Press Release March 1st 2017
From Cystoscopy to Da Vinci: The UKE Clinic for Urology Turns 50
As in other fields of medicine, urology has experienced rapid development in the area of operative medicine. 50 years ago the Clinic for Urology was part of the UKE Clinic for Surgery, now the UKE Clinic for Urology and the Martini-Klinik perform complex constructive and tumor surgeries independently.
The growth of the Clinic for Urology is closely tied to its 3 clinic directors; Prof. Herbert Klosterhalfen (1966 to 1991), Prof. Dr. Hartwig Huland (1991 to 2008) and Prof. Dr. Margit Fisch (since 2008). “The face of urology has changed dramatically over the course of the last 50 years – today urology is at the forefront of high-tech medical procedures, such as the Da Vinci surgical robots at the Martini Klinik and the plastic-reconstructive procedures now available at our clinic” says Prof. Dr. Fisch, the only female professorial chair holder in urology in Germany.
Under the stewardship of Prof. Klosterhalfen, the UKE Clinic for Urology developed an excellent national and international reputation – especially in the fields of clinical and experimental research, kidney transplantation, pediatric urology, andrology, transsexual treatments, oncology, extracorporeal shock wave lithotripsy and renal physiology.
First Kidney Transplant in 1970
The first kidney transplant in Hamburg was carried out in 1970 at the Clinic for Urology. During the night of the 2nd into the morning of the 3rd of February, Prof. Klosterhalfen transplanted the kidney of a 25-year old accident victim to a 28-year man – which ushered in the beginning of a new era, making the UKE the biggest transplantation center in Germany. Today, over 2800 kidney transplants have been carried out at the UKE. Since the 1990s, kidney transplantations have been carried out under the supervision of the UKE Clinic for Hepatobiliary Surgery and Transplantation Medicine.
Founding of the Martini Klinik in 2005
In 1991 Prof. Huland took over the reins of the clinic from Prof. Klosterhalfen. Prof. Huland proceeded to further expand the tumor surgical areas of the clinic and developed a method of complete prostate removal (radical prostatectomy). This led to the founding of the Martini Klinik in 2005 – initially as a purely private clinic. In 2017 the Martini Klinik now treats similar numbers of private and statutory insured patients. This highly specialized clinic treats over 2200 patients annually, making it the biggest Prostate Cancer Center in the world. It remains interconnected with the UKE Clinic for Urology – there are always one consultant and two physicians from the UKE present at the Martini Klinik. Prof. Huland: “Working only two or three years at the Martini Klinik allows specialists to learn far more about prostate cancer than they would during a normal career at an urological clinic”.
Focus on Plastic-reconstructive Surgery since 2008
The current head of the Clinic for Urology has turned her attention to a completely different clinical focus. Prof. Fisch specializes in reconstruction of the bladder using tissue grafts taken from other parts of the patient’s body. She has expanded her team to become Germany’s biggest Center for Urethral Surgery. Children with congenital urethral deformities, deformities of the other genital and reconstructive transgender surgeries are all fields of expertise which are available now at the UKE Clinic for Urology. Prof. Dr. Fisch: “We have expanded our focus to include research into tissue engineering and we aim to fully harness the possibilities presented by 3D printing technology”. The Clinic for Urology and Martini Klinik has a total of 54 beds, treating a total of 6000 inpatients each year. Urology is often seen as “medicine for old men”, this is a cliché, says Prof. Fisch. Today, 50 percent of the patients are male and the other 50 percent is made up of women and children. “There has been a notable increase of the number of the very youngest patient stemming from the interest that has been created by the construction of the UKE Pediatric Clinic – which has not yet opened” says Prof. Fisch “So there will be an ever increasing number of patients visiting the UKE Clinic for Urology over the next 50 years”
Press Release February 1st 2017
Research with Colors - Method Developed at the UKE in Use Worldwide
The image on the monitor looks like a work of art; multi-colored dots look as if they have been painted with an artist’s brush. The images show clones of cancer cells which have been stained using a new method developed by researchers at the UKE and which has found use worldwide.
“Using the coloration we are able to identify which of the cancer cells live the longest and are most likely to metastasize” says Prof. Dr. Boris Fehse from the UKE Clinic for Stem Cell Transplantation. Prof. Fehse and his team are researching the underlying mechanic of the metastasizing process. The coloration helps to answer the decisive questions; which cells are responsible for the development of metastases? “Is it the results of a chaotic process where random cells are released into the blood stream by the primary tumor? Or are special cells the only one able to leave the primary tumor and develop in another part of the body? And if this is the case how do these cells differentiate themselves from other tumor cells?
To determine the answer it is necessary to isolate the various cell lines which make up a tumor by making each cell line clearly visible. This is achieved by transfecting the gene of colored proteins into the cells and then have the biochemical machinery of the cells produce the colors. The tools needed for transfection are known as gene taxis and are based on the characteristics of a virus with the ability to smuggle their genes into cells. The UKE researchers have made use of specially adapted transfectors “We chose vectors which stem from lentiviruses and developed a modular vector system which can be used for a variety of applications” explains Dr. Kristoffer Riecken. Due to the modular nature of the development we decided to name them LeGO vectors. “Our LeGO system has increasingly gained traction in the scientific community and has been cited in more than 150 scientific publications worldwide”.
The cargo carried in the vectors has been obtained from corals, jellyfish and other organisms with the ability to produce organisms with the ability to produce fluorescent proteins which we then used to mark the various types of cells. However, the available range of color is not extensive enough to mark the large number of cells which need to be tracked. “During the examination of the creation, development and treatment of malignant cancer cells it is important to be able to follow as many cells as possible at the same time to help depict the variability of the cell cloning” explains Prof. Fehse.
How can the limited number of fluorescent proteins be used to mark a large number of different cell closes and allow for sufficient differentiation between the cells? “The idea was to use the basic color of red, green and blue to generate a wide range of new colors in the same way that a television or computer monitor does” says Kristoffer Riecken. But can this principle be successfully applied to the marking of cells using fluorescent proteins? To assess this the researchers infected cell culture using LeGO vectors, each of which contained a fluorescent protein with one of the three basic colors. After the cells had been left to develop for a few days and the color genes were mixed through the process of cell division the cells were examined under the microscopy in a darkened laboratory and activated by short bursts of light. Dr. Riecken: “We had a eureka moment looking through the microscope: The cells were now colored!”
Due to the various mixing ratios of the basic colors, each cells developed its own individual colors using the entire spectrum of visible colors. The researchers named this method RGB marking. “The next step was to show that RGB marking allows for the analysis of malignant cells in a living organism” explains Prof. Fehse. The process proved itself in tests on liver tumors and in cooperation with other UKE researchers in the special research group 841 “hepatic infections”. The duo Fehse/Riecken now has a network of international partners examining the heterogeneity of developing tumors.
Press Release January 1st 2017
New Paths in the Treatment of Cancer: Genetic Keys
A revolution in the treatment of cancer? It may be that it is not where the tumor is situated. The genetic map of the tumor, which makes every tumor unique, is the decisive factor in the treatment of cancer. Frank Hohensee hopes to benefit from this new insight.
Incurable: When Frank Hohensee (41), father of three children, found out in 2014 that it was unclear if his highly aggressive tumor was situated in the bladder, prostate or intestines, he had been confronted with this word many times. It took only 48 hours from the first clinical diagnosis to confirming that the lymph nodes are massively affected and that the metastases had spread throughout the body. He was told that the tumor was too large for an operation “It was a devastating diagnosis for us all” says Frank’s wife Daniela (36). Mr. Hohensee was referred to the Martini Klinik in February 2016. Since this time there have been many positive changes. He first received a course of hormone therapy which led to a reduction in the size of the tumor which in turn made surgery possible. He then received a course of chemotherapy. When the standard program of established therapies had been completed and tumor metastases were identified in the liver then the tailored, gene-specific treatment began.
“Each patient is like a new textbook” says Prof. Thorsten Schlomm of the Martini Klinik, who together with Priv.-Doz. Dr. Gunhild von Amsberg of UKE Clinic for Oncology, is overseeing the treatment of Frank Hohensee. “Similar to when one travels along the streets in Google Earth, we travel along all the streets of the genome looking for mutation, gene fusions and breakages which do not belong there. This allows us to develop a map to navigate the tumor and decide which medications are most suitable to treat the genetic mutations” says Prof. Schlomm. These genetic sequences are collected all over the world and their pathways, which are involved in the distribution of metastases, are deciphered. Many types of tumor have similar sequences. The collected genetic profiles are then compared with healthy DNA and are planned to be made available to physicians and prostate cancer sufferers using a social network which has been given the name “Progether”.
“The aim of this resource is to help optimize treatments worldwide.” says Prof. Schlomm, who works with an international network of genetic researchers, mathematicians, physicians who are attempting to decipher the cancers gene and develop targeting treatments.
In the opinion of Schlomm and von Amsberg, genomics has ushered in a new era of tailored cancer treatments. “The analysis of the entirety of the human DNA allows us to identify genetic damage which can lead to cancer and metastases. At the same time, new gene-specific medications are being developed which make use of this genetic information to target the tumor cells”. The International Cancer Genome Consortium (ICGC) The Cancer Genome Atlas (TCGA) have compiled a catalogue using the data from 20 000 cancer patients which lists the changes which are responsible for the development and metastasizing of tumors. The Martini Klinik and the UKE Institute for Pathology and involved in this research project and analyze their data in cooperation with the National Center for Tumor Diseases in Heidelberg.
The first available data shows that there seem to be only very few relevant molecular pathways which are responsible for metastasizing. Many tumors appear to be genetically related – some prostate carcinomas are genetically similar to lung or ovarian carcinoma. “This is why we have to broaden our horizons and not depend solely on the classic types of prostate cancer treatment.” says Dr. von Amsberg. The aim of gene-based treatment is to block their genetic pathways using medications instead of treating every tumor using the same standard treatment. For Frank Hohensee, gene-based therapy offered him hope. He was the first patient at the Martini Klinik to receive a gene-specific medication that is tailored to his genetic pattern. If this proves to be the right treatment for Mr. Hohensee, and if he requires further treatments, only time will tell.
Press Release December 1st 2016
Can Sport Prevent Cancer? A study on How a healthy lifestyle can help benefit cancer prevention
Someone who is physically active and has a healthy diet can actively reduce their risk of developing cancer. But, does this also apply to women who have certain genetic risk factors which aid the development of breast and ovarian cancers? Researchers at the UKE are looking for answers.
Each year around 70,000 women in Germany are diagnosed with breast cancer. Especially at risk are those women who carry the mutated “Breast Cancer Gene”. “Studies have shown that women who are not overweight and are physically active suffer notably less from breast cancer than those who are overweight and not physically active. There is also evidence that a healthy diet can have a positive impact on the risk of developing cancer – at least in those women who do not have the genetic predisposition.” explains Prof. Dr. Barbara Schmalfeldt, director of the UKE Clinic for Gynecology. “We want to find out if a healthy life style can reduce the chance of developing genetically predisposed cancers or help improve the chances of curing the cancer once it has developed.”
In cooperation with the specialist at the Hubertus Wald Tumor Center, the University Cancer Center of Hamburg (UCCH) and other partners, Prof. Schmalfeldt and her research group are participating in the Germany-wide LIBRE study (Engl: Lifestyle Intervention for Woman with Breast and Ovarian Cancers). Concurrently researchers are working on another healthcare research project – for this project the researcher gathered all the important data for patients with ovarian cancer and divided them into two groups: One group is the so-called control group who will receive information regarding the benefits of regular exercises and a balanced diet and an invention group who will complete a targeted sport and nutrition program. Both groups will be monitored for a period of three years and then the finding of each group compared with one another.
The positive effects of a healthy can also be seen in patients suffering from prostate cancer. The interdisciplinary UKE research group “Prostate Cancer and Lifestyle” headed by Dr. Matthias Rostock and Dr. Imke Thederan are attempting to ascertain if the risk of the recurrence after prostate removal can be reduced by healthy changes to a patient’s lifestyle. In the long term both studies aim to help develop a preventive concept – with the aim of reducing the risk of developing cancer and increase the chances of successfully treating the cancer.
Press Release November 1st 2016
“Like a Hospital CSI“
Prof. Dr. Johannes Knobloch is the new head of the Department of Hospital Hygiene at the UKE. He aims to analyze and optimize existing processes and identify potential sources of danger. He also has another pet project: Research.
Prof. Knobloch aims to apply scientific based knowledge to help further develop and improve his department.
“The Department of Hospital Hygiene works like the American crime scene investigators in the show CSI: Follow the clues, analyze the process while investigating and asking questions” says Prof. Knobloch. This is why the 47-year old Prof. Knobloch will first analyze existing UKE processes to determine where he and his team can intervene to effectively deal with possible sources of danger. To allow for the effective execution of the on-site analysis Prof. Knobloch, who was previously head of hospital hygiene at the Paracelsus Klinik, aims to continually widen the remit of the UKE Department for Hospital Hygiene. Prof. Knobloch also places great emphasis on hospital hygiene not being exclusively a concern of the specialists in his department and that it should be something that all hospital staff are concerned with: “We must all ensure the hospital hygiene standards are adhered to and help increase and improve the safety of the patients in the long term” according to Prof. Knobloch.
Along with process analysis and optimization the new head will focus on furthering research. “The field of hospital hygiene requires more evidence-based research. Therefore at the UKE I am looking forward to utilizing the structural possibilities available at the UKE to help the scientific development of hospital hygiene” says Prof. Knobloch, who worked for several years at the UKE Institute for Microbiology, Virology and Hygiene after finishing his medical studies. Prof. Knobloch also wishes to use his experience and knowledge and get involved in the teaching side of the field of hospital hygiene: “Hygiene has a lot to do with setting an example. If we are able to use targeted teaching to develop and improve the example being set by young people then we have already made a massive step in improving the German healthcare system”.
Press Release October 15th 2016
Minimally Invasive Mitral Valve Reconstruction at the University Heart Centre Hamburg: 750th MitraClip Implantation
A team of specialists at the UKE University Heart Centre has successfully carried out the implantation of a so-called MitraClip for the 750th time to treat mitral valve insufficiency.
The mitral valve is one of the heart’s four valves and is made up of two sails which stop the blood from returning from the left chamber of the heart into the left atrium. If this valve no longer closes correctly then this is called mitral valve insufficiency. Patients who are considered of being at high risk can have a small clip placed in the beating heart between the sails of the mitral valve without invasive opening of the thorax and without the need for a heart-lung machine. The specialist enters the body through a vein in the groin area and proceeds upwards until reaching the heart and then places the clip using an ultrasound as guidance. “The UKE University Heart Centre was the first clinic in Europe to use the MitraClip technique, and has now treated more patients using this procedure than any other clinic worldwide” says Priv.-Doz. Edith Lubos at the Clinic for General and Interventional Cardiology.
Please click here for further details about the University Heart Center Hamburg
Press Release September 15th 2016
A Powerful Ally
The Hubertus Wald Tumor Center and the University Cancer Center Hamburg (UCCH) unite all the UKE clinics and institutes who deal with the treatment of cancer as well as cooperate with a wide array of health care partners and research centers in the Greater Hamburg region – A look behind the scenes.
Heinz-Dieter Eberhardt (69) has a great deal of confidence in the UKE. “Three years ago I was successfully treated for an ear condition at the UKE. In 2015, when I was diagnosed with laryngeal cancer, I knew right away that I wanted to be treated at the UKE,” explains the patient, who hails from the northern German city of Flensburg.
Eberhardt was referred to the Head and Neck Tumor Center and then admitted to the ENT clinic as an inpatient. The Head and Neck Tumor Center is one of six organ cancer centers at the UCCH. Here, they specialize in the treatment of laryngeal, throat, mouth, salivary gland and nasal cancers. The center also includes an ENT clinic, Oral and Maxillofacial Surgery clinic, Radiology, Radiotherapy and Pathology.
Approximately 60 percent of all tumor patients will require radiotherapy during the course of their treatment. The Outpatient Clinic and the Clinic for Radiotherapy and Radio-Oncology combined treat around 1850 new patients each year. The Clinic for Radiotherapy has replaced all of its large machines over the last few years with state of the art technology. A new linear accelerator was put into service in March of this year. Due to the upgrades, UKE Radiology is one of the most modern clinics in Europe. One of the most innovative treatments on offer is image-guided radiotherapy which allows for exact localization and targeting of the tumor. They also offer intensity-modulated radiotherapy which allows for the dosage to be better tailored to the extension of the tumor and to protect healthy tissue as much as possible. “The biggest advantage of the UCCH for patients is that they don’t have to be transferred between clinics during their course of treatment or have to explain everything over and over again. The specialist and nursing teams work using an interdisciplinary process where the teams cooperate extremely closely to organize and discuss all cases together,” explains Prof. Dr. Carsten Bokemeyer, Medical Director of the Oncology Clinic and UCCH spokesman. “Using digital patient files and regular meetings of our specialist tumor boards we are able to discuss each case in detail and agree on how to proceed with treatment using the newest medical treatments available”
The patient Eberhardt also benefitted from this process to understand his condition. “From the start it was important to me that all examination findings and available therapeutic options were explained in detail and in a way that I could understand. I was referred for chemotherapy and combination chemotherapy-radiotherapy. All appointments were arranged for me, including a heart examination in between. I didn’t have to deal with any of the administrative or organizational aspects of my treatment and I was very well taken care of by the doctors and nursing staff”.
Cancer treatments have improved exponentially over the course of the last 20 years. New discoveries from the fields of molecular biology and genome research have made their way into everyday clinical treatment. Now, many more patients can receive a course of treatment tailored to their specific condition and greatly improve the chances of fully recovering. “Intensive research is required to achieve such progress,” explains Prof. Dr. Jörg Haier, Director of the UCCH. The research at the UCCH focuses on making new discoveries available to the patient as quickly as possible as well as focusing on the fields of prevention and early detection.
The main focuses of research are tumor metastasizing, prostate cancer, leukemia and lymphoma, brain tumors and the extensive field of psycho-oncology. The UCCH researchers in the various clinics and institutes, and those based outside of the UKE cooperate very closely. Prof. Haier offered an example: “The researcher can access the biobanks, tissue sample collections, state of the art technologies for molecular and genetic examinations, and specialist imaging technology from approximately 50 cooperating institutes, which we call Core Facilities”
Along with the close cooperation in research and clinical fields, Prof. Bokemeyer is convinced that the cooperation between the various specialist and vocational groups is the key to success. “The interdisciplinary coordination of the cancer treatment has been one of the major advancements. This allows all treatment approaches – radiotherapy, medication therapy, surgical therapy – to be optimized and the patient brought into the decision-making process. All of this has significantly improved overall results”.
Heinz-Dieter Eberhardt’s treatment was successfully completed in March. “I am delighted that there is no longer any evidence of the tumor. I am still somewhat hoarse sometimes but the doctors have promised that it should get progressively better over the course of the next twelve months”. Mr. Eberhardt´s confidence in the UKE was fully validated. The patient´s wife, Waltraud Kruse-Eberhardt is ecstatic that her husband has fully recovered. “I am so relieved, I was so full of worry and anxiety during my husband’s illness. Now he is fully back to normal, riding his bike every day and even doing the shopping by himself – it is so fantastic!”
40 UKE Institutes and 11 clinics and 15 medical practices from the Greater Hamburg region belong to the UCCH. Around 15 000 in- and out-patients are treated annually. “German Cancer Aid” rated the UCCH as the only oncological center of excellence in Northern Germany again.
Press Release September 1st 2016
Using the Liver to Support Nanotherapy: 14 Million Euro in Funding for a New Treatment Approach
In the future, special liver cells may offer a better way to treat autoimmune illnesses. A new treatment approach has been developed by Collaborative Research Group 841 “Liver Infections”
Multiple sclerosis leads to nerve damage, psoriasis damages the skin and infectious rheumatism damages the joints – autoimmune illnesses cause the immune system to mistakenly identify the body's own tissue as foreign matter which has to be combated. This leads to severe infectious reactions which can cause permanent damage to the affected organs. A normal organism uses T-cells (tregs) to regulate over-activity of the immune system and stop the development of autoimmune illnesses.
The CRG 841 team, led by Prof. Dr. Johannes Herkel, has discovered that such protective tregs are preferably formed in the liver. The liver’s endothelial cells play a decisive role in the re-programming of the inflammation-promoting T-cell into inflammation-inhibiting tregs. These findings made it possible to develop a completely new therapy approach for the targeted treatment of autoimmune illnesses – even those not directly affecting the liver.
Using nanoparticles, the illness-triggering proteins are selectively transferred into the liver endothelial cells. When the T-cells in the liver come into contact with the protein-containing endothelial cells, they are automatically re-programmed into tregs which are then able to inhibit the specific autoimmune illness. The high effectiveness of this brand new therapeutic principle was shown in a trial by the CRG on an illness similar to multiple sclerosis.
The research is being supported by the Federal Ministry of Education and Research (BMBF in German), and human clinical trials of this new treatment have already begun. A consortium of international investors were so impressed by this therapeutic approach that they have provided 14 million Euro of venture capital. This money was used to found Topas Therapeutics GmbH with the aim of developing further nanotherapy concepts that can be applied to other illnesses.
Press Release September 1st 2016
To Mars and Back: “Heart in Space” Cooperation Project between the University Heart Center and NASA
The first astronaut mission to Mars is due to take place as early as 2018. Dr. Sonja Schrepfer from the University Heart Center has been chosen by NASA to research the effects of zero gravity on the human cardiovascular system.
The NASA Mars mission aims to reach another milestone in space travel – astronauts orbiting the red planet. It is planned to send two astronauts to orbit Mars in a small capsule. The journey would take approximately three years total. Humans have never spent so much time in space. “The possible effects of long-term zero gravity on an astronaut’s cardiovascular system have barely been researched,” explains Prof. Schrepfer, Director of the University Heart Center’s TSI laboratory and leader of the research project “Heart in Space”. The project has received US$750,000 in funding from NASA. A team of eight scientists from the fields of medicine, biotechnology, space medicine, physics and biology is currently working at the NASA Center in San Francisco to acquire new insights.
The team of specialists suspects that long-term zero gravity negatively affects the human heart and vascular system and may cause strokes and heart attacks. To test this theory, the TSI laboratory carried out highly specialized cell culture experiments where human muscle cells from the heart vessels were transferred into an artificial zero gravity environment. The findings: the cells reproduced extremely rapidly but did not experience normal cellular death which makes room for newly developed cells. This caused a blockage of the vessels eventually leading to vascular stenosis. The research team devised an experiment to test these initial findings using tissue samples taken from mice who have already spent one month in the International Space Station in zero gravity. The team is already hard at work devising possible therapeutic treatments. Prof. Schrepfer and her team have isolated a molecule that may be able to hinder the development of vascular occlusions. They plan to begin a clinical study this year to determine if the therapeutic approach is also suitable for humans.
Press Release May 15th 2016
Life-Saving Stem Cell Transplantation
The opening of the new UKE Pediatric Clinic is eagerly awaited, though the current clinic continues to provide first-class medical treatment. Since 1990, the UKE Pediatric Clinic – in cooperation with the Interdisciplinary Clinic for Stem Cell Transplantation – has overseen more than 500 boys and girls receive either a bone marrow or stem cell transplant. The UKE Pediatric Oncology and Hematology Center is one of the largest of its kind in Germany.
For children suffering from cancer, a blood stem cell or bone marrow transplant (BMT) can be a lifeline. Both are invaluable methods of treating leukemia, congenital blood disorders and severe immune defects. A so-called HLA-identical donor is needed for such transplants. The donor may be a sibling or an unrelated person. If no suitable donor is found then an HLA-haploidic stem cell transplant from the patient’s mother or father is also a possibility. A child is haploidic to its parents: haploidic means half-identical, due to the fact that a child receives half of its HLA genes from each parent. Twelve percent of all bone marrow and stem cell donors are patient’s parents.
A research team, led by Prof. Dr. Ingo Müller, is currently investigating why one parent may be a more suitable donor than the other. “Only a few years ago we thought that fathers were the more suitable donors; now we know that the opposite is more often the case,” reports the head of the UKE Pediatric Stem Cell Transplantation Clinic. “We have discovered evidence that the cells transferred from the child to the mother during pregnancy play a pivotal role. Approximately fifty percent of mothers carry their child´s cells after birth. These mothers are the most suitable donors in the groups that we have investigated.”
This was especially relevant in the treatment of children suffering from leukemia. Their chance of survival was around forty percent higher if the donating mother had a high level of the child’s cells. Prof. Dr. Ingo Müller explained, “the immunological mechanisms behind this finding will be investigated further with BMT Head of Research Prof. Dr. Boris Fehse, as part of a nationwide study. Over the course of the next two years a total of ten major treatment centers in Germany will be taking part.”
An Excerpt from the Press Coverage of the Construction of the New UKE Pediatric Clinic:
The University Clinic Hamburg-Eppendorf (UKE) has begun the construction of its new University Pediatric Clinic. The first patient will be welcomed in autumn 2017. The clinic will have a total floor space of 10 449 m², 138 Inpatient beds and 14 Day Clinic beds. Each room has been lovingly decorated and space has been allocated for parents to spend the night. The clinic also boasts a range of common rooms and playrooms. Children and teenagers will always share rooms with patients of a similar age for the duration of their stay; WLAN will be available to all as a standard service.
The layout of the new clinic allows for optimal cooperation between the various specialist medical departments. The Central Pediatric Emergency Room on the ground floor will have its own access route, making it easier and quicker to reach. The Radiology Department will be directly adjacent to the Emergency Room, allowing for medical imaging to be carried out immediately if needed. The Department for Physiotherapy, the Oncology Outpatient Clinic, the Day Clinic, the Dialysis Center, the Cafeteria and the Pediatric Clinic Seminar Rooms are also all on the ground floor.
The University Pediatric Clinic in Numbers:
• 152 Inpatient beds and 14 Day Clinic beds
• 20 Pediatric Intensive Care beds
• 6 BMT beds for patients following a bone marrow transplant
• 3 operating theatres, including a hybrid operating theatre
• 2 Day Clinics, including the only Oncology Day Clinic in Metropolitan Hamburg
• The total cost of the new Pediatric Clinic will be 69.5 million Euros
• The Free and Hanseatic City of Hamburg is providing a total of 20 million Euros
• 13,400 m³ of cement and 1,500 tons of steel will be used during construction
• 150,000 m of power cables will be laid
• The crown of the largest European Hornbeam in the inner courtyard has a diameter of 24 m
Press Release March 15th 2016
A Focus on Security
After two years of extensive renovations, the University Medical Center Hamburg Eppendorf (UKE) Hospital Pharmacy is now complete, and even more modern than before. All its operations and processes in regards to preparation of medication meet international industry standards. The overall cost was approximately 7 million Euros.
The pharmacy manufactures around 50 000 chemotherapy solutions for patients receiving treatment at the Oncology Center every year. These cytotoxic medications, which attack tumor cells, can be very dangerous for healthy people should they come into contact with them. This is why they are manufactured in isolators, which are hermetically sealed to ensure complete sterility and that toxic substances cannot escape.
Pharmacy employees access the isolators using a special glove system that keeps them 100 % safe from direct contact with toxic materials. Safety was at the forefront of the plans when renovating the pharmacy. Before the individually packed dosages are sent to the wards, they are subjected to a rigorous check by the pharmaceutical-technical assistant (PTA) to ensure they have been packaged correctly.
During the renovations, particular attention was paid to the manufacturing rooms, in which tumor therapy solutions, infusion or analgesic medications are manufactured under the strictest sterile conditions. “We are delighted that we were able to complete the renovation in such a short time. This enables us to meet the UKE’s needs in the coming years,” said the Pharmacy Director, Dr. Micheal Baehr.
Employees enter the new aseptic manufacturing area – where toxic and aseptic solutions are manufactured in strictly separated areas – through a multi-stage personnel sluice system. Each sluice has an independent ventilation and filter system, which removes used air less than 3 minutes after someone enters the sluice and then fills the space with new, filtered air. The aim of the system is to guarantee stage-by-stage removal of bacteria that could compromise the sterility of the manufacturing area. There is also a material sluice, which all material entering the sterile area must pass through. A computerized monitoring system constantly checks the air quality in the manufacturing areas along with airflow, humidity and temperature. All employees adhere to established work procedures meticulously to ensure not only their own safety but also especially that of the patients.
The electronic pharmaceutical supply process is an integral part of the UKE’s daily operations. Clinical pharmacists assess each new prescription and release the prescribed medications in the digital patient file. Every day, around 10 000 individual dosages are mechanically packaged and transported to the 71 wards and the Central Emergency Room. This process is monitored and overseen by pharmaceutical-technical assistants (PTAs).
The pharmaceutical processing of analgesic solutions and the filling of syringe pumps takes place using several laminar-flow-benches, with the highest level of room sterility. In this area each year, around 20 000 bags for parenteral feeding of premature and newborn babies are manufactured. Four special sluices, special air filters and special garments ensure complete sterility.
We have a new autoclave. This is used to sterilize products that are to be used in so-called “clean rooms” such as infusion solutions and local anesthetic solutions. All materials pass through a material sluice, where they are subjected to various stages of disinfection and sterilization.
Press Release March 1st 2016
Interaction of the Senses
Neuroscience Research at the Forefront of New International Collaborative Research Projects
How do seeing, hearing and tasting interact in the brain to create an overall impression of something? This is the fascinating question that a group of neuroscience researchers from the (University Medical Center Hamburg-Eppendorf) UKE are investigating as part of a new international collaborative research project.
“The long-term aims of our research are to understand the fundamentals of cross-modal learning and to improve the application of artificial intelligence,” says Prof. Dr. Andreas K. Engel from the Institute for Neurophysiology and Pathophysiology. “Cross-modal learning is important in helping people understand their surroundings. For example, it is crucial in reading, writing and learning to grab and utilize objects.” During all these activities, the various types of signals necessary for the completion of various tasks must be processed in the brain at the same time and then integrated with each other. Computers are able to carry out similar processes, but to a far lesser extent. “We want to learn from the human brain and use the information to improve the processes of computers and robots,” says Dr. Engel. “A concrete aim is, for example, to make the recognition of people and objects more robust – and less prone to mistakes - by improving the integration of sensory information.”
The UKE neuroscientists are being sponsored and supported as part of a research association that has been recognized as exemplary: the project has been assigned the abbreviation “TRR 169” (Project Name: Cross-Modal Learning: Adaptivity, Prediction and Interaction) and is one of the very few international trans-regional, collaborative research centers being sponsored by the German Research Society (Deutschen Forschungsgemeinschaft –DFG). Other partners of the UKE research project are colleagues from the Institutes of Computer Sciences and Psychology at Hamburg University and researchers from China (Chinese Academy of Sciences, Tsinghua University, Beijing Normal University, Peking University). These projects have a maximum duration of 12 years and the first financial sponsorship period will last until the end of 2019. Around 3.4 million Euros will be made available to the 20 UKE researchers during this time. For a total of seven of the 16 scientific sub-projects and for the graduate school, the representatives of the management team are chosen from the UKE: along with Prof. Engel, who is a member of the SFB board, there are also Prof. Dr. Christian Gerloff, Dr. Friedhelm Hummel (Neurology), Dr. Guido Nolte (Neurophysiology), Prof. Dr. Claus Hilgetag (Computational Neuroscience), Dr. Michael Rose and Dr. Jan Gläscher (Systemic Neurosciences).
Press Release February 1st 2016
Using Antibiotics to Treat Appendicitis - No need for an Operation!
For the last 100 years, surgical intervention has been the standard method of treating appendicitis. However, new studies have begun to challenge this view. The specialists at the University Medical Center Hamburg Eppendorf (UKE) Clinic for General, Visceral and Thoracic Surgery do not immediately reach for the scalpel. In cases deemed to be less severe, antibiotics are administered instead.
Two years ago, Petra Boldt arrived at the UKE Emergency Room complaining of severe pain in her right lower abdomen and vomiting. The UKE team quickly diagnosed appendicitis. The 53-year old Petra, who works in the Senior Physician’s Office of the UKE Surgical Clinic, recalls, “I began to panic. I thought I would need an operation and would be in hospital for a long period of time.” Her boss, and the treating physician, Prof. Jakob Izbicki, decided on a different approach. He opted to try and treat the condition using antibiotics – a plan that challenged a decades-old medical dogma.
This approach appears to make sense when one considers that appendicitis is caused by bacteria, and of course bacterial infections are treated with antibiotics. It was 20 years ago that Prof. Izbicki first decided to attempt to treat a case of low-grade appendicitis with antibiotics. The most recent studies support the course taken by Prof. Izbicki and his team. A study in Finland found that doctors at a university clinic were able to successfully treat 73 percent of patients suffering from low-grade appendicitis using antibiotics. The remaining 27 percent required surgery within the next 12 months, but it was noted that there were fewer complications than normal. “Despite a failure rate above the target value of 24 percent, the results prove that this is an applicable therapy,” says Dr. Alexandra König, senior physician at the UKE Surgical Clinic.
The crucial skill is differentiating between complicated and uncomplicated cases straightaway. “A great deal of clinical experience is required,” says Dr. König. Ultrasound images, laboratory blood testing and CT images all also provide important information. However, before this treatment method can become established and universally accepted, long-term clinical studies are necessary. The UKE plans to initiate a randomized study this year, which will provide the long-term information required. According to Dr. König, “if the results of the study are as we hope, then in the future one third of appendicitis patients will be able to avoid operative intervention.”
Petra Boldt’s case shows how successful this treatment method can be: after 24 hours as an inpatient, during which time she received a course of antibiotics as an infusion, she was able to return home. A few days later, she had fully recovered and was able to return to her desk at the UKE. “I was extremely lucky,” she says today, “and I wish all appendicitis patients the same kind of good luck that I had.”
Press Release January 15th 2016
Testing a New Type of Treatment for Leukemia - Targeted elimination of cancer cells
After five years of intensive research, Priv.-Doz. Dr. Dr. Sonja Loges and her team have developed a tailored therapeutic treatment for leukemia patients. Based on initial findings, the new medication dupes tumor cells and prevents them from growing. It is currently being tested in clinical trials.
Why does chemotherapy help some patients and seem to have no positive effect on others? This question is what motivated Dr. Loges and her research team at the Clinic of Oncology and Institute of Tumor Biology to begin their research. During their examinations of a group of cancer patients, they discovered that the activation of the protein molecule – known as the Axl receptor – makes the cancer resistant and insensitive to chemotherapy. “We discovered that around 50 percent of patients developed this receptor and this drastically reduced their chance of survival,” explained the cancer specialist.
In close cooperation with a Norwegian company, the research group was able to develop a molecule blocker – a small molecular inhibitor that can penetrate cells and disrupt the signal transmission through the axl receptor. The first laboratory tests showed that the underlying mechanism worked. The new substance made the leukemia cells more sensitive to chemotherapy. Not only that: the researchers also discovered that the medication was effective without chemotherapy and caused cancer cells to die.
That the research results are based on concrete patient data is no coincidence; Dr. Loges places great emphasis on the combination of clinical and research aspects in medicine: “my job is the development of new and relevant therapeutic approaches. I move constantly between the laboratory and the patients’ rooms,” says Dr. Loges. The certified physician and biochemistry graduate heads a research team of ten people. This team acts as a bridge between the Institute for Tumor Biology and the Oncology Clinic at the Oncology Center. “This ‘bridge’ enables us to conduct research directly with the patients we are treating, and in turn immediately apply the results of our research to help them,” explained Dr. Loges.
The research team seems to have been successful in its quest to overcome the chemotherapy-resistant form of leukemia. Currently, nine patients worldwide have been given the new medication as part of the Phase-1 clinical study, with three of these patients at the UKE. “Our current aim is to determine the maximum effective dosage and to discover possible side-effects,” explains Dr. Loges. The patients receive treatment at the clinic for a period of four days, after which they are able to return home and administer the medication themselves. They then return to the clinic regularly for check-ups. The initial findings are positive: “our laboratory tests showed that after only three weeks there was complete inhibition and cellular inactivity,” explains a researcher. It is hoped that this medication will be able to prevent progression of the illness.
Running alongside this study is a secondary trans-national study, being carried out in cooperation with a Norwegian laboratory. The aim of this study is to determine exactly how the new medication works. Cells are taken from individual patients and then analyzed in the laboratory. The researchers in the program have also made it a priority to identify a new biomarker, which would then allow them to determine which therapeutic approach is best suited to each individual patient. Dr. Loges explained, “if we are able to determine in advance which type of treatment is best suited to each patient, then we can avoid patients suffering from unnecessary side-effects.” This is one of the central pillars of tailored and personalized medicine, the prerequisite of which is to be able to offer patients the most suitable treatment for their individual conditions.
The researching and testing of the medication has already proved an important step in the treatment of this cancer. The study will soon be entering its second phase. During this phase, a group of patients will be given the highest tolerable dosage, after which the exact effectiveness of the treatment can be assessed. “At this time we are not going to assume that this medication can cure leukemia. But for patients who have no other therapeutic option available to them, it offers a glimmer of hope that it is possible to stop the progression of the condition without the application of chemotherapy,” says Dr. Loges.
Dr. Loges’ aim for the future is to uncover more tailored therapeutic treatments and to combine them with existing treatments – she hopes this will mean more targeted medicine can be put to use in the ongoing fight against cancer.
Press Release December 15th 2015
A view inside a newborn baby's heart
Radiologists Develop a New Type of Medical Imaging
Researchers at the University Medical Center Hamburg Eppendorf (UKE) have developed a new technique to guide MRT devices. Using ultrasound technology, it is now possible to synchronize MRI images with the heart activity of a fetus. This enables specialists to assess an unborn baby’s heart function in an unprecedented level of detail.
Fabian Kording points to a black plastic container that resembles a box of chocolates; it is adorned with flashing lights and an array of switches, as well as a cable attaching it to the head of an ultrasound device. This box is the result of years of painstaking research undertaken by the “sMaRT-sync” project team. And if the project continues to develop in the way the research team at the Center for Radiology and Endoscopy hopes, then it will yield significant results: the technology, which was developed in cooperation with the German Research Society (Deutsche Forschungsgemeinschaft –DFG) and the German Federal Ministry for Economic affairs and Energy (Bundesministerium für Wirtschaft und Technologie (BMWi)), could change the face of medical imaging. “Using ultrasound waves, the device is able to analyze heart activity and use this information to guide MRT images,” explains Prof. Dr. Gerhard Adam.
Prof. Dr. Adam is the head of the Clinic and Policlinic for Diagnostic and Interventional Radiology at the UKE and the medical consultant on this project. The primary aim of the project – undertaken in cooperation with the Clinic for Obstetrics – is to be able to diagnose congenital heart defects definitively before birth. This would mean: affected children could undergo necessary operative procedures immediately after birth and avoid losing precious time while awaiting a diagnosis. “The new technology allows us to gather images of the baby’s heart while still in the womb – images that are clearer than ever before,” says Prof. Adam. He is extremely optimistic that this technology will be applicable in a wide range of other medical fields. “This technology will most likely also be usable in imaging the hearts of adult patients, particularly in cases in which regular body movements – such as breathing or movement of the liver or diaphragm – previously affected the quality of the images.”
Fabian Kording and his team have managed to solve a problem in the field of medical imaging that photographers are all too familiar with: if movement is too fast for the camera, then the images captured are not sufficiently sharp. Blurred photos may be of some value to an artist but are not helpful in medical imaging. To allow a specialist to diagnose, medical images need to be produced clearly and with high-contrast. Photographers have a simple solution to such problems: they can use a flash and, thanks to short exposure time, are able to capture a split second of movement and create a clear and sharp image.
The engineers at the UKE, on the other hand, had to find a completely new solution: since the time needed for an MRT device to create an image cannot simply be increased because of the complexity of the technology. The device will create only a partial image given insufficient time. “This is only useful when you want images of repetitive movement, such as a heartbeat,” explains Fabian Kording. “And even then, only when the MRT device can be guided in such a way that it creates an image at the exact same time as the heartbeat cycle; step by step it creates a full image. We are able to place electrodes on the chest of an adult patient and then attach the ECG to the MRT and use the impulse as a trigger for the MRT device to create an image. This is not possible with a fetus in the womb. Dr. Yin Yamamura from the Department of Radiology had the idea to try using ultrasound.”
Using the sonic head, it became possible to create an ultrasound signal that was sent towards the child’s heart, and then capture the returning echo. The heartbeat changes the frequency of the signal and the change in frequency reveals the status of the heart, thanks to the so-called Doppler Shift Effect. All the collected data is then entered into a computer. The individual images can then be ordered and compiled into a video, producing a record not dissimilar to a child´s flipbook. “We are able to see all phases of the heartbeat,” enthuses Fabian Kording. “The advantage of the MRT in comparison to other types of medical imaging is the excellent tissue contrast,” Mr. Kording continues. “The images allow us to quickly identify any problems there may be with the heart.”
A prototype of the “sMaRT-sync”+ is due to come to market in 2016. “Our aim is to start our own company. The market seems to be in need of a fully automatic MRT-compatible module for heart imaging, for treatment of both newborns and adults,” says Fabian Kording. In Europe, one in ten babies is born with a congenital heart defect. The development of this black plastic box may well one day be seen as a historic step in combating such disorders: “the box is still too large and takes up too much space in the MRT machine,” according to Mr. Kording. He is now aiming to develop a small black disc that can simply be placed on the abdomen and can guide the MRT without cables.
Press Release November 1st 2015
Every Minute Counts
New Blood Test Speeds Heart Attack Diagnosis
The earlier that a heart attack is diagnosed, the better the chances of survival and recovery. Researchers at the UKE have developed an improved diagnostic procedure as part of the “Biomarkers in Acute Vascular Care” (BACC) study that allows for a heart attack to be definitively diagnosed within one hour.
When a patient arrives at an emergency room complaining of chest pain and difficulty breathing, time is of the essence. “It must be determined, as quickly as possible, if the symptoms are the result of a heart attack,” says PD Dr. Dirk Westermann from the University Heart Center (UHZ) at the University Medical Center Hamburg-Eppendorf (UKE). This requires a highly precise, dependable and simple-to-use test procedure.
Before now, the applied guideline recommended using blood tests at the time of admission, and again after 3 hours to determine troponin levels. Troponin is a biomarker which provides information on possible damage to the heart muscle cells. This laboratory test has been vastly improved upon by the specialists at the UHZ and was recently presented at the congress of the European Cardiology Conference (ESC) in London. The main advantage of the new test is that it manages to reduce the time period required to reach a definitive diagnosis and allows the specialist to begin the required treatment, from 3 hours previously, to now only 60 minutes.
Rigorous Testing: As part of the BACC study, the UHZ researchers examined a total of 1045 patients with an average age of 65-years old who had been undergoing treatment for acute chest pain at the UKE emergency room. The researchers applied both the existing Troponin-I test, with the 3-hour wait necessary before a definitive diagnosis could be made, as well as the new test procedure. The comparison of both methods showed that notably lower Troponin I values at admission were required to reliably diagnose a heart attack. “This allows us to greatly reduce the time needed to diagnose the patient correctly, and to immediately begin administering live-saving treatment, such as a cardiac catheterization,” said Prof. Dr. Stefan Blankenberg, director of the Clinic for General and Interventional Cardiology.
An additional comparison of the findings with the results of the BiomarCaRE study, which calculated Troponin-I levels for the entire population, confirmed that people with a Troponin-I level above 6 ng/L have an increased risk for vascular problems; previously, this level had been perceived to be 27 ng/l. This new information was applied to the patients participating in the BACC study. The study concluded that fewer people in this group would have died if the decision relating to further treatment or discharge was based on the new diagnostic procedure.
“This new test will help us to recognize such situations in the future and ensure that only truly healthy patients are sent home, and the patient suffering from a heart attack can quickly receive the treatment they require,” stated Dr. Westermann. The new rapid test procedure is already being used successfully at the UKE Chest Pain Unit.
Press Release September 3rd, 2015
Foundations Laid for the New UKE Pediatric Clinic
In the beginning of September, the University Medical Center Hamburg-Eppendorf (UKE), together with Hamburg Senator Katharina Fegebank, and employees, friends, donors, the general contractor, Züblin, and a large crowd of children witnessed the laying of the foundation for the new University Pediatric Clinic. The 69.5 million Euro project is jointly financed by the City of Hamburg and the UKE, as well as one-third of the money provided by private donors. The largest individual donation was generously provided by businessman, Dr. Michael Otto, who donated a total of 10 million Euros.
The new pediatric clinic has a total floor space of 10,449 square meters and incorporates 148 beds. In cooperation with the Altonaer Pediatric Hospital, which is owned by the UKE, the clinic will be able to offer treatments for complex and rare illnesses and optimally fulfill its role in providing university-level, state of the art medicine for the greater Hamburg metropolitan region.
The medical emphasis of the new pediatric clinic will be on oncology, severe neurological and rare congenital conditions, as well as liver, kidney, and bone marrow transplants. The medical infrastructure already exists at the current UKE Pediatric Clinic, but is spread throughout the campus in various buildings. The new UKE Pediatric Clinic will allow the infrastructure to be enlarged and improved. Under the motto “Under One Roof” the wide array of specialist medical professionals will work using an interdisciplinary model – a model which has already been successfully implemented at the UKE clinics for adult patients. The central pediatric emergency room on the ground floor will have its own access road making it easier and quicker to reach. The radiology department will be situated directly adjacent to the emergency room allowing for medical imaging to be carried out immediately if needed.
Status of the Construction Site
The demolition of the older building began in May 2014. The connections for heating, potable water, sewage, and electricity are all in place. The pneumatic tube mail system for the new pediatric clinic has been connected to UKE main building’s system - Building O10. The general contractor, Züblin, began with construction on the May 20th, 2015. The current site boasts 3 tower cranes, 60 construction workers, and 60 engineers. The structural work for the basement has already been completed. The contractor will require two to three months to complete the structure for each of the remaining 4 floors. The structural work is due to be completed by May/June 2016. The interior construction process is due to begin in August/September 2016. If everything goes according to plan, we shall be able to welcome the first patients to the new Pediatric Clinic in the fall of 2017.
The Tree as a Central Feature
The central feature of the original blueprints for the new Pediatric Clinic, drawn up by the architects TSJ from Lübeck, is a 126 year old European Hornbeam. The young patients will be able to look upon the tree during their stay at our clinic. The tree was originally planted during the founding of the University Clinic Hamburg-Eppendorf and has taken on the character of a natural monument. To ensure the preservation of the tree during the construction process, an 1800 m² “flower pot” was built. We also called on the expertise of several specialists and the gardening team of KFE Facility Management Eppendorfer GmbH, a UKE subsidiary, to trim and prune the tree crown and roots. The crown of the tree is 24 meters in diameter and we hope that birds will soon return to nest there again.
The University Pediatric Clinic in Numbers
• 148 beds (potential for 152 beds)
• 14 day clinic beds, including the only Oncology Day Clinic for the Hamburg metropolitan area
• 20 pediatric intensive care unit beds
• 6 bone marrow transplant beds for patients recovering from a bone marrow transplant
• 3 surgical theatres
• 13,400 m³ of cement and 1,500 tons of steel will be used during construction.
• 150,000 meters of power cables will be put in place.
• When fully functional, the clinic will have between 500 and 600 employees, 160 of whom will be doctors.
Press Release June 1, 2015
Enhanced Technology for Patients
Shorter radiation times, maximum conservation of the surrounding tissue: UKE has installed a new tomotherapy device for radiation therapy. The new high-tech equipment benefits patients with tumor diseases in many ways.
Since April, a new radiation unit has been available for the treatment of tumor patients at the UKE. The equipment is a so-called tomotherapy device of the latest generation – the first of its kind put into service in Germany. Patients profit in a number of ways from the high-tech device: “The new system provides an intensity-modulated radiation of tumors in the most varied locations. This technology allows for the maximum conservation of any neighboring organs,” explains Priv.-Doz. Dr. Andreas Krüll, head of the Out-Patient Center at the UKE. Another benefit: “Optimizing the imaging process and the intensity of the radiation reduces the overall radiation time for the respective patient,” rejoices Prof. Dr. Cordula Petersen, the director of the Clinic for Radiation Therapy and Radio-Oncology. The procurement of the modern tomotherapy system was financed by the Out-Patient Center. The new device is particularly intended for the treatment of head and neck tumors, as well as breast, lung and prostate cancers.
Press Release March 15, 2015
High-tech for neuroradiology
At the Campus Clinical Research: Imaging, it is not just the new MPI technology that is being tested. neuroradiologists use other high-tech equipment for training purposes and examine possibilities for the treatment of strokes and vascular dilations.
An aneurysm in the brain is life-threatening. A bursting of the saccular or spindle-shaped expansion of the vascular wall may lead directly to death. But if such a pathological vascular change is diagnosed in time, then the patient may be saved. Prof. Dr. Jens Fiehler, Director of the Clinic for Neuroradiological Diagnostics and Intervention, and his team use special models to test the best therapy for each case. “Within the framework of the Research Center for Medical Technology and together with our colleagues of the Technical University Harburg, we have utilized a 3D printer to develop aneurysm models. We use them to decide, which treatment option may be applied. Moreover, the intervention can be acted out in advance.”
The Campus Clinical Research provides an experimental angiography system for that very purpose. “Internally, we have named the premises “Hermann Zeumer Lab” after my predecessor. We also use them for training and further education. The system allows us to simulate minimally invasive procedures,” explains Prof. Fiehler. In the future, the neuroradiologists want to test the 3D models on an MPI scanner.
The latest project: In order gain time in the intensive treatment of critically ill stroke patients, the neuroradiologists are testing procedures to cool the injured brain and reduce cerebral pressure; the German Federal Ministry for Education and Research has approved 500,000 EUR for the research. “Overall, various high-tech devices are available for radiologists and neuroradiologists,” concludes Prof. Fiehler. “They allow for an intensive interdisciplinary exchange with many clinics and institutes within the UKE, including the Center for Molecular Neurobiology (ZMNH)”
Press Release March 1, 2015
Not just healed – but healthy as well
Today, patients suffering head or neck cancer have a good chance to be cured. But what about their quality of life after treatment? A team of doctors at UKE, led by Ms. Dr. Silke Tribius, have conducted a study to address this question.
“If I would have known what to expect after the therapy, I would have preferred to die from my tumor.” Ever since Dr. Tribius heard a patient make this statement as a young medical student in the United States, the quality of life issue has not let go of her. “It affected me deeply that after surgery and radiation, a patient healed of cancer did not view his life as worth living,” the radio-oncologist of UKE remembers. Indeed, only 20 years ago, patients with tumors in the head and neck area had to accept severely impaired functionality after their treatment. Affected organs such as the tongue or larynx were often surgically removed – resulting in the fact that for the rest of their lives, such patients were neither able to swallow autonomously nor eat or speak. Today, the preservation of the organs and their functionality takes top priority in treatment. “Our goal is to refine therapies even further in order to minimize long-term effects and thus to further improve the quality of life.”
Within the framework of an interdisciplinary study with physicians of the Clinic for Oral and Maxillofacial Surgery (MKG), the ENT Clinic and the Institute for Medical Psychology, Dr. Tribius has been performing a thorough stock-taking of the health condition of patients with locally advanced head and neck tumors since 2009. She has collected data of a total of 250 patients who, using standardized questionnaires, most patients, almost all symptoms such as reductions in the swallowing function or inflammation of the mucosa completely regressed within one year.” A success that may be traced back to improved treatment techniques such as intensity-modulated radiation therapy (IMRT), which allows for the targeted radiation of the diseased tissue and the protection of the neighboring organs.
Despite significantly improved recorded their quality of life during and up to five years after the treatment. “The statistical analysis showed that the general health condition particularly of young people who began their treatment with a relatively high quality of life dramatically worsened during the acute stage. This is really where we have to start,” explains the physician.
The study also provides new findings concerning the rehabilitation period after the completion of the therapy. “In chances for recovery and quality of life, Dr. Silke Tribius is determined to adjust therapies even more precisely in the future wherever that is necessary and possible in order the return patients to their daily lives not just healed, but healthy as well.
Press Release September 3, 2014
European cancer society honors Prof. Dr. Carsten Bokemeyer with the ESMO Award
As the first German scientist, Prof. Dr. Carsten Bokemeyer, cancer specialist at the University Medical Center Hamburg-Eppendorf (UKE), has been honored with the ESMO Award by the European Society for Medical Oncology (ESMO). Prof. Bokemeyer is a leader in the field of oncology. In their statement, ESMO said that he had excelled at being both a researcher as well as a physician. Thanks to his commitment, the latest discoveries in cancer research reach sick-beds faster in order for patients to reap the benefits.
“Receiving such an important recognition also means having had many good teachers, role models and committed colleagues and co-workers,” says Prof. Bokemeyer. “I would like to thank all of them at this time.” The award recognized joint efforts in research and education. Since 2005, Prof. Bokemeyer has been managing the Oncological Center of the University Medical Center Hamburg- Eppendorf (UKE). At the same time, he is the chairman of the board of the Hubertus Wald Tumor Center at the University Cancer Center Hamburg (UCCH).
Prof. Bokemeyer receives the award for his work in applying experimental results of cancer research, particularly in the areas of urogenital and intestinal tumors, in new and enhanced treatment concepts for affected patients. “This translational approach, i.e. the transfer from a lab model to the sick-bed, is one the focal points of the cancer research at the University Medical Center Hamburg- Eppendorf (UKE). We are very happy to have such a successful researcher and clinician as Prof. Bokemeyer here at the UKE, and we extend our heartfelt congratulations to him for this special recognition,” says Prof. Dr. Christian Gerloff, the deputy medical director and chairman of the board of the University Medical Center Hamburg- Eppendorf (UKE).
Prof. Bokemeyer is one of the worldwide leading experts for malignant germinal cell tumors and was able to discover, among other things, the molecular mechanisms of the development of resistances and to explain why chemotherapy fails in some germinal cell tumors and which medications are still beneficial in such cases. Furthermore, he develops new therapy concepts for a targeted treatment of solid tumors, an important marker for the identification of suitable patients to undergo antibody therapy for intestinal cancer.
ESMO Award: Award for extraordinary commitment in oncology
The ESMO Award has been presented since 1985. It honors members of the European Society for Medical Oncology who have made extraordinary achievements in the development of oncology and who publicly represent the science in an exemplary manner. The European Society for Medical Oncology (ESMO) is the leading medical society in the area of oncology in Europe.
Press Release July 10, 2014
Magnetic particle imaging system for the UKE: DFG promotes new imaging procedure with 4 million EUR.
In a ceremony on Thursday, July 10, the first industrially manufactured magnetic particle imaging (MPI) system worldwide was delivered to the University Medical Center Hamburg-Eppendorf (UKE). MPI is a new imaging procedure. The UKE wants to use it for researching new applications in the area of tumor medicine, cardiovascular and neurovascular medicine, as well as inflammation and metabolic research.
Magnetic particle imaging (MPI) is a new imaging procedure that uses the measurement of the magnetizing properties of super-paramagnetic iron oxide for imaging. These iron oxide nanoparticles are already used in the contrast agents applied during magnetic resonance tomography which are injected into the blood before the procedure. MPI is able to align the particles during the circulation in the blood stream based on a faintly oscillating magnetic field, in which the particles align themselves in the field like small compass needles. This induces a weak, but measurable signal in special receiving antennas, which is used for reconstructing images. The magnetic fields necessary for creating images can be generated by means of a series of permanent magnets and coils. The entire imaging process can be performed relatively fast and allows for real-time imaging with up to 46 three-dimensional images per second.
The research project is supported with more than 4 million EUR by the German Research Foundation (DFG) within the framework of a major instrumentation initiative. Within the course of this initiative, the scientists of the University Medical Center Hamburg-Eppendorf (UKE) were able to prevail against other university clinics.
Press release June 19, 2014
University Medical Center Hamburg-Eppendorf Researchers Conduct an International Study for the Treatment of Bile Duct Cancer
Researchers of the University Clinic Hamburg-Eppendorf (UKE) want to improve the therapy of bile duct cancer with an international study under the leadership of the University Cancer Center Hamburg (UCCH). "The demand is high: more than half of all patients experience a recurrence two years after the initial treatment, meaning the cancers returns," explains the Director of Studies Priv.-Doz. Dr. Henning Wege of the Department of Internal Medicine. Every year, about 5,000 people develop cancer of the bile duct and gall bladder in Germany, with increasing tendency. The first study results are expected in four years.
To date, the standard treatment for curing bile duct cancer (cholangiocarcinoma) consists of the surgical removal of the tumor. An additional chemotherapy for the enhancement of the long-term results is not recommended by medical societies. "However, a chemotherapy with a high risk of recurrence has been established in other types of tumors – pancreatic cancer or colon cancer – and sometimes, it is performed in bile duct cancer as well," says Dr. Wege. But as of now, there are no reliable treatment results supporting such an approach. "We aim to change that. We will compare the standard therapy – surgery without a chemotherapy – with an additional chemotherapy after the surgery." The study - a phase III study named ACTICCA-1 – is supported by the German Cancer Aid (Deutsche Krebshilfe).
The study will include a total of 280 patients. All will be treated with surgeries. After the successful removal of the tumor, 140 patients will receive an additional chemotherapy lasting 24 weeks. "If, in two years, we succeed to gather the last patients for the study, then we will see the first results in four years." This will be followed up with a long-term observation of all patients. The final result of the ACTICCA-1 study, i.e. the effect of the additional chemotherapy on overall survival, will then be available in 2021 at the earliest. The first patients are already to be treated in June. Partners of the University Medical Center Hamburg-Eppendorf are primarily the top oncological centers certified by the German Cancer Aid (Deutsche Krebshilfe), the so-called “comprehensive cancer centers” (CCC). There is a great international interest in this issue. The participation of several Dutch and British centers has already been gained, while that of clinics in other countries (Austria, Belgium, Australia) is being prepared.
Interdisciplinary Disease Pattern
The therapy of cholangiocarcinomas requires coordinated action of different medical disciplines. Therefore, the coordination of the study was based at the UCCH whose stated mission includes the execution of such interdisciplinary projects.
Press release June 11, 2014
Prof. Reichenspurner - New President of the International Transplantation Society ISHLT
Prof. Dr. Dr. Hermann Reichenspurner is the new president of the International Society for Heart and Lung Transplantation (ISHLT). The multinational, interdisciplinary society, which focuses primarily on the treatment of patients with severe heart or lung failures, was founded in 1981 and currently has more than 2,500 members in more than 45 countries. Prof. Reichenspurner was appointed at the society’s 34th annual convention in San Diego, California, and is the first medical doctor practicing in Germany who is honored with this function. His presidential term will last one year, i.e. until the next annual convention of the transplantation experts in April 2015 in Nice, France, which he will jointly organize with Prof. Zuckermann (Vienna, Austria).
Prof. Reichenspurner is the Medical Director of the Heart Center and the Transplantation Center of the University Medical Center Hamburg-Eppendorf (UKE) and the Director of the Department of Cardiovascular Surgery.
Press release May 12, 2014
125 Years of Exemplary University Medicine
The University Clinic Hamburg-Eppendorf (UKE) celebrates the 125th anniversary of its foundation. In the course of a festive week, the eventful history of the “Neues Allgemeines Krankenhaus Eppendorf,” which was inaugurated on May 19, 1889, will be remembered. The first highlight of the day was the Open House on Saturday, May 17. In about 200 individual events, the University Medical Center Hamburg-Eppendorf provided the citizens of Hamburg and all other visitors with multifaceted insights into the complexities of university medicine, excellent research and state-of-the-art education.
“In the name of the Senate of the Free and Hanseatic City of Hamburg, I sincerely congratulate the University Clinic Hamburg-Eppendorf on its 125th birthday. As the largest hospital of the city, as an outstanding educational and research institute, the University Medical Center Hamburg-Eppendorf is of special importance for many of Hamburg’s citizens. In recent years, the University Medical Center Hamburg-Eppendorf has provided national and international impulses in patient care, in education and – last, but not least – in research. Likewise, the close scientific cooperation with the University of Hamburg and the Technical University Hamburg-Harburg, as well as with the regional Leibniz Institutes and the DESY has been exemplary,” says Dr. Dorothee Stapelfeldt, Second Mayor and Senator for Science of the Free and Hanseatic City of Hamburg.
“Today, the birthday child University Medical Center Hamburg-Eppendorf is doing really well. Our approximately 9,400 employees achieve great things, for the demands on modern university medicine are particularly high. With the integration of many medical disciplines under one roof, we have accomplished the development from the “pavilion concept” toward a modern university clinic. Not just in terms of space, but in the minds of University Medical Center Hamburg-Eppendorf employees as well. Today, the team spirit has reached a new dimension in our organization. Thanks to improvements in patient care, research and education, the University Medical Center Hamburg-Eppendorf is positively recognized even in international terms. There is a global development toward a small number of centers of excellence. Within that context, we want to be a key player,” says Prof. Dr. Christian Gerloff, the Deputy Medical Director and chairman of University Medical Center Hamburg-Eppendorf’s board.
“In the past 20 years, University Medical Center Hamburg-Eppendorf has reinvented itself. The closer integration of the clinic, research and education we experience today plays a significant role in that. Compared to all other patient care structures, university medicine is characterized by a close proximity to research. Thus, we have reinvented ourselves particularly in the area of research and education. The grants that are so important for our research – the so-called ‘third-party funding’ that scientists raise themselves for their outstanding research projects – have risen from 30 to almost 69 million EUR in the past seven years; the model course of studies, which was introduced in 2012, attracts not just students and instructors, but the curiosity of experts from all over the world. At University Medical Center Hamburg-Eppendorf, we have closed ranks, interdisciplinarity is not just a slogan, but is being lived,” says Prof. Dr. Dr. Uwe Koch-Gromus, Dean and Board Member of the University Medical Center Hamburg-Eppendorf.
Press Release May 1, 2014
Restoring Physical Integrity
The best possible restoration of physical integrity, functionality and aesthetic - this is the aim of all treatments offered at the new Department of Plastic Surgery at the University Medical Center Hamburg-Eppendorf (UKE) Centre for operative Medicine.
“Our highly-specialized department is focused on the treatment and reconstruction of physical defects which have been caused by accidents, infections, tumor illnesses, chronic wound healing disorders, postoperative problems or congenital conditions” states Prof. Dr. Dr. Marco Blessmann, Medical Director at the new department. The four pillars of the specialist treatment are reconstructive surgery, aesthetic surgery, breast surgery and adiposity surgery.
The Department of Plastic Surgery works in close cooperation with several other specialist UKE clinics such as the Clinical for General and Trauma Surgery, the Adiposity Treatment Centre, the Breast Centre, The Clinical for Neurosurgery as well as the ENT and the Oral and Maxillofacial Clinic.
Press release April 24, 2014
Worldwide Largest Database for Prostate Cancer Offer Facts for the Best Therapies and Individual Surgery Methods
Leading through unique knowledge: with the worldwide largest database on curing rates and the quality of life of its prostate cancer patients, the Martini Klinik at the University Medical Center Hamburg-Eppendorf (UKE) achieves the best treatment results. Surgical therapies are constantly being improved. For example, the precise preparation and preservation of the urethral sphincter has improved the continence of a significantly higher number of patients. While the rate of severe incontinence amounts to 4.5 percent throughout Germany, the specialized center in Hamburg boasts a rate of 0.4 percent. The application of the NeuroSAFE technique as a nerve-saving surgery procedure has preserved full continence in 93.5 percent of the patients treated. According to the Barmer-GEK Report 2012, 55 percent of patients throughout Germany were treated with a prostate removal preserving nerves and vessels.
The "Value-Based Healthcare" project initiated by chief physicians Professor Hartwig Huland and Professor Markus Graefen is unusual for a hospital: the urologists working at the University Medical Center Hamburg-Eppendorf and the Martini Klinik have already involved patients in their treatment strategies since 1992 – as active information partners who include doctors and scientists in their lives. Oftentimes, a surgeon does not know what happens to his patient once he has left the hospital. Thus, valuable knowledge is missed. At the Martini Klinik, patients are asked to provide information about quality-of-life issues such as continence and potency within a validated questionnaire. "We continue to care for the patient after the surgery. It is a life-long contact that is very well appreciated by the men treated by us. This data collection provides us with continually updated success rates regarding the various therapies," explains chief physician Professor Markus Graefen.
Together with the tissue samples of the prostate as well as blood and serum samples, the facts concerning the quality of the post-surgery results as well as the clinical data form a tumor database that has grown to 23,000 patient data sets by now. "Thanks to the meticulous analysis of the data regarding the treatment of prostate cancer collected at the University Medical Center Hamburg-Eppendorf and the Martini Klinik over the course of 22 years, we were able to identify genetic changes that, in the long term, may serve the recognition of high-risk patients. This identification allows for an early adjuvant therapy such as radiation or a targeted therapy," explains Professor Markus Graefen. Besides research, the quality result data also serves the internal quality control and the enhancement of surgery techniques. For example, the database provided surprising insights in prostate cancer patients in whom metastases in the lymph nodes were already present. Unlike the guidelines specified at the time, the physicians of the Martini Klinik did not abort the surgical procedure in such cases, but continued the intervention as planned. Chief physician Graefen comments the result: "We found out that patients with this profile had a dramatic chance for survival if the prostate is removed with the main tumor burden. That was previously unknown. It was possible to improve the course of the disease for these patients by about ten years."
The conclusion: Treatments benefitting the patient may be improved with small, but effective corrections. Data collection helps the surgeons to perfect their craft even further. "You can only become better if you measure," says Professor Markus Graefen.
Together with the Clinic and Polyclinic for Urology of the University Medical Center Hamburg-Eppendorf, the Martini Klinik is the largest prostate cancer center in the world. They perform approximately 2,200 prostate surgeries per year and have systematically collected and documented the result quality of surgery through patient surveys for more than 20 years. The faculty system implemented at the Martini Klinik by chief physician Prof. Hartwig Huland guarantees high competence and experience throughout the medical team, with an individual specialization on the small area of prostate cancer. The Martini Klinik enjoys an excellent reputation in patients and physicians thanks to the high result quality and many scientific research projects.
Press Release January 27, 2014
UKE physicians lead the Europe-wide research for the treatment of pediatric brain tumors
An effective and atraumatic therapy for children and adolescents with brain tumors:: That is the goal of the research project “PNET5 Medulloblastoma”. The research center of this Europe-wide study for therapy optimization has its headquarters at the University Medical Center Hamburg-Eppendorf (UKE) and is led by Prof. Dr. Stefan Rutkowski.
Even though the curing prospects for patients with a diagnosis of medulloblastoma have sharply risen in recent years, the intensive treatment may be accompanied by late and long-term effects. “For example, the therapy causes restrictions in fine motor skills, memory impairment and organ damage in many patients,” explains Prof. Dr. Stefan Rutkowski of the Clinic for Pediatric Oncology and Hematology at the University Medical Center Hamburg- Eppendorf (UKE). Therefore, our rule for treatments is: as intensive as necessary, but as gentle as possible. “We have found that not all children with medulloblastoms need to be treated with the same intensity and this allows us to tailor the best individual therapy for each patient.”
In the examinations of a major precursor study completed in 2011, new biological risk factors indicating a higher or lower recurrence risk in the tumor samples of patients were identified. In the new studies, the oncologists are now testing treatment concepts for children with medulloblastome. In this process, the combination treatment consisting of radiation and chemotherapy is adjusted to the individual prerequisites of each patient (e.g. the age, the stage of the disease).
About 150 clinics from 16 European countries participate in the new research project. The long-established treatment network HIT for children and adolescents with brain tumors is a worldwide unique joint project combining clinical studies, reference centers and associated research projects. Prof. Rutkowski: “All HIT employees are extraordinarily thankful to the German Childhood Cancer Foundation for its support, which allows us to continue with these studies. It is only through clinical studies that the recovery rate of the affected children may be increased.”
The research center at the UKE has also been supported by the Fördergemeinschaft Kinderkrebs-Zentrum Hamburg e.V. since 2009. In addition, the society supports two pilot projects for the “diagnosis and training of neuro-cognitive deficits in pediatric brain tumor patients”. They are to help in offsetting the late effects of the tumor therapy in children as much as possible, so that they are better able to return to their daily lives.
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