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Stuttgart Mühlhausen, Germany

Roessler K.,Friedrich - Alexander - University, Erlangen - Nuremberg | Krawagna M.,Friedrich - Alexander - University, Erlangen - Nuremberg | Bischoff B.,Friedrich - Alexander - University, Erlangen - Nuremberg | Rampp S.,Friedrich - Alexander - University, Erlangen - Nuremberg | And 4 more authors.
World Neurosurgery | Year: 2016

The pros and cons of semisitting positioning (SSP) versus lateral, horizontal positioning (LP) during retrosigmoid vestibular schwannoma (VS) surgery, especially concerning postoperative cranial nerve and brain stem preservation, are under continuous discussion. Methods In a single-center retrospective cohort study, 30 VSs operated on in SSP compared with 30 operated on in LP with comparable demography were analyzed. During SSP surgery, transesophageal echocardiographic monitoring for venous air embolism was used continuously. Electrophysiologic cranial nerve monitoring was used in both groups. Results Length of surgery was significantly different between both groups: 183 minutes mean in SSP surgery versus 365 minutes mean in LP surgery (P = 0.0001). Postoperative rates of facial palsy and hearing loss were also significantly different. Six months postoperatively, 63% had normal facial nerve function after SSP surgery, whereas in LP surgery, 40% had no facial palsy (P = 0.02). Hearing preservation rate was also significantly different: 44% in SSP surgery compared with 14% in LP surgery who had preserved hearing (P = 0.006). Because of cerebrospinal fluid leaks, there were 3 operative revisions in the LP group (10%) and 1 (3.3%) in the SSP group. A clinically insignificant venous air embolism rate was found in 3.3% of patients (1/30) during SSP surgery. The neurologic outcome after 6 months was 1.2 on the Rankin Scale in the LP group and 1.0 in the SSP group, with zero mortality. Conclusions SSP compared with LP surgery was associated with significantly shorter operation time and better facial and cochlear nerve function in VS surgery postoperatively, without differences in complication rates. © 2016 Elsevier Inc. All rights reserved.

Jenner S.,Katharinen Hospital Stuttgart | Techel D.,Katharinen Hospital Stuttgart
Tumor Biology | Year: 2015

A gapped ligase chain reaction (gLCR)-based technique was developed and tested on clinical formalin-fixed, paraffin-embedded (FFPE) tissues from colorectal cancer patients. The technique was designed to detect low-level KRAS codon 12 or 13 mutations or confirming doubtful results gained by less sensitive KRAS screening techniques. The gLCR approach was compared with mutation screening techniques commonly used in routine diagnostics regarding sensitivity and specificity. The herein described monoplex gLCR technique is a useful and powerful tool for detecting low-level KRAS codon 12 and 13 mutations in a vast majority of wild type DNA. The gLCR has the capacity to detect one mutated allele in an excess of at least one million wild type alleles (0.0001 %) and is therefore an ideal technique for confirming doubtful KRAS mutation screening results obtained by other techniques. The variance of the gLCRs signal amplitude was very low and is showing a high reproducibility with constant sensitivity even at higher dilutions. The financial effort and the handling time for this technique are low and comparable to a standard cycle sequencing reaction. Additionally, the gLCR technique is easy extendable for the detection of many other clinical relevant mutation hotspots. © 2015, International Society of Oncology and BioMarkers (ISOBM).

Jenner S.,Katharinen Hospital Stuttgart | Jenner S.,Institute For Pathologie | Wiedorn K.H.,Katharinen Hospital Stuttgart | Techel D.,Katharinen Hospital Stuttgart
Pathology and Oncology Research | Year: 2015

A methylation screening assay for DUSP9 (dual-specificity phosphatase 9) has been developed and applied on 79 FFPE samples from patients with colorectal cancer (CRC) and 22 corresponding tumor free colon samples in this study. Quantitative pyrosequencing was used for the determination of the methylation in the promoter CpG island, including 83 CpG motifs. In this way, the methylation pattern of the 11 tumor samples with the weakest and the strongest methylation could be identified and were compared to their corresponding tumor free colon samples. Forty six percent of the weakly methylated samples showed no significant difference to their tumor free counterparts, whereas in 27 % of the cases an increased or reduced methylation was detectable. For the strongly methylated tumor samples only 18 % showed no significant difference to their tumor free counterparts, whereas 82 % were significantly stronger methylated. In CRC, the aberrant promoter methylation of tumor suppressor genes is one aspect that defines the CpG island methylator phenoptype (CIMP) and is frequently observed in a subpopulation of cases. Patients harboring a CIMP phenotype often show additional clinicopathological characteristics, the so called CIMP features. Interestingly, no CIMP features were found for the weakly methylated samples analyzed in this study but could be seen in 82 % of the strongly methylated cases, indicating a possible use for DUSP9 as CIMP marker. © 2014, Arányi Lajos Foundation.

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