyników niniejszych badań w praktyce gospodarczej i w teorii, w tym w przyszłych badaniach międzykulturowych

Cross-cultural differences in the development of trust in relational service exchange - an empirical analysis of the moderating role of uncertainly avoidance

Customer trust is of high importance for customer relationship management in services. While service providers increasingly provide their services globally, little is known about cross-cultural differences in the way customers develop trust in their service providers. The present paper fills this void by providing a research model that builds on the idea that cross-cultural differences in the development of trust can be explained by moderating effects of uncertainty avoidance. This view is supported by results of an empirical analysis conducted in the banking context in six countries. Managerial implications are derived and directions for further research are proposed

Peptide receptor radionuclide therapy in a patient with disabling non-functioning pituitary adenoma

Non-functioning pituitary adenoma (NFPA) with higher proliferation index (WHO II) are often a therapeutical challenge. Low somatostatin receptor expression in these tumors usually prevents a treatment with somatostatin analogs. In 1996, a 55-year-old patient was referred due to right-sided headache. A pituitary macroadenoma with infiltration into the right cavernous sinus was diagnosed. There was no visual field deficit and the clinical and biochemical work up was consistent with a NFPA. The patient underwent transsphenoidal surgery. Residual adenoma remained in the right cavernous sinus. Histologically, a null-cell adenoma with a high proliferation index was documented (MIB-1: 11.6 %, WHO II). Somatostatin receptor autoradiography was performed in the surgical specimen showing a homogenous expression of sst2 receptors. Radiosurgery was completed with stable disease for 8 years. In 2004, the patient was diagnosed with an incomplete palsy of the right oculomotorius nerve and a significant increase in the volume of the adenoma in the right cavernous sinus. After a positive Octreoscan(®) the patient consented to an experimental therapy approach using Lutetium DOTATOC (3 × 200 mCi). The palsy of the oculomotorius nerve improved and remained stable until today (March 2013), the follow-up MRI scans demonstrated stable disease. This is the first case of a patient with a NFPA (WHO II) in whom PRRT successfully improved the local complications of the tumor for more than 8 years after ineffective surgery and gamma knife therapy. The determination of sst2 in vitro using autoradiography and in vivo by Octreoscan was instrumental to administer this therapy in a challenging situation

Cross-Cultural Differences in the Effect of Received Word-of-Mouth Referral in Relational Service Exchange

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