Abstract Background We aimed to demonstrate that MYC amplification in adenocarcinomas of the stomach (GC) and gastroesophageal junction (GEJ) is of tumor biological significance and exhibits intratumoral heterogeneity. Methods MYC amplification was analyzed by fluorescence in situ hybridization using whole mount tissue sections obtained from resection specimens of 460 chemotherapy naive (surgery only) and 122 neoadjuvantly treated GC-GEJs. The extent of intratumoral heterogeneity was quantified and a MYC score was established. Results The number of MYC-amplified tumor cells varied largely ranging from few scattered single cells (< 20 per high power field) up to all tumor cells. MYC score 1 was found in 276 cases (47.4%). Split by cohorts, 199 (43.3%) tumors of the chemotherapy naïve (surgery only) and 77 (63.1%) tumors of the neoadjuvant cohort were sorted into the category MYC Score 1. These tumors were frequently located in the gastroesophageal junction, showed non-diffuse differentiation according to Lauren, and favored male sex. Additionally, correlations with higher T- and N category were observed. Overall survival and tumor-specific survival correlated negatively with the MYC score. Conclusions MYC amplification is common in GC-GEJ, most often heterogeneously distributed, and associated with reduced therapy response. Most interestingly, MYC amplification is far more common in men, providing evidence for sex-specific disease mechanisms, and in tumors that show little response to neoadjuvant chemotherapy, suggesting a link to therapy resistance.
In sharp force injury cases, assessments of applied force and injury severity primarily rely on empirical judgment, lacking quantitative and objective data support. This study aims to construct a high-fidelity finite element (FE) head model, validate it using 3D-printed biomimetic skull experiments, and investigate the relationship between momentum and injury severity in sharp instrument stabs to the head, thereby providing scientific evidence for case analysis. A high-fidelity FE head model was reconstructed based on the Total Human Model for Safety (THUMS) model. Biomimetic skulls were 3D-printed using PEEK material. Experimental data obtained from slashing with a Chinese kitchen knife were collected via sensors and motion capture systems, using the erosion failure model to simulate wound formation. Following model validation, the approach was applied to a real stabbing fatality case to systematically simulate stabbing processes under varying momenta (0.75—11.25 kg·m/s). FE model validation demonstrated close alignment between simulation and experimental results, with errors in wound dimensions and slashing force within 15.0
Purpose Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany. Methods The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, Würzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained. Results As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36% wished to participate and 1295 have already been examined at least once. Conclusion NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity. Trial registration Registered at the German registry for clinical studies (DRKS00023742).
Pelvic fractures are classified as stable or unstable. They correlate with a severity of trauma and the initial medical treatment is decisive. This study evaluated the transferrals of such fractures and described the initial treatment as well as the clinical course. We analysed retrospective data from a large cohort of the TraumaRegister DGU® (TR-DGU), covering the period from 2014 to 2023, comprising a total of n = 397,910 patients. All patients aged ≥ 16 years were included. Injury patterns were described according to the Abbreviated Injury Scale (AIS), the mechanically unstable fractures were classified with an AIS ≥ 3. We considered all participating hospitals within Germany. The patients were subdivided in three groups: Group 1 = primary admitted patients with outcome, group 2 = pre-treated patients transferred in from other hospitals, and group 3 = primary admitted and early (< 48 h) transferred out. The majority of the patients was male and about 53 years old. Blunt trauma was the leading trauma mechanism. Concomitant injuries (AIS 2+) affected thorax (56
Abstract Purpose The aim of this study was to evaluate the visibility of colorectal liver metastases (CRLM) using photon-counting detector computed tomography (PCD-CT) and to determine the optimal virtual monoenergetic image (VMI) and iodine map reconstructions for improved contrast detection between metastases and surrounding liver parenchyma. Materials and methods A total of 117 patients with 227 CRLM (up to three measurements per patient) who underwent abdominal PCD-CT for staging between 09/2022 and 08/2024 were retrospectively included. VMI were reconstructed at energy levels between 40 and 90 keV (in 10 keV increments), and scanner-generated iodine maps were additionally analysed. To quantify contrast between CRLM and liver parenchyma, the parenchyma-to-lesion ratio (PLR) was calculated for each VMI and iodine map. The contrast-to-noise ratio (CNR) was determined based on attenuation values of the metastases and the bilateral musculus erector spinae, as well as its standard deviation. For the iodine map, lesion and parenchyma iodine concentrations were used analogously. Subjective assessment of metastases visibility on the three best VMIs in PLR and CNR (40–60 keV) and iodine maps were independently performed by three radiologists. Results Lesion and liver attenuation decreased steadily with higher keV levels. Iodine maps showed markedly higher iodine concentration in liver parenchyma than in metastases. The PLR was highest on the iodine map (3.29 ± 2.01), followed by 40 keV (2.19 ± 0.73). Regarding CNR, the 40 keV VMI showed the highest value (1.49 ± 1.70), followed by the iodine map (1.09 ± 0.99). CNR values decreased further at higher energies and significantly reduced at 70–90 keV. Paired superiority testing confirmed 40 keV as the best-performing VMI, showing significantly higher CNR than the iodine map, whereas PLR remained superior on the iodine map. Subjective ratings indicated that the 50 keV VMI provided the best visibility of CRLM. The iodine map consistently received lower subjective ratings across all criteria. Conclusion Both iodine maps and low-keV VMIs, particularly at 40 keV, demonstrated high PLR and CNR values, contributing to improved depiction of CRLM in PCD-CT. The complementary use of these reconstructions may enhance lesion detection and overall diagnostic confidence.
