Medizin - Open Access LMU - Teil 14/22 Ludwig-Maximilians-Universität München

The 43rd ASCO Annual Meeting took place from June 1-5, 2007 at McCormick Place in Chicago, IL, USA. This year's meeting had the special theme of `Translating Research into Practice', particularly featuring 445 abstracts on translational research in addition to approximately 2,000 abstracts presented on subjects like surgery, radiation therapy, chemotherapy, endocrine therapy, and targeted therapies. This short summary will focus on the two important breast cancer oral presentation sessions only, and will try to comment on the presented data with regard to their immediate impact on clinical practice. Many more research results regarding breast cancer were presented (all presentations will be available to the public from September 1, 2007 at wwwasco.org). In general, breast cancer data presented at this year's ASCO Annual Meeting confirmed current standards, and introduced promising new substances which may soon enter clinical practice. The 44th ASCO Annual Meeting will again be held in Chicago from May 30 to June 3, 2008. Those who do not want to wait another year may visit ASCO's first special Breast Cancer Symposium taking place September 7-8, 2007 in San Francisco, CA, USA. Whether this meeting will start a new tradition of a specialized ASCO breast cancer symposium, and how this development will eventually will impact on the regular San Antonio Breast Cancer Symposium in December, only time will tell.

Purpose: To evaluate the differences of cortical activation patterns in young and elderly healthy subjects for object and spatial visual processing using a face- and location-matching task. Materials and Methods: We performed a face- and a location-matching task in 15 young (mean age: 28 +/- 9 years) and 19 elderly (mean age: 71 +/- 6 years) subjects. Each experiment consisted of 7 blocks alternating between activation and control condition. For face matching, the subjects had to indicate whether two displayed faces were identical or different. For location matching, the subjects had to press a button whenever two objects had an identical position. For control condition, we used a perception task with abstract images. Functional imaging was performed on a 1.5-tesla scanner using an EPI sequence. Results: In the face-matching task, the young subjects showed bilateral (right 1 left) activation in the occipito-temporal pathway (occipital gyrus, inferior and middle temporal gyrus). Predominantly right hemispheric activations were found in the fusiform gyrus, the right dorsolateral prefrontal cortex (inferior and middle frontal gyrus) and the superior parietal gyrus. In the elderly subjects, the activated areas in the right fronto-lateral cortex increased. An additional activated area could be found in the medial frontal gyrus (right > left). In the location-matching task, young subjects presented increased bilateral (right > left) activation in the superior parietal lobe and precuneus compared with face matching. The activations in the occipito-temporal pathway, in the right fronto-lateral cortex and the fusiform gyrus were similar to the activations found in the face-matching task. In the elderly subjects, we detected similar activation patterns compared to the young subjects with additional activations in the medial frontal gyrus. Conclusion: Activation patterns for object-based and spatial visual processing were established in the young and elderly healthy subjects. Differences between the elderly and young subjects could be evaluated, especially by using a face-matching task. Copyright (c) 2007 S. Karger AG, Basel.

Objective: The aim of the present study was to investigate if somatoform disorders (SFD) are associated with changes in the normal serum levels of important interleukins, and further, to establish if these changes are related to the presence and severity of alexithymia in patients with SFD. Methods: Twenty-four unmedicated patients who met the International Classification of Diseases (ICD-10) diagnostic criteria for SFD completed the psychological questionnaire to assess alexithymia (Toronto Alexithymia Scale), symptom reporting (SCL-90-R) and diagnostic criteria for SFD (Screening for Somatoform Symptoms scale). Serum concentrations of soluble interleukin 2 receptor alpha(sIL-2R alpha), IL-4, IL-6, IL-10 and IL-12 were determined in patients with SFD and in 9 healthy subjects. Results: In patients with SFD, serum levels of IL-6 (p ! 0.001), IL-10 (p = 0.047) and immunoglobulin E (p = 0.045) were significantly increased in comparison with healthy controls. Additionally, a negative correlation was observed between the level of alexithymia ('total' Toronto Alexithymia Scale score) and the serum levels of sIL-2R alpha (r = -0.538) in SFD. Conclusions: Taken together, these results suggest that SFD, with clinically significant alexithymia, are associated with a reduction in Th1-mediated immune function and an increase in the activation of the Th2 immune function, indicated by the augmented serum levels of IL-6 and IL-10 and elevated immunoglobulin E. Copyright (c) 2007 S. Karger AG, Basel.

Background: The carbohydrate antigen 19-9 (CA 19-9) is currently the most widely used serum tumor marker in pancreatic cancer (PC). CA 19-9 pretreatment levels as well as CA 19-9 kinetics during systemic chemotherapy can provide prognostic information regarding survival of patients with metastatic PC. Case Reports: We report the clinical course of 2 patients with metastatic PC who underwent palliative chemotherapy with gemcitabine. Both patients showed a significant elevation of pretreatment CA 19-9 levels (7,505 and 150,000 U/ml, respectively), however, subsequently they experienced a highly significant reduction (> 90%) of CA 19-9 kinetics under gemcitabine chemotherapy. A good disease control and a clinical benefit response were achieved in both patients. Time to tumor progression was 30 weeks and 28 weeks, overall survival 14 months and 11 months, respectively. Conclusion: These data indicate that CA 19-9 kinetics under chemotherapy may possibly serve as a useful surrogate marker for time to tumor progression and survival in advanced PC.

Background: The implementation of automated techniques improves the workflow and quality of immuno-hematological results. The workflows of our university blood bank were reviewed during the implementation of an automated immunohematological testing system. Methods: Work impact of blood grouping and subgrouping, cross- matching and antibody search using the Immucor Galileo system was compared to the previous used standard manual and semi- automated methods. Results: The redesign of our workflow did not achieve a significant reduction of the specimen's working process time, the operator's time however was reduced by 23%. Corresponding results were achieved for blood grouping, Rhesus typing, antibody screen and for autocontrol when changing from two semi- automated to the Galileo system. Because of the higher sensitivity of the Immucor antibody detection system, the rate of the initial positive antibody screens rose from 4 to 6% Conclusion: The Immucor Galileo system automates routine blood bank testing with high reliability, specificity and higher sensitivity compared to our previous used standard manual and semi- automated methods.