Risk of basal cell carcinoma after Hodgkin's disease

Background: Basal cell cancer is a common skin cancer, yet studies of second tumors after Hodgkin's disease tend to exclude basal cell cancers as second malignant tumors from analysis. Basal cell carcinomas (BCC) are possibly more common in immunosuppressed patients and were recently implicated as indicators of subsequent malignancies. Materials and Methods: Our database of 1,120 patients with Hodgkin's disease (derived from the tumor registry) was investigated for the occurrence of later BCCs. Kaplan-Meier curves were calculated. Results: A total of 9 cases of BCC were observed 0-20 years after the diagnosis of Hodgkin's disease, One case relapsed after excision. The probability of second BCC was 2.1% after 15 years of follow-up and 7.1% after 20 years. Statistically, the risk for second BCC was increased only in younger patients and with prolonged follow-up, but not in the total group of patients with Hodgkin's disease. Conclusion: BCC is not a major threat: for the survivors of Hodgkin's disease, but continued follow-up is necessary

Spontaneous bleeding in a patient with malignant lymphoma: A case of acquired hemophilia

Background: Acquired hemophilia is a rare condition which can be associated with lymphoproliferative disease. Case Report: Eleven yea rs after the diagnosis of immunocytoma had been made, a 72-year-old man developed a high-titer factor VIII inhibitor. At this time, the lymphoma was without significant progress and there was no paraprotein in the serum. Partial thromboplastin time (PTT) was 83 a, factor-VIII clotting activity was <1%, and inhibitor level was 50.4 Bethesda units. The patient presented with spontaneous hematomas in the skin and musculature of the extremities. Following combination chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), there was a prompt disappearance of the inhibitor and normalization of coagulation; however, the patient developed serious infectious complications. When the inhibitor recurred he was treated with low-dose cyclophosphamide and prednisolone. This time there was a more delayed response, but the inhibitor disappeared again completely. Two months after cessation of therapy, there was again relapse. Conclusion: Causal relationship between lymphoma and acquired hemophilia remains speculative. At least in some cases of factor VIII inhibitors associated with malignant disease, immunosuppressive therapy may be sufficient to suppress the inhibitor

Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyper-fractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and - if possible - prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer

Use of checkpoint inhibitors in liver transplant recipients

In spite of their major impact in cancer therapy, immune checkpoint inhibitors are considered to be contraindicated in liver transplant recipients due to fear of rejection and fatal liver failure. Nevertheless, an increasing number of instances of liver transplant recipients treated with checkpoint inhibitors is being published. We reviewed the reports on 14 known cases of liver transplant recipients who underwent treatment with checkpoint inhibitors and discuss factors likely to determine susceptibility to organ rejection including the choice of the agent and the immunosuppression employed, the assessment of Programmed cell death 1 ligand 1 (PD-L1) status in liver graft biopsies, and the time of treatment initiation

Simulations of CMOS pixel sensors with a small collection electrode, improved for a faster charge collection and increased radiation tolerance

CMOS pixel sensors with a small collection electrode combine the advantages of a small sensor capacitance with the advantages of a fully monolithic design. The small sensor capacitance results in a large ratio of signal-to-noise and a low analogue power consumption, while the monolithic design reduces the material budget, cost and production effort. However, the low electric field in the pixel corners of such sensors results in an increased charge collection time, that makes a fully efficient operation after irradiation and a timing resolution in the order of nanoseconds challenging for pixel sizes larger than approximately forty micrometers. This paper presents the development of concepts of CMOS sensors with a small collection electrode to overcome these limitations, using three-dimensional Technology Computer Aided Design simulations. The studied design uses a 0.18 micrometer process implemented on a high-resistivity epitaxial layer.Comment: Proceedings of the PIXEL 2018 Worksho

Ein Ansatz zur anwenderorientierten Systemmodellierung für die interdisziplinäre Produktentwicklung = A User-Oriented Concept of Systems Modeling for Interdisciplinary Product Engineering

Die Welt verändert sich, auch für den Menschen in der Produktentwicklung. War früher die Kompetenz eines Entwicklers durch disziplinspezifisches Fachwissen geprägt, ist heute und in Zukunft eine interdisziplinäre Ausrichtung des Kompetenzprofils erforderlich. Die Karlsruher Schule der Produktentwicklung begreift diesen Menschen als denkendes und handelndes Zentrum in der Produktentstehung

Kann die Kommunikationsstruktur in Schulen durch ein Training in systemisch-konstruktivistischer Gesprächsführung verändert werden?

Die neuen Ansätze für Schulentwicklung gehen in Richtung einer erweiterten Selbständigkeit der Einzelschule, die gewährleisten soll, daß in Schulen nicht nur anders und anderes gelernt wird, sondern dass sie darüber hinaus in die Lage versetzt werden, sich selbst zu verändern. Wenn in Projektteams ein Schulprogramm entwickelt, Zielvereinbarungen getroffen und neue Unterrichtsformen entwickelt werden sollen, fordert dies von den Lehrern die grundsätzliche Bereitschaft zu Zusammenarbeit und Austausch. Damit üben die neuen Aufgaben, die die bisherigen Grenzen von Klasse und Fach überschreiten, einen deutlichen Druck auf die traditionelle Verfasstheit der Lehrerrolle aus. Gerade der bisherige, aus der Isolation am Arbeitsplatz resultierende Lehrerindividualismus, stellt jedoch ein entscheidendes Hemmnis für die weitere Professionalisierung der Berufsgruppe dar. Um die aus der Berufsgruppe selbst erwachsende Form von Professionalität zu entwickeln, beschreiben Schulforscher die neue Lernrichtung dahingehend, dass die individuelle Autonomie durch kommunikative Vernetzung ergänzt werden muss. Ob die Kommunikationsstruktur in Schulen sich durch ein Training in systemisch-konstruktivistischer Gesprächsführung verbessern lässt, ist von daher das zentrale Thema der vorliegenden Arbeit