TY - JOUR A1 - Horn, Lars-Christian A1 - Fischer, Uta A1 - Raptis, Georgios A1 - Bilek, Karin A1 - Hentschel, Bettina T1 - Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer JF - Gynecologic Oncology N2 - Objectives Tumor size is a well recognized prognostic factor in early stage cervical carcinoma (CX). However, limited knowledge exists about the value of tumor size in surgically treated CX with extrauterine extension. Methods 245 cases of local advanced CX (FIGO stage IIA and IIB) who received upfront surgery were evaluated regarding tumor size, regarding the prediction of pelvic lymph node involvement and recurrence free and overall survival during a median follow-up time of 54 months (95% CI 45.4–62.6 months). Tumors larger than 4 cm were defined as bulky stage disease. Results Bulky disease was seen in 46.1% (113/245). 60.2% of these patients showed pelvic lymph node involvement, compared to 42.4% (56/132) in non-bulky tumors (p = 0.006; odds ratio: 2.2 [95% CI: 1.3–3.6]). Patients with bulky tumors showed an increase of recurrent disease (40.2% vs. 28.0%; p = 0.045). The relative risk for recurrent disease was 1.97 (95% CI: 1.3–3.0). The 5-year overall survival rate was significantly lower (67.7% [95% CI: 58.2–74.8] vs. 49.5% [95% CI: 36.8–59.1]; p = 0.0015). In multivariate analysis, tumor stage, pelvic lymph node involvement and maximal tumor size were independent prognostic factors. Conclusions The results suggest that tumor size, defining bulky disease as tumors larger than 4 cm, is of prognostic impact also in FIGO stage II cervical carcinomas. A revised FIGO/TNM classification system similar to the subgrouping of stage IB CX is recommended for stage II using a cut-off value of 4 cm as discriminator: stage IIA1 and stage IIB1 for tumors with ≤ 4 cm and IIA2 and IIB2 for tumors > 4 cm (i.e. bulky disease). KW - Gebärmutterhalskrebs KW - Chirurgie KW - Tumorwachstum Y1 - 2007 U6 - https://doi.org/10.1016/j.ygyno.2007.06.026 VL - 107 IS - 2 SP - 310 EP - 315 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Fischer, Uta A1 - Raptis, Georgios A1 - Bilek, Karin A1 - Hentschel, Bettina A1 - Richter, Christine E. A1 - Braumann, Ulf Dietrich A1 - Einenkel, Jens T1 - Pattern of invasion is of prognostic value in surgically treated cervical cancer patients JF - Gynecologic Oncology N2 - Objectives: Different patterns of invasion (representing different grades of tumor cell dissociation) are associated with prognostic outcome in cancer. We evaluated the prognostic value of different patterns of invasion (PI) in cervical carcinomas (CX). Methods: Six hundred eleven surgically treated CX (FIGO IB to IIB) were re-evaluated histologically regarding the PI, using a three-level scoring system. Closed PI was defined as cohesive growth with well-delineated (pushing) borders. In finger-like PI the tumor grows in solid cords/trabecles. Highly dissociative growth in small groups or single cells was defined as spray-like PI. Types of PI were correlated to tumor stage, histo-morphologic factors and prognostic outcome. Results: Sixty percent of the tumors showed a spray-like PI, 30% a finger-like PI and only 7.4% were of the closed type. Spray-like PI showed a significant correlation with advanced stage disease, lymphovascular space involvement, poorly differentiated tumors and pelvic lymph node metastases. Spray-like PI was accompanied by a reduced 5-year overall survival when compared to the finger-like and closed PI (68.7% vs. 80.9% vs. 88.5%; P=0.0004). The prognostic impact of the PI disappeared in node-positive patients (P=0.06) but persisted in patients without pelvic lymph node disease (P=0.03). In multivariate analysis, using COX regression model, the PI represented as independent prognostic factor. Conclusions: Spray-like PI (i.e., highest degree of tumor cell dissociation) is associated with advanced tumor stages, increased rate of recurrency and a reduced overall survival. In separate analysis of patients with and without lymph node metastases, the impact of PI persisted only in node-negative cases as a prognostic factor. KW - Gebärmutterhalskrebs KW - Chirurgie KW - Metastase Y1 - 2006 U6 - https://doi.org/10.1016/j.ygyno.2006.05.046 VL - 103 IS - 3 SP - 906 EP - 911 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Hentschel, Bettina A1 - Köhler, U. A1 - Richter, Christine E. A1 - Martin, Rosemarie T1 - CD44-v6 concentrations in carcinoma of the uterine cervix: lack of prognostic significance JF - Archives of Gynecology and Obstetrics N2 - Several kinds of cellular adhesion molecules, like different splicing variants of CD 44, have gained important as prognostic or markers for metastatic disease. Fresh frozen samples from 64 cervical carcinoma (CX) were stored in liquid nitrogen and examined using ELISA-technique, testing the prognostic impact. Normal cervical tissue served as control. CD 44-v6 concentration, was significant elevated in tumor tissue, when compared to the controls (P=0.04). There was no correlation to tumor stage (P=0.61), lymphovascular space involvement (P=0.075) or pelvic lymph node involvement (P=0.81). The CD 44-v6 concentration was not informative regarding recurrence-free and overall survival. Contrary to immunohistochemistry, the quantification of CD 44-v6 using ELISA-technique does not provide any further information. KW - Gebärmutterhalskrebs KW - Antigen CD44 Y1 - 2005 U6 - https://doi.org/10.1007/s00404-005-0039-5 VL - 273 IS - 2 SP - 104 EP - 106 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Nenning, Hans T1 - DNA cytometric analysis of surgically treated squamous cell cancer of the uterine cervix, stage pT1b1-pT2b JF - Analytical and quantitative cytology and histology N2 - Objective: To determine the utility of DNA content and DNA-related variables of proliferative activity regarding prognosis in cervical cancer. Study design: DNA image (ICM) andflow cytometry (FCM) were performed to determine the DNA index (DI), 5c-exceeding rate (5c-ER), S-phase fraction (SPF) and proliferation index (PI) in 163 patients with surgically staged pT1b1-pT2b squamous cell cancer of the uterine cervix and treated with primary radical hysterectomy. ICM was performed on imprint cytology, obtained from fresh tumor tissue, which was also used for FCM. Results were analyzed using the chi2 test and Cox regression analysis for risk of pelvic lymph node involvement, tumor recurrence and recurrence-free survival (RFS). Results: ICM was performed on all 163 and FCM on 133 samples. One-third of the tumors showed DNA aneuploidy. Analysis demonstrated prognostic significance of a DI > or = 1.70, with a (70:30) 2.3-fold risk of recurrence (P=.024) and reduced RFS of 10 months (P=.003) in cases of DI > or = 1.70. A high 5c-ER > 11% was associated with pelvic lymph node involvement and decreased RFS (P < or = .04). Significantly more relapses were found in tumors with SPF > 12% (70.8% vs. 29.2%, P=.007). RFS was markedly reduced in tumors with high SPF (52.3 vs. 61.1 months, P=.011). Low proliferative tumors (PI<25%) were associated with lower stage (P=.036) and increased RFS (61.2 vs. 47.1 months, P=.028). In multivariate analysis of clinicopathologic variables (pT category, nodal status, lymphovascular space involvement) and DNA related variables, pelvic lymph node involvement was the only significant predictor of RFS. In patients with nodal involvement, tumors with DI >1.70 were associated with lessfavorable outcomes. Conclusion: DNA-related variables of cell cycle analysis were valuablefor predicting prognosis in cervical cancer patients. Tumors with DI>1.70, 5c-ER >11% and high proliferative activity (SPF>12%, PI>25%) represent a subgroup with a poor prognosis. KW - Gebärmutterhals KW - squamöser Krebs KW - Cytometrie KW - Chirurgie Y1 - 2002 VL - 24 IS - 1 SP - 23 EP - 29 ER - TY - CHAP A1 - Horn, Lars-Christian A1 - Pippig, S. A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Köhler, U. A1 - Hentschel, Bettina A1 - Martin, Rosemarie T1 - Tumorassoziierte Proteolyse beim Zervixkarzinom BT - Vortrag T2 - 87. Tagung der Deutschen Gesellschaft für Pathologie, 14. Juni 2003 KW - Gebärmutterhalskrebs KW - Chirurgie KW - Tumorassoziierte Proteolyse KW - Immuncytochemie KW - Zelladhäsion Y1 - 2003 ER - TY - CHAP A1 - Höh, H. A1 - Raptis, Georgios T1 - Applications of the Erbium: YAG Laser in Ophthalmology - Cataracta-, Glaukoma-, Eyelid-Surgery and pars plana Vitrectomy BT - Symposium on Cataract, IOL, and Refractive Surgery. Boston, 20.05.2000 und 22.05.2000 N2 - Recent developments in lasers have provided us the possibility of laser ocular surgery. The xenon, argon, neodymium:YAG and dye lasers have been successfully used in out-patient clinics. The excimer laser has been attracting researchers' interest in the new application of laser to cornea and lens. The erbium:YAG laser emits a 2.94-microns beam that can ablate the transparent ocular tissues such as lenses and corneas. The author has applied this laser to the cornea, lens, vitreous and other ocular tissues. The erbium:YAG laser beam was directed through a 1.5-meter-long, 200-microns-diameter fiberoptic guide. The radiant energy measured about 50 mJ at the end of the probe. The laser was emitted as a 400-microsecond pulse. Freshly enucleated rabbit eyes were used in this study. Laser burns were applied to the tissue surface at various energy settings. At minimal power, the tissues were coagulated by the erbium:YAG laser application. At a power of more than 636-954 mJ/mm2, tissue began to evaporate; the tissue loss was observed under a surgical light microscope. Corneal photoablation, lens ablation, iridotomy, trabeculotomy, cutting of the vitreous and retinal ablation were easily performed. Like the excimer laser, the erbium:YAG laser is a potential tool for ocular surgery. KW - Augenchirurgie KW - YAG-Laser KW - Erbium-Laser Y1 - 2000 ER - TY - JOUR A1 - Chaloupka, I. A1 - Raptis, Georgios A1 - Zach, A. A1 - Brändlin, K. A1 - Meier-Ewert, H. T1 - Rolle der quantitativen CMV-DNA-Bestimmungen in der Diagnostik und Therapie der Cytomegalovirusinfektion bei immunsupprimierten Patienten BT - Vortrag JF - Jahrestagung der Gesellschaft für Virologie in Wien, April 2000 KW - Cytomegalie-Virus KW - Diagnose KW - Immunsuppresion Y1 - 2000 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Pippig, S. A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Köhler, U. A1 - Hentschel, Bettina A1 - Martin, Rosemarie T1 - Clinical relevance of urokinase-type plasminogen activator and its inhibitor type-1 (PAI-1) in squamous cell carcinoma of the uterine cervix JF - Australian and New Zealand Journal of Obstetrics and Gynaecology N2 - Objective The expression of uPA and PAI‐1 as parameters of tumour‐associated proteolysis has been implicated in the process of tumour cell invasion and the metastatic process. However, there is limited information on the impact of these parameters in cervical carcinoma. Methods Quantitative levels for uPA (n = 114) and PAI‐1 (n = 103) were researched in operatively treated, surgically staged squamous cell cancer of the uterine cervix, using an ELISA‐technique. Results were assessed regarding their impact in predicting pelvic lymph nodes metastases, tumour recurrence rate and recurrence free survival (RFS) using uni‐ and multivariate analysis. Results Median levels of both parameters were significantly higher in tumour tissue than in normal cervical tissue (p < 0.001). Detection of uPA gave no useful prognostic information. PAI‐1 concentration showed a positive correlation with advanced tumour stage (p = 0.008), but no significant correlation with nodal status (pN0: 2.6 vs. pN1: 4.0 ng/mg protein; p = 0.092). Using a cut‐off level of 2.4 ng/mg protein, patients with elevated PAI‐1 levels demonstrated reduced RFS (45.9 versus 52.9 months; p = 0.1). Multivariate analysis, including nodal status, tumour stage, lymphovascular space involvement and grading failed to demonstrate any prognostic impact of uPA and PAI‐1. Conclusions The results indicate, that PAI‐1 expression is of some prognostic impact in cervical cancer, indicating an association of elevated PAI levels with local tumour progression and reduced recurrence‐free survival. KW - Plasminogen human-Aktivator KW - Urokinase KW - squamöser Krebs KW - Gebärmutterhals Y1 - 2004 U6 - https://doi.org/10.1111/j.0004-8666.2002.00385.x VL - 42 IS - 4 SP - 385 EP - 388 ER - TY - JOUR A1 - Fischer, Uta A1 - Raptis, Georgios A1 - Geßner, W. A1 - Roschlau, U. A1 - Dressel, K. A1 - Bilek, Karin A1 - Horn, Lars-Christian T1 - Epidemiologie und formale Pathogenese des Zervixkarzinoms JF - Zentralblatt für Gynäkologie T2 - Epidemiology and pathogenesis of cervical cancer KW - Gebärmutterhalskrebs KW - Epidemiologie KW - Pathogenese Y1 - 2001 VL - 123 IS - 4 SP - 198 EP - 205 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Fischer, Uta A1 - Hanel, C. A1 - Kuhn, H. A1 - Raptis, Georgios A1 - Bilek, Karin T1 - p53 in surgically treated and pathologically staged cervical cancer BT - correlation with local tumor progression, but not with lymphatic spread JF - Pathology - Research and Practice KW - Gebärmutterhalskrebs KW - Tumorsuppressor-Gen KW - Chirurgie KW - Histopathologie Y1 - 2001 VL - 197 IS - 9 SP - 605 EP - 609 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Bilek, Karin T1 - Impact of tumorload in surgically treated, histologically staged early cervical cancer: Multivariate analysis of 568 patients JF - International Journal of Gynecology & Obstetrics KW - Gebärmutterhalskrebs KW - Chirurgie KW - Tumorklasifikation Y1 - 2000 VL - 70 IS - Suppl. 1 SP - 20 EP - 21 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Bilek, Karin T1 - p53-tumorsuppressor gene in surgically treated histologically staged early cervical cancer JF - International Journal of Gynecology & Obstetrics KW - Tumorsuppressor-Gen KW - Chirurgie KW - Histopathologie KW - Gebärmutterhalskrebs Y1 - 2000 VL - 70 IS - Suppl. 1 SP - 112 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Martin, Rosemarie T1 - Tumorassoziierte Proteolyse, p53-Immunhistochemie und Zelladhäsion bei primär operierten Zervixkarzinomen JF - Geburtshilfe und Frauenheilkunde KW - Tumorassoziierte Proteolyse KW - Immuncytochemie KW - Zelladhäsion KW - Gebärmutterhalskrebs Y1 - 2000 VL - 60 IS - Suppl. 1 SP - 200 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Fischer, Uta A1 - Bilek, Karin T1 - Standardised handling of hysterectomy specimen in cervical cancer – report of over 900 stage pT1b1- to pT2b-tumors JF - Pathology - Research and Practice KW - Gebärmutterhalskrebs KW - Chirurgie KW - Gewebe KW - Gebärmutterentfernung Y1 - 2000 VL - 196 SP - 450 ER - TY - JOUR A1 - Kopper, Andreas A1 - Klotz, Stefan A1 - Westner, Markus A1 - Strahringer, Susanne T1 - Shadow IT and Business-managed IT BT - Practitioner Perceptions and Their Comparison to Literature JF - Journal of Information Technology Management (JITM) N2 - Two concepts describe the autonomous deployment of IT by business entities: Shadow IT and Business-managed IT. Shadow IT is deployed covertly, that is, software, hardware, or IT services created/procured or managed by business entities without alignment with the IT organization. In contrast, Business-managed IT describes the overt deployment of IT, that is, in alignment with the IT organization or in a split responsibility model. The purpose of this paper is to extend the conceptual understanding of Shadow IT and Business-managed IT, comparing the perceptions of 29 CIOs and senior IT managers with the results of a systematic literature review. By doing so, this paper presents a structured and comprehensive view of causing factors, outcomes, and governance of Shadow IT and Business-managed IT in practice. A comparison of academic literature and practitioner perceptions reveals the limitations and gaps of the current research and highlights avenues for future research. The authors find three category-spanning themes occurring as causing factors, outcomes, and—as part of governance measures—factors to improve the IT organization: (1) (Poor) business-IT alignment (2) (lack of) agility, and (3) (lack of) policies. This study is innovative with its comprehensive qualitative interview data that the authors compare to the existing literature. Therefore, the paper brings together theoretical and practical insights into Shadow IT and Businessmanaged IT, which should aid practitioners and scholars in decision making and future research. KW - Corporate Governance KW - Strategisches Management KW - Shadow IT KW - Business-managed IT KW - IT governance KW - Agility KW - Business-IT alignment KW - Informationsmanagement Y1 - 2019 UR - http://home.thejitm.org/XXX-4/contents.html SN - 1042-1319 VL - 30 IS - 4 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Raptis, Georgios A1 - Fischer, Uta T1 - Familial cancer history in patients with carcinoma of the cervix uteri JF - European Journal of Obstetrics & Gynecology and Reproductive Biology KW - Gebärmutterhalskrebs KW - Familienanamnese Y1 - 2002 U6 - https://doi.org/10.1016/s0301-2115(01)00520-6 VL - 101 IS - 1 SP - 54 EP - 57 ER - TY - JOUR A1 - Horn, Lars-Christian A1 - Fischer, Uta A1 - Tannapfel, A. A1 - Kuhn, H. A1 - Hänel, C. A1 - Raptis, Georgios T1 - The role of p53 tumorsuppressorgene in tumor progression in cervical cancer JF - Pathology - Research and Practice KW - Tumorsuppressor-Gen KW - Tumorwachstum KW - Gebärmutterhalskrebs Y1 - 1999 VL - 195 SP - 328 ER - TY - CHAP A1 - Raptis, Georgios T1 - Die Konzepte und Mechanismen der elektronischen Gesundheitskarte und des Heilberufsausweises aus der Sicht der Datensicherheit / des Datenschutzes BT - Vortrag T2 - Forschungsseminar med. Informatik an der Universität Heidelberg, 22.06.2006 KW - Elektronische Gesundheitskarte KW - Heilberuf KW - Ausweis KW - Datenschutz KW - Datensicherheit Y1 - 2005 ER - TY - CHAP A1 - Raptis, Georgios T1 - Empfehlungen der BÄK zum Datenschutz im Praxisalltag, Darstellung unter technischen Aspekten BT - Vortrag im Rahmen der conhIT 2009, Berlin, 22.04.2009, zertifiziert von der Ärztekammer Berlin T2 - conhIT 2009, Berlin, 22.04.2009 KW - Arztpraxis KW - Datenschutz Y1 - 2009 ER - TY - CHAP A1 - Raptis, Georgios T1 - Health Professional eIDs vis-á-vis a Single Market Perspective BT - Vortrag T2 - European Health Telematics Association, Berlin, 25.10.2011 KW - eArztausweis KW - Elektronischer Arztausweis Y1 - 2011 ER - TY - JOUR A1 - De Pieri, Enrico A1 - Atzori, Federica A1 - Ferguson, Stephen J. A1 - Dendorfer, Sebastian A1 - Leunig, Michael A1 - Aepli, Martin T1 - Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation JF - HIP International N2 - Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved. KW - Cup medialisation KW - femoral offset KW - hip contact force KW - total hip anthroplasty KW - total hip replacement KW - Hüftgelenkprothese KW - Kontaktkraft KW - Biomechanische Analyse KW - Simulation Y1 - 2020 U6 - https://doi.org/10.1177/1120700020917321 VL - 31 IS - 5 SP - 624 EP - 631 PB - Sage ER -