Determination of the molecular subtypes of diffuse large B-cell lymphomas using immunohistochemistry: a case series from the Inselspital, Bern, and a critical appraisal of this determination in Switzerland

The two major subtypes of diffuse large B-cell lymphoma (DLBCL) (germinal centre B-cell - like (GCB-DLBCL) and activated B-cell - like (ABC-DLBCL)) are defined by means of gene expression profiling (GEP). Patients with GCB-DLBCL survive longer with the current standard regimen R-CHOP than patients with ABC-DLBCL. As GEP is not part of the current routine diagnostic work-up, efforts have been made to find a substitute than involves immunohistochemistry (IHC). Various algorithms achieved this with 80-90% accuracy. However, conflicting results on the appropriateness of IHC have been reported. Because it is likely that the molecular subtypes will play a role in future clinical practice, we assessed the determination of the molecular DLBCL subtypes by means of IHC at our University Hospital, and some aspects of this determination elsewhere in Switzerland. The most frequently used Hans algorithm includes three antibodies (against CD10, bcl-6 and MUM1). From records of the routine diagnostic work-up, we identified 51 of 172 (29.7%) newly diagnosed and treated DLBCL cases from 2005 until 2010 with an assigned DLBCL subtype. DLBCL subtype information was expanded by means of tissue microarray analysis. The outcome for patients with the GCB subtype was significantly better compared with those with the non-GC subtype, independent of the age-adjusted International Prognostic Index. We found a lack of standardisation in the subtype determination by means of IHC in Switzerland and significant problems of reproducibility. We conclude that the Hans algorithm performs well in our hands and that awareness of this important matter is increasing. However, outside clinical trials, vigorous efforts to standardise IHC determination are needed as DLBCL subtype-specific therapies emerge.

Net CO 2 surface emissions at Bern, Switzerland inferred from ambient observations of CO 2 , δ(O 2 /N 2 ), and 222 Rn using a customized radon tracer inversion

The 222Radon tracer method is a powerful tool to estimate local and regional surface emissions of, e.g., greenhouse gases. In this paper we demonstrate that in practice, the method as it is commonly used, produces inaccurate results in case of nonhomogeneously spread emission sources, and we propose a different approach to account for this. We have applied the new methodology to ambient observations of CO2 and 222Radon to estimate CO2 surface emissions for the city of Bern, Switzerland. Furthermore, by utilizing combined measurements of CO2 and δ(O2/N2) we obtain valuable information about the spatial and temporal variability of the main emission sources. Mean net CO2 emissions based on 2 years of observations are estimated at (11.2 ± 2.9) kt km−2 a−1. Oxidative ratios indicate a significant influence from the regional biosphere in summer/spring and fossil fuel combustion processes in winter/autumn. Our data indicate that the emissions from fossil fuels are, to a large degree, related to the combustion of natural gas which is used for heating purposes.

Tastend von Gott reden : drei systematisch-theologische Antrittsvorlesungen aus Bern

Nach Gott tasten ist die Grundbewegung, die die drei in diesem Band versammelten Vorlesungen verknüpft und für die Paul Klees «Engel, noch tastend» zum hermeneutischen Leitbild wird. Torsten Meireis, inspiriert durch Karl Barth, reflektiert inmitten religiöser und weltanschaulicher Pluralität ein moralisches Verhalten, das dem Handeln des in Jesus Christus offenbaren Gottes entspricht. Wegweisend wird ihm dabei ein dreifacher Begriff des Guten: unverfügbares, intendiertes und realisiertes Gutes. Um angesichts des Sinnverlustes religiöser Rede dennoch nicht von Gott zu schweigen, plädiert Andreas Krebs, angeregt durch Ludwig Wittgensteins Spätphilosophie, für ein «halbes Sagen, halbes Verstehen», das sich in der Nähe zur Sprache der Poesie weiss – eine Gottesrede, die sich ihrer selbst nicht mehr sicher ist und gerade so Gott Gewicht zu geben sucht. Als Baustein einer um den Eigennamen kreisenden Eschatologie entwirft Magdalene L. Frettlöh die Hoffnung auf eine als neuschöpferischen göttlichen Namensruf an die Toten verstandene Auferweckung. Diese schliesst Rettung wie Verwandlung des irdischen Lebens ein.