Transarterielle Chemoembolisation als Selektionsmarker für Patienten mit HCC vor LTX unter retrospektiver Zuhilfenahme histologischer Ergebnisse [meeting abstract]

Einleitung: Für die meisten Patienten mit HCC ist die LTX die einzige kurative Behandlungsoption. Bei diesen Patienten scheint eine Kontrolle der Erkrankung durch lokale Verfahren im Intervall bis zur LTX zu erreichen zu sein. Als das beste Verfahren gilt die transarterielle Chemoembolisation (TACE). Die Effektivität ist jedoch umstritten. Möglicherweise kann sie aber Patienten startifizieren, die ein hohes Rezidivrisiko haben. Material und Methoden: Im Zeitraum zwischen 1995 und 2005 wurden n=27 Patienten mit HCC im Alter zwischen 22 und 69 Jahren transplantiert. Hiervon erhielten n=15 Patienten eine Vorbehandlung in Form einer alleinigen TACE oder kombiniert mit PEI [n=1] bzw. LITT [n=1]. Retrospektiv wurde das Gesamtüberleben sowie das „Event-free-survival“ (Rezidiv, Reinfektion und Tod) analysiert. Ergebnisse: Die mittlere Wartezeit betrug bei Patienten in der TACE-Gruppe 214 Tage, bei Patienten ohne Vorbehandlung 133 Tage. Bei einem mittleren Nachbeobachtungszeitraum von 1097 ± 1193 Tagen für TACE-Patienten und 1674 ± 966 Tagen für non-TACE-Patienten betrug das Überleben für Patienten, die mit TACE vorbehandelt wurden 83,3%, für Patienten, die keine TACE erhielten 86.7% (p=0,5693). Gleiches fand sich für das Event-free-survival (p=0,8823). Das Gesamtüberleben der Patienten, die auf der Warteliste einen Tumorprogress hatten lag bei 77%, während Patienten mit stabiler Tumorgröße oder Regredienz der Tumore ein Überleben von 93% aufwiesen (p=0,0153). Unter TACE-Behandlung zeigten 5/15 Patienten eine zunehmende Anzahl an Herden im histologischen Präparat verglichen mit der Ausgangsbildgebung. Nur bei einem Patienten zeigte sich der Progress der Erkrankung bereits in der präoperativen Bildgebung. Patienten mit einem Progress der Erkrankung hatten ein Gesamtüberleben von 60%, während Patienten mit „stable disease“ oder Rückgang der Herde ein Gesamtüberleben von 100% hatten (p=0,0180). Schlussfolgerung: Unseren Ergebnisse zufolge ist der Effekt der TACE als Bridgingverfahren auf das Überleben der Patienten fraglich. Allerdings scheint die TACE zur Riskostratifizierung geeignet zu sein. In unserem Patientenkollektiv hatten Patienten, die eine Progredienz der Erkrankung auf der Warteliste zeigten ein signifikant schlechteres Gesamtüberleben. Dies gilt auch bei ausschließlicher Betrachtung der Patienten mit TACE

Baryon Spectrum and Chiral Dynamics

New results on baryon structure and spectrum developed in collaboration with Dan Riska [1-4] are reported. The main idea is that beyond the chiral symmetry spontaneous breaking scale light and strange baryons should be considered as systems of three constituent quarks with an effective confining interaction and a chiral interaction that is mediated by the octet of Goldstone bosons (pseudoscalar mesons) between the constituent quarks.Comment: 12 pages + 1 fig., LaTeX, fig. is available from author, to appear in Proceedings of the Int. School of Nucl. Physics: Quarks in Hadrons and Nuclei (Erice, 19-27 September, 1995) - Progr. Part. Nucl. Phys., v. 36 (1996

Expectation values of four-quark operators in pions

The values of four-quark operators averaged over pions are expressed through those averaged over vacuum. The specific values are obtained in the framework of the factorization assumption. For the condensates of the light quarks of the same flavour \bar q\Gamma q\bar q\Gamma q the scalar condensate is shown to be an order of magnitude larger than the other ones. The condensates containing the strange quarks \bar q q\bar s s appear to be only about twice smaller than those of the light quarks. The degeneracy of the ground state in the Nambu--Jona--Lasinio model is shown explicitly.Comment: 9 pages, no figures, typos correcte

The LIM-only protein FHL2 attenuates lung inflammation during bleomycin-induces fibrosis

Fibrogenesis is usually initiated when regenerative processes have failed and/or chronic inflammation occurs. It is characterised by the activation of tissue fibroblasts and dysregulated synthesis of extracellular matrix proteins. FHL2 (four-and-a-half LIM domain protein 2) is a scaffolding protein that interacts with numerous cellular proteins, regulating signalling cascades and gene transcription. It is involved in tissue remodelling and tumour progression. Recent data suggest that FHL2 might support fibrogenesis by maintaining the transcriptional expression of alpha smooth muscle actin and the excessive synthesis and assembly of matrix proteins in activated fibroblasts. Here, we present evidence that FHL2 does not promote bleomycin-induced lung fibrosis, but rather suppresses this process by attenuating lung inflammation. Loss of FHL2 results in increased expression of the pro-inflammatory matrix protein tenascin C and downregulation of the macrophage activating C-type lectin receptor DC-SIGN. Consequently, FHL2 knockout mice developed a severe and long-lasting lung pathology following bleomycin administration due to enhanced expression of tenascin C and impaired activation of inflammation-resolving macrophages

Medium modifications of nucleon electromagnetic form factors

We use the Nambu-Jona-Lasinio model as an effective quark theory to investigate the medium modifications of the nucleon electromagnetic form factors. By using the equation of state of nuclear matter derived in this model, we discuss the results based on the naive quark-scalar diquark picture, the effects of finite diquark size, and the meson cloud around the constituent quarks. We apply this description to the longitudinal response function for quasielastic electron scattering. RPA correlations, based on the nucleon-nucleon interaction derived in the same model, are also taken into account in the calculation of the response function.Comment: 46 pages, 16 figure

Observation of the Higgs Boson of strong interaction via Compton scattering by the nucleon

It is shown that the Quark-Level Linear $\sigma$ Model (QLL$\sigma$M) leads to a prediction for the diamagnetic term of the polarizabilities of the nucleon which is in excellent agreement with the experimental data. The bare mass of the $\sigma$ meson is predicted to be $m_\sigma=666$ MeV and the two-photon width $\Gamma(\sigma\to\gamma\gamma)=(2.6\pm 0.3)$ keV. It is argued that the mass predicted by the QLL$\sigma$M corresponds to the $\gamma\gamma\to\sigma\to NN$ reaction, i.e. to a $t$-channel pole of the $\gamma N\to N\gamma$ reaction. Large -angle Compton scattering experiments revealing effects of the $\sigma$ meson in the differential cross section are discussed. Arguments are presented that these findings may be understood as an observation of the Higgs boson of strong interaction while being part of the constituent quark.Comment: 17 pages, 6 figure

Nucleon Structure Functions at Moderate Q**2: Relativistic Constituent Quarks and Spectator Mass Spectrum

We present a model description of the nucleon valence structure function applicable over the entire region of the Bjorken variable x, and above moderate values of Q**2 (> 1 GeV**2). We stress the importance of describing the complete spectrum of intermediate states which are spectator to the deep-inelastic collision. At a scale of 1 GeV**2 the relevant degrees of freedom are constituent quarks and pions. The large-x region is then described in terms of scattering from constituent quarks in the nucleon, while the dressing of constituent quarks by pions plays an important role at intermediate x values. The correct small-x behavior, which is necessary for the proper normalization of the valence distributions, is guaranteed by modeling the asymptotic spectator mass spectrum according to Regge phenomenology.Comment: 44 pages RevTeX, 9 uuencoded figures, accepted for publication in Nucl. Phys.

Baryon Structure and the Chiral Symmetry of QCD

Beyond the spontaneous chiral symmetry breaking scale light and strange baryons should be considered as systems of three constituent quarks with an effective confining interaction and a chiral interaction that is mediated by the octet of Goldstone bosons (pseudoscalar mesons) between the constituent quarks.Comment: Lecture given at the 35. Universit\"atswochen f\"ur Kern- und Teilchenphysik, Schladming, Austria, March 1996 (Perturbative and Nonperturbative Aspects of Quantum Field Theory, ed. by H. Latal and W. Schweiger, Springer 1996). Paper (23 pages) with 2 figures and the required macro lamuphy