LMU Munich Research Articles

86P Prophylactic cranial irradiation in SCLC: A survey of German radiation oncology institutions on recommendations for brain imaging

Background: Prophylactic cranial irradiation in SCLC is recommended in therapy responders to primary treatment. The landmark PCI trials largely took place in the pre-MRI era. Recently, the role of brain imaging in PCI has come under increased scrutiny. We conducted this survey to gauge the patterns of brain imaging in PCI amongst radiation oncologists in Germany. Methods: We surveyed radiation oncology institutions in Germany via an online questionnaire sent by e-mail to member institutions in the online directory of the German Society for Radiation Oncology (DEGRO e.V.). The questions covered aspects of brain imaging in limited- and extensive-stage SCLC. Results: We received a total of 39 responses. Of which 34 were completed and eligible for further evaluation. 97% and 92% of respondents recommended brain imaging prior to initial treatment in LS- and ES-SCLC, respectively with contrast-enhanced MRI being the preferred modality in 86% of cases. Ninety-one percent of respondents recommended brain imaging not older than 4 weeks prior to PCI delivery with 71% recommending commencing PCI <4 weeks after primary treatment. Of all responses, 38% followed their patients regularly with serial brain imaging following PCI with the absolute majority preferring image acquisition only in symptomatic patients. On detection of brain metastases (BMs), 59% recommended stereotactic radiosurgery (SRS) or repeat whole brain radiotherapy depending on the number of BMs. Conclusions: Patterns of brain imaging in Germany are in general consistent with the guidelines with contrast-enhanced MRI being the preferred modality for brain staging prior to primary treatment and especially after multimodality treatment and before PCI delivery. Legal entity responsible for the study: University Hospital, LMU Munich Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest.

Long-term effects of canine parvovirus infection in dogs.

BackgroundCanine parvovirus (CPV) is the most important viral cause of acute canine enteritis leading to severe damage of the intestinal barrier. It has been speculated that dogs might develop chronic disorders after surviving CPV infection. However, no studies regarding the long-term implications of CPV infection have been published to date. The aim of this study was to evaluate whether dogs that have survived CPV infection will have an increased risk for developing chronic gastroenteritis, atopic dermatitis, or cardiac disease.Methodology/Principal findingsDogs that had been treated at the Clinic of Small Animal Medicine, LMU Munich, for CPV infection for which a follow-up of at least 12 months was available, were included in the study. Owners completed a questionnaire on the presence of chronic gastrointestinal and cutaneous signs, cardiac disease, and other potential disorders. An identical questionnaire was sent to owners of matched control dogs during the same time period. Seventy-one questionnaires of dogs with CPV infection and 67 of control dogs were analyzed. Significantly more CPV-infected dogs (30/71) compared to control dogs (8/67) had developed chronic gastrointestinal signs later in their lives (P < 0.001). No significant differences were observed regarding skin diseases (P = 1), cardiac problems (P = 0.160), or any other diseases (P = 0.173) later in life.ConclusionsResults of this study suggest that dogs that survive CPV infection have a significantly higher risk (odds ratio = 5.33) for developing a chronic gastrointestinal disease. Further prospective studies to identify the trigger for the development of chronic diarrhoea and possible targeted treatment strategies are needed.

The Cuneiform Documents from the Iraqi Excavation at Drehem

Abstract: Drehem, ancient Puzriš-Dagān, is well known as the place of origin of more than 15,000 cuneiform tablets from the Ur III period that were sold on the antiquities markets from 1909 onwards. The State Board of Antiquities and Heritage of Iraq undertook the first controlled excavations at the site in 2007 under the direction of Ali Ubeid Shalkham. The cuneiform texts and fragments found there not only add to the well-known royal archives dealing with cattle, treasure or shoes, but they include many records on crafts and agriculture. With this evidence, the subsistence economy behind this important administrative center and royal palace of the Third Dynasty of Ur becomes more evident. We thank the Iraqi State Board of Antiquities and Heritage, the Iraq Museum Baghdad and Mr Ali Ubeid Shalkham for the permission to publish the tablets from the excavation season of 2007. The stays of Nawala Al-Mutawalli at LMU Munich in 2015 and 2016 in order to prepare this article were generously funded by the Gerda Henkel Stiftung. We are grateful to Margarete van Ess for the invitation to a first meeting in 2013 at the DAI Orientabteilung, Berlin. Thanks are owed to Manuel Molina for his careful reading of this article and his helpful remarks and Frans van Koppen for his editorial care. Walther Sallaberger’s work also contributes to his “Sumerisches Glossar” project. – All photos and plans of the excavation were made by Ali Ubeid Shalkham, the tablets in the Iraq Museum were photographed by Nawala Al-Mutawalli Mahmood. The abbreviations follow the Reallexikon für Assyriologie und Vorderasiatische Archäologie. The online digital resources CDLI (cdli.ucla.edu) and especially BDTNS (bdtns.filol.csic.es) have proven once more to be indispensable for our studies of lexicography and prosopography.

Design of Poly-l-Glutamate-Based Complexes for pDNA Delivery.

Macromol. Biosci. 2017, 10, 1700029 Petra Kos contributed to the work by providing data for Figures 3, S2 and S3. She was involved in the early phases of the project and one of the supervisors of Amaya Niño-Pariente at her research stay at LMU Munich (2013). The fact that Petra Kos deserves a coauthorship on the paper was not recognized at time of submission and should be corrected with this corrigendum. Amaya Niño-Pariente, Ana Armiñán, Sören Reinhard, Claudia Scholz, Petra Kos, Ernst Wagner,* Maria J. Vicent* A. Niño-Pariente, Dr. A. Armiñán, Dr. M. J. Vicent Polymer Therapeutics Lab Centro de Investigación Príncipe Felipe (CIPF) C/Eduardo Primo Yúfera 3, Valencia 46012, Spain E-mail: mjvicent@cipf.es S. Reinhard, Dr. C. Scholz, Dr. P. Kos, Prof. E. Wagner Pharmaceutical Biotechnology Department of Pharmacy Center for Nanoscience Ludwig-Maximilians-Universität Butenandtstr. 5-13, Building D, 81377 Munich, Germany E-mail: ernst.wagner@cup.uni-muenchen.de

Sub-3mm spatial resolution from a large monolithic LaBr3 (Ce) scintillator

Abstract A Compton camera prototype for ion beam range monitoring via prompt (&lt; 1 ns) gamma detection in hadron therapy is being developed and characterized at the Medical Physics Department of LMU Munich. The system consists of a large (50x50x30 mm3) monolithic LaBr3(Ce) scintillation crystal as absorber component to detect the multi-MeV Compton scattered photons, together with a stack of 6 double-sided silicon strip detectors (DSSSD) acting as scatterer component. Key ingredient of the γ-source reconstruction is the determination of the γ-ray interaction position in the scintillator, which is read out by a 256-fold segmented multi-anode photomultiplier tube (PMT). From simulations an angular resolution of about 1.5o for the photon source reconstruction can be expected for the energy range around 3 – 5 MeV, provided that a spatial resolution of 3 mm can be reached in the absorbing scintillator [1]. Therefore, particular effort was dedicated to characterize this latter property as a function of the γ-ray energy. Intense, tightly collimated 137Cs and 60Co photon sources were used for 2D irradiation scans (step size 0.5 mm) as prerequisite for studying the performance of the “k-Nearest-Neighbors” algorithm developed at TU Delft [2] (together with its variant ”Categorical Average Pattern”, CAP) and extending its applicability into the energy range beyond the original 511 keV. In this paper we present our most recent interaction position analysis in the absorbing scintillator, leading to a considerably improved value for the spatial resolution: systematic studies were performed as a function of the k-NN parameters and the PMT segmentation. A trend of improving spatial resolution with increasing photon energy was confirmed, resulting in the realization of the presently optimum spatial resolution of 2.9(1) mm @1.3 MeV, thus reaching the design specifications of the Compton camera absorber. The specification goal was reached also for a reduced PMT segmentation of 8x8 anode segments (each with 6x6 mm2 active area), thus allowing to reduce the complexity of the signal processing while preserving the performance.

The Doktabörse - an innovative online platform for research projects at the medical faculty of the LMU Munich.

Introduction: One of the most important extracurricular aspects of medical studies in Germany is a research thesis completed by most students. This research project often times conveys relevant competencies for the physician’s role as scientist. Nevertheless, the choice of the right project remains a challenge. Reasons for this are among others, missing structures for a comprehensive overview of research groups and their respective projects.Description of the project: We developed the online platform Doktabörse as an online marketplace for doctoral research projects. The platform enables authorized researchers to create working groups and upload, deactivate and change research projects within their institute. For interested students, a front end with integrated search function displays these projects in a structured and well-arranged way. In parallel, the Doktabörse provides for a comprehensive overview of research at the medical faculty. We evaluated Researchers‘ and students‘ use of the platform. Results: 96,6% of students participating in the evaluation (n=400) were in favor of a centralized research platform at the medical faculty. The platform grew at a steady pace and included 120 research groups in June 2016. The students appreciated the structure and design of the Doktabörse. Two thirds of all uploaded projects matched successfully with doctoral students via the platform and over 94% of researchers stated that they did not need technical assistance with uploading projects and handling the platform. Discussion: The Doktabörse represents an innovative and well accepted platform for doctoral research projects. The platform is perceived positively by researchers and students alike. However, students criticized limited extent and timeliness of offered projects.In addition, the platform serves as databank of research at the medical faculty of the LMU Munich. The future potential of this platform is to provide for an integrated management solution of doctoral thesis projects, possibly beyond the medical field and faculty.

Exceptionally preserved arthropodan microfossils from the Middle Ordovician Winneshiek Lagerstätte, Iowa, USA

This work was funded by the ANR (Agence National de la Recherche, France) as part of the ‘RALI – The Rise of Animal Life’ project (Grant number ANR-11-BS56-0025), and by the NSF of USA (grant numbers EAR 0921245 and EAR 0922054). Acid treatment and slide preparation were conducted by Laurence Debeauvais (CNRS/Universite Lille 1). Paul K. Strother (Boston College) found the first possible xiphosuran coxae in our material. Massimo Morpurgo (Museum of Nature South Tyrol) provided exuviae of Limulus polyphemus. We thank James C. Lamsdell (Yale University), Petra Tonarova (Tallinn University of Technology, Czech Geological Survey), Olle Hints (Tallinn University of Technology), Denis Audo (Universite de Rennes 1), Carolin Haug (LMU Munich), Joachim T. Haug (LMU Munich) and Alexander Blanke (Hull, UK) for discussing our findings, and two anonymous reviewers for their helpful comments. This work is a contribution to IGCP project 653 – ‘The onset of the Great Ordovician Biodiversification Event’ and to the CPER research project CLIMIBIO. The authors thank the French Ministere de l'Enseignement Superieur et de la Recherche, the Hauts-de-France Region and the European Funds for Regional Economic Development for their financial support to this project and the Department of Innovation, Research and University of the Autonomous Province of Bozen/Bolzano for covering the Open Access publication costs.

How Simple Could Life Be?

Will we be ever able to produce living matter artificially? Despite our increasingly precise understanding of the details of life, its fundamental principles still lie in the dark. Armed with today's technology and knowledge about living systems, it is high time for us to re-address this persistent challenge in understanding nature. Graphics: Monika Krause, MPIB.

Unexplained recurrent miscarriages are associated with an aberrant sperm protamine mRNA content

Are unexplained recurrent miscarriages associated with abnormal protamine-1 and protamine-2 mRNA levels in spermatozoa? Both protamine-1 and protamine-2 mRNA levels as well as the protamine-1 to protamine-2 mRNA ratio in spermatozoa from men whose female partners experienced two or more consecutive miscarriages were significantly different compared to those from both healthy control men and subfertile couples undergoing IVF/ICSI. Aberrant sperm protamine ratios are known to be associated with male-factor infertility. Data from this study suggest that the protamine mRNA ratio may additionally affect early embryo development. The study population was recruited from men whose female partners presented with two or more consecutive unexplained miscarriages in a consultation for recurrent pregnancy loss between 2014 and 2016. At the research laboratory of the Urological Clinic of the University Giessen, spermatozoa from cases and controls were subjected to reverse transcription quantitative PCR (RTqPCR) using specific primer pairs for protamine-1 and protamine-2. Protamine-1 and protamine-2 mRNA levels were analysed in semen samples from 25 men whose female partners experienced at least two consecutive idiopathic miscarriages before the 20th week of gestation. The couples were recruited during consultation at the Fertility Center of the LMU Munich, Germany, and at the Clinical Division of Gynecologic Endocrinology and Reproductive Medicine of the Medical University of Vienna, Austria. Results were compared with those from 32 healthy donors (WHO, 2010) recruited at the Department of Urology, Pediatric Urology and Andrology, Giessen, Germany, and 107 men whose partners participated in an IVF/ICSI program at the Fertility Center of the LMU Munich, Germany. Protamine-1 and protamine-2 mRNA levels as well as the protamine mRNA ratio and all routine semen parameters revealed significant differences between recurrent miscarriage couples and healthy volunteers (P < 0.01). When comparing recurrent miscarriage couples with couples undergoing IVF/ICSI, Ct-values of protamine-1 and protamine-2 mRNAs were significantly higher and the protamine mRNA ratio was significantly lower in RM couples (P < 0.01). When comparing protamine mRNA levels and the protamine mRNA ratio with routine semen parameters, a significant negative correlation was evident between progressive motility and the protamine-2 mRNA level (P = 0.015), as well as between non-progressive motility and the protamine mRNA ratio (P = 0.023). Although our data demonstrate significant abnormalities in RM, larger sample sizes will be needed to confirm our results. Larger sample sizes should also balance the fact that we had to focus mainly on median protamine mRNA levels. Finally, men in the healthy control group were younger in age than those in the case group, which might have introduced some bias, at least concerning the classic semen parameters. Moreover, only protamine mRNA instead of protein levels could be measured. Although the exact mechanism remains to be elucidated, our data suggest that protamine mRNA levels in spermatozoa are not only important for successful fertilization, but also for proper development of the early embryo. Grant from the University Clinic Giessen and Marburg (UKGM 29/2015GI). There are no competing interests. N/A.

Meet the First Authors

HomeCirculation ResearchVol. 120, No. 8Meet the First Authors Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBMeet the First Authors Originally published14 Apr 2017https://doi.org/10.1161/RES.0000000000000147Circulation Research. 2017;120:1214–1215Polydom Affects Lymphatic Vessel Remodeling (p 1276)Download figureDownload PowerPointNanami Morooka is a PhD student at Osaka University in Japan, conducting her thesis research in Kiyotochi Sekiguchi’s Laboratory. Nanami received her BS and Master’s Degrees in Chemistry from Osaka University. In the study featured in this issue, she discovered that mice lacking the extracellular matrix protein “polydom” have a defect in lymphatic vessel remodeling. She thinks that listening to disco funk music helps her with her delicate microscopic dissection, and dancing in the dark room is secret to getting good images of whole-mount samples. Her dream is to uncover the mechanism underlying lymphatic and blood vascular development, with the hope that future research will be able to apply her findings to clinical solutions.Lipid Droplets in Endothelium (p 1289)Download figureDownload PowerPointDr Andrew Kuo earned a BS in Zoology from National Taiwan University and his PhD in Cell Biology from Yale University under the supervision of Dr William C. Sessa. During his PhD training, he became passionate about lipid metabolism in endothelial biology. He will continue his postdoctoral training with Dr Timothy Hla at Boston Children’s Hospital with the goal of studying sphingosine-1-phosphate biology. His long-term goal is to unveil the diverse functions of lipids in the context of vascular biology. His favorite lipid molecule is dolichol.miRNA Mimics for Cardiac Regeneration (p 1298)Download figureDownload PowerPointDr Pierluigi Lesizza earned his MD in 2014 at the University of Trieste, Italy. He is now pursuing his PhD in Cardiology at the University of Trieste under the supervision of Dr Gianfranco Sinagra, and collaborating with the Molecular Medicine Laboratory of ICGEB, Trieste (supervisor: Prof Mauro Giacca). He became familiar with the field of regenerative medicine during his University studies and has been drawn to the potential development of innovative therapies for heart failure exploiting the mechanisms of heart regeneration. He would like to continue working both in clinics and at the bench to try to translate basic research discoveries to clinical therapies.Novel Sympathetic Function: Positive Adhesiotropy (p 1305)Download figureDownload PowerPointDr Camilla Schinner has been fascinated by science and anatomy and is especially intrigued by the cardiovascular system since the beginning of her medical studies. As a result, she conducted her MD thesis (common in German medical educational system) at the Institute of Anatomy and Cell Biology, LMU Munich, resulting in this manuscript. The question of how cells maintain contact, especially in the heart, is the main focus of her research. In November 2016, she graduated from medical school and started her career in anatomy. For her, anatomy provides the perfect combination of biomedical science, and teaching students is an exciting and important subject.3D-Printed Scaffolds for Engineered Myocardium (p 1318)Download figureDownload PowerPointDr Ling Gao is a postdoctoral associate in the laboratory of Professor Jianyi (Jay) Zhang, at the University of Alabama at Birmingham. He graduated with a Bachelor of Science in Biological Pharmacy and a Master of Science in Physiology from Nanjing University, and then he earned a Doctoral degree in Physiology at Shanghai Jiao Tong University. Dr Gao’s research currently focuses on using 3 lineages of human iPSC-derived cardiac cells (cardiac myocytes, smooth-muscle cells, and endothelial cells) to generate cardiovascular tissues and then testing these engineered tissues in a porcine model of left-ventricular remodeling.Meta-Analysis of Cell Therapy for PAD (p 1326)Download figureDownload PowerPointDr Mauro Rigato earned his MD at the University of Padova in 2008 and concluded a 5-year residency in the Unit of Endocrinology, directed by Dr A. Avogaro. He is experienced in the management of patients with diabetic complications, especially foot and cardiovascular disease, which represent major health care issues worldwide. Dr Rigato is currently concluding his PhD studies in Translational Medicine under the supervision of Dr G.P. Fadini, with a focus on stem cells in diabetes and its complications. He is also involved in a project for the study of diabetes in Africa. In his free time, he likes mountaineering and travelling. Previous Back to top Next FiguresReferencesRelatedDetails April 14, 2017Vol 120, Issue 8 Advertisement Article InformationMetrics © 2017 American Heart Association, Inc.https://doi.org/10.1161/RES.0000000000000147PMID: 28408442 Originally publishedApril 14, 2017 PDF download Advertisement

Development of a Compton camera for prompt-gamma medical imaging

A Compton camera-based detector system for photon detection from nuclear reactions induced by proton (or heavier ion) beams is under development at LMU Munich, targeting the online range verification of the particle beam in hadron therapy via prompt-gamma imaging. The detector is designed to be capable to reconstruct the photon source origin not only from the Compton scattering kinematics of the primary photon, but also to allow for tracking of the secondary Compton-scattered electrons, thus enabling a γ-source reconstruction also from incompletely absorbed photon events. The Compton camera consists of a monolithic LaBr3:Ce scintillation crystal, read out by a multi-anode PMT acting as absorber, preceded by a stacked array of 6 double-sided silicon strip detectors as scatterers. The detector components have been characterized both under offline and online conditions. The LaBr3:Ce crystal exhibits an excellent time and energy resolution. Using intense collimated 137Cs and 60Co sources, the monolithic scintillator was scanned on a fine 2D grid to generate a reference library of light amplitude distributions that allows for reconstructing the photon interaction position using a k-Nearest Neighbour (k-NN) algorithm. Systematic studies were performed to investigate the performance of the reconstruction algorithm, revealing an improvement of the spatial resolution with increasing photon energy to an optimum value of 3.7(1)mm at 1.33MeV, achieved with the Categorical Average Pattern (CAP) modification of the k-NN algorithm.

Urban Economies: Cultural Perspectives on Grassroots Entrepreneurs and Neighborhood Economies, 14 – 15th July 2016, LMU Munich, Germany

Urban Economies: Cultural Perspectives on Grassroots Entrepreneurs and Neighborhood Economies, 14 – 15th July 2016, LMU Munich, Germany

Hyperostotic tympanic bone spicules in domestic and wild animal species

Hyperostotic tympanic bone spicules (HTBS), or mucoperiosteal exostoses (ME, syn.) are small, globular (≥ 1 mm in diameter), mostly stalked and drumstick-like, bony structures, which arise from the inner wall of the tympanic bulla and project into the middle ear cavity. HTBS present as mineral densities inside the tympanic bulla on radiographs or computed tomographic (CT) images. They have previously been referred to as otoliths and were thought to represent mineral concretions secondary to otitis media. Recently, it was shown that HTBS actually consist of regularly composed bone tissue, covered by normal middle ear mucosa. So far, HTBS have only extensively been described in dogs, where they occur with a prevalence of up to > 45%. A recent study detected ME, most likely representing HTBS, in the tympanic cavities of skeletonised skull bones of African lions. To estimate the occurrence of HTBS in other mammal species, the middle ears of adult animals of 78 different domestic, wild, and zoo species undergoing routine necropsy at the Institute of Veterinary Pathology of the LMU Munich, Germany were examined in the present study. HTBS were found in the tympanic bullae of carnivorous species, such as canids (wolf, fox), and in several large felid species (lion, tiger, leopard, cheetah). In contrast, HTBS were not present in domestic cats (more than to 200 cases), small carnivorous species such as mustelids, nor in any primate, ungulate, ruminant, pig, insectivore, or rodent species. The detectability of HTBS by CT of the tympanic bullae of large felids was demonstrated in an African lion. Histologically, HTBS consisted of mature lamellar bone, covered by periosteum and a partially ciliated, flat epithelium, regularly without any apparent inflammatory alterations. The present study demonstrates that HTBS may frequently occur in large felids and in different canid species. These findings should be taken into account when examining the middle ear, or interpret - ing bulla radiographs/CT-images of the respective species. However, the factors triggering the development of HTBS remain to be identified.

Child Mortality Using Bayesian Semi-Parametric Discrete-Time Survival Model

The Bayesian Approach offers the viable and rigorous solution, though there is also the added benefit of providing much-needed uncertainty and probability assessments in non-linear and non-Gaussian situations in a valid and rigorous way. Mortality and its various determinants have been traditionally studied in a regression modeling framework. Initial studies mostly used the usual linear regression models which, however, are not appropriate in situations where the mortality information is given by a binary indicator of death or alive. Binary regression models (logit and probit) are, therefore, a logical alternatives. There are, however, problems, with logit and probit models, namely, that they do not take into consideration the information on the survival time. Hence, most studies now utilize the survival analysis techniques. Recently, Fahrmeir and co-researchers at the LMU Munich have proposed a Bayesian Geo-Additive modeling framework which encompasses most of the known regression models and improves upon their shortcomings. The proposed model is also called Bayesian semi-parametric structured regression model.

Abstract P4-11-13: Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors

Abstract Introduction It is known that young breast cancer (BC) patients tend to suffer more psychological stress and have lower quality of life than older women, are less sexually active and have more body image issues than healthy women of the same age. They may also be challenged by reproductive concerns. To our knowledge, no data exist about the effect of the disease on the life satisfaction of premenopausal BC patients. This study tries to elucidate life satisfaction in several aspects of daily life in this special cohort as well as aspects of cancer-specific distress and parenting concerns in order to improve our support strategies. Materials and methods In a cross-sectional study design, all patients with &amp;lt; 40 years at primary BC diagnosis treated at Breast Center, CCC LMU Munich (Germany) between 2006 and 2013 were eligible for participation. Standardized questionnaires assessing life satisfaction (Life Satisfaction Questionnaire; Fahrenberg et al, 2000) and cancer-specific distress (Questionnaire on Stress in Cancer patients; Herschbach et al, 2003), as well as a self-developed questionnaire on partnership, employment situation, family planning, demographic and medical data were mailed in 2014. Results 88 patients responded (55%). Compared with population data stratified for age and sex, patients showed significantly less satisfaction in the domains of health (p&amp;lt;0.001) and sexuality (p=0.002) but not in any other domains or overall life satisfaction. The patients' most pronounced cancer-specific problems were fear of cancer recurrence and fear of further hospital stays, diminished sexual activity, and psychosomatic problems like nervousness, fatigue and insomnia. Of those patients who retrospectively evaluated their decision for or against fertility preservation, 76.4% were satisfied with their choice. Current desire to have children was reported by 45.8% of patients and another 15.6% were uncertain, but only 21.7% actually planned to have children. The most frequently reported reasons to refrain from childbearing were shortened life expectancy, negative impact of pregnancy on prognosis, and treatment-related infertility. Discussion In our cohort, the general life satisfaction of young breast cancer survivors showed no difference from women without cancer, but these patients were not satisfied with their general health status and with their sexuality. Also, cancer-related fears and psychosomatic problems considerably stress young patients and thus need to be addressed by supportive care programs. There is also a need for counselling regarding childbearing after BC treatment. In contrast, fertility preservation seems to be well established in medical consultations. In conclusion, tailored supportive care programs have to be realized to respond the unique needs of young BC patients. Citation Format: Burgmann M, Hermelink K, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Wuerstlein R. Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-13.

Vaccination: Developing and implementing a competency-based-curriculum at the Medical Faculty of LMU Munich.

Background: In Germany medical students should gain proficiency and specific skills in the vaccination field. Especially important is the efficient communication of scientific results about vaccinations to the community, in order to give professional counseling with a complete overview about therapeutic options.Aim of the project: The aim of this project is to set up a vaccination-related curriculum in the Medical Faculty at the Ludwig-Maximilians-University in Munich. The structure of the curriculum is based on the National catalogue for competency-based learning objectives in the field of vaccination (Nationaler Kompetenzbasierter Lernzielekatalog Medizin NKLM). Through this curriculum, the students will not only acquire the classical educational skills concerning vaccination in theory and practice, but they will also learn how to become independent in the decision-making process and counseling. Moreover, the students will become aware of consequences of action related to this specific topic.Methods: According to defined guidelines, an analysis was performed on courses, which are currently offered by the university. A separate analysis of the NKLM was carried out. Both analyses identified the active courses related to the topic of vaccination as well as the NKLM learning objectives. The match between the topics taught in current courses and the NKLM learning objectives identified gaps concerning the teaching of specific content. Courses were modified in order to implement the missing NKLM learning objectives.Results: These analyses identified 24 vaccination-related courses, which are currently taught at the University. Meanwhile, 35 learning objectives on vaccination were identified in the NKLM catalogue. Four of which were identified as not yet part of the teaching program. In summary, this interdisciplinary work enabled the development of a new vaccination-related curriculum, including 35 learning objectives, which are now implemented in regular teaching courses by the Medical Faculty.Conclusions: This project successfully describes a method to develop and implement a competency-based teaching program on the topic of vaccination. Importantly, the process presented here can serve as a guide to develop and implement similar teaching programs on other subjects and Universities.

Pathologic Alterations of Canine and Feline Adrenal Glands

The aim of the study was to determine the frequency and age-dependency of adrenal changes in dogs and cats, which were dissected between 2004 and 2006 at the Institute of Veterinary Pathology, LMU Munich. The adrenal glands of 101 dogs and 159 cats were dissected free from adjacent tissue, weighed, lamellated perpendicular to its longitudinal axis and were embedded in paraffin and plastic for histologic inspection. Ageing cats most frequently showed accessory cortical nodules in the capsule, cortex and medulla, pigment deposition and shock bodies. The appearance of accessory cortical nodules and pigment deposition were linked to the age of the cats and that of shock bodies was linked to infectious diseases. Inflammatory alterations were rare and neoplastic changes were not observed. In dogs, the most frequent alterations were accessory cortical nodules in the capsule, cortex and medulla and circulatory disturbances and there was a significant linkage of the appearance of cortical nodules and pigment deposition and age. Metabolic, inflammatory and tumorous diseases were rarely observed in the dogs examined. In summary, cats and dogs show similar incidental alterations of the adrenals. Clinical relevant adrenal lesions such as atrophy or primary neoplasia were rarely diagnosed.

Finding the right doctoral thesis - an innovative research fair for medical students.

Introduction: The importance of research, as promoted by the CanMEDS framework, is widely acknowledged. Many medical students in Germany work on a research project as part of their doctoral thesis whilst still going to medical school. However, a significant amount of projects are abandoned unfinished, which leads to substantial wastage of resources. One reason for this is an information deficit concerning undergraduate research projects.Project description: To counteract this, we introduced an annual event at LMU Munich called DoktaMed with more than 600 visitors each year. It combines medical convention and research fair including keynote lectures, workshops and poster sessions as well as an exhibition of research groups and institutes. DoktaMed is a peer-to-peer event organized by a team of 40 students. Results: A needs analysis before its implementation underlined the information deficit as a possible cause for the high rate of abandoned projects. In the annual evaluation, visitors of DoktaMed rate the event with an average grade of 2.1 on a six-level Likert scale (n=558, SD=1.06, with "1=very good", "6=poor"). They stated to now feel better informed about the topic and regarded visiting DoktaMed as a worthwhile investment of time.Discussion: Students are generally satisfied with the event and feel better informed after visiting DoktaMed. However, many students never visit DoktaMed for various reasons. A possible improvement would be to present a greater number of clinical studies in addition to the laboratory work that DoktaMed focuses on now.Conclusion: Evaluation after six years of DoktaMed is very promising. Visitors seem to be better informed. Nevertheless there is space for improvement in order to get more students and more faculty members involved. More studies are needed to assess long-term effects.

The Virgin Mary and Catholic Identities in Chinese History by Jeremy Clarke (review)

Dong Zhongshu but not an attempt at understanding the potentially religious dimension of Confucianism as a social phenomenon in traditional Chinese culture. The book really is on “controversies,” as the title says, not on the facts that lie behind these controversies. Chapter 4 on the “Cultural and Historical Significance of the Controversy over Confucian Religiosity” is an attempt to deal with the “consequences.” It does so by first pointing to the “loss of meaning” that characterizes today’s China and then again goes back to some important books on Confucianism such as Joseph Levenson’s trilogy Confucian China and its Modern Fate.4 A discussion of the famous Confucian Manifesto of 1958 follows before we get to the theoretical limitations of the Neo-Confucianism of the twentieth century (pp. 158ff.), which have been pointed out by such scholars as Yü Ying-shih 余英時. Jiang Qing marks the end of the book. In his epilogue Chen states that his book “attempts to illustrate how the controversy has less to do with the academic discipline of religious studies or of philosophy than with the cultural and social concerns of Chinese intellectuals. What is at stake in the controversy is not an academic examination of Confucianism within the Western category of religion, but rather an existential endeavor to explore the possibility and feasibility of reinventing Confucianism within the paradigms of modernity” (p. 181f.). I was grateful to read these sentences although I would have been glad to find them on the first pages of the book, not the last, because here I finally understood that this book is not about facts, but about a contemporary Chinese discussion that is not all that interested in historical facts. I do wonder, however, whether a discussion that is removed so far from historical realities, be they historical or present, will have actual consequences in the future. HANS VAN ESS LMU Munich JEREMY CLARKE, The Virgin Mary and Catholic Identities in Chinese History. Hong Kong: Hong Kong University Press, 2013. xiii, 275 pp. HK$420, US$55 (hb). ISBN 978-988-8139-99-6 The Virgin Mary is a tough subject in the history of Catholicism in China. It seems that we have more sources about the blending of the Virgin’s identity with local religions, and of her story as it was associated with different levels of Chinese people, than for other sacred images including that of Christ. However, a variety of primary sources and rigorous interactions with Chinese discourses make Mary in China a fascinating but complicated subject. Until the publication of this book by Jeremy Clarke, there had not yet been a scholarly book on this knotty topic. Although it is not the principal purpose of Clarke’s research to describe Mary’s cult overall in China, a number of primary sources raised in this book ought to be of great interest to scholars of Christianity in China. In terms of Catholic history in 4 Joseph Levenson, Confucian China and Its Modern Fate (Berkeley and Los Angeles: University of California Press, 1958–1965), p. 195 of the bibliography the years are incorrectly given as 1958–1968. 96 BOOK REVIEWS China, writing about the Virgin Mary in the modern period covered by this book, beginning with the First Opium War (1839–1842) until the early twentieth century, is not an easy task, since the era simultaneously witnessed a chaotic transformation in Chinese history and an unstable up-and-down response to Christianity in China. Clarke organizes the multiple entangled threads with a great number of longneglected but tremendously valuable sources and images. A reader who is interested in this history seen from different perspectives can enjoy this book. The book has three parts and six chapters in total, excluding Introduction and Conclusion. Clarke’s primary thesis is that the Virgin Mary, or “the way Marian devotions are portrayed artistically” (p. 195), can best be regarded as a lens through which the establishment of a Chinese and local Catholic identity may be observed after 1900. This evolution is in contrast with that of the preceding decades, when French influence on the China missions was strong after a series of treaties was signed by the Qing dynasty with...

Conversation about the Concept of Spirit

The following dialogue is an excerpt from a longer conversation in Piran (Slovenia) between Andrej Ule (University of Ljubljana) and Matthias Varga v. Kibed (LMU Munich) on April 19, 2015 regarding Ule’s concept of spirit.