Less than half a year Prof. Dr. Tung Yu Tsui is employed at the University Hospital in Rostock - and the new head of the equally new Section Oncological Surgery and Transplantation has mastered interventions to which otherwise trusted few doctors in Germany.
Recently, he was the first surgeon in Mecklenburg-Vorpommern at the Unimedizin the hemihepatectomy in laparoscopic technique by. An engagement, are treated with the cancer of the right half of the liver. The affected lobe of the liver will be removed by a minimal access. The technique is performed only at a few university hospitals.
Smaller average - but greater glories
"In Germany we have many colleagues who were trained under the old school," says Tsui . "They are accustomed to openly operate. There are now good alternatives that bring many advantages. "So could be dissected more closely with the new method through the use of a small camera and operated. The bleeding during surgery leave better keep them under control. "More comfort for the patient," says Tsui. "Since access is very small, they are subject to less stress. You recover faster and can go home earlier. There is less pain and at the end we see no cut. "Tsui is the beginning of July by the University Medical Center Hamburg-Eppendorf came to Rostock Unimedizin. Born in China in 1969, he studied in Hong Kong and Hanover before he finally moved to Germany ten years ago. Shortly after his debut in Rostock dared Tsui surgery on a liver tumor which was considered inoperable and sat on the Unimedizin new standards. The patient is free of tumor today.
First combination of two methods
Together with his colleagues from the Department of Nephrology Tsui succeeded in August the treatment of a patient who was diagnosed with a rare form of acute hepatitis. "The status of women was very critical when it came to our hospital," says Departmental Director Prof. Dr. Steffen Mitzner. "A rare infection had led to several organs, especially the liver, failed within a few hours."
In such an emergency, the patient will be forwarded immediately to the transplant list. To get the woman to surgery alive, the doctors of two methods which have been combined for the first time together world served: In addition to a developed in Rostock liver dialysis method, a novel absorber was applied, which usually comes with sepsis used. The absorber inhibits the progression of inflammation and organ failure. "With this new combination, the patient could be stabilized so far in the waiting time for the organ that surgeon Tsui was able to successfully install a new liver," says Mitzner. The patient was discharged after four weeks. ". There is on the one hand institutions, while treating critically ill liver patients, but fail if the person is septic" In intensive care, however, are often ill sepsis -'ll add organ failure, it'll also critical here. "Therefore, we want to study the combination of transplantation and sepsis absorbers."
Cytokines: The Good, the Bad, and the Deadly.
Ramani T1, Auletta CS2, Weinstock D3, Mounho-Zamora B4, Ryan PC5, Salcedo TW6, Bannish G2.
Over the past 30 years, the world of pharmaceutical toxicology has seen an explosion in the area of cytokines. An overview of the many aspects of cytokine safety evaluation currently in progress and evolving strategies for evaluating these important entities was presented at this symposium. Cytokines play a broad role to help the immune system respond to diseases, and drugs which modulate their effect have led to some amazing therapies. Cytokines may be "good" when stimulating the immune system to fight a foreign pathogen or attack tumors. Other "good" cytokine effects include reduction of an immune response, for example interferon β reduction of neuron inflammation in patients with multiple sclerosis. They may be "bad" when their expression causes inflammatory diseases, such as the role of tumor necrosis factor α in rheumatoid arthritis or asthma and Crohn's disease. Therapeutic modulation of cytokine expression can help the "good" cytokines to generate or quench the immune system and block the "bad" cytokines to prevent damaging inflammatory events. However, care must be exercised, as some antibody therapeutics can cause "ugly" cytokine release which can be deadly. Well-designed toxicology studies should incorporate careful assessment of cytokine modulation that will allow effective therapies to treat unmet needs. This symposium discussed lessons learned in cytokine toxicology using case studies and suggested future directions.
© The Author(s) 2015.
Molecular Therapy (21 April 2015)
Case Report of a Fatal Serious Adverse Event Upon Administration of T Cells Transduced With a MART-1-specific T-cell Receptor
Joost H van den Berg, Raquel Gomez-Eerland, Bart van de Wiel, Lenie Hulshoff, Daan van den Broek, Adriaan Bins, Hanno L Tan, Jane V Harper, Namir J Hassan, Bent K Jakobsen, Annelies Jorritsma, Christian U Blank, Ton N M Schumacher and John B A G Haanen
Here, we describe a fatal serious adverse event observed in a patient infused with autologous T-cell receptor (TCR) transduced T cells. This TCR, originally obtained from a melanoma patient, recognizes the well-described HLA-A*0201 restricted 26–35 epitope of MART-1, and was not affinity enhanced. Patient 1 with metastatic melanoma experienced a cerebral hemorrhage, epileptic seizures, and a witnessed cardiac arrest 6 days after cell infusion. Three days later, the patient died from multiple organ failure and irreversible neurologic damage. After T-cell infusion, levels of IL-6, IFN-γ, C-reactive protein (CRP), and procalcitonin increased to extreme levels, indicative of a cytokine release syndrome or T-cell-mediated inflammatory response. Infused T cells could be recovered from blood, broncho-alveolar lavage, ascites, and after autopsy from tumor sites and heart tissue. High levels of NT-proBNP indicate semi-acute heart failure. No cross reactivity of the modified T cells toward a beating cardiomyocyte culture was observed. Together, these observations suggest that high levels of inflammatory cytokines alone or in combination with semi-acute heart failure and epileptic seizure may have contributed substantially to the occurrence of the acute and lethal event. Protocol modifications to limit the risk of T-cell activation-induced toxicity are discussed.
These hospitals have already registered for participation:
University Hospital Ulm
University Hospital Göttingen
University Hospital Rostock
University Hospital Greifswald
Ev. Hospital Bielefeld
University Hospital Oldenburg
Heart and Diabetes Center Bad Oeynhausen
University Hospital Hamburg-Eppendorf
University Hospital Essen
University Hospital Munich Rechts der Isar
University Hospital Düsseldorf
Hospital Barmherzige Brüder Munich
Hospital St. Elisabeth und St. Barbara Halle
Vivantes Hospital Berlin Neukölln
University Hospital Freiburg
St. Johannes Hospital Dortmund
Asklepios Hospital Hamburg
University Hospital Bergmannsheil Bochum
Agaplesion Hospital Rotenburg
University Hospital Zurich
Hospital Hietzing Vienna
University Hospital Innsbruck
University Hospital Szeged
VieCuri Medical Center Noord-Limburg, NL
Maasstadziekenhuis Rotterdam, NL
Ziekenhuis De Tongerschans, Heerenveen, NL
Laurentius Ziekenhuis Rotterdem
Erasme Hospital Brussels
Ain Shams University, Kairo
Fundeni Clinical Insitute Bucharest
Muljibhai Patel Urological Hospital
Clinica de la Mujer, Bogotá
Cardio Center Pontika, Burgas
Severe sepsis is a significant cause of rehospitalization along the lines of nationally recognized outcome measures and more commonly discussed conditions such as heart failure (HF) and pneumonia, said Darya Rudym, MD, New York University School of Medicine, New York, lead author of a study presented at the 2015 American Thoracic Society International Conference.
at the Jena University Hospital. It is the only institution of its kind in Thuringia and can look back on a history of more than 200 years. The University's tradition as a medical school is yet older. Ever since the foundation of the University 450 years ago, the School of Medicine has been training and educating doctors-to-be.
Today, the University hospital with a staff of more than 4,500 is the biggest employer in the region. Its 25 clinical centers and 27 institutes provide care for 250,000 in- and outpatients per year, as well as teaching for 2,200 students of medicine and dentistry. At the Jena University hospital, scientists and physicians from more than 25 nations work both in the field of fundamental biomedical research and in patient-related clinical research.
"What individuals don’t understand is how complex it is to develop a product that addresses one of the most difficult problems in medicine that has no known treatment. You cannot just rush to a pivotal trial without first doing your homework and knowing who to treat, when to treat, and how to treat. Otherwise, you would be doomed to failure."
The value of CytoSorbents is not in our current revenue. The difference of a few hundred thousand dollars in revenue is meaningless. The true value of CytoSorb is in the tremendous number of potential applications of the technology, the interest from strategic partners, and the potential future revenue that will come if we can establish CytoSorb as a cornerstone treatment for intensive care medicine and cardiac surgery.
"There is a reason that there are no active treatments approved to treat critical illnesses like sepsis, ARDS, pancreatitis, trauma, burn injury and many others. It’s because it is very hard. If it were so easy to show a mortality benefit, there would be dozens of products on the market now. But that’s not the case. If you visit any one of a number of critical care conferences and visit the exhibit hall, you will see what I mean. There is literally nothing in the way of new effective therapies for life-threatening illnesses."
Go to CytoSorbents Facebook and watch the videos.
Professor Zsolt Molnar about CytoSorb (University of Szeged, Hungary)
Dr Albert Grootendorst, Maasstad Ziekenhuis Rotterdam/Netherlands, about CytoSorb
Professor John Kellum, University of Pittsburgh, about CytoSorb
Professor Molnar is among the leading intensive care physicians in Hungary. Furthermore he is President of the SepsEast Forum, an organization dedicated to the fight against sepsis and its burden. For him CytoSorb represents potentially a great tool to treat and avoid the devastating complications in septic shock. Professor Molnar is currently conducting a pilot trial with CytoSorb in septic shock patients.
Professor Kellum is seen as one of the top ICU nephrologists worldwide. He has carried out a significant part of the preclinical work for CytoSorb. He has no doubts about the medical efficiency of this therapy and is very much involved in the efforts to generate the needed data and evidence to make it standard of care.
Dr. Grootendorst is one of the leading intensive care physicians in the Netherlands. He is doing active research for decades in the field of cytokine removal and high-volume hemofiltration. He has introcuced CytoSorb at his hospital and is excited about the therapeutic effects he has seen. Dr. Grootendorst is currently preparing the publication on his clinical results with CytoSorb.