Characterization of igneous terranes by zircon dating: implications for the UHP relicts occurrences and suture identification in the Central Rhodope, Northern Greece

One of the key for the understanding of an orogenic belt is the characterization of the terranes involved and the identification of the suture(s) separating crustal blocks: these are essential information for large-scale paleo-reconstructions. In addition, the structural relationships between the terranes involved in the collisional processes and the eventual UHP relicts may provide first order inputs to exhumation models of subducted rocks. The structure of the Rhodope Massif (northern Greece and southern Bulgaria) results from the stacking of high-grade nappes during a continental collision, which age is comprised between Latest-Jurassic and Early-Cenozoic. UHP and HP relicts, associated with oceanic and ultramafic material, suggest the presence of a dismembered suture zone within the massif. The location of this suture remains unclear; furthermore, up to now, the UHP and eclogitic localities represent isolated spots and no synthesis on their structural position within the massif has been proposed. The first aim of this work is to define the relationships between HP-UHP relicts, crustal blocks, shear zones and amphibolitic material. To achieve this objective, we characterized the accreted blocks in terms of protoliths ages of the orthogneisses mainly along two cross sections on the Greek part of the belt. Geochemical affinities of meta-igneous rocks served as a complementary tool for terrane characterization and geodynamic interpretation. Single-zircon Pb-Pb evaporation and zircon U-Pb SHRIMP dating of orthogneiss protoliths define two groups of intrusion-ages: Permo-Carboniferous and Late Jurassic-Early Cretaceous. Structurally, these two groups correspond to distinct units: the Late Jurassic gneissic complex overthrusts the one bearing the Permo-Carboniferous orthogneisses. Mylonites, eclogites, amphibolites of oceanic affinities, and UHP micaschists, mark a “melange” zone, intensively sheared towards the SW, which separates the two units. Thus, we interpret them as two distinct terranes, the Rhodope and Thracia terranes, separated by the Nestos suture. The correlation of our findings in northern Greece to the Bulgarian part of the Massif suggests a northern rooting of the Nestos Suture. This configuration results of the closure of a marginal oceanic basin of the Tethys system by a north-directed subduction. This interpretation is supported by the geochemical affinities of the orthogneisses: the Late-Jurassic igneous rocks formed by subduction-related magmatism, pprobably the same north-directed subduction that gave rise to the UHP metamorphism of the metasediments of the “melange” zone. It is noteworthy that the UHP-HP relicts seem to be restricted to the contact between the two terranes suggesting that the UHP relicts are exhumed only within the suture zone. Furthermore, the singularity of the suture suggests that the Late-Jurassic subduction explains the occurrence of UHP and eclogite relicts in the Central Rhodope despite the large age range previously attributed the UHP and/or HP stage.

Die Re-Definition der Wirklichkeit durch Motto-Events

Eine aktuelle Ausprägung der Veranstaltungslandschaft sind die so genannten Motto-Events, die die Inszenierung einer Anderswelt-Konstruktion einsetzen, um emotionale und kommunikatorische Ziele zu erreichen. Dabei werden themengebundene Entwürfe räumlich und inhaltlich in die lebensweltliche Wirklichkeit transportiert und auf diese Weise eine dynamische und integrative Scheinwelt erschaffen. In dieser konstruierten Welt können schließlich Abenteuer erlebt und heroische Taten begangen werden. Durch die reziproke Beeinflussung von Inszenierung und Handlung befinden sich die Akteure außerhalb der gesellschaftlichen Norm, sie erleben innerhalb der "gated community" der Motto-Veranstaltung eine re-definierte Wirklichkeit. Aus einer Kombination von aktiven und passiven Elementen werden homogene Klischees inszeniert, die durch ihren Bekanntheitsgrad eine hohe Anschlussfähigkeit der Teilnehmer garantieren. Die vorliegende Arbeit beschäftigt sich mit den Mechanismen, die diese re-definierte Wirklichkeit in Szene setzen. Dadurch wird es möglich, in einer zusammenfassenden Betrachtung die Rezeption verschiedener Event-Modelle zu beschreiben und Handlungsempfehlungen zu geben.

Partial melting within the lower crust – Constraints from bulk rock geochemical data and trace element mineral analyses of granulites and migmatites from Central Finland

This PhD thesis concerns geochemical constraints on recycling and partial melting of Archean continental crust. A natural example of such processes was found in the Iisalmi area of Central Finland. The rocks from this area are Middle to Late Archean in age and experienced metamorphism and partial melting between 2.7-2.63 Ga. The work is based on extensive field work. It is furthermore founded on bulk rock geochemical data as well as in-situ analyses of minerals. All geochemical data were obtained at the Institute of Geosciences, University of Mainz using X-ray fluorescence, solution ICP-MS and laser ablation-ICP-MS for bulk rock geochemical analyses. Mineral analyses were accomplished by electron microprobe and laser ablation ICP-MS. Fluid inclusions were studied by microscope on a heating-freezing-stage at the Geoscience Center, University Göttingen. Part I focuses on the development of a new analytical method for bulk rock trace element determination by laser ablation-ICP-MS using homogeneous glasses fused from rock powder on an Iridium strip heater. This method is applicable for mafic rock samples whose melts have low viscosities and homogenize quickly at temperatures of ~1200°C. Highly viscous melts of felsic samples prevent melting and homogenization at comparable temperatures. Fusion of felsic samples can be enabled by addition of MgO to the rock powder and adjustment of melting temperature and melting duration to the rock composition. Advantages of the fusion method are low detection limits compared to XRF analyses and avoidance of wet-chemical processing and use of strong acids as in solution ICP-MS as well as smaller sample volumes compared to the other methods. Part II of the thesis uses bulk rock geochemical data and results from fluid inclusion studies for discrimination of melting processes observed in different rock types. Fluid inclusion studies demonstrate a major change in fluid composition from CO2-dominated fluids in granulites to aqueous fluids in TTG gneisses and amphibolites. Partial melts were generated in the dry, CO2-rich environment by dehydration melting reactions of amphibole which in addition to tonalitic melts produced the anhydrous mineral assemblages of granulites (grt + cpx + pl ± amph or opx + cpx + pl + amph). Trace element modeling showed that mafic granulites are residues of 10-30 % melt extraction from amphibolitic precursor rocks. The maximum degree of melting in intermediate granulites was ~10 % as inferred from modal abundances of amphibole, clinopyroxene and orthopyroxene. Carbonic inclusions are absent in upper-amphibolite facies migmatites whereas aqueous inclusion with up to 20 wt% NaCl are abundant. This suggests that melting within TTG gneisses and amphibolites took place in the presence of an aqueous fluid phase that enabled melting at the wet solidus at temperatures of 700-750°C. The strong disruption of pre-metamorphic structures in some outcrops suggests that the maximum amount of melt in TTG gneisses was ~25 vol%. The presence of leucosomes in all rock types is taken as the principle evidence for melt formation. However, mineralogical appearance as well as major and trace element composition of many leucosomes imply that leucosomes seldom represent frozen in-situ melts. They are better considered as remnants of the melt channel network, e.g. ways on which melts escaped from the system. Part III of the thesis describes how analyses of minerals from a specific rock type (granulite) can be used to determine partition coefficients between different minerals and between minerals and melt suitable for lower crustal conditions. The trace element analyses by laser ablation-ICP-MS show coherent distribution among the principal mineral phases independent of rock composition. REE contents in amphibole are about 3 times higher than REE contents in clinopyroxene from the same sample. This consistency has to be taken into consideration in models of lower crustal melting where amphibole is replaced by clinopyroxene in the course of melting. A lack of equilibrium is observed between matrix clinopyroxene / amphibole and garnet porphyroblasts which suggests a late stage growth of garnet and slow diffusion and equilibration of the REE during metamorphism. The data provide a first set of distribution coefficients of the transition metals (Sc, V, Cr, Ni) in the lower crust. In addition, analyses of ilmenite and apatite demonstrate the strong influence of accessory phases on trace element distribution. Apatite contains high amounts of REE and Sr while ilmenite incorporates about 20-30 times higher amounts of Nb and Ta than amphibole. Furthermore, trace element mineral analyses provide evidence for magmatic processes such as melt depletion, melt segregation, accumulation and fractionation as well as metasomatism having operated in this high-grade anatectic area.

Identificazione di fattori trascrizionali associati al differenziamento neurale in cellule di sarcoma di Ewing: ruolo di NF-kB

Il sarcoma di Ewing (ES) è un tumore maligno pediatrico dell’apparato scheletrico; è associato a una traslocazione specifica codificante la proteina di fusione EWS-FLI1 e all’alta espressione di CD99, una glicoproteina di membrana fisiologicamente coinvolta in diversi processi biologici. EWS-FLI1 e CD99, sono riportati avere ruoli divergenti nella modulazione della malignità e del differenziamento di ES. CD99 inoltre è riportato modulare il pathway di MAPK, il quale interagendo con molteplici fattori di trascrizione partecipa a processi di proliferazione e differenziamento. In questo studio abbiamo investigato in due linee cellulari di ES silenziate per CD99 (TC-71shCD99 e IOR/CARshCD99) l’attività basale di diversi fattori trascrizionali quali: NF-kBp65, AP1, Elk-1, E2F e CREB. L’unico fattore trascrizionale statisticamente significativo è risultato essere NF-kBp65 e abbiamo valutato il suo ruolo nel differenziamento neurale di cellule di ES e la relazione con EWS-FLI1 e CD99. L’attività trascrizionale di NF-kB è stata valutata attraverso gene reporter assay in linee cellulari di ES a diversa espressione di CD99, EWS-FLI1 e NF-kB stesso. Il differenziamento neurale è stato valutato come espressione di βIII-Tubulin in immunofluorescenza. Il silenziamento di CD99 induce una down-modulazione dell’attività trascrizionale di NF-kB, mentre il knockdown di EWS-FLI1 ne induce un’aumento. Inoltre, il silenziamento di EWS-FLI1 non è in grado di contrastare la riduzione dell’attività di NF-kB osservata dopo silenziamento di CD99, suggerendo un ruolo dominante del CD99 nel signaling di NF-kB. Cellule deprivate di CD99 ma non di EWS-FLI1, mostrano un fenotipo differenziato in senso neurale, fenotipo che viene perso quando le cellule sono indotte a sovraesprimere NF-kB. Inoltre, in cellule CD99 positive, il silenziamento di NF-kB induce un leggero differenziamento neurale. In conclusione, questi dati hanno evidenziato il ruolo di NF-kB nel differenziamento di cellule di ES e che potrebbe essere un potenziale target nel ridurre la progressione di questo tumore.

UHP metamorphic rocks of the Eastern Rhodope Massif, NE Greece: new constraints from petrology, geochemistry and zircon ages

In this PhD thesis, a multidisciplinary study has been carried out on metagranitoids and paragneisses from the Eastern Rhodope Massif, northern Greece, to decipher the pre-Alpine magmatic and geodynamic evolution of the Rhodope Massif and to correlate the eastern part with the western/central parts of the orogen. The Rhodope Massif, which occupies the major part of NE Greece and S Bulgaria, represents the easternmost part of the Internal Hellenides. It is regarded as a nappe stack of high-grade units, which is classically subdivided into an upper unit and a lower unit, separated by a SSE-NNW trending thrust plane, the Nestos thrust. Recent research in the central Greek Rhodope Massif revealed that the two units correspond to two distinct terranes of different age, the Permo-Carboniferous Thracia Terrane, which was overthrusted by the Late Jurassic/Early Cretaceous Rhodope Terrane. These terranes are separated by the Nestos suture, a composite zone comprising metapelites, metabasites, metagranitoids and marbles, which record high-pressure and even ultrahigh-pressure metamorphism in places. Similar characteristic rock associations were investigated during this study along several well-constrained cross sections in vincity to the Ada, Sidiro and Kimi villages in the Greek Eastern Rhodope Massif. Field evidence revealed that the contact zone of the two terranes in the Eastern Rhodope Massif is characterized by a mélange of metapelites, migmatitic amphibolites/eclogites, strongly sheared orthogneisses and marbles. The systematical occurrence of this characteristic rock association between the terranes implies that the Nestos suture is a continuous belt throughout the Greek Rhodope Massif. In this study, a new UHP locality could be established and for the first time in the Greek Rhodope, metamorphic microdiamonds were identified in situ in their host zircons using Laser-Raman spectroscopy. The presence of the diamonds as well as element distribution patterns of the zircons, obtained by TOF-SIMS, indicate metamorphic conditions of T > 1000 °C and P > 4 GPa. The high-pressure and ultrahigh-pressure rocks of the mélange zone are considered to have formed during the subduction of the Nestos Ocean in Jurassic times at ~150 Ma. Melting of metapelitic rocks at UHP conditions facilitated the exhumation to lower crustal levels. To identify major crust forming events, basement granitoids were dated by LA-SF-ICPMS and SHRIMP-II U-Pb analyses of zircons. The geochronological results revealed that the Eastern Rhodope Massif consists of two crustal units, a structurally lower Permo-Carboniferous unit corresponding to the Thracia Terrane and a structurally upper Late Jurassic/Early Cretaceous unit corresponding to the Rhodope Terrane, like it was documented for the Central Rhodope Massif. Inherited zircons in the orthogneisses from the Thracia Terrane of the Eastern Rhodope Massif indicate the presence of a pre-existing Neoproterozoic and Ordovician-Silurian basement in this region. Triassic magmatism is witnessed by the zircons of few orthogneisses from the easternmost Rhodope Massif and is interpreted to be related to rifting processes. Whole-rock major and trace element analyses indicate that the metagranitoids from both terranes originated in a subduction-related magmatic-arc environment. The Sr-Nd isotope data for both terranes of the Eastern and Central Rhodope Massif suggest a mixed crust-mantle source with variable contributions of older crustal material as already indicated by the presence of inherited zircons. Geochemical and isotopic similarity of the basement of the Thracia Terrane and the Pelagonian Zone implies that the Thracia Terrane is a fragment of a formerly unique Permo-Carboniferous basement, separated by rifting and opening of the Meliata-Maliac ocean system in Triassic times. A branch of the Meliata-Maliac ocean system, the Nestos Ocean, subducted northwards in Late Jurassic times leading to the formation of the Late Jurassic/Early Cretaceous Rhodope magmatic arc on remnants of the Thracia Terrane as suggested by inherited Permo-Carboniferous zircons. The ~150 Ma zircon ages of the orthogneisses from the Rhodope Terrane indicate that subduction-related magmatism and HP/UHP metamorphism occurred during the same subduction phase. Subduction ceased due to the closure of the Nestos Ocean in the Late Jurassic/Early Cretaceous. The post-Jurassic evolution of the Rhodope Massif is characterized by the exhumation of the Rhodope core complex in the course of extensional tectonics associated with late granite intrusions in Eocene to Miocene times.

Entwicklung des Emirates Qatar : Strategien - Probleme - Erfolge

Qatar boomt. Da es hierzu keine ganzheitlichen Forschungsarbeiten gibt, werden in dieser Arbeit die neuesten Entwicklungen und Planungen mit hoher Aktualität und Praxisrelevanz erstmals erfasst und analysiert. Der Autor führt Informationssplitter von internationalen Organisationen und eigene Recherchen in ein ganzheitliches Bild zusammen. Qatar ist sich bewusst, dass Wachstum endlich sein kann. Welche Möglichkeiten hat das kleine Qatar von der Globalisierung zu profitieren und für sich Vorteile für die Zukunft nach dem Öl zu generieren? Der Fokus der Arbeit liegt auf den ökonomische und ökologischen Stellschrauben der Transformation unter wirtschaftsgeographischen, soziodemographischen und strategischen Gesichtspunkten mit lokalen, regionalen und internationalen Betrachtungsweisen in den Themenfeldern (Welt-) Wirtschaft, Bildung, Infrastruktur und Umwelt. Ausgewählte Faktorungleichgewichte werden in Bezug auf Aussenwirtschaft und Binnenwirtschaft erläutert sowie die Nutzung von korankonformen Finanzierungsinstrumenten und Direktinvestitionen von und in Qatar.rnrnKeywords: Qatar / Katar / Peak-Oil / Emirat / FDI / Qatarisches Modell / Masterplan / Wohlfahrtsmehrung / Disparität / Nachhaltigkeit / Islamic Banking / Agglomeration / Akkumulation / Globalisierung / Arabische Halbinsel / Persischer Golf / Faktor- Gleichgewichte / Doha / Aluminium / LNG / Gas / best practicern

Valutazione del coinvolgimento dell'oncogene c-myc e dei trasportatori abc nella farmacoresistenza dell'osteosarcoma ad alto grado

L’insorgenza di fenomeni coinvolti nello sviluppo della farmacoresistenza costituisce al momento la principale causa di mancata risposta al trattamento chemioterapico nell’osteosarcoma. Questo è in parte dovuto ad una sovraespressione di diversi trasportatori ABC nelle cellule tumorali che causano un aumento dell’efflusso extracellulare del chemioterapico e pertanto una ridotta risposta al trattamento farmacologico. L'oncogene C-MYC è coinvolto nella resistenza al metothrexate, alla doxorubicina e al cisplatino ed è un fattore prognostico avverso, se sovraespresso al momento della diagnosi, in pazienti affetti da osteosarcoma. C-MYC è in grado di regolare l'espressione di diversi trasportatori ABC, probabilmente coinvolti nella resistenza ai farmaci nell’osteosarcoma, e questo potrebbe spiegare l’impatto prognostico avverso dell’oncogene in questo tumore. L’espressione genica di C-MYC e di 16 trasportatori ABC, regolati da C-MYC e / o responsabili dell'efflusso di diversi chemioterapici, è stata valutata su due diverse casistiche cliniche e su un pannello di linee cellulari di osteosarcoma umano mediante real-time PCR. L'espressione della proteina è stata valutata per i 9 trasportatori ABC risultati più rilevanti.Infine l'efficacia in vitro di un inibitore, specifico per ABCB1 e ABCC1, è stata valutata su linee cellulari di osteosarcoma. ABCB1 e ABCC1 sono i trasportatori più espressi nelle linee cellulari di osteosarcoma. ABCB1 è sovraespresso al momento della diagnosi in circa il 40-45% dei pazienti affetti da osteosarcoma e si conferma essere un fattore prognostico avverso se sovraespresso al momento della diagnosi. Pertanto ABCB1 diventa il bersaglio di elezione per lo sviluppo di strategie terapeutiche alternative, nel trattamento dell’osteosarcoma, atte al superamento della farmacoresistenza. L’inibizione dell'attività di tale trasportatore causa un aumento della sensibilità al trattamento chemioterapico nelle linee cellulari di osteosarcoma farmacoresistenti, indicando questo approccio come una possibile strategia per superare il problema della mancata risposta al trattamento farmacologico nei pazienti con osteosarcoma che sovraesprimono ABCB1.

Granulite facies metamorphism and partial melting processes in the Ivrea Zone, Northern Italy

The Ivrea Zone in northern Italy has been the focus of numerous petrological, geochemical and structural studies. It is commonly inferred to represent an almost complete section through the mid to lower continental crust, in which metamorphism and partial melting of the abundant metapelites was the result of magmatic underplating by a large volume of mantle-derived magma. This study concerns amphibolite and granulite facies metamorphism in the Ivrea Zone with focus on metapelites and metapsammites/metagreywackes from Val Strona di Omegna and metapelites from Val Sesia and Val Strona di Postua, with the aim to better constrain their metamorphic evolution as well as their pressure and temperature conditions via phase equilibria modelling.rnrnIn Val Strona di Omegna, the metapelites show a structural and mineralogical change from mica-schists with the common assemblage bi-mu-sill-pl-q-ilm ± liq at the lowest grades, through metatexitic migmatites (g-sill-bi-ksp-pl-q-ilm-liq) at intermediate grades, to complex diatexitic migmatites (g-sill-ru-bi-ksp-pl-q-ilm-liq) at the highest grades. Within this section several mappable isograds occur, including the first appearance of K-feldspar in the metapelites, the first appearance of orthopyroxene in the metabasites and the disappearance of prograde biotite from the metapelites. The inferred onset of partial melting in the metapelites occurs around Massiola. The prograde suprasolidus evolution of the metapelites is consistent with melting via the breakdown of first muscovite then biotite. Maximum modelled melt fractions of 30–40 % are predicted at the highest grade. The regional metamorphic field gradient in Val Strona di Omegna is constrained to range from conditions of 3.5–6.5 kbar at T = 650–730 °C to P > 9 kbar at T > 900 °C. The peak P–T estimates, particularly for granulite facies conditions, are significantly higher (around 100 °C) than those of most previous studies. In Val Sesia and Val Strona di Postua to the south the exposure is more restricted. P–T estimates for the metapelites are 750–850 °C and 5–6.5 kbar in Val Sesia and approximately 800–900 °C and 5.5–7 kbar in Val Strona di Postua. These results show similar temperatures but lower pressure than metapelites in Val Strona di Omegna. Metapelites in Val Sesia in contact with the Mafic Complex exhibit a metatexitic structure, while in Val Strona di Postua diatexitic structures occur. Further, metapelites at the contact with the Mafic Complex contain cordierite (± spinel) that overprint the regional metamorphic assemblages and are interpreted to have formed during contact metamorphism related to intrusion of the Mafic Complex. The lower pressures in the high-grade rocks in Val Sesia and Val Strona di Postua are consistent with some decompression from the regional metamorphic peak prior to the intrusion of the Mafic Complex, suggesting the rocks followed a clockwise P–T path. In contrast, the metapelites in Val Strona di Omegna, especially in the granulite facies, do not contain any cordierite or any evidence for a contact metamorphic overprint. The extrapolated granulite facies mineral isograds are cut by the rocks of the Mafic Complex to the south. Therefore, the Mafic Complex cannot have caused the regional metamorphism and it is unlikely that the Mafic Complex occurs in Val Strona di Omegna.

The "Orthoplastic" combined surgical approach to open tibia fractures: a multicentric prospective outcome study

Introduction: Open fractures of the leg represent a severe trauma. The combined approach, shared between plastic and orthopaedic surgeons, is considered to be important, although this multidisciplinary treatment is not routinely performed. Aim of this study was to verify whether the orthoplastic treatment is of any advantage over the traditional simply orthopedic treatment, through a multicentric inclusion of these unfrequent injuries into a prospective study. Material and methods: The following trauma centres were involved: Rizzoli Orthopaedic Institute/University of Bologna (leading centre) and Maggiore Hospital (Bologna, Italy), Frenchay Hospital (Bristol, United Kingdom), Jinnah Hospital (Lahore, Pakistan). All patients consecutively hospitalized in the mentioned centres between January 2012 and December 2013 due to tibial open fractures were included in the study and prospectively followed up to December 2014. Demographics and other clinical features were recorded, including the type of treatment (orthopaedic or orthoplastic). The considered outcome measures included duration of hospitalization, time for bone union and soft tissue closure, Enneking score at 3, 6 and 12 months, the incidence of osteomyelitis and other complications. Results: A total of 164 patients were included in the study. Out of them 68% were treated with an orthoplastic approach, whereas 32% received a purely orthopedic treatment. All considered outcome measures showed to be improved by the orthoplastic approach, compared to the orthopaedic one: time for soft tissue closure (2 versus 25 weeks), duration of hospital stay (22 versus 55 days), time for bone union (6 versus 8.5 months) , number of additional operations (0.6 versus 1.2) and functional recovery of the limb at 12 months (27 versus 19, Enneking’s score). All results were statistically significant. Conclusion: The combined orthoplastic approach to the treatment of open tibia fractures, in particular for high grade injuries (Gustilo 3B), is proven to improve the outcome of these severe injuries.

Nuovi protocolli chemioterapici per i sarcomi dei tessuti molli ad alto grado di malignita' negli adulti: Risultati clinici, radiologici e istologici comparando chemioterapia standard e orientata sull'isotopo

I sarcomi dei tessuti molli sono un gruppo eterogeneo di tumori maligni di origine mesenchimale che si sviluppa nel tessuto connettivo. Il controllo locale mediante escissione chirurgica con margini ampi associato alla radioterapia e chemioterapia è il trattamento di scelta. Negli ultimi anni le nuove scoperte in campo biologico e clinico hanno sottolineato che i diversi istotipi posso essere considerati come entità distinte con differente sensibilità alla chemioterapia pertanto questa deve essere somministrata come trattamento specifico basato sull’istologia. Tra Ottobre 2011 e Settembre 2014 sono stati inclusi nel protocollo di studio 49 pazienti con sarcomi dei tessuti molli di età media alla diagnosi 48 anni (range: 20 - 68 anni). I tumori primitivi più frequenti sono: liposarcoma mixoide, sarcoma pleomorfo indifferenziato, sarcoma sinoviale. Le sedi di insorgenza del tumore erano più frequentemente la coscia, il braccio e la gamba. 35 pazienti sono stati arruolati nel Braccio A e trattati con chemioterapia standard con epirubicina+ifosfamide, 14 sono stati arruolati nel Braccio B e trattati con chemioterapia basata sull’istotipo. I dati emersi da questo studio suggeriscono che le recidive locali sembrano essere correlate favorevolmente alla radioterapia ed ai margini chirurgici adeguati mentre la chemioterapia non sembra avere un ruolo sul controllo locale della malattia. Anche se l'uso di terapie mirate, che hanno profili di tossicità più favorevoli e sono quindi meglio tollerate rispetto ai farmaci citotossici è promettente, tali farmaci hanno prodotto finora risultati limitati. Apparentemente l’insieme delle terapie mirate non sembra funzionare meglio delle terapie standard, tuttavia esse devono essere esaminate per singolo istotipo e confrontate con il braccio di controllo. Sono necessari studi randomizzati controllati su ampie casistiche per valutare l’efficacia delle terapie mirate sui differenti istotipi di sarcomi dei tessuti molli. Inoltre, nuovi farmaci, nuove combinazioni e nuovi schemi posologici dovranno essere esaminati per ottimizzare la terapia.

Konzept eines aktiven Pulverinhalators

In dieser Arbeit wird das Konzept eines aktiven Pulverinhalators entwickelt. Im Gegensatz zu einem passiven Pulverinhalator ist bei solch einem Gerät die Abgabe und Dispergierung der Arzneistoffformulierung nicht von einem Inhalationsmanöver abhängig, welches von Patient zu Patient variiert. Solch ein System würde folglich die Zuverlässigkeit und Effizienz der inhalativen Therapie verbessern. Mögliche Anwendungen für einen aktiven Pulverinhalator wären vor allem Indikationen, die die Abgabe hoher Dosen erfordern, wie z.B. in der Therapie mit Antibiotika.rnIn einem Designprozess, der alle aus Kundenwünschen ermittelten Konstruktionsanforderungen sammelt und verschiedene Lösungsansätze vergleicht, wird ein mit Treibgas betriebener atemzugsausgelöster, Mehrfach-Dosis Pulverinhalator als aussichtsreichstes Konzept ermittelt. Dieses Konzept wird in Form von eigens konstruierten Labor-Test-Rigs entwickelt und vor allem hinsichtlich Höhe der Dosierung, Dosiergenauigkeit, und Flussratenabhängigkeit evaluiert. In der Spitze können über 16 mg lungengängiger Dosis erreicht werden, bei im Vergleich zu dem eingesetzten passiven Inhalator mindestens nur halb so großer Streuung. Bei niedrigen Flussraten können immer noch bis zu 80 % der erzielten inhalierbaren Dosis von hohen Flussraten erreicht werden und damit die Ergebnisse des passiven Inhalators deutlich übertreffen.rnTeil der Aufgabe war es, dieses treibgasbetriebene Labor-Test-Rig so zu entwickeln, dass es implementierbar in einen atemzugsausgelösten Mehrfachdosis-Pulverinhalator ist. Dieser treibgasbetriebene, atemzugsausgelöste Mehrfachdosis-Pulverinhalator würde die Kundenwünsche und Konstruktionsanforderungen in sehr hohen Maße erfüllen, so dass hier die Möglichkeit besteht einen Inhalator mit sehr hohem Grad an Patienten-Compliance zu verwirklichen. Durch die Verwendung und Neukombination bereits etablierter Technologien und einen akzeptablen Stückkostenpreis besteht die Möglichkeit den Inhalator tatsächlich zu realisieren und zu vermarkten.

The pharmacokinetics and safety of porfimer after repeated administration 30-45 days apart to patients undergoing photodynamic therapy

Porfimer is an intravenous (i.v.) injectable photosensitizing agent used in the photodynamic treatment of tumours and of high-grade dysplasia in Barrett's oesophagus.

Intratumoral budding as a potential parameter of tumor progression in mismatch repair-proficient and mismatch repair-deficient colorectal cancer patients

In colorectal cancer, tumor budding at the invasive front (peritumoral budding) is an established prognostic parameter and decreased in mismatch repair-deficient tumors. In contrast, the clinical relevance of tumor budding within the tumor center (intratumoral budding) is not yet known. The aim of the study was to determine the correlation of intratumoral budding with peritumoral budding and mismatch repair status and the prognostic impact of intratumoral budding using 2 independent patient cohorts. Following pancytokeratin staining of whole-tissue sections and multiple-punch tissue microarrays, 2 independent cohorts (group 1: n = 289; group 2: n = 222) with known mismatch repair status were investigated for intratumoral budding and peritumoral budding. In group 1, intratumoral budding was strongly correlated to peritumoral budding (r = 0.64; P < .001) and less frequent in mismatch repair-deficient versus mismatch repair-proficient cases (P = .177). Sensitivity and specificity for lymph node positivity were 72.7% and 72.1%. In mismatch repair-proficient cancers, high-grade intratumoral budding was associated with right-sided location (P = .024), advanced T stage (P = .001) and N stage pN (P < .001), vascular invasion (P = .041), infiltrating tumor margin (P = .003), and shorter survival time (P = .014). In mismatch repair-deficient cancers, high intratumoral budding was linked to higher tumor grade (P = .004), vascular invasion (P = .009), infiltrating tumor margin (P = .005), and more unfavorable survival time (P = .09). These associations were confirmed in group 2. High-grade intratumoral budding was a poor prognostic factor in univariate (P < .001) and multivariable analyses (P = .019) adjusting for T stage, N stage distant metastasis, and adjuvant therapy. These preliminary results on 511 patients show that intratumoral budding is an independent prognostic factor, supporting the future investigation of intratumoral budding in larger series of both preoperative and postoperative rectal and colon cancer specimens.

Appendiceal mucocele in an elderly patient: how much surgery?

Appendiceal mucoceles are rare cystic lesions with an incidence of 0.3-0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary - depending on the level of complication - from right lower quadrant pain, signs of intussusception, gastrointestinal bleeding to an acute abdomen with sepsis, most mucoceles are asymptomatic and found incidentally. We present the case of a 70-year-old patient with an incidentally found appendiceal mucocele. He was seen at the hospital for backache. The CT scan showed a vertebral fracture and a 7-cm appendiceal mass. A preoperative colonoscopy displayed several synchronous adenomas in the transverse and left colon with high-grade dysplasia. In order to lower the cancer risk of this patient, we performed a subtotal colectomy. The appendiceal mass showed no histopathological evidence of malignancy and no sign of perforation. The follow-up was therefore limited to 2 months. In this case, appendectomy would have been sufficient to treat the mucocele alone. The synchronous high-grade dysplastic adenomas were detected in the preoperative colonoscopy and determined the therapeutic approach. Generally, in the presence of positive lymph nodes, a right colectomy is the treatment of choice. In the histological presence of mucinous peritoneal carcinomatosis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is indicated. In conclusion, mucoceles of the appendix are detected with high sensitivity by CT scan. If there is no evidence of synchronous tumor preoperatively and no peritoneal spillage, invasion or positive sentinel lymph nodes during surgery, a mucocele is adequately treated by appendectomy.

Evidence Based Development of a Novel Lateral Fibula Plate (VariAx Fibula) Using a Real CT Bone Data Based Optimization Process During Device Development

Development of novel implants in orthopaedic trauma surgery is based on limited datasets of cadaver trials or artificial bone models. A method has been developed whereby implants can be constructed in an evidence based method founded on a large anatomic database consisting of more than 2.000 datasets of bones extracted from CT scans. The aim of this study was the development and clinical application of an anatomically pre-contoured plate for the treatment of distal fibular fractures based on the anatomical database. 48 Caucasian and Asian bone models (left and right) from the database were used for the preliminary optimization process and validation of the fibula plate. The implant was constructed to fit bilaterally in a lateral position of the fibula. Then a biomechanical comparison of the designed implant to the current gold standard in the treatment of distal fibular fractures (locking 1/3 tubular plate) was conducted. Finally, a clinical surveillance study to evaluate the grade of implant fit achieved was performed. The results showed that with a virtual anatomic database it was possible to design a fibula plate with an optimized fit for a large proportion of the population. Biomechanical testing showed the novel fibula plate to be superior to 1/3 tubular plates in 4-point bending tests. The clinical application showed a very high degree of primary implant fit. Only in a small minority of cases further intra-operative implant bending was necessary. Therefore, the goal to develop an implant for the treatment of distal fibular fractures based on the evidence of a large anatomical database could be attained. Biomechanical testing showed good results regarding the stability and the clinical application confirmed the high grade of anatomical fit.