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1.
Cells ; 13(12)2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38920652

RESUMO

Mesenchymal stem cells (MSCs) of placental origin hold great promise in tissue engineering and regenerative medicine for diseases affecting cartilage and bone. However, their utility has been limited by their tendency to undergo premature senescence and phenotypic drift into adipocytes. This study aimed to explore the potential involvement of a specific subset of aging and antiaging genes by measuring their expression prior to and following in vitro-induced differentiation of placental MSCs into chondrocytes and osteoblasts as opposed to adipocytes. The targeted genes of interest included the various LMNA/C transcript variants (lamin A, lamin C, and lamin A∆10), sirtuin 7 (SIRT7), and SM22α, along with the classic aging markers plasminogen activator inhibitor 1 (PAI-1), p53, and p16INK4a. MSCs were isolated from the decidua basalis of human term placentas, expanded, and then analyzed for phenotypic properties by flow cytometry and evaluated for colony-forming efficiency. The cells were then induced to differentiate in vitro into chondrocytes, osteocytes, and adipocytes following established protocols. The mRNA expression of the targeted genes was measured by RT-qPCR in the undifferentiated cells and those fully differentiated into the three cellular lineages. Compared to undifferentiated cells, the differentiated chondrocytes demonstrated decreased expression of SIRT7, along with decreased PAI-1, lamin A, and SM22α expression, but the expression of p16INK4a and p53 increased, suggesting their tendency to undergo premature senescence. Interestingly, the cells maintained the expression of lamin C, which indicates that it is the primary lamin variant influencing the mechanoelastic properties of the differentiated cells. Notably, the expression of all targeted genes did not differ from the undifferentiated cells following osteogenic differentiation. On the other hand, the differentiation of the cells into adipocytes was associated with decreased expression of lamin A and PAI-1. The distinct patterns of expression of aging and antiaging genes following in vitro-induced differentiation of MSCs into chondrocytes, osteocytes, and adipocytes potentially reflect specific roles for these genes during and following differentiation in the fully functional cells. Understanding these roles and the network of signaling molecules involved can open opportunities to improve the handling and utility of MSCs as cellular precursors for the treatment of cartilage and bone diseases.


Assuntos
Diferenciação Celular , Condrogênese , Células-Tronco Mesenquimais , Osteogênese , Placenta , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Feminino , Placenta/metabolismo , Placenta/citologia , Diferenciação Celular/genética , Condrogênese/genética , Gravidez , Osteogênese/genética , Biomarcadores/metabolismo , Senescência Celular/genética , Condrócitos/metabolismo , Condrócitos/citologia , Envelhecimento , Lamina Tipo A/metabolismo , Lamina Tipo A/genética
2.
Phys Rev Lett ; 126(5): 053202, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33605768

RESUMO

Strong-field ionization of atoms by circularly polarized femtosecond laser pulses produces a donut-shaped electron momentum distribution. Within the dipole approximation this distribution is symmetric with respect to the polarization plane. The magnetic component of the light field is known to shift this distribution forward. Here, we show that this magnetic nondipole effect is not the only nondipole effect in strong-field ionization. We find that an electric nondipole effect arises that is due to the position dependence of the electric field and which can be understood in analogy to the Doppler effect. This electric nondipole effect manifests as an increase of the radius of the donut-shaped photoelectron momentum distribution for forward-directed momenta and as a decrease of this radius for backwards-directed electrons. We present experimental data showing this fingerprint of the electric nondipole effect and compare our findings with a classical model and quantum calculations.

3.
Phys Rev Lett ; 127(27): 273201, 2021 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-35061406

RESUMO

We present experimental data on the nonadiabatic strong field ionization of atomic hydrogen using elliptically polarized femtosecond laser pulses at a central wavelength of 390 nm. Our measured results are in very good agreement with a numerical solution of the time-dependent Schrödinger equation (TDSE). Experiment and TDSE show four above-threshold ionization peaks in the electron's energy spectrum. The most probable emission angle (also known as "attoclock offset angle" or "streaking angle") is found to increase with energy, a trend that is opposite to standard predictions based on Coulomb interaction with the ion. We show that this increase of deflection angle can be explained by a model that includes nonadiabatic corrections of the initial momentum distribution at the tunnel exit and nonadiabatic corrections of the tunnel exit position itself.

4.
Phys Rev Lett ; 121(16): 163202, 2018 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-30387676

RESUMO

We report on the nonadiabatic offset of the initial electron momentum distribution in the plane of polarization upon single ionization of argon by strong field tunneling and show how to experimentally control the degree of nonadiabaticity. Two-color counter- and corotating fields (390 and 780 nm) are compared to show that the nonadiabatic offset strongly depends on the temporal evolution of the laser electric field. We introduce a simple method for the direct access to the nonadiabatic offset using two-color counter- and corotating fields. Further, for a single-color circularly polarized field at 780 nm, we show that the radius of the experimentally observed donutlike distribution increases for increasing momentum in the light propagation direction. Our observed initial momentum offsets are well reproduced by the strong-field approximation. A mechanistic picture is introduced that links the measured nonadiabatic offset to the magnetic quantum number of virtually populated intermediate states.

5.
Neurology ; 90(19): e1692-e1701, 2018 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-29643084

RESUMO

OBJECTIVE: To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). METHODS: This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. RESULTS: We studied 219 patients (53% males) with a median (25th-75th percentiles [p25-p75]) age of 3.9 (1.2-9.5) years in whom rSE started out of hospital (141 [64.4%]) or in hospital (78 [35.6%]). The median (p25-p75) time from seizure onset to treatment was 16 (5-45) minutes to first benzodiazepine (BZD), 63 (33-146) minutes to first non-BZD antiepileptic drug (AED), and 170 (107-539) minutes to first continuous infusion. Factors associated with more delays to administration of the first BZD were intermittent rSE (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.14-2.09; p = 0.0467) and out-of-hospital rSE onset (HR 1.5, 95% CI 1.11-2.04; p = 0.0467). Factors associated with more delays to administration of the first non-BZD AED were intermittent rSE (HR 1.78, 95% CI 1.32-2.4; p = 0.001) and out-of-hospital rSE onset (HR 2.25, 95% CI 1.67-3.02; p < 0.0001). None of the studied factors were associated with a delayed administration of continuous infusion. CONCLUSION: Intermittent rSE and out-of-hospital rSE onset are independently associated with longer delays to administration of the first BZD and the first non-BZD AED in pediatric rSE. These factors identify potential targets for intervention to reduce time to treatment.


Assuntos
Anticonvulsivantes/uso terapêutico , Benzodiazepinas/uso terapêutico , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Estado Epiléptico/tratamento farmacológico , Tempo para o Tratamento , Adolescente , Criança , Pré-Escolar , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto Jovem
6.
Chem Commun (Camb) ; 54(8): 916-919, 2018 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-29318242

RESUMO

Bismuth(iii) TEMPOxide compounds have been synthesized from the coupling of Bi(ii) species with the TEMPO˙ radical. The steric profile of the supporting bis(amido)disiloxane ligand promotes different fluxional behaviour in solution, and DFT calculations suggest variation in the Bi-O bond character. These compounds are active catalysts for oxidative coupling of TEMPO and silane substrates, believed to proceed via metathesis of Bi-O and Si-H bonds followed by decomposition of bismuth-hydride intermediate species.

7.
Chem Commun (Camb) ; 54(5): 460-462, 2018 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-29215108

RESUMO

A rare terminal cadmium hydride complex [(BDI)CdH] (BDI = [{N(2,6-iPr2C6H3)C(Me)}2CH]) has been synthesised from [(BDI)CdCl] and LiEt3BH. The hydride can be reduced to the cadmium(i) dimer, [(BDI)CdCd(BDI)] upon treatment with a catalytic amount of diisopropyl- or dicyclohexylcarbodiimide.

8.
Seizure ; 40: 88-101, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27376911

RESUMO

Epilepsy affects almost 1% of the population and most of the approximately 20-30% of patients with refractory epilepsy have one or more seizures per month. Seizure detection devices allow an objective assessment of seizure frequency and a treatment tailored to the individual patient. A rapid recognition and treatment of seizures through closed-loop systems could potentially decrease morbidity and mortality in epilepsy. However, no single detection device can detect all seizure types. Therefore, the choice of a seizure detection device should consider the patient-specific seizure semiologies. This review of the literature evaluates seizure detection devices and their effectiveness for different seizure types. Our aim is to summarize current evidence, offer suggestions on how to select the most suitable seizure detection device for each patient and provide guidance to physicians, families and researchers when choosing or designing seizure detection devices. Further, this review will guide future prospective validation studies.


Assuntos
Monitorização Neurofisiológica/instrumentação , Monitorização Neurofisiológica/métodos , Convulsões/diagnóstico , Humanos , Convulsões/classificação
9.
Dalton Trans ; 43(47): 17746-53, 2014 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-25025874

RESUMO

Exciton coupling is investigated in a copper azadipyrrin complex, Cu(L-aza)2. Exciton coupling in Cu(L-aza)2 assuming a single π-π* state on the L-aza ligand fails to account for the electronic structure of Cu(L-aza)2, which displays two almost equal intensity transitions at 15 600 cm(-1) and 17 690 cm(-1). TD-UB3LYP/6-31G(d) calculations suggest multiple π-π* transitions for the L-aza ligands and simple vector addition of the transition dipoles predicts two nearly orthogonal co-planar excitonic transitions that correctly reproduce the absorption band profile. Empirical modelling of absolute resonance Raman intensities using wavepacket dynamics confirms Cu(L-aza)2 has two equal intensity orthogonal exciton transitions. The phenyl substituents at the α- and γ-positions of the pyrrole rings play a central role in determining the orientation of the transition dipoles. Consequently the π-π* transitions for the L-aza ligands are oriented towards the substituent groups and are not in the plane of the pyrrole rings. Mode displacements in the Franck-Condon (FC) region obtained from the wavepacket model suggest that pyrrole ring and phenyl modes control the exciton FC dynamics. Our results suggest that Cu(L-aza)2 is an ideal model for theoretical, computational and experimental investigations of molecular excitons in molecular systems.

10.
Opt Express ; 20(23): 25239-48, 2012 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-23187340

RESUMO

We report studies of high-order harmonic generation in laser-produced manganese plasmas using sub-4-fs drive laser pulses. The measured spectra exhibit resonant enhancement of a small spectral region of about 2.5 eV width around the 31st harmonic (~50eV). The intensity contrast relative to the directly adjacent harmonics exceeds one order of magnitude. This finding is in sharp contrast to the results reported previously for multi-cycle laser pulses [Physical Review A 76, 023831 (2007)]. Theoretical modelling suggests that the enhanced harmonic emission forms an isolated sub-femtosecond pulse.

11.
Br J Cancer ; 103(1): 18-28, 2010 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-20551952

RESUMO

BACKGROUND: Testicular germ cell tumour (TGCT) is the most common cause of death from solid tumours in young men and especially for platinum-refractory patients novel treatment approaches are urgently needed. Using an in silico screening approach for the detection of novel cancer drugs with inhibitory effects on the tyrosine kinase activity of growth factors (e.g., VEGFR, PDGFR), we identified two compounds (HP-2 and HP-14) with antiangiogenic and antiproliferative potency, which were evaluated in endothelial cell models and TGCT cells. RESULTS: HP-2 and HP-14 effectively inhibited the growth of VEGFR-2-expressing TGCT cell lines (Tera-1, Tera-2 and 2102EP) and endothelial cell models, while they failed to supress the growth of VEGFR-2-lacking tumour cells. cDNA-microarrays revealed an inhibition of the expression of several growth factor receptors and related signal transduction molecules. Vascular endothelial growth factor (VEGF)-induced cell migration was also potently inhibited. Cell cycle-regulating proteins such as p21 and p27 were upregulated, leading to an S-phase arrest. Additional in vivo evaluations confirmed the antiangiogenic potency and good tolerability of the novel substances. CONCLUSION: Our data show that the identified novel compounds inhibit the growth of TGCT cells and decrease angiogenic microvessel formation. The mode of action involves cell cycle arresting effects and changes in the expression pattern of several angiogenic genes. The novel compounds may qualify as new candidates for targeted treatment of TGCT and merit further evaluation.


Assuntos
Inibidores da Angiogênese/farmacologia , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Inibidores de Proteínas Quinases/farmacologia , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Neoplasias Testiculares/tratamento farmacológico , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , MAP Quinases Reguladas por Sinal Extracelular/antagonistas & inibidores , Perfilação da Expressão Gênica , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/patologia , Receptores de Fatores de Crescimento do Endotélio Vascular/genética , Neoplasias Testiculares/patologia
12.
Urologe A ; 49(1): 75-80, 2010 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-19830402

RESUMO

BACKGROUND: Guidelines are developed to improve the quality of patient care. The effect of German urologic guidelines has not been evaluated so far. Therefore, we aimed to systematically investigate the acceptance, use, and quality of the published guidelines from a user's perspective. METHODS: A link to an online questionnaire concerning use and barriers to the application of guidelines was distributed via e-mail by the German Society of Urology (DGU). German urologists' opinions on differences in national guideline quality were evaluated regarding prostate cancer (PCA), bladder cancer, germ cell tumors (GCT), renal cell carcinomas, and erectile dysfunction. RESULTS: Four hundred sixty-seven German urologists participated. More than 90% of the participants considered guidelines to be helpful. The Internet as the main tool for guideline distribution was favored by 28.4%, followed by publication in Urologe A. The main barrier to guideline usage was attributed to the lack of up-to date clinical data. Guidelines for GCT scored best in all quality categories and reached the highest level of use (65.8%), and 40.5% of participating urologists considered the additional establishment of comprehensive care centers for GCT as more effective for quality improvement than guideline development alone. For the other urologic tumors, especially PCA, guideline development was favored as a tool for quality improvement. CONCLUSION: More than 90% of participating urologists accept clinical guidelines as useful instruments in clinical practice and for therapeutic decisions. Our results should be integrated into guideline dissemination and implementation strategies in order to achieve a higher degree of treatment conformation to guidelines.


Assuntos
Atitude do Pessoal de Saúde , Fidelidade a Diretrizes/estatística & dados numéricos , Médicos/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Urologia/estatística & dados numéricos , Urologia/normas , Alemanha
13.
Aktuelle Urol ; 40(4): 221-30, 2009 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-19634072

RESUMO

The specificity of PSA has been enhanced by using molecular forms of PSA and free PSA (fPSA) such as percent free PSA (%fPSA), proPSA, intact PSA or BPHA and / or new serum markers. Most of these promising new serum markers like EPCA2 or ANXA3 still lack confirmation of the outstanding initial results or show only marginally enhanced specificity at high sensitivity levels. PCA3, TMPRSS2-ERG, and other analytes in urine collected after digital rectal examination with application of mild digital pressure have the potential to preferentially detect aggressive PCa and to decrease the number of unnecessary repeat biopsies. The combination of these new urinary markers with new and established serum markers seems to be most promising to further increase specificity of tPSA. Multivariate models, e. g., artificial neural networks (ANN) or logistic regression (LR) based nomograms have recently been performed by incorporating these new markers in several studies. There is generally an advantage to include the new markers and clinical data as additional parameters to PSA and %fPSA within ANN and LR models. Results of these studies and also unexpected pitfalls are discussed in this review.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias da Próstata/diagnóstico , Humanos , Calicreínas/análise , Masculino , Análise Multivariada , Valor Preditivo dos Testes , Antígeno Prostático Específico/análise , Neoplasias da Próstata/sangue
14.
Urologe A ; 48(8): 877-85, 2009 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-19517088

RESUMO

MicroRNAs (miRNAs) are non-coding RNAs that regulate basic cellular processes and are associated with cancer characteristics. The aim of this review is to summarize the principles of miRNA biogenesis and function and to describe their contribution to tumor development, especially in uro-oncology. Therefore a PubMed search was conducted. Up to March 2009 approximately 4,500 miRNA-related articles were cited in this database. Studies of miRNA expression and functional analyses prove their impact in carcinogenesis and their potential as diagnostic or prognostic markers or as novel therapeutic targets. Only a few miRNA-related studies have been published in uro-oncology so far. Although tumor-specific miRNA expression has been shown for urological neoplasms, the contradicting data show that miRNA research is still in its infancy in this field. A systematic elucidation of characteristic miRNA abnormalities could decisively improve diagnostics as well as therapy of urological tumors.


Assuntos
Perfilação da Expressão Gênica/métodos , MicroRNAs/genética , Proteínas de Neoplasias/genética , Publicações Periódicas como Assunto/estatística & dados numéricos , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/genética , Humanos
15.
Aktuelle Urol ; 40(1): 23-6, 2009 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-19177317

RESUMO

Laparoscopic surgery in urology has undergone a rapid development in the last decade. In general, many studies have underlined the benefits of laparoscopy in urology. The latest innovations in the field of minimally invasive urology are aimed at a further reduction of the morbidity associated with minimally invasive surgery. Two novel innovations are currently being developed, natural orifice transluminal endoscopic surgery (NOTES), whereby intraperitoneal access is gained through natural orifices and laparo-endoscopic single-site surgery (LESS), wherein one surgical access is used both for introducing instruments and for retrieving the specimen. Many case reports and small patient series have been published rapidly in the past two years. However, comparative randomised studies to conventional laparoscopy or open surgery do not yet exist. LESS and NOTES are two new innovative approaches, whereby feasibility studies not only for simple nephrectomy but also for complex procedures like partial nephrectomy, radical prostatectomy, ureterocystoneostomy have been published. In the next few years, comparative studies between these techniques and conventional laparoscopy can be expected.


Assuntos
Endoscopia/métodos , Laparoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos , Nefrectomia/métodos , Prostatectomia/métodos , Terminologia como Assunto , Procedimentos Cirúrgicos Urológicos , Animais , Humanos , Modelos Animais , Suínos , Ureter/transplante , Bexiga Urinária/cirurgia
16.
Aktuelle Urol ; 39(6): 429-35, 2008 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-18979397

RESUMO

This article offers a review about the current facts of chemotherapy in testicular cancer. Besides a short presentation of the guideline-standard therapy the authors deal with the question as to why testicular cancer shows an extraordinarily high chemosensibility compared to other tumours. Furthermore, the current data on alternative chemotherapies as well as of molecular, molecular-genetic and pharmacogenetic therapeutic concepts are explored. Data were obtained from researches in Medline of the Pubmed database.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Apoptose/efeitos dos fármacos , Cisplatino/administração & dosagem , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Neoplasias Testiculares/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Linhagem Celular Tumoral , Cisplatino/farmacocinética , Cisteína Endopeptidases/genética , Reparo do DNA/efeitos dos fármacos , Reparo do DNA/genética , Proteínas de Ligação a DNA/genética , Relação Dose-Resposta a Droga , Resistencia a Medicamentos Antineoplásicos/genética , Endonucleases/genética , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/genética , Neoplasias Embrionárias de Células Germinativas/mortalidade , Neoplasias Embrionárias de Células Germinativas/patologia , Polimorfismo Genético/genética , Guias de Prática Clínica como Assunto , Taxa de Sobrevida , Neoplasias Testiculares/genética , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/patologia , Proteína Supressora de Tumor p53/genética
17.
Phys Rev Lett ; 101(5): 053901, 2008 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-18764392

RESUMO

We report a new dynamic two-center interference effect in high-harmonic generation from H2, in which the attosecond nuclear motion of H2+ initiated at ionization causes interference to be observed at lower harmonic orders than would be the case for static nuclei. To enable this measurement we utilize a recently developed technique for probing the attosecond nuclear dynamics of small molecules. The experimental results are reproduced by a theoretical analysis based upon the strong-field approximation which incorporates the temporally dependent two-center interference term.

18.
Br J Cancer ; 99(6): 939-48, 2008 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-18781151

RESUMO

GOLPH2 is coding the 73-kDa type II Golgi membrane antigen GOLPH2/GP73. Upregulation of GOLPH2 mRNA has been recently reported in expression array analyses of prostate cancer. As GOLPH2 protein expression in prostate tissues is currently unknown, this study aimed at a comprehensive analysis of GOLPH2 protein in benign and malignant prostate lesions. Immunohistochemically detected GOLPH2 protein expression was compared with the basal cell marker p63 and the prostate cancer marker alpha-methylacyl-CoA racemase (AMACR) in 614 radical prostatectomy specimens. GOLPH2 exhibited a perinuclear Golgi-type staining pattern and was preferentially seen in prostatic gland epithelia. Using a semiquantitative staining intensity score, GOLPH2 expression was significantly higher in prostate cancer glands compared with normal glands (P<0.001). GOLPH2 protein was upregulated in 567 of 614 tumours (92.3%) and AMACR in 583 of 614 tumours (95%) (correlation coefficient 0.113, P = 0.005). Importantly, GOLPH2 immunohistochemistry exhibited a lower level of intratumoral heterogeneity (25 vs 45%). Further, GOLPH2 upregulation was detected in 26 of 31 (84%) AMACR-negative prostate cancer cases. These data clearly suggest GOLPH2 as an additional ancillary positive marker for tissue-based diagnosis of prostate cancer.


Assuntos
Adenocarcinoma/metabolismo , Biomarcadores Tumorais/metabolismo , Proteínas de Membrana/metabolismo , Neoplasias da Próstata/metabolismo , Adenocarcinoma/diagnóstico , Adenocarcinoma/secundário , Adulto , Idoso , Biomarcadores Tumorais/genética , Imunofluorescência , Complexo de Golgi/metabolismo , Humanos , Técnicas Imunoenzimáticas , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Prostatectomia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Racemases e Epimerases/genética , Racemases e Epimerases/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise Serial de Tecidos , Transativadores/genética , Transativadores/metabolismo , Fatores de Transcrição , Células Tumorais Cultivadas , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo , Regulação para Cima
19.
Urologe A ; 47(11): 1460-4, 2008 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-18813902

RESUMO

Neoadjuvant and adjuvant therapeutic strategies are widely employed for a variety of cancer entities. The basic aim and the potential benefit for the patient are to eradicate micrometastases, with the downside being side effects and overtreatment. Neoadjuvant and adjuvant hormone therapy for prostate cancer have been investigated in a number of clinical studies. Based on these studies, the following recommendations can be given: there is currently no indication for neoadjuvant therapy prior to radical prostatectomy. Adjuvant therapy using LHRH analogs for patients with lymph node-positive tumors following radical prostatectomy can be considered but should be weighed against early"biochemical progression triggered" treatment. For locally advanced tumors the same is true (bicalutamide): adjuvant treatment has shown an advantage in clinically progression-free survival; however, no systematic comparison is available with early"biochemical progression triggered" treatment. Before radiotherapy 2 months of neoadjuvant LHRH analog treatment has shown a survival advantage in patients with locally advanced tumors and a low risk of systemic spread (Gleason <7). For high-risk patients, long-term (2-3 years) adjuvant LHRH analog treatment is indicated.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Terapia Neoadjuvante , Prostatectomia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Antineoplásicos Hormonais/efeitos adversos , Quimioterapia Adjuvante , Terapia Combinada , Intervalo Livre de Doença , Diagnóstico Precoce , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Radioterapia Adjuvante , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Urologe A ; 47(6): 712-7, 2008 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-18379751

RESUMO

BACKGROUND: Fast-track surgery describes perioperative treatment concepts ensuring a faster postoperative convalescence phase. By using a multimodal fast-track concept in patients undergoing laparoscopic radical prostatectomy, we aimed to investigate the feasibility of this procedure after elective surgery and a possible discharge 3 days postoperatively. PATIENTS AND METHODS: Twenty-five patients per group were randomized for conventional or fast-track treatment, respectively. Perioperative data, early complications, possible hospital discharge, and readmission rate were analyzed. Before hospital discharge, all patients were interviewed about their evaluation of the received regimen and their overall satisfaction perioperatively. RESULTS: The mean postoperative hospital stay was 3.6 days in the fast-track group vs. 6.7 days in the conventional group (p<0.01). Overall complications were low but were significant between the two groups, with the fast-track procedure being more favorable. Readmission rate was also low but was not significant. Overall satisfaction was significantly higher in the fast-track group, whereas the subjective evaluation did not differ between the two regimens. CONCLUSIONS: Fast-track concepts are well transferable in laparoscopic radical prostatectomy settings. Patients receiving this procedure, as well as clinics offering it, may benefit from a suitable fast-track concept.


Assuntos
Laparoscopia/métodos , Prostatectomia/instrumentação , Prostatectomia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
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