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265 Publications visible to you, out of a total of 265
Acute renal failure in patients with severe sepsis and septic shock–a significant independent risk factor for mortality: results from the German Prevalence Study
SepNet - German Competence Network Sepsis

Abstract (Expand)

BACKGROUND Sound data about the prevalence of acute renal failure (ARF) among patients with severe sepsis and septic shock are lacking. Further, it is not known whether ARF is an independent risk factor …r for mortality in septic patients or merely an indicator of disease severity. METHODS A prospective cross-sectional one-day prevalence study was carried out in a representative sample of German ICUs, divided into five strata (\textless 200 beds; 201-400 beds; 401-600 beds; \textgreater 600 beds; university hospitals). 3877 patients were screened of whom 415 had severe sepsis and septic shock. RESULTS Fourteen patients (3.4%) had chronic dialysis-dependent RF and were excluded from analysis. Of the remaining 401 patients, 166 (41.4%) had ARF, as defined by a rise in creatinine above twice the upper limit of normal and/or a drop in urine output to \textless 0.5 ml/kg bodyweight. Median APACHE II score was 22 in patients with ARF and 16 in patients without ARF (p\textless 0.0001). Patients with severe sepsis/septic shock had an overall hospital mortality of 55.2%. Hospital mortality in patients with ARF was 67.3% and without ARF 42.8% (p\textless 0.0001). After adjustment for APACHE II score and age, ARF remained a significant independent risk factor for death [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.27-3.52]. Mortality in septic patients was not associated with pre-existing, non-dialysis-dependent chronic kidney disease, whereas in dialysis-dependent patients with sepsis mortality increased to 86%. CONCLUSION In this representative survey in patients with severe sepsis/septic shock, prevalence of ARF is high with 41.4%. ARF represents a significant independent risk factor for mortality in these patients.

Authors: Michael Oppert, Christoph Engel, Frank-Martin Brunkhorst, Holger Bogatsch, Konrad Reinhart, Ulrich Frei, Kai-Uwe Eckardt, Markus Loeffler, Stefan John

Date Published: 15th Oct 2007

Publication Type: Journal article

Human Diseases: disease by infectious agent

Association of the BRCA1 missense variant R1699W with a malignant phyllodes tumor of the breast
GC-HBOC - German Consortium for Hereditary Breast and Ovarian Cancer

Abstract (Expand)

Familial breast carcinomas that are attributable to BRCA1 or BRCA2 mutations have characteristic morphologic and immunhistochemical features. BRCA1-associated carcinomas are poorly differentiated … infiltrating ductal carcinomas frequently exhibiting morphologic features of typical or atypical medullary carcinomas such as prominent lymphocytic infiltrate and pushing margins. We report on a patient carrying the deleterious BRCA1 germline mutation R1699W, who presented with a malignant phyllodes tumor of the breast. The re-investigation of archival material by a reference pathologist of the German Consortium for Hereditary Breast and Ovarian Cancer (GCHBOC) revealed BRCA-associated pronounced pushing margins. In a total of 618 unrelated index patients who are registered in the GCHBOC database, no other phyllodes tumor has been described, while 10 carriers of the R1699W mutant have been identified. We conclude that the histopathologic appearance of the phyllodes tumor indicates an association with the BRCA1 mutation R1699W although it is a rare event in BRCA-positive families.

Authors: Kerstin Rhiem, Uta Flucke, Christoph Engel, Barbara Wappenschmidt, Axel Reinecke-Lüthge, Reinhard Büttner, Rita Katharina Schmutzler

Date Published: 1st Jul 2007

Publication Type: Journal article

Human Diseases: hereditary breast ovarian cancer syndrome

AURKA F31I polymorphism and breast cancer risk in BRCA1 and BRCA2 mutation carriers: a consortium of investigators of modifiers of BRCA1/2 study
GC-HBOC - German Consortium for Hereditary Breast and Ovarian Cancer

Abstract (Expand)

The AURKA oncogene is associated with abnormal chromosome segregation and aneuploidy and predisposition to cancer. Amplification of AURKA has been detected at higher frequency in tumors from BRCA1 and … BRCA2 mutation carriers than in sporadic breast tumors, suggesting that overexpression of AURKA and inactivation of BRCA1 and BRCA2 cooperate during tumor development and progression. The F31I polymorphism in AURKA has been associated with breast cancer risk in the homozygous state in prior studies. We evaluated whether the AURKA F31I polymorphism modifies breast cancer risk in BRCA1 and BRCA2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1/2. Consortium of Investigators of Modifiers of BRCA1/2 was established to provide sufficient statistical power through increased numbers of mutation carriers to identify polymorphisms that act as modifiers of cancer risk and can refine breast cancer risk estimates in BRCA1 and BRCA2 mutation carriers. A total of 4,935 BRCA1 and 2,241 BRCA2 mutation carriers and 11 individuals carrying both BRCA1 and BRCA2 mutations was genotyped for F31I. Overall, homozygosity for the 31I allele was not significantly associated with breast cancer risk in BRCA1 and BRCA2 carriers combined [hazard ratio (HR), 0.91; 95% confidence interval (95% CI), 0.77-1.06]. Similarly, no significant association was seen in BRCA1 (HR, 0.90; 95% CI, 0.75-1.08) or BRCA2 carriers (HR, 0.93; 95% CI, 0.67-1.29) or when assessing the modifying effects of either bilateral prophylactic oophorectomy or menopausal status of BRCA1 and BRCA2 carriers. In summary, the F31I polymorphism in AURKA is not associated with a modified risk of breast cancer in BRCA1 and BRCA2 carriers.

Authors: Fergus J. Couch, Olga Sinilnikova, Robert A. Vierkant, V. Shane Pankratz, Zachary S. Fredericksen, Dominique Stoppa-Lyonnet, Isabelle Coupier, David Hughes, Agnès Hardouin, Pascaline Berthet, Susan Peock, Margaret Cook, Caroline Baynes, Shirley Hodgson, Patrick J. Morrison, Mary E. Porteous, Anna Jakubowska, Jan Lubinski, Jacek Gronwald, Amanda B. Spurdle, Rita Schmutzler, Beatrix Versmold, Christoph Engel, Alfons Meindl, Christian Sutter, Jurgen Horst, Dieter Schaefer, Kenneth Offit, Tomas Kirchhoff, Irene L. Andrulis, Eduard Ilyushik, Gordon Glendon, Peter Devilee, Maaike P. G. Vreeswijk, Hans F. A. Vasen, Ake Borg, Katja Backenhorn, Jeffery P. Struewing, Mark H. Greene, Susan L. Neuhausen, Timothy R. Rebbeck, Katherine Nathanson, Susan Domchek, Theresa Wagner, Judy E. Garber, Csilla Szabo, Michal Zikan, Lenka Foretova, Janet E. Olson, Thomas A. Sellers, Noralane Lindor, Heli Nevanlinna, Johanna Tommiska, Kristiina Aittomaki, Ute Hamann, Muhammad U. Rashid, Diana Torres, Jacques Simard, Francine Durocher, Frederic Guenard, Henry T. Lynch, Claudine Isaacs, Jeffrey Weitzel, Olufunmilayo I. Olopade, Steven Narod, Mary B. Daly, Andrew K. Godwin, Gail Tomlinson, Douglas F. Easton, Georgia Chenevix-Trench, Antonis C. Antoniou

Date Published: 1st Jul 2007

Publication Type: Journal article

Human Diseases: hereditary breast ovarian cancer syndrome

Epidemiology of sepsis in Germany: results from a national prospective multicenter study
SepNet - German Competence Network Sepsis

Abstract (Expand)

OBJECTIVE To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size. DESIGN Prospective, observational, cross-sectional 1-day …day point-prevalence study. SETTING 454 ICUs from a representative nationwide sample of 310 hospitals stratified by size. Data were collected via 1-day on-site audits by trained external study physicians. Visits were randomly distributed over 1 year (2003). PATIENTS Inflammatory response of all ICU patients was assessed using the ACCP/SCCM consensus conference criteria. Patients with severe sepsis were followed up after 3 months for hospital mortality and length of ICU stay. MEASUREMENTS AND RESULTS Main outcome measures were prevalence and mortality. A total of 3,877 patients were screened. Prevalence was 12.4% (95% CI, 10.9-13.8%) for sepsis and 11.0% (95% CI, 9.7-12.2%) for severe sepsis including septic shock. The ICU and hospital mortality of patients with severe sepsis was 48.4 and 55.2%, respectively, without significant differences between hospital size. Prevalence and mean length of ICU stay of patients with severe sepsis were significantly higher in larger hospitals and universities (\textless/= 200 beds: 6% and 11.5 days, universities: 19% and 19.2 days, respectively). CONCLUSIONS The expected number of newly diagnosed cases with severe sepsis in Germany amounts to 76-110 per 100,000 adult inhabitants. To allow better comparison between countries, future epidemiological studies should use standardized study methodologies with respect to sepsis definitions, hospital size, and daily and monthly variability.

Authors: Christoph Engel, Frank M. Brunkhorst, Hans-Georg Bone, Reinhard Brunkhorst, Herwig Gerlach, Stefan Grond, Matthias Gruendling, Guenter Huhle, Ulrich Jaschinski, Stefan John, Konstantin Mayer, Michael Oppert, Derk Olthoff, Michael Quintel, Max Ragaller, Rolf Rossaint, Frank Stuber, Norbert Weiler, Tobias Welte, Holger Bogatsch, Christiane Hartog, Markus Loeffler, Konrad Reinhart

Date Published: 23rd Mar 2007

Publication Type: Journal article

Human Diseases: disease by infectious agent

SOM portrayal of the peripheral blood transcriptome
LIFE - Leipzig Research Center for Civilization Diseases

Abstract (Expand)

Background: The transcriptome of healthy blood offers an option to characterize the physiological state of an individual with diagnostic impact. As a prerequisite such application requires the understanding … of the variability of the expression landscape of healthy individual’s as a function of factors such as age, gender, and aspects of the human constitution and lifestyle. Previous studies mostly were limited to only small population sizes and thus lack representativeness in many respects. Methods and data: The present thesis provides an extensive and detailed study on the gene expression landscape of peripheral blood of healthy individuals based on transcriptome data of 3,388 individuals screened in the population study LIFE between 2011 and 2014. For analysis we applied a neural network technique using self-organizing maps (SOM). Our home-made R-program ‘oposSOM’ enables to reduce the dimension of expression data from tens of thousands of genes to a few thousand ‘meta-genes’ and generates portraits of transcriptional activity that allowed us the sample-to-sample comparison of expression patterns. Results: We disentangled the expression patterns of the portraits into 15 well separated modules of co-expressed genes. Their activation patterns allowed us to aggregate the participants into three types (‘1’, ‘M’, ‘2’). Enrichment techniques extracts the functional context of the modules and revealed that corresponding cellular processes are selectively activated and de-activated in a type-specific fashion: For example, ‘Inflammation’ and ‘Blood coagulation’ are activated in type ‘1’ and ‘Metabolic activity’ and ‘Translation’ in Type ‘2’ samples. We map clinical parameters (complete blood count, lifestyle status, medication and the anthropometric body and BMI type) into the expression landscape in order to study the association between them and the transcriptome landscape. We found that red blood cell components, drug consumption of several drug classes affecting the cardio-vascular system or blood forming organs, tobacco and alcohol consumption, and the BMI types of obese participants highly correlate with meta-genes in the type ‘1’ area, whereas type ‘2’ meta-genes maximal correlate with the lymphocyte count and pre-obese characteristics of the participants. For blood count parameters and medication we found a gender-specific bias. Conclusion: Our analysis provides a comprehensive description of the human blood transcriptome in terms of a series of characteristic expression modules and of health-relevant factors. It provides a healthy reference system for blood transcriptome profiling studies in healthcare to extract potential associations between emerging diseases and the gene expression patterns in clinical research.

Author: M. Schmidt

Date Published: 9th Jul 2005

Publication Type: Not specified

Viewing distance affects stereoscopic tilt created with spatial frequency disparity.
LIFE Adult

Abstract (Expand)

A controversy exists as to whether stereoscopic tilt created with interocular differences in spatial frequency is based on perception of spatial frequency disparity or positional disparity. To determine … which hypothesis is correct, we investigated the influence of viewing distance on perceived tilt. Tilt was induced by having observers view, at three viewing distances, dichoptic spatial frequency grating patterns differing in frequency by 25%. By appropriate physical scaling of the size of the patterns, their spatial frequency and angular width remained unchanged as distance varied. Under such conditions, the spatial frequency disparity hypothesis predicts no effect of distance, whereas the positional disparity hypothesis predicts a significant effect of distance (due to stereoscopic depth constancy) on the magnitude of tilt. The results showed that perceived tilt does covary with distance, a result consistent with only the positional disparity hypothesis.

Authors: R. Patterson, G. Burns, S. Mooney

Date Published: 1st Aug 1989

Publication Type: Not specified

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