Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID)

Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting. Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators. Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm). Conclusions: Data from this registry indicate that rituximab is a commonly employed, well-tolerated therapy with potential beneficial effects in standard of care-refractory autoimmune diseases, and support the results from other open-label, uncontrolled studies

Otto Wagner Areal at Steinhof

Abweichender Titel nach Übersetzung der Verfasserin/des VerfassersEin Konzept zur Revitalisierung und Weiterentwicklung des Otto-Wagner-Spitals basierend auf der Recherche und unter Beibehaltung des Bestandes.Das Projektgebiet gründet auf der im Jahre 1907 errichteten Anlage der „Heil- und Pflegeanstalt für Nerven- und Geisteskranke“ in Wien. Seit 2006 ist der historische Gebäudebestand durch den Denkmalschutz und die Schutzzonen gesichert.Seit der Absiedelung des Krankenhausbetriebes am Otto-Wagner-Spital, stehen viele der Pavillons leer und sind zudem von Zerfall geprägt. Das einzigartige Gebäudeensemble und die großzügigen Grünflächen sind ein wertvolles Gut für die Stadt Wien. Bis zum heutigen Zeitpunkt hat das Areal jedoch noch kein Nachnutzungskonzept erfahren und die Zukunft der Gebäude ist ungewiss.Ziel der Arbeit ist ein Entwurfsprojekt, welches diesen einzigartigen Ort wiederbelebt. Durch behutsames, aber auch entschlossenes Eingreifen soll die bestehende Baustruktur und das gesamte Areal verbessert, weiterentwickelt und reaktiviert werden.Die städtebaulichen Maßnahmen sehen eine Erweiterung und eine nachhaltige Nachnutzung des Otto-Wagner-Spitals vor. Das Areal soll zu einem einmaligen Ort, der Wohnen, Kultur, Bildung und Arbeit zusammenführt, werden.A concept for the revitalization and further development of the Otto Wagner Hospital based on the research and maintenance of the existing structures.The project area is based on the facility of the „Heil- und Pflegeanstalt für Nerven- und Geisteskranke“ in Vienna, built in 1907. Since 2006, the historical building stock has been protected by the preservation order and the protection zones.Since the hospital operations at the Otto Wagner Hospital were relocated, many of the buildings are unused and are also characterized by decay. With its unique ensemble of buildings and lavish green spaces, this is a valuable asset for the City of Vienna. Up to the present time, however, the area has not yet been reused and the future of the buildings is uncertain.The aim of this thesis is a design project which revives this exceptional location. Through careful, but also determined intervention, the existing building structure and the entire area is to be improved, further developed and reactivated.The urban development measures foresee an extension and sustainable reuse of the Otto Wagner Hospital. The area is to become a unique place that brings together living, culture, education and work.15

Determination of the position of the boundaries of the terminal repetitive sequences within the genome of molluscum contagiosum virus type 1 by DNA nucleotide sequence analysis

The repetitive DNA sequences of the genome of Molluscum contagiosum virus type 1 (MCV-1) have been localized within the terminal regions of the viral genome corresponding to the BamHI MCV-1 DNA fragments B (18 kbp; 0 to 0.096 map units (m.u.)) and E (10.5 kbp; 0.944 to 1 m.u.). The fine mapping of these particular regions of the genome of MCV-1 revealed that the boundaries of the terminal repetitive DNA sequences of the viral genome are located within the DNA sequences of the HindIII MCV-1 DNA fragments K (3.8 kbp; 0.014 to 0.036 m.u.) and J1 (4.1 kbp; 0.962 to 0.985 m.u.). The exact position of the boundary of the repetitive DNA sequences was determined by DNA nucleotide sequencing. The HindIII DNA fragments K and J1 compose 3859 and 4107 bp, respectively. The DNA sequences of HindIII MCV-1 DNA fragment K possess repetitive DNA sequences between the nucleotide positions 1 and 1675 which are homologous to the inverted and complementary DNA sequences of the Hin dIII MCV-1 DNA fragment J1 between the nuclotide positions 2437 and 4107 (1670 bp). The degree of DNA sequence homology detected between the repetitive DNA sequences in the HindIII DNA fragments K and J1 of the viral genome was found to be 98%. The number of open reading frames (ORFs) detected by the analysis of the DNA sequences of the HindIII MCV-1 DNA fragments K and J1 was found to be 14 (70 to 219 amino acid residues) and 11 (70 to 365 amino acid residues), respectively

Geschichte denken statt pauken auf der Sekundarstufe II. 20 Jahre nach der friedlichen Revolution: Deutsche und europäische Perspektiven im gymnasialen Geschichtsunterricht

Didaktische Ansätze für einen kompetenzorientierten Unterricht in der gymnasialen Oberstufe; aufgezeigt am Gegenstand der friedlichen Revolution in der DDR. Diese Broschüre enthält neben theoretischen und grundlegenden Arbeiten vor allem eine umfangreiche Sammlung von Unterrichtskonzepten und Materialien für einen Geschichtsunterricht, der die Entwicklung eines reflektierten und selbstreflexiven Geschichtsbewusstseins bei den Schülern in das Zentrum stellt. (Verlag

The genome of equine herpesvirus type 2 harbors an interleukin 10 (IL10)-like gene

A gene was identified within the DNA sequences of theEcoRI DNA fragment N (4.3 kbp) of the genome of equine herpesvirus type 2 (EHV-2) coding for a protein (179 amino acid residues) homologous to the cytokine synthesis inhibitory factor (CSIF; interleukin 10) of the human and mouse, and to the Epstein-Barr virus (EBV) protein BCRF1. This finding is further significant evidence that the interleukin 10 (IL-10) and/or IL-10-like gene can indeed be present in the genomes of members of the herpesviral family

Molecular characterization and determination of the coding capacity of the genome of equine herpesvirus type 2 between the genome coordinates 0.235 and 0.258 (theEcoRI DNA fragment N; 4.2 kbp)

The complete DNA nucleotide sequence of theEcoRI DNA fragment N (0.235 to 0.258 viral map units) of equine herpes virus type 2 (EHV-2) strain T400/3 was determined. This DNA fragment comprises 4237 bp with a base composition of 55.23% G+C and 44.77% A+T. Nineteen open reading frames (ORFs) of 50-287 amino acid (aa) residues were detected. ORF number 10 is located between the nucleotide position 2220 and 2756 coding for a protein of 179 amino acid residues. This protein shows significant homology to the cytokine synthesis inhibitory factor (CSIF; interleukin 10) of human (76.4%) and mouse (68.5%), and to the Epstein-Barr virus (EBV) protein BCRF1 (70.6%). The existence of an interleukin 10 (IL-10) analogous gene within the genome of the EHV-2 was confirmed by screening the genome of nine EHV-2 strains using specific oligonucleotide primers corresponding to the 5′ and 3′ region of this particular gene by polymerase chain reaction. In all experiments an 870 bp DNA product was amplified. The specifity of the amplified DNA fragments obtained from individual EHV-2 strains was confirmed by DNA-DNA hybridization experiments. The DNA sequence analysis of the amplified DNA products of the EHV-2 strain LK was carried out. This analysis revealed the identity of the corresponding IL-10 gene (540 bp) of this strain to the IL-10 gene of EHV-2 strain T400/3. The presented data indicate that the EHV-2 genome harbors a viral interleukin 10-like gene. This is further evidence that the IL-10 gene can be present in the genomes of members of the Herpesviridae family

Paving the road for modern particle therapy - what can we learn from the experience gained with fast neutron therapy in Munich?

While neutron therapy was a highly topical subject in the 70s and 80s, today there are only a few remaining facilities offering fast neutron therapy (FNT). Nevertheless, up to today more than 30,000 patients were treated with neutron therapy. For some indications like salivary gland tumors and malignant melanoma, there is clinical evidence that the addition of FNT leads to superior local control compared to photon treatment alone. FNT was available in Munich from 1985 until 2000 at the Reactor Neutron Therapy (RENT) facility. Patient treatment continued at the new research reactor FRM II in 2007 under improved treatment conditions, and today it can still be offered to selected patients as an individual treatment option. As there is a growing interest in high-linear energy transfer (LET) therapy with new hadron therapy centers emerging around the globe, the clinical data generated by neutron therapy might help to develop biologically driven treatment planning algorithms. Also FNT might experience its resurgence as a combinational partner of modern immunotherapies

Fibroblast growth factor receptor 4: a putative key driver for the aggressive phenotype of hepatocellular carcinoma

Recently, we found upregulation of fibroblast growth factor receptor 4 (FGFR4) in a subset of hepatocellular carcinoma (HCC). Here, we provide mechanistic insight into the role of FGFR4-mediated signalling for the aggressive behaviour of HCC cells. To overexpress FGFR4, hepatoma/hepatocarcinoma cells were transfected with a construct coding for FGFR4. For downmodulation of endogenous FGFR4, we used small interfering RNA or adenoviral infection with dominant-negative FGFR4 constructs being either kinase dead (kdFGFR4) or coding for the autoinhibitory soluble domain (solFGFR4). FGFR4 overexpression in non-tumourigenic hepatocarcinoma cells significantly reduced cell-matrix adhesion, enabled cells to grow anchorage-independently in soft agar, to disintegrate the lymph-/blood-endothelial barrier for intra-/extravasation of tumour cells and to form tumours in SCID mice. Transcriptome analysis revealed altered expression of genes involved in cell-matrix interactions. Conversely, in highly tumourigenic cell lines, kdFGFR4 or solFGFR4 lowered the proportion of cells in S phase of the cell cycle, enhanced the G0/G1 and G2/M-phase proportions, reduced anchorage-independent growth in vitro and attenuated disintegration of the lymph-/blood-endothelium and tumour formation in vivo. These findings were confirmed by altered expression profiles of genes being important for late stages of cell division. Deregulated FGFR4 expression appears to be one of the key drivers of the malignant phenotype of HCC cells. Accordingly, blockade of FGFR4-mediated signalling by soluble dominant-negative constructs, like solFGFR4, may be a feasible and promising therapeutic approach to antagonize aggressive behaviour of hepatoma/hepatocarcinoma cells. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected]