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Expression of beta-catenin and p53 are prognostic factors in deep aggressive fibromatosis 总被引:1,自引:0,他引:1
Gebert C Hardes J Kersting C August C Supper H Winkelmann W Buerger H Gosheger G 《Histopathology》2007,50(4):491-497
AIMS: To determine the prognostic significance of beta-catenin in aggressive fibromatosis and to identify potential molecular markers for new targeted therapies. METHODS AND RESULTS: A tissue microarray of 37 cases of deep aggressive fibromatosis was constructed and subjected to immunohistochemical analysis for beta-catenin, p53, smooth muscle actin (SMA), desmin, Ki67, c-erbB2, epidermal growth factor receptor (EGFR), c-kit, CD34 and S100. Complete clinical follow-up was available for 23 patients. Nuclear beta-catenin expression was associated with an increased rate of local tumour recurrence (60.0% 1-year and 0% 5-year event-free survival; P < 0.05). Furthermore, p53 expression was associated with an increased risk of tumour recurrence (50% 1-year event-free survival rate and 0% 5-years event-free survival rate, P < 0.05). The coexpression of p53 and beta-catenin was significantly correlated (P < 0.05). No statistically significant association was seen between MIB1 and p53 or beta-catenin expression, respectively. No expression of EGFR, c-erbB2 or c-kit was seen. CONCLUSIONS: The overexpression of beta-catenin and p53 is associated with a decreased event-free survival in deep aggressive fibromatosis. Further studies are required to establish whether these findings can lead to an improvement in the treatment of this rare neoplasm. 相似文献
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Prof. Dr. J. Hardes H. Ahrens G. Gosheger M. Nottrott R. Dieckmann M.-P. Henrichs A. Streitbürger 《Der Unfallchirurg》2014,117(7):607-613
Background
Megaprostheses are frequently used after segmental resection of bone sarcomas, bone metastases, and in large osseous defects in revision arthroplasty.Objectives
The incidence of the most common complications associated the use of megaprostheses are reported. The management of complications including therapeutic recommendations are described.Materials and methods
The current knowledge and our own experience of complication management with the use of megaprostheses are presented.Results
Prospective, randomized studies or meta-analyses on this topic are lacking. An analysis of the literature shows that beside the occurrence of a local recurrence, periprosthetic infection remains the most serious complication. Two-stage revision remains the gold standard, but a single-stage exchange of the prosthesis without removing the stems might be possible in selected cases. Infection is associated with a higher risk of secondary amputation. In contrast, mechanical failures (e.g., wear of the bushings in knee replacements and aseptic loosening of the stems) can be treated more easily. Dislocation of a proximal femur replacement can mostly be prevented by using bi- or tripolar cups.Conclusions
Complications with the use of megaprostheses can be successfully treated by revision surgery in most cases. 相似文献5.
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Niklas Deventer Nils Deventer Georg Gosheger Tymoteusz Budny Marieke de Vaal Arne Riegel Birthe Heitkoetter Torsten Kessler Monika Poeppelmann Claudia Rossig Heribert Juergens Timo Luebben 《Pediatric blood & cancer》2020,67(10)
Aneurysmal bone cyst (ABC) is a benign locally aggressive tumor that occurs in childhood and early adulthood. Most relevant differential diagnoses are the telangiectatic osteosarcoma and the giant cell tumor. In the present case series chemotherapy following the EURAMOS or the Euro‐Ewing 99 protocol was externally applied in three patients with the misdiagnosis of ABC as malignant bone tumor. In all three cases, a significant reduction of the volume of the ABC was achieved. This is the first report about the use of neoadjuvant chemotherapy in ABC. Chemotherapy reduces the size of an ABC and leads to progressive sclerosis. 相似文献
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Tobias Lange Werner Schmoelz Georg Gosheger Martin Eichinger Christian H. Heinrichs Albert Schulze Boevingloh Tobias L. Schulte 《The spine journal》2017,17(8):1148-1155
Background Context
Proximal junctional kyphosis (PJK) is a challenging complication after rigid posterior instrumentation (RI) of the spine. Several risk factors have been described in literature so far, including the rigidity of the cranial aspect of the implant.Purpose
The aim of this biomechanical study was to compare different proximal implants designed to gradually reduce the stiffness between the instrumented and non-instrumented spine.Study Design/Setting
This is a biomechanical study.Methods
Eight calf lumbar spines (L2–L6) underwent RI with a titanium pedicle screw rod construct at L4–L6. The proximal transition segment (L3–L4) was instrumented stepwise with different supplementary implants—spinal bands (SB), cerclage wires (CW), hybrid rods (HR), hinged pedicle screws (HPS), or lamina hooks (LH)—and compared with an all-pedicle screw construct (APS). The flexibility of each segment (L2–L6) was tested with pure moments of ±10.0?Nm in the native state and for each implant at L3–L4, and the segmental range of motion (ROM) was evaluated.Results
On flexion and extension, the native uninstrumented L3–L4 segment showed a mean ROM of 7.3°. The CW reduced the mean ROM to 42.5%, SB to 41.1%, HR to 13.7%, HPS to 12.3%, LH to 6.8%, and APS to 12.3%. On lateral bending, the native segment L3–L4 showed a mean ROM of 15°. The CW reduced the mean ROM to 58.0%, SB to 78.0%, HR to 6.7%, HPS to 6.7%, LH to 10.0%, and APS to 3.3%. On axial rotation, the uninstrumented L3–L4 segment showed a mean ROM of 2.7°. The CW reduced the mean ROM to 55.6%, SB to 77.8%, HR to 55.6%, HPS to 55.6%, LH to 29.6%, and APS to 37.0%.Conclusions
Using CW or SB at the proximal transition segment of a long RI reduced rigidity by about 60% in relation to flexion and extension in that segment, whereas the other implants tested had a high degree of rigidity comparable with APS. Clinical randomized controlled trials are needed to elucidate whether this strategy might be effective for preventing PJK. 相似文献8.
PD Dr. G. Gosheger H. Ahrens A. Streitbürger C. Gebert W. Winkelmann J. Hardes 《Best Practice Onkologie》2007,2(1):24-35
Sind Skelettmetastasen nachweisbar, so ist dies ein untrügliches Zeichen dafür, dass sich die Tumorerkrankung im gesamten
Organismus ausgebreitet hat. Eine Heilung ist nur in seltenen F?llen zu erwarten. Die Therapie ist in diesem Stadium eher
palliativ. Bei konservativer Therapiestrategie sollte wegen des Risikos von pathologischen Frakturen eine Abstimmung mit dem
Chirurgen und Orthop?den erfolgen, um ggf. rechtzeitig operativ zu intervenieren. W?hrend eine pr?ventive operative Stabilisierung
im Bereich der langen R?hrenknochen relativ unproblematisch ist, kann sie im Becken- und Wirbels?ulenbereich Komplikationen
mit sich bringen. 相似文献
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Sweet's syndrome (acute febrile neutrophilic dermatosis) was first described in 1964. The typical symptoms of Sweet's syndrome are high temperature, peripheral leucocytosis, painful cutaneous rashes (papules, plaques) and arthralgia. Sweet's syndrome has particularly been described in association with neoplastic, infectious and immunological diseases. The pathogenesis of Sweet's syndrome can be explained by a reaction to an antigenic structure with accumulation of immunological complexes and liberation of inflammatory mediators. For the first time we report on a patient with Sweet's syndrome and pigmented villonodular synovitis, which is believed to play the antigenic role in the Sweet syndrome. 相似文献
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Ozaki T Putzke M Bürger H Gosheger G Winkelmann W Lindner N 《Acta orthopaedica Scandinavica》2002,73(2):220-226
We analyzed the incidence, route, and characteristics of hip joint infiltration in pelvic or proximal femoral sarcomas. 67 patients with a sarcoma that originated around the hip joint (50 pelvic and 17 femoral) were included in this study. Preoperative CT and MRI were matched with the histological findings in tumor specimens. Tumor infiltration into the hip joint was suspected on the basis of preoperative imaging in 29 patients due to articular cartilage disruption, diffuse signal changes in the acetabulum or femoral neck, signs of a tumor in the joint, or markedjoint effusion. Of these 29 patients, 15 showed tumor invasion on histological examination. 12 of 31 chondrosarcomas, none of 12 Ewing's sarcomas, and 3 of 24 osteosarcomas infiltrated into the hip joint (p = 0.008). 10 of 26 low-grade sarcomas and 5 of 41 high-grade sarcomas infiltrated into the hip joint (p = 0.02). The joint infiltration rate of the chondrosarcomas was related to their size. Of 10 tumors originating in the acetabulum, 9 penetrated through or around the osseous-ligamentous junction and one through the acetabular cartilage. In 5 proximal femur lesions, all infiltrated the joint through the femoral neck, 3 of them also through the ligamentum teres. 相似文献