Current Oncological Treatment of Patients with Pancreatic Cancer in Germany: Results from a National Survey on behalf of the Arbeitsgemeinschaft Internistische Onkologie and the Chirurgische Arbeitsgemeinschaft Onkologie of the Germany Cancer Society

Background: No data have previously been available regarding the current treatment of patients with pancreatic cancer (PC) in German hospitals and medical practices. Methods: Between February 2007 and March 2008 we conducted a national survey {[}on behalf of the Arbeitsgemeinschaft Internistische Onkologie (AIO) and the Chirurgische Arbeitsgemeinschaft Onkologie (CAO)] regarding the current surgical and oncological treatment of PC in Germany. Standardized questionnaires were sent via mailing lists to members of the AIO and CAO (n = 1,130). The data were analyzed using SPSS software (version 16.0). Pre-defined subgroup analysis was performed by grouping the results of each question with regard to the professional site of the responding physician and to the number of patients treated in their institution by year. Results: 181 (16%) of the oncological questionnaires were sent back. For 61% of the participating centers, a histological confirmation of PC diagnosis is obligatory. 21% of physicians offer neoadjuvant therapy to patients with potentially resectable PC. In the adjuvant treatment after curative-intent surgery, gemcitabine (Gem) is regarded as standard of care by 71% after R0 resection and 62% after R1 resection. For patients with locally advanced PC, 52% of the participating centers recommend systemic chemotherapy, 17% prefer combined primary chemoradiotherapy. Most centers (59%) base their decision of combination regimens for metastatic disease on the performance status of their patients. In patients with a good status, 28% apply single-agent Gem, 3% use Gem + capecitabine, 12% Gem + erlotinib, 16% Gem + oxaliplatin, and 8% Gem + cisplatin. Only 28% of the survey doctors offer second-line treatment to the majority of their patients with advanced PC. Conclusion: Not every PC patient in Germany is treated according to the present S3 guidelines. Diagnosis and treatment of PC in Germany still need to be improved. Copyright (C) 2009 S. Karger AG, Base

Experimental characterization of the COndensation PArticle counting System for high altitude aircraft-borne application

A characterization of the ultra-fine aerosol particle counter COPAS (COndensation PArticle counting System) for operation on board the Russian high altitude research aircraft M-55 Geophysika is presented. The COPAS instrument consists of an aerosol inlet and two dual-channel continuous flow Condensation Particle Counters (CPCs) operated with the chlorofluorocarbon FC-43. It operates at pressures between 400 and 50 hPa for aerosol detection in the particle diameter (dp) range from 6 nm up to 1 micro m. The aerosol inlet, designed for the M-55, is characterized with respect to aspiration, transmission, and transport losses. The experimental characterization of counting efficiencies of three CPCs yields dp50 (50% detection particle diameter) of 6 nm, 11 nm, and 15 nm at temperature differences (DeltaT) between saturator and condenser of 17°C, 30°C, and 33°C, respectively. Non-volatile particles are quantified with a fourth CPC, with dp50=11 nm. It includes an aerosol heating line (250°C) to evaporate H2SO4-H2O particles of 11 nm<dp<200 nm at pressures between 70 and 300 hPa. An instrumental in-flight inter-comparison of the different COPAS CPCs yields correlation coefficients of 0.996 and 0.985. The particle emission index for the M-55 in the range of 1.4–8.4×10 16 kg -1 fuel burned has been estimated based on measurements of the Geophysika's own exhaust

EFEMP1 binds the EGF receptor and activates MAPK and Akt pathways in pancreatic carcinoma cells

The EGF-related protein EFEMP1 (EGF-containing fibulin-like extracellular matrix protein 1) has been shown to promote tumor growth in human adenocarcinoma. To understand the mechanism of this action, the signal transduction activated upon treatment with this protein has been investigated. We show that EFEMP1 binds EGF receptor (EGFR) in a competitive manner relative to epidermal growth factor (EGF), implicating that EFEMP1 and EGF share the same or adjacent binding sites on the EGFR. Treatment of pancreatic carcinoma cells with purified EFEMP1 activates autophosphorylation of EGFR at the positions Tyr-992 and Tyr-1068, but not at the position Tyr-1048. This signal is further transduced to phosphorylation of Akt at position Thr-308 and p44/p42 MAPK (mitogen-activated protein kinase) at positions Thr-202 and Tyr-204. These downstream phosphorylation events can be inhibited by treatment with the EGFR kinase inhibitor PD 153035. The observed signal transduction upon treatment with EFEMP1 can contribute to the enhancement of tumor growth shown in pancreatic carcinoma cells overexpressing EFEMP1

Investigations on the physical and mechanical behaviour of sycamore maple ( Acer pseudoplatanus L.)

Physical and mechanical properties of sycamore maple (Acer pseudoplatanus L.) were extensively investigated as basis for three-dimensional material modelling for structural simulations (e.g., with finite element method) based on this species. The physical properties of swelling, water absorption, water vapour resistance and thermal conductivity were tested and the mechanical properties of tensile, bending and compression strength and of Young's modulus (static and dynamic) as well as of Poisson's ratio, shear strength, shear modulus and fracture toughness were determined. The tests were carried out for most of the features depending on moisture content and also in all three anatomical main directions: longitudinal, radial and tangentia

Human RELMβ is a mitogenic factor in lung cells and induced in hypoxia

AbstractRELMβ (resistin-like molecule) represents the most related human homologue of mouse RELMα, also known as hypoxic-induced mitogenic factor (HIMF). In this study, we isolated RELMβ cDNA from human lung tissue and performed regulatory and functional expression studies. RELMβ mRNA was upregulated in hypoxia in human lung A549 cell line as well as primary cultured adventitial fibroblasts and smooth muscle cells (SMC) of pulmonary arteries. Upon transfection of a RELMβ encoding expression plasmid into these cells, we observed significant induction of proliferation particularly in SMC and A549 cells, which could be blocked by phosphatidyl-inositol 3-kinase (PI3K) inhibitors LY294002 and wortmannin. The results suggest that human RELMβ may contribute to hypoxic-induced pulmonary vascular remodeling processes or hypoxia related fibrotic lung disease

Synthesis of low-size flower-like AlOOH structures

Al/Cu, Al/Zn, and Al/Fe bimetallic nanoparticles have been obtained using the method of simultaneous electrical explosion of metal pairs in an argon atmosphere. The nanoparticles are chemically active and interact with water at 60°C forming flower-like hierarchical porous structures with a high specific surface area. As the Al/Cu nanopowder is oxidized with water, flower-like pseudoboehmite composite structures are formed with the size of under 1.0 [mu]m; structurally heterogeneous electron-dense spherical inclusions of unreacted metal copper and intermetallides are identified inside them. Al/Fe product transformations are presented by the flower-like pseudoboehmite surrounded by lamellar structures enriched with ferric oxides. Al/Zn nanoparticles react with water, forming the flower-like pseudoboehmite and mainly hexagonal zinc oxide laminae. The composite particles obtained can be used as antibacterial agents in manufacturing medical supplies

Effect of ritonavir on the pharmacokinetics of the benzimidazoles albendazole and mebendazole: an interaction study in healthy volunteers

Background: Benzimidazoles are often used concomitantly with protease inhibitors in patients with helminthic disease and HIV infection. Low bioavailability and extensive first-pass metabolism make benzimidazoles prone to pharmacokinetic drug interactions. The aim of the present study was to investigate potential drug interactions between the benzimidazoles albendazole and mebendazole and the potent CYP3A4 inhibitor ritonavir. Methods: Sixteen healthy volunteers were administered a single oral dose of 1,000mg mebendazole or 400mg albendazole (2 × n = 8). AUC, Cmax, and t1/2 of mebendazole, albendazole, and albendazole sulfoxide were studied in absence and after short-term (2 doses) and long-term (8days) treatment with ritonavir 200mg bid. Results: Pharmacokinetic parameters of albendazole and mebendazole were not changed by short-term administration of ritonavir. However, long-term administration of ritonavir resulted in significant changes in albendazole and mebendazole disposition, with a significant decrease in AUC0-24 (27 and 43% of baseline for albendazole and mebendazole, respectively) and Cmax (26 and 41% of baseline, respectively). Conclusion: The AUC0-24 of benzimidazoles decreased after long-term use of ritonavir, while no changes in pharmacokinetic profiles were observed under short-term administration. These findings might help to optimize benzimidazole efficacy when used in combination with protease inhibitor

Variations in follow-up services after inpatient stroke rehabilitation: A multicentre study

Background: Care after discharge from inpatient stroke rehabilitation units varies across Europe. The aim of this study was to compare service delivery after discharge. Methods: A total of 532 consecutive patients after stroke were recruited from 4 European rehabilitation centres in Germany, Switzerland, Belgium and the UK. At 2-month intervals, clinical assessments and structured interviews were carried out to document functional status and delivery of services after discharge. Significant factors for receiving follow-up services were analysed using a logistic generalized estimating equation model. Results: After controlling for case-mix, the results showed that Belgian patients were most likely to receive physical therapy but least likely to receive occupational therapy. German patients were least likely to receive nursing care. UK patients were less likely to receive medical care from their general practitioner compared with the other patient groups. Conclusion: Clinical characteristics did not explain the variations in service delivery after discharge from inpatient stroke rehabilitation. The decision-making processes involved in the provision of follow-up services need to be better documented. To improve our understanding of events post-discharge, the influence of non-clinical factors, such as healthcare regulations, should be explored further

The role of the dyke in recreational activities along the Wadden Sea area in vicinity of Delfzijl (Groningen).

This research addresses the question on how Delfzijl can take advantage of the dykes referred to recreational activities within the next five years. In order to investigate this problem statement, the elaboration was started with the definition of research questions and secondary research. Here, brochures, websites, books and other researches were used to gather significant information about Delfzijl. Next, quantitative and qualitative research methods were used in order to collect data and information about the different stakeholders, the current situation of the municipality and the expectations of the people concerning the future. Thus, a fieldtrip was done to interview stakeholders and to distribute questionnaires to the sample. Additionally, a benchmarking was done with the German city `Nessmersiel` in order to compare and discover development possibilities. The research outcome is that Delfzijl suffers from a decreasing population number, a low level of recreational attractiveness and lack of money. Many people claim that the dyke is a significant resource that should be used for recreational developments. Hereby, developments can be done on a small budget