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04.04.2024 NEWS

Martini-Klinik: 20 Years of robotic-assisted surgery for prostate cancer

Questions to…Prof Dr Alexander Haese

Prostate cancer is the most prevalent type of cancer in men. Annually, approximately 66 000 men fall ill in Germany alone. The Martini-Klinik at the University Medical Center Hamburg-Eppendorf (UKE) specialises in the treatment of prostate cancer and is the leading clinic in surgical removals of tumours with robotic-assisted surgery systems, which have been in use for the past 20 years. Prof. Dr. Alexander Haese, leading physician of the Martini-Klinik explains the advantages of this method for patients, as well as how the new da Vinci single-port surgical system works.

Diagnosis prostate cancer: When should treatment start?
Prof Dr Alexander Haese: Prostate cancer treatment depends on the stage. When a case is recognised at an early stage, initially active monitoring suffices. Here, we observe, how fast it develops and, depending of the development of the tumour over time, initiate the appropriate treatment. Locally confined tumours, which require treatment can be fully removed by means of a surgery. Alternatively, a radiotherapy in different variations could be a possible therapy approach. In case of an advanced tumour, or in case of an already metastasised tumour, a combination of medicinal and, if necessary local therapy, is aimed at keeping the tumour under control for as long as possible. This often works for years, sometimes over ten years and more.

Which surgical options are there in case of a malignant finding?
In the surgical treatment of prostate cancer, there are two approaches: the tumour can be removed by means of the classic incision access (radical retropubic prostatectomy), or with the aid of the robotic-assisted surgery technique. Both methods aim to remove the entire prostate with the seminal vesicles and, if necessary, lymph nodes, in order to liberate the patient of his tumour.

Surgical robots have been used at the Martini-Klinik for 20 years, why?
Surgical robots are the future of surgery for certain indications, especially for radical prostatectomy. The accu-racy and precision of the surgeries in the narrow male pelvic cavity, combined with a tenfold magnification and maximal agility in the smallest spaces, which even very experienced surgeons cannot reach with an open ac-cess, make the robotic-assisted surgery technique so successful. This leads to significantly more sparing opera-tions with less complications, with the goal of a long-term healing of the tumour.

What advantages does the new da Vinci single-port surgical system have?
The new single-port surgical system, which we at the Martiki-Klinik were the first to use in Europe, offers, be-sides the already known advantages of robotics, such as e.g. a tenfold magnification of the surgical field, scaleability of hand movements, and no tremor of the hands of the surgeons, further advantages. Instead of the usual 6 accesses, which are distributed in a semicircle around the navel in order to access the prostate, now the surgery is conducted through only one incision, approximately two and a half centimetres in length and located right under the navel. This enables a high-quality surgery with a minimal pain and surgical trauma, a faster mobili-sation and recovery for the patient.

Which problems can occur after the prostate surgery?
After a prostate surgery, the usual problems that are possible with any surgery can occur, such as haemorrhages, pain, and wound healing issues. Problems specific to prostate surgeries are possible changes in the continence (ability to hold urine) and erectile function. Therefore, it is important, that such surgeries are conducted by experts specialising in the field.

What happens after the surgery?
The follow-up care after the prostate surgery is conducted by the referring urologist as well as by the Martini-Klinik. We monitor the healing process and the life quality of the patient, by means of regularly sending them questionnaires regarding healing, continence, erectile function and possible complications and evaluating the questionnaires. Based on our quality measurements and the experience with over 40 000 treated patient, we can offer the best suited therapy option individually.

What are the chances of healing after removal of the tumour?
The probability of a long-term healing strongly depends on the stage of the tumour. Under ideal circumstances, if the tumour is recognised and surgically removed at an early stage, and if it turns out to be locally confined, then the patient can count on an 80 to 90 percent chance of a long-term recovery.


UKE/ Media library


PD (Privatdozent) Dr Monika Pötter-Nerger on the chronic disease of the nervous system - Parkinson's disease

The clinic and outpatient clinic of neurology of the University Medical Center Hamburg-Eppendorf (UKE) is a certified specialist clinic for the treatment of one of the most common chronic diseases of the nervous system: Parkinson’s disease. It is neurodegenerative disease that is accompanied by typical symptoms such as movement disorders, stiff muscles, limited facial expressions, tremors, vestibular disorders and swallowing difficulties. According to estimates, in Germany alone approxi-mately 400 000 people are affected. PD Dr Monika Pötter-Nerger, head of the working group for movement disorders and deep brain stimulation, clinic and outpatient clinic of neurology, explains how the treatment of Parkinson’s disease looks like, why dancing is such an integral part of the treatment and what the research in this area is working on.

The interview

My name is Monika Pötter-Nerger, I am the senior physician in the clinic of neurology at the UKE and head of the working group for movement disorders and deep brain stimulation, and my main profile is Morbus Parkinson.

What is Parkinson’s disease?
Parkinson’s disease is a neurodegenerative disease; in other words, a premature cell ageing in cer-tain areas of the brain is taking place. Parkinson’s disease is an umbrella term for various diseases, the best known being Morbus Parkinson. All Parkinson’s syndromes are characterised by akinesia, which can be accompanied by tremors, stiff muscles, or vestibular disorders. Moreover, the loss of a neurotransmitter in the brain, namely dopamine, is the main common characteristic of all Parkin-son’s syndromes.

How does the disease manifest itself?
Symptoms of Parkinson’s disease can manifest in various ways. Some patients report developing back pain that could not be explained otherwise. Other patients report tremors in one hand and others report akinesia, which can appear differently in different body parts. In the legs, the akinesia can appear as a small-step, slow, shuffling gait pattern. The akinesia (loss of mobility) can appear in the hands, so that certain daily activities, such as e.g. buttoning up buttons, do not function properly anymore. Or alternatively in the region of the face, so that there is a reduction in facial ex-pressions.

Who has an increased risk of developing Parkinson's disease?
The main risk factor for Parkinson's disease is age. Older people are more likely to develop Par-kinson’s disease. The usual age of onset lies between 60 to 70 years. There are fewer Parkinson’s disease patients, who develop Parkinson’s disease earlier. Such cases could have a genetic pre-disposition – however overall, this group is small, it accounts for only 10 to 15% of all cases. There are further risk factors, which are currently being discussed, e.g. the exposure to pesticides, but here we have to wait for the long-term results.

How is Parkinson’s disease diagnosed?
Initially, the diagnosis is based upon the clinical symptoms, the description and detection. There are also additional instrumental diagnostics, which can be applied. One such example is the DaTSCAN, a nuclear medicine procedure, which shows the dopamine metabolism in the brain.

What treatment options are there?
The treatment should be adjusted to the stage of the Parkinson’s disease. In case of an early Mor-bus Parkinson, the main focus should be to replace the deficiency of the neurotransmitter dopa-mine. There is a wide range of medicinal options for that. In an advanced stage, the focus is on dealing with complications, which can even arise through the treatment itself. For example, there are so-called effect fluctuations, which can appear in the course of illness, when the patient fluctuates between good and bad mobility. Here treatment methods such as deep brain stimulation or pump therapy are used. A further field of treatment is taken by so-called non-motor symptoms, as it is known that Parkinson’s disease is not only a movement disorder, but that other symptoms, such as memory disorders, sleep disorders, and pain all can play a role. These can be approached thera-peutically.

What is the effect of deep brain stimulation?
Deep brain stimulation is a procedure that has become an important component of the treatment in the last 30 years. Deep brain stimulation is carried out via two very thin electrodes, which are insert-ed in certain deep lying brain areas. Among these deep lying nuclei is, for example, the subthalam-ic nucleus. It is known that deep brain stimulation can improve mobility, tremors, the gait pattern, and that the medicine of the patient can be reduced by approximately 50%.

Why is movement an important component of the treatment?
Only recently has the importance of movement therapy become apparent. Currently there are vari-ous studies, which investigate whether movement therapy can also slow down the course of the disease. Movement therapy leads to an improvement in the overall mobility, to an improved move-ment coordination, and to a better balance.

Dance therapy belongs to movement therapy. What are its effects?
Dance therapy can improve various aspects of Parkinson’s disease. For example, it was shown that equilibrium and balance are improved through dance therapy. Attention can be improved by dance therapy as well. Furthermore, it was observed, that mood is elevated by dance therapy, so that depressive episodes decrease. Overall, it is known that dance therapy can positively influence the quality of life of patients with Parkinson’s disease.

What advances have been made in the recent years in Parkinson’s disease research?
A large part of studies focuses on slowing down the disease, on the so-called modification of the course of the disease. In this regard there are lots of studies, which have, however, not yet reached the clinical field, e.g. vaccination against Parkinson’s disease. Here we just have to wait and see. Various forms or administration routes of the drug Levodopa, to replace the dopamine deficiency, will be clinically applicable. This includes injections into the skin, or braces, which can release Levodopa, or specially folded pills, which can release the active ingredient very, very slowly. A lot is expected here. Especially interesting is the research conducted in the field of deep brain stimula-tion, since there is a range of technological advances. Through certain configurations of the elec-trodes, the electric field can be better adjusted, so that there will be fewer side effects. There is the possibility to simultaneously listen to the neural noise and only turn on the stimulation on demand, so-called closed-loop stimulation. All that remains is to wait until this will find its way into the clini-cal field.

Is there anything else you would like to say?
We are glad to be the first university to be certified as a Parkinson's specialist clinic. We want to show that Parkinson's is an important disease for us and that we want to focus on it – and not only on acute diagnostics, but also on chronic treatment!


UKE News Magazine Autumn 2023


Modifiable risk factors responsible for half of cardiovascular diseases

Scientists of the Global Cardiovascular Risk Consortium under the auspices of the Department of Cardiology at the University Heart & Vascular Center of the Medical Center Hamburg-Eppendorf (UKE) and the German Center for Cardiovascular Research (DZHK) have proven that the five classic cardiovascular risk factors overweight, high blood pressure, high cholesterol, smoking, and diabetes mellitus are directly connected to more than half of all cardiovascular diseases worldwide. High blood pressure is the most significant factor for the occurrence of heart attacks and strokes. The study’s results were published today in the New England Journal of Medicine and are based on the data of 1.5 million persons from 34 countries.

Cardiovascular diseases cause approximately a third of all deaths worldwide. They often develop silently over decades. Frequently without being recognised, the vascular walls change, giving rise to arteriosclerosis, in the wake of which coronary heart disease may occur, including complications such as heart attacks, acute cardiac death, or strokes. “Our study clearly shows that over half of all heart attacks and strokes are avoidable by checking and treating the classic risk factors. These results are of the highest significance for strengthening prevention in this area. At the same time, approximately 45 percent of all cardiovascular cases cannot be explained with these risk factors; they should motivate us and the academic funders to further research efforts,” says Professor Doctor Stefan Blankenberg, the medical director of the University Heart & Vascular Center at the UKE.

The Global Cardiovascular Risk Consortium assessed the individual-level data of 1.5 million persons who took part in 112 cohort studies and originate from the eight geographical regions North America, Latin America, Western Europe, Eastern Europe and Russia, North Africa and the Middle East, Sub-Saharan Africa, Asia, and Australia. The objective of the study was to gain a better understanding of the global distribution, the significance of the individual risk factors and their effects on cardiovascular diseases, and overall mortality in order to derive targeted preventive measures.

“In principle, the five classic risk factors that we examined are modifiable, and thus responsive to preventive measures. So far, the proportion of preventable risk attributed to these five risk factors is still matter of debate,” lead author and associate professor Dr. Christina Magnussen, Department of Cardiology at the University Heart & Vascular Center of the UKE, explains.

Regional differences in risk factors
The study showed differences in the eight global regions regarding the frequency of the risk factors. The scientists saw the highest rates for overweight in Latin America, and the highest values for high blood pressure and high cholesterol in Europe. The risk factor smoking is particularly decisive in Latin America and Eastern Europe, diabetes mellitus in North Africa and in the Middle East. All five risk factors combined (overweight, high blood pressure, high cholesterol, smoking, and diabetes mellitus) amount to 57.2 per cent of women’s cardiovascular risk and to 52.6 per cent of men’s. Thus, a substantial share of cardiovascular risk remains unexplained. In comparison, the five risk factors merely account for about 20 per cent of the risk to die (overall mortality).

Furthermore, the study also clearly shows a linear relation between high blood pressure, and high cholesterol, and the occurrence of cardiovascular diseases. The higher the values, the higher the likelihood of the occurrence of cardiovascular diseases. This result applies to all examined regions in the world. The scientists also identified a remarkable connection between cholesterol levels and overall mortality: Very low as well as high cholesterol levels increase overall mortality.

The significance of all risk factors decreases with age; e.g., high blood pressure is more damaging to a forty than an eighty-year-old. The body mass index (BMI) is the only exception and remains equally significant at any age. “This raises the question to which extent the target values for treating cardiovascular risk factors for the most elderly should be identical with those for the middle to older age bracket,” says Professor Blankenberg.

Study identifies extensive range of starting points for preventive measures

The study provides an extensive dataset to avoid cardiovascular diseases or reduce their effects for at-risk persons, or patients with cardiovascular diseases, by improving their lifestyle and by lowering blood pressure or cholesterol. “High systolic blood pressure accounts for the largest share of cardiovascular risk. We should place a particular focus on the therapy of patients with high blood pressure to avoid cardiovascular diseases as much as possible,” says associate professor Dr. Magnussen."


UKE News Magazine Autumn 2023


A study conducted by the University Medical Center Hamburg-Eppendorf (UKE) showed better prognosis for patients with high-risk myeloma

A new combination of four drugs has significantly improved the prognosis of patients with high-risk myeloma, a malignant disease of the bone marrow. A clinical study initiated at the University Medical Center Hamburg-Eppendorf (UKE), in which 20 German treatment centers took part, showed that nearly 80% of the up to 70-year-old patients and over 60% of the over 70-year-old patients showed no signs of relapse two years after completion of the therapy. For a long time, the average survival time of high-risk myeloma patients was only about two years. Scientists of the UKE have now published the findings of the study in the Journal of Clinical Oncology.

Multiple myeloma is the second most common hematological systemic disease, with approximately 6700 new cases per year in Germany. A quarter of the patients is diagnosed with a high-risk myeloma, which is characterised by genetic alterations, which lead to a more aggressive progression. “Treatment of multiple myeloma has substantially changed over the last two decades, which has been accompanied by a constant improvement of the prognosis. The average survival of standard-risk patients has increased from three years to over ten years, yet for high-risk patients the average survival time was, until recently, only about two years,” principal investigator Prof. Dr. Katja Weisel, deputy director of the II. Medical Clinic of the University Cancer Center Hamburg (UCCH) of the UKE, explains. “The study initiated by the UKE is one of the first clinical studies which focuses on treatment of high-risk patients.”

Goal of treatment: No evidence of disease activity

Standard treatment of multiple myeloma is a high-dose chemotherapy with a subsequent autologous blood stem cell transplantation. Using a combination of the most effective and most innovative drugs in an intensified treatment regimen, the goal of the UKE study is to improve the maximum of the disease remission so far that there will be no evidence of disease activity in as many patients as possible. In doing so, the generally difficult-to-treat early relapses in high-risk patients should be prevented and their survival time prognosis improved. “For treatment, a combination of four drug classes, consisting of the monoclonal antibody isatuximab, the proteasome inhibitor carfilzomib, the immunomodulator lenalidomide, as well as the glucocorticoid dexamethasone, is used. This quadruple combination was initially applied at the beginning of the study in 2017 for the first time in the world,” lead author of the scientific publication, Dr. Lisa Leypoldt, also from the II. Medical Clinic of the UKE, explains. The initial, very promising results of the study involving 153 treated patients were already presented at a congress in New Orleans in December 2022. The now-published current evaluation of the study outlines the relapse-free survival as well as the total survival. “The high effectiveness of the treatment is reflected by the fact that 78.3% of the younger, up to 70-year-old patients and 62.6% of the older patients showed no signs of relapse after two years. The total survival further developed positively as well - 83.9% of the younger patients and 71% of the older patients were alive after two years,” says Dr. Leypoldt.
The study is a multicenter phase II study for initial treatment of high-risk patients, initiated by the UKE and in which 20 clinics in Germany took part, among them the Berlin Charité, as well as university clinics and hospitals, among others in Tübingen, Heidelberg, Köln, Essen, and Chemnitz. The biometric evaluation of the study was conducted at the German Cancer Research Center (DKFZ) in Heidelberg. The findings of the study were presented by Dr. Leypoldt on the 27. September at the annual conference of the International Myeloma Society and simultaneously published in the digital issue of the scientific journal “Journal of Clinical Oncology”. Prof. Weisel: “We now know, how important the optimised combination therapy is for treatment of multiple myeloma and we could show with our results that under this treatment, the prognosis of high-risk patients approaches the prognosis of standard-risk patients. This is very encouraging. Nevertheless, there is room for further optimisation. With the planned follow-up study at the UKE we wish to improve the results of the treatment once again."


UKE News Magazine Spring 2023

Prof. Dr. Thilo Hackert

Early detection and better treatment of pancreatic cancer: this is the main focus of Professor Dr. Thilo Hackert, the new director of the Clinic for General, Visceral and Thoracic Surgery. 

The 51-year-old follows Professor Dr. Jakob Izbicki, who retired in February. Professor Hackert was previously employed at Heidelberg University Hospital, where he studied and completed his doctoral and post-doctoral studie. He now specializes there in research into serious diseases of the pancreas. "We now have quite precise knowledge of the risk factors for many other kinds of cancer and have been able to significantly improve the results of treatments and cures by way of increasingly effective therapies."  However, this does not apply to cancer of the pancreas – with the result that pancreatic  cancer will be the second most common cause of death from cancer in women (following breast cancer) and men (following lung cancer) by 2030. "Unfortunately, the prognosis for pancreatic cancer continues to be poor; without surgery, the survival rate is virtually zero." Improving early detection is therefore one of the expert’s key concerns: "The aim is to detect precursors of tumors at an early stage and to remove them, even before they become malignant."  Artificial intelligence can make a contribution to more precise diagnostics, and robotics will improve operative techniques even further. "Overall, we are already well advanced in these methods at the UKE" Professor Hackert emphasizes. The expert had already cooperated closely with his new colleagues on collaborative studies before commencing his work at the UKE. The decision to come to the UKE and Hamburg was not a difficult one; the reception in Hamburg was very warm and open. "The team is extremely motivated and I have the feeling that I am very welcome here."   


UKE News Magazine Autumn 2022

Tracking down hidden cancer cells

Detecting prostate cancer metastases and removing them with pinpoint accuracy –PSMA radioguided surgery has made this possible. This method, co-developed by Prof. Dr. Tobias Maurer, was performed robot-assisted for the first time world-wide at the Martin-Klinik in 2018.  Meanwhile, the method has become part of clinical routine, and already about 40 patients have undergone this type of surgery. 

Prostate cancer cells have the ability to hide themselves, such as when they invade and multiply in lymphatic tissue. However, they are not completely invisible, because on the surface of cancerous cells there is a special protein structure – the so-called prostate-specific membrane antigen PSMA. Small molecules are able to recognize PSMA. „Prior to surgery, our colleagues from the Department of Nuclear Medicine add a contrast medium to the molecules, which then bind to the PSMA, thus radioactively marking the prostate cancer cells. In the imaging procedure the radioactive marker causes the affected cells to light up, so that we can locate them precisely “, explains Prof. Maurer. 

Also during surgery, the marked PSMA accurately leads the doctors to the lymph nodes affected by the cancer. The patient is given an injection of a molecule loaded with a minimal radioactive dose in order to expose the cancer cells. During surgery, the radiation in the tissue can be measured using a Gamma detector – similar to a Geiger counter – and can be targeted and removed. At the Martini-Klinik, PSMA radioguided surgery is now also performed with the da Vinci surgery robot using a minimally invasive technique. 

How successful is this new method? First studies have shown that the method has made it possible to reduce the PSA values of patients for a sustained period of time, and in the year following surgery no further therapeutic measures have been necessary. Prof. Maurer: „We hope that this innovative method will enable us to delay stressful hormone or radiation therapy, even in the case of a recurrence.“ 


UKE News Magazine summer  2021

Diagnostic challenges

Severe malaise, a high fever and diffuse pain can be an indication of many illnesses. In rare cases, a lymphoma, a malignant form of blood cancer, is the cause. When a diagnosis is made in such cases, patients of the University Cancer Center Hamburg (UCCH) at the UKE benefit from the interdisciplinary cooperation within the hospital.

„Not all lymphoma manifest the direct symptoms of the illness, such as extreme swelling in the lymph nodes“, says Prof. Dr. Katja Weisel, Deputy Director of the UCCH and Deputy Director of the II Medical Clinic for Oncology and Hematology, "in some cases malignant cancer of the blood can only be clearly identified by the analysis of various tissue samples.“ At the Center for Oncology cancer experts cooperate closely with specialists from the Departments of Radiology, Pathology and Intensive Medicine, as well as with experts from the hospital pharmacy.

After exact diagnosis chemotherapy is usually the treatment of choice. "Before or after the blocks of chemotherapy, which are carried out at intervals of several weeks, radiation therapy of the lymph nodes may be indicated“, explains Prof. Dr. Carsten Bokemeyer, Director of the UCCH and Medical Director of the II Medical Clinic for Oncology and Hematology. "In particular cases, an autologous stem cell transplant may be considered“. This involves removing the patient’s own stem cells from the blood marrow and then later re-implanting them, after the chemotherapy has not only weakened the growth of the cancerous cells but also the body’s immune system.

In a significantly predominant number of patients the illness can be overcome in its early stages by chemotherapy and other supportive therapies; during the more advanced stages of the illness, between 50 to 60 percent of the patients affected overcome the illness.


Press release of 10 September 2020

Celebratory laying of foundation stone for new University Heart & Vascular Center building

UKE's Plan for the Future 2050 | Cutting-edge care for cardiovascular diseases

A brand-new building for cardiovascular medicine with 388 beds is being built on the grounds of the University Medical Center Hamburg-Eppendorf (UKE). The modern 6-storey new home of the University Heart & Vascular Center should be ready for occupancy in 2023. Today the UKE board and the managers of the Heart & Vascular Center of the UKE laid the foundation stone in the presence of Katharina Fegebank, Senator for Science, Research, Equal Opportunities and Districts of the Free and Hanseatic City of Hamburg, with the motto "This is where the heart of the future beats."

Senator for Science Katharina Fegebank: “Today marks a big step forward for Hamburg. With the new building and the expansion of capacities, the global top position of the University Heart & Vascular Center will be further strengthened. Larger rooms, more operating theaters and laboratories as well as the latest technology will provide excellent conditions for top-class university medicine. Our goal is to continue to advance the development of innovative diagnostic options and state-of-the-art treatment concepts in the future. Patients and UKE employees will benefit from this in equal measure.”

Prof. Dr. Burkhard Göke, Medical Director and Chairman of the Board of the UKE said: “We are building for our future: for the future of cardiovascular medicine, for the future of the campus and thus also for the future of the city of Hamburg. Above all, we are building for the best possible care for our patients. With this new building, we are creating optimal conditions to treat our patients in the latest cardiovascular medicine and nursing facilities, and provide them the space they need for their recovery.”

Prof. Dr. Stefan Blankenberg, Medical Director of the University Heart & Vascular Center said: “Cardiology is developing dynamically in every area, which has led to a remarkable expansion of minimally invasive treatment options in recent years. We already perform many therapies in interdisciplinary teams. In addition, there are the advances in personalized heart medicine - extensive amounts of data from molecular analyses are already being processed. In this next-generation clinic, we want to further develop this progress in continuously expanding individualized treatment options and drive it forward with heart and precision.”

New building supports new cardiological treatment options

With up to 388 beds, nine operating theaters and nine cardiac catheterization laboratories, a pioneering new clinic is being built in which patients and their relatives will find a pleasant and supportive environment, and the employees of the Heart & Vascular Center will be provided with attractive working conditions. Instead of the previous two, there will in future be four hybrid operating theaters in which cardiologists, cardiac surgeons, pediatric heart specialists and vascular specialists can treat patients with a combination of catheter procedures and surgery. For example, vascular specialists will use these rooms to perform complex interventions of the aorta. Hybrid operating theaters are also of great importance for the care of children and adults with congenital heart defects and for heart valve interventions.

Especially in the area of minimally invasive, gentle treatment of cardiovascular diseases, doctors are already jointly applying innovative treatment strategies that are continuously being further developed as part of clinical research projects. For this, imaging of the heart and blood vessels is of great importance. Therefore, working with the radiologists, a "Cardiovascular Imaging Center" for highly specialized imaging will be created in the new building.

The heart of the future beats here

The new building has an ambitious schedule: it should be ready for occupancy in 2023. The design comes from Nickl & Partner Architects (Munich). The costs total around 200 million Euros. Like most projects in the UKE's Plan for the Future 2050, the financing is to be implemented via the tenant-landlord model practiced in the city. It stipulates that Clinic Facility Management Eppendorf (KFE), a wholly-owned subsidiary of the UKE, as the implementation agency, will construct the building on behalf of a property company. The property company will then rent to the user, i.e. the UKE, which in turn will receive a rent subsidy from the city.

The building offers more than 72,000 square meters of gross floor area on six upper floors and three basement floors with underground parking and a central sterile supply department. The building is divided into a spacious two-storey entrance space with a bistro as well as areas for the outpatient departments, functional diagnostics, imaging diagnostics and interventions. The cardiac catheterization laboratories and numerous examination rooms are also located on the ground floor. The operating theaters and some of the intensive care units (two units for adults and one unit for children) can be found up on the 1st floor. On the 2nd floor there are two intensive care units for adults and a pediatric cardiology ward, as well as a monitoring ward for transplant and artificial heart patients. This is followed by two more floors (3rd and 4th) with six normal wards and two optional service wards, then a 5th floor for the administrative areas, with a study center, teaching and seminar rooms and a dialysis unit.

University Heart & Vascular Center

As a maximum care provider, the Heart & Vascular Center currently offers 270 beds, including the Departments of Cardiology, Cardiovascular Surgery, Vascular Medicine and Pediatric Cardiology, including adults with congenital heart defects.
The range of services of the Heart & Vascular Center includes all non-invasive and invasive diagnostic and treatment procedures in cardiac surgery and cardiology, for example the treatment of patients with coronary heart disease, cardiac arrhythmia, cardiac valve defects and heart muscle diseases. The unique features of the Heart & Vascular Center within the Hamburg metropolitan region are heart, lung and combined heart-lung transplants as well as cardiac surgery for congenital heart defects including pediatric and premature-birth cardiac surgery. The Center currently treats over 10,000 inpatients and 18,000 outpatients per year.


Press release of 21 September 2020

Laying of foundation stone for new Martini-Klinik

Important construction phase for future medical care of patients with prostate cancer: Today the Martini-Klinik celebrated the laying of the foundation stone for the new building. A seven-storey building with 100 beds and 8 operating theaters will be constructed on the grounds of the University Medical Center Hamburg-Eppendorf (UKE) by 2023. With around 2,500 prostate cancer operations per year, this specialist clinic is the world leader in the surgical treatment of prostate tumors.

Hamburg's Senator for Science Katharina Fegebank, Medical Director of the UKE Prof. Dr. Burkhard Göke, Commercial  Director of the UKE Marya Verdel and Senior Physicians of the Martini-Klinik Prof. Dr. Hartwig Huland and Prof. Dr. Markus Graefen put construction plans, a daily newspaper, surgical utensils, the book “The Martini Principle” as well as guest book entries and employee photos into the time capsule.

Senator for Science Katharina Fegebank: “The Martini-Klinik is one of the world's leading institutions for the treatment and research of prostate cancer. At the same time, it forms a supporting pillar of healthcare at the UKE. State-of-the-art diagnostic and treatment methods as well as more beds and expanded space will ensure even better medical care in the future, which will also benefit more patients. That patients feel very well cared for in the Martini-Klinik is shown not only by the very high recommendation rates over the years, but also by the numerous grateful comments in the guest book that we put into the foundation stone's time capsule. Many thanks to everyone involved and continued success!”

Prof. Dr. Burkhard Göke, Medical Director and Chairman of the Board of the UKE said: “An important feature of the Martini-Klinik is that our physicians can remove prostate tumors particularly gently on a large scale using robot-assisted surgical systems. These systems require space and special IT equipment. With the new high-tech building, we will soon be able to care for even more patients in our prostate cancer center to an especially high standard with the best possible quality results.”

Prof. Dr. Hartwig Huland, founder and Senior Physician of the Martini-Klinik said: “Our Martini-Klinik principle – which means specializing in one disease, the supporting team of Senior Physicians of equal rank and the systematic recording of treatment results even after the patient has been discharged – all contribute to our success. We have done real pioneering work in the field of prostate cancer: Our surgical techniques have become established worldwide in order to be able to maintain continence and potency for as many patients as possible. We have become a point of contact for patients from Germany and abroad and can only meet this demand through a significant increase in bed and operating theater capacities.”

Prof. Dr. Markus Graefen, Senior Physician of the Martini-Klinik said: “The new building will form the framework for our daily endeavors, which are geared towards treating the patient as one would like to be treated oneself: Not reduced to laboratory values or imaging procedure results, but holistically - as a man and person. In addition to excellent medical and nursing care, this includes a high degree of empathy in order to meet the patient on an equal footing and to take him seriously with all his concerns. The special ambience of the new building will help to create an open atmosphere in which employees and patients will feel equally comfortable.”

Future-oriented concept

The Martini-Klinik offers every option for the diagnosis and treatment of prostate cancer. With around 2,500 prostate cancer operations per year, the doctors at the Martini-Klinik perform the largest number of complete (radical) surgical removals of the prostate worldwide. A great many of these interventions are performed using the Da Vinci surgical system. The most important goal: to offer each patient the best possible treatment and maximum preservation of quality of life. The specialist clinic began in 2005 with just eight beds, then grew rapidly in the following years up to 72 beds today. Due to steadily increasing patient demand, there will now be four wards with 100 beds for privately and publicly insured patients in the new building. The eight operating theaters fulfill all the requirements for the use of robot-assisted surgical systems.

The construction costs for this self-financed building project amount to around 70 million Euros. The groundbreaking was in July 2019. Completion is expected in 2023. The design of the new building comes from the AC/HWP (Vienna/Stuttgart) consortium. The building offers a total of more than 17,000 square meters of gross floor space on seven floors and a basement. The building is divided into a two-storey podium zone with a bright, spacious entrance space and areas for the outpatient departments, functional diagnostics and examination rooms (ground floor and 1st floor). Above that is the operating floor with a distinctive lamellar facade (2nd floor) and a three-story bed block (3rd to 5th floor). The penthouse storey for the administrative area, with an elegant light metal facade, forms the top of the building (6th floor).


UKE News Magazine Summer 2019

Making the World Audible

If the ear is damaged, cochlear implants (CI) can help patients regain an auditory connection to their environment. For Prof. Dr. Christian Betz, Medical Director of the Clinic for Ear, Nose, and Throat Medicine at the UKE, and his team, fitting cochlear implants is now a routine procedure.

Listening to music, hearing what is going on, understanding speech: Many aspects of human interactions are dependent on the ability to hear. In Prof. Betz’s opinion, the auditory system is the most important of the human senses: “The ability to hear is incredibly important for human interaction – losing the ability to hear can, in some cases, lead to depression, isolation, and possibly even dementia.”, according the head of the clinic. He goes on: “Even spatial orientation is impaired without the capacity for three-dimensional hearing.”

In contrast to hearing aids, which amplify acoustic stimuli, a cochlear implant replaces the inner ear using a receptor placed in the bone of the skull. The implant sends electrical impulses directly to the cochlea, the snail-shaped structure in the inner ear, and the brain can then process the signals in a similar way to how it processes acoustic signals. External sounds are transmitted via a transmitter with a microphone which is connected to the skin via a magnet placed above the implant.

After the implantation of a CI, the device must be adjusted for each patient during a series of outpatient rehabilitation appointments. The patient then must re-learn how to hear with their new inner ear. “The sound perception is different to natural hearing. However, the more intensive the rehabilitation course, the more natural the patient’s perception of music and speech will be.”, according to Prof. Betz. Children, adolescents, adults, and the elderly can all suffer from loss of hearing. Especially for children, who have not yet learned to speak, a CI offers them the opportunity to master speech without limitations.

Cochlear Implants

Cochlear implants (CI) can replace the function of a damaged inner ear. This is made possible by the interaction between the externally worn signal processor with an implant located in the bone of the skull. The processor receives acoustic signals, converts these into electrical impulses, and uses contactless transmission to send the impulses to the internally located implant. From here, the information is then transmitted directly to the auditory nerve via a chain of electrodes implanted in the cochlea.

UKE News Magazine Spring 2019

From the Laboratory to the Hospital Bed

Finding new solutions to treat disease and improve medical care – that is the focus of intensive research at the UKE. The UKE subsidiary, MediGate, acts as a technology transfer center to support researchers in bringing their research results to patients, quickly and safely.

Many years ago, when a patient with acute mitral valve insufficiency turned up at the UKE Heart Center, heart surgeons Dr. Yalin Yildirim and Dr. Simon Pecha were faced with an exceptionally difficult situation. “At that time, there were surgical procedures to reduce leaks in the cardiac valves between the left atrium and left main chamber. However, in this specific case, the patient was already too weak to survive such a procedure,” recalls Dr. Yildirim. Fortunately, the surgeons were able to use a new interventional procedure to reduce leakage and save the patient – the mitral valve clip. But this topic continued to occupy them both. “The clip procedure has a catch – it is not suitable for every patient and it is also a complex procedure,” explains Dr. Pecha. “We began developing a new method that would allow the treatment of all patients with acute mitral valve insufficiency.”

Development of an Artificial Tubular Heart Valve

The young doctors experimented with various options for weeks until, one day, something clicked. “We had the idea to develop a heart valve in the shape of a tube, which can be positioned in the pulmonary vein. When in the outflow mode, the valve is open and causes only minimal flow resistance. When closed, the valve ensures that blood does not flow back into the lung,” explains Dr. Yildirim.

The young researchers realized their idea could end up being something medically applicable, so they contacted Tina Marschall at MediGate. Taking Research Results from the Laboratory to the Hospital Bed – this has been MediGate’s mission statement since it was founded in 2004. Ms. Marschall heads the Legal, Patent and License division, which is one of the fundamental pillars of the UKE subsidiary. “We help researchers protect their findings – which is their intellectual property - using all legal means,” she explained. “It is important that inventors contact us as soon as possible. When we receive the report of a new invention, we evaluate the details of the results,” explains MediGate employee, Regina Radig-Neuber.

If all the criteria to be considered a new invention are met, the researchers, together with a patent attorney, will present a patent registration to the respective authorities. “This process allows for the further development and exploration of research findings. Only then are the findings protected and can be published,” Ms. Radig-Neuber said. MediGate also accompanied Dr. Yildirim and Dr. Pecha in their application for “Research Start-Up Financing” from the Dean’s Office. Since then, the heart surgeons have confirmed the effectiveness of their invention in model and animal studies.

UKE News Magazine Winter 2019

Repaired Hearts

Around 7000 children are born every year in Germany with a heart defect. Even during the 1970s only half of such patients would survive – today, it is over 90 percent. This has led to the creation of a wholly new patient group: Adults with Congenital Heart Disease (ACHD).

Up to 300 000 ACHD patients currently live in Germany and annually around 6500 new patients join them. „This is good news; nowadays most cardiological abnormalities can be treated successfully and allow the patients to reach adulthood. For thousands of years, there have been more adults with congenital heart defects than children” says Prof. Dr. Carsten Rickers, who has been the head of the ACHD section at the University Heart Center since 2018.

And why are children not considered to be fully healthy after a successful heart operation? “This is because we repaired their heart problem, we didn’t cure it. In the long term, secondary problems, such as arrhythmia or insufficiency, can develop slowly and unnoticed. Therefore, it is important that those in this patient group receive life-long monitoring and medical care” stresses the pediatric cardiologist.

Several years ago, patients in this group were affected by a gap in medical care once they had outgrown pediatric cardiological care. Now, there are twelve national ACHD centers in Germany along with a network of specialist clinics and practices which provide expert aftercare by certified medical specialists. The University Heart Center is an accredited ACHD center. Each year our interdisciplinary team, comprised of pediatric cardiologists, adult cardiologist, and cardiac surgeons, treat approximately 1000 in- and outpatients. “The treatment of ACHD patients requires specialist skills and knowledge of congenital heart defects and their long-term course as well as special age-related cardiological problems” states Prof. Rickers, explaining the interprofessional cooperation.

UKE News Magazine Summer 2018

High-Tech in the Radiology Clinic

State-of-the-art high-tech equipment at the Clinic for General and Interventional Radiology and Nuclear Medicine: A new generation PET/CT scanner has been put into service. This scanner will focus, in particular, on the examination of cancer patients. The UKE has invested around 3.5 million euros in the new scanner.

The installation and assembly of the new PET/CT scanner presented the KFE team with many challenges. “It was necessary to make approximately ninety breaches in walls and ceilings in the ground floor and basement of building O22 to install the system as planned,” says Carol Wallerich, Head of Construction Management. Ms. Wallerich executed the project alongside Kora Kossack (Construction) and Nikola Dohse (Project Management/Planning). Construction-related costs totalled 1.3 million euros and construction was completed in four months.

“The new device is the first with fully digital PET components and is only available in a few places in Europe. This is the first and only one in northern Germany,” says Prof. Dr. Susanne Klutmann, Chief Physician for Nuclear Medicine. At the Clinic for Diagnostic and Interventional Radiology and Nuclear Medicine, the new scanner, under the management of Clinic Director Prof. Dr. Gerhard Adam, will mainly be used to examine cancer patients, but also to examine patients with brain diseases such as Alzheimer or Parkinson’s disease.

“The new PET/CT system enables us to identify tumors earlier and closely follow the illness’s development and therefore begin to plan and monitor individually tailored treatment in a timely fashion,” summarized Prof. Klutmann.

PET stands for Positron Emission Tomography and CT for Computed Tomography. PET and CT complement each other: The PET provides functional information (how is the examined organ working?) while the CT provides structural information (What does the examined organ look like?). A PET/CT system allows the PET and CT images to be combined during a single examination. The new device requires just 15 to 20 minutes to examine the whole body. “The new image quality is very impressive, I am delighted for our patients,” says MTRA Tarin Sid Mohammad. The new device is expected to provide improved diagnostic accuracy, by identifying small metastases for example. The combined examination method also enables the expected effectiveness of chemotherapy to be determined early on. A further benefit for many patients is that the use of special light effects can help reduce the fear of being in the “tube”. According to Prof. Klutmann, “In the new scanner, the light effects are a distraction that allow patients with claustrophobia to be examined easier.”

UKE Life Magazine Summer 2018

Aortic Valve Reconstruction instead of Artificial Replacement

For the past two years, the University Heart Centre has had a program focusing on aortic valve reconstruction, headed by Prof. Dr. Evaldas Girdauskas. One hundred defect cardiac valves have already been repaired using minimally-invasive techniques. Young patients, in particular, benefit enormously from the reconstructive procedure, which until now has only been carried out in a select few cardiology centres.

Bicuspid aortic valves are one of the most common congenital heart defects. They affect approximately 1.3 percent of the population. Instead of having three leaflets (similar in shape to wings) there are only two in the case of bicuspid valves. “If a valve is missing a leaflet, it is unable to fully close and this can lead to permanent damage,” explains Prof. Dr. Girdauskas, who founded the program at the University Heart Centre.

Patients suffering from such a condition were routinely fitted with an organic or artificial cardiac valve – a solution which, especially for younger patients, is not permanent. “For these patients, the organic cardiac valve only has a shelf life of three to seven years,” explains Prof. Girdauskas. Heart valve replacement patients must also use blood-thinning medication, which has many side-effects, for the rest of their lives. “The risk of developing complications, such as internal bleeding or thrombosis, within a time span of thirty years is almost one hundred percent,” according to the cardiology specialist.

In many cases, defect heart valves can be reconstructed simply, using minimally-invasive techniques. “One of the main advantages in repairing the valves is that the patient retains their own tissue, which is notably more resistant to infection,” explains Priv.-Doz. Dr. Christoph Sinning. The heart is also required to work less than when it must manage the increased flow resistance caused by an artificial valve. If, and to what an extent, a repair procedure is possible is decided at the Heart Centre following extensive examinations.

Article published in Wissen+Forschen 2018

Slowing tumor growth

Brain tumors are under-researched and are difficult to treat in children and adults alike. New treatment approaches are currently in development. The field of tumor immunology is focusing on the improvement of the defense mechanisms for tumor cells in the brain. And for tumors in children, the focus is on the curbing of tumor growth.

“A well-planned operation that takes all the collected functional and imagining diagnostics into account is pivotal for the quality of care provided to the patient,” says Dr. Manfred Westphal, Clinic Director of the Clinic for Neurosurgery. Often an operative procedure alone does not lead to full recovery, it is common for patients to undergo a course of radiotherapy following the operation –combined with chemotherapy, if necessary.

Glioblastomas, the most aggressive form of brain tumors, are the current subject of intense tumor biological research. “We still do not know from which cells gliomas emerge. However, we suspect that tumor stem cells are the source” says Prof. Westphal. “With the help of a viral cells marker system, we are attempting to understand their dynamic.”

In the field of tumor biology, researchers are especially focused on findings ways to improve the insufficiency of tumor cell defenses in the brain. In cooperation with the Institute for Tumor Biology, the team of neurosurgeons are using the markers to study tumor cells that circulate in the bloodstream.  

Progress in the Research of Brain Tumors in Children

In conjunction with the Institute for Children’s Cancer in Hamburg, UKE cancer researchers have made progress in studying a previously untreatable type of brain tumor in children. The researchers were able to identify molecular mechanisms which are responsible for what is known as an embryonal tumor with multi-layered rosettes (EMTR). Under laboratory conditions, the researchers were able to use medication to significantly slow the growth of the tumors.

ETMR is an uncommon but very aggressive form of brain tumor in children – which particularly affects children under 3 years-old. In Germany there are less that ten new cases each year. Most of the children with this condition die within a very short time. “The cause of ETMR remains unexplained. Standard treatments and even specifically effective medications are not avaiable,” says the head of the study group, Prof. Dr. Ulrich Schueller. The aim of the research is to understand, on a molecular level, how the precursor cells in the brain degenerate. According to the researchers, the simultaneous over-activation of two molecular signal pathways, which play a significant role in brain development, play a decisive role in the development of EMTR. The researchers have already been able to successfully treat EMTR typical tumors in the laboratory.

Prof. Schueller is a senior physician at the UKE Institute for Neuropathology. He is also the endowed professor at the Molecular Pediatric Oncology, which is co-financed by the Society of the Children’s Cancer Center Hamburg, and the UKE. The research institute of the Children’s Cancer Center is located on the UKE’s grounds and since 2006 has been run via the financing of the society and donations. 

Article published in Wissen+Forschen 2018

New impulses for the brain

Physicians at the UKE use deep brain stimulation to treat movement disorders such as Parkinson’s disease and dystonia. This requires the insertion of needle-thin electrodes into a pea-sized area of the brain and optimally setting the level of stimulation using the electric fields.

No-one wants to have a hole made in their head. But what if it offers the best (and perhaps only) chance to successfully treat previously untreatable movement disorders, such as uncontrollable muscle cramps, the slowing of your movements and tremors? “For the patient the operation is a special moment. At times, they’re awake and must actively participate to make sure the operation is successful,” says Priv.-Doz. Dr. Monika Pötter-Nerger. The senior physician belongs to a team made up of neurologists, neurophysiologists and neurosurgeons who carry out extraordinary surgical procedures at the UKE Head and Neurocenter. During such a procedure, which can take several hours, the specialists implant one or two electrodes into the patient’s brain and connect these electrodes with cables that run along the neck below the skin. The cables connect to a small box, which is usually placed near the clavicula. This device is known as a neurostimulator and it is where the batteries for the electrodes are situated as well as the electronic control unit. “Women who are thinner and wish to have the device in a less conspicuous part of the body can choose to have the impulse generator implanted into their abdominal cavity. This poses no problem from a surgical-technical standpoint,” says Dr. Pötter-Nerger.  

Precision: The insertion of the brain electrodes.

Once the impulse generator has been put in place the team has already completed the biggest surgical hurdle - the insertion of an approximately 1.3-millimeter thin electrode into the pea-sized target area deep in the brain. To ensure that this part of the procedure is successful, the patient’s head is fixated using a stereotactic frame – allowing for zero range of movement. The target area, and the path to the target area, are predetermined using a navigation program and there is very little margin for error. “The MRI images from inside the brain help us with planning,” says Dr. Pötter-Nerger. However, the margin of error can be up to 1 millimeter. “When one knows that the brain swims in cerebral fluid and can be displaced by 1 millimeter when the electrode is inserted, then this is overall too great a margin.”

To determine the best approach and position for the electrodes, surgeons use two further sources of information. During the operation, three to five microelectrodes are inserted into the brain to allow them to listen in on nerve activity. And the intraoperative stimulation allows one to determine exactly where in the subthalamic nucleus one is during the procedure, according to Dr. Pötter-Nerger. She goes on: “The electrode is then implanted in the area where both the best electrode conduction with the least side-effects are found.”

It has not been fully determined as to how exactly deep brain stimulation works. One hypothesis is that the disease-causing activity in the nerves is overridden by the high-frequency electrical impulses. However, the therapeutic effects and side-effects may only be seen after days or weeks – this is evidence of previously unknown transformation processes that take place inside the human brain.  

The Setting of the Stimulation Parameters

During the OP the team begins with the fine adjustment of the electrical fields around the electrodes. Postoperative, and with patient participation, Monika Pötter-Nerger and her team optimize the effectiveness of the neurostimulator. Using an antenna, the implanted impulse generator can be read and programmed via telemetry. Impulse frequency amplitude, impulse width and, therefore, the exact form and position of the electrical fields around the electrodes can be changed and adjusted using an external control unit to suit the patient’s individual needs. The aim is to maximize the effectiveness of the operation and brain stimulation without affecting the neighboring structures. Occasionally, the UKE specialists will call on the patient’s participation during the operation. During a study, carried out by special research group 936, the effects of stimulation on the networks in the brain were examined. Some patients – while lying on the operation table – carried out tasks such as footstep motion on an exercise stepper. “The stepper was specially built for intraoperative tests. This allows us to use the unique opportunity to listen in on nerve activity during the operation to find out more about the role the basal ganglia cells play in the control of footstep movement,” says Dr. Pötter-Nerger. The tests extend the duration of the eight to ten hours procedure by approximately a further thirty minutes. Only specially selected patients are suitable candidates for the physical nature of these tests. “The specially selected patients have to consent to undergoing the operation whilst remaining awake, have a low enough level of tremors and be fit enough for the intraoperative step motion test,” says Dr. Pötter-Nerger.  

Deep Brain Stimulation (DBS) is an option for treating various forms of movement disorders, such as essential tremors, dystonia or for Parkinson’s disease. These conditions are triggered defective firing of nerve cells in the brain. The most important criterium that must be fulfilled before undergoing DBS is severe functional impairment in one’s everyday life, once conventional therapies have proven ineffective. The most common indication for undergoing DBS is Parkinson’s disease – especially when coupled with Dopaminergic long-term effects or medication intolerance. In certain cases, deep brain stimulation of the subthalamic nucleus can reduce the need for medication by up to half.

Press Release February 15th 2018

Martini-Klinik: Clinic Extension Opened

The Martini-Klinik team opened the new fourteen-bed annex on Friday, January 19th 2018. The annex is another step on the way to the construction of the new Martini-Klinik, due to be completed in 2021. The new clinic will house 100 beds and eight operating theaters. The architect contract has been signed and the detailed planning phase begun. In autumn 2017 the Martini-Klinik had already constructed modules as part of the extension project.

Press Release January 15th 2018

“Excuse me, how do I get to…?”

Anyone who works at the UKE is confronted with the above question several times a day, be it from patients, visitors or fellow employees. It’s not a surprise. The UKE, with its numerous buildings, entrances and roads, is known as ‘the city within the city’. Both analogue and digital wayfinding has been available since the end of 2017, to help people find their way around campus.

Via a touchscreen situated in the main building’s foyer (O10), and soon in the UKE Pediatric Clinic (O45/O47), there’s now a helping hand to navigate the various floors and entrances of the many buildings on the UKE campus. On columns and site maps, strategically placed throughout the campus, you can scan a QR code to determine your current position, then use your smartphone to give you a step-by-step description of how to reach your destination. A keyword search simplifies the process further.

“It used to be that when one asked for directions, one was given a printed site map with a rudimentary X marked at one’s destination,” explains Alexander Baaß from Project Management.

Simple, hard-to-read aluminum signs were also used as signposts. In 2014, the Board of Directors decided to modernize the wayfinding system and use new technologies.

“Nowadays, anyone can carry their own web-based personal signpost with them to show them the way,” says Mr. Baaß. “It’s now possible for QR codes or links to be placed on letterheads, business cards and email templates – the technological options for wayfinding are varied.”

Gerhard Mentges, Head of Project Management, and his team worked for three years on the project alongside Klinik Facility Eppendorf (KFE), the Department for Corporate Communications and external service providers. “The challenges for the new system and the effort invested in co-ordination were huge,” recalls Mr. Baaß.  The aim is that no-one will ever need to ask for directions when visiting the UKE again.Only a few companies considered themselves up to the complex task at hand, and responded to the Europe-wide search. “Specialist knowledge was essential, for example, how were people with impaired vision to move through open spaces and buildings? Where were the signposts needed? Where was the confirmation needed that a person was taking the right path? And how should these aspects be built and positioned?” Mr. Baaß said.

The final concept was presented in 2015. The system used concise colors to show the various compass directions on the UKE campus, and included robust signs with interchangeable information sections, as well as many new details, such as banner signposts on the walls of various buildings. The new wayfinding systems were installed in the main building (O10) at the start of 2016.

The other challenge was the re-design of the sitemap to make it more user-friendly and readable on digital screens. Which entrance to the building is most suitable for me? Which route is barrier-free? The answers to these questions had to be defined. Following extensive testing, the wayfinder system has been in operation since the end of 2017 and is being continually optimized and improved. 

“The biggest challenge is the constant synchronization of the analogue and digital systems,” explains Alexander Baaß. “Many of the UKE institutes are undergoing construction and many signposts have not been allocated a final position or have been moved or adjusted.” How often the system will require revision is not clear. However, we do know that since the system has been operational it has received almost 23,000 clicks. Now, instead of asking passers-by, most people connect to the digital system to find their way to the University Heart Center, the Policlinics, the ENT Department or whatever building has brought them to the UKE.

Press Release December 14th 2017

Treatment under One Roof: New Stem Cell Transplantation Ward at the UKE Pediatric Center

The new ward for Pediatric Stem Cell Transplantation and Immunology at the UKE Pediatric Center is now fully operational. Children and young adults are able to undergo a transplant without having to be transferred between various wards and buildings, as was the case previously.

“Welcome,” says the sign at the new Stem Cell Transplantation Ward reception. The long hall, from which the six patient rooms branch out, is full of natural light and painted in bright colors. There is also a fully equipped kitchen and common room – a place for parents to meet and relax. “Children especially are very sensitive to their surroundings. That is why it is of the utmost importance that patients and their families, despite the difficult time they find themselves in, feel they are in a safe and caring environment,” says Prof. Dr. Ingo Müller, chief physician on the ward.

Children and young adults stay around six weeks on the ward on average when undergoing stem cell transplantation. Before the new ward was opened, patients underwent chemotherapy and transplantation at the Interdisciplinary Clinic for Stem Cell Transplantation and were transferred to the Clinic for Pediatric Hematology and Oncology after three weeks. Now everything is situated under one roof and young patients are surrounded by the same highly professional team of pediatric specialists and nurses while undergoing their treatment.

“Now that the team is so close knit, important information can be passed directly to those who need it,” explains Prof. Dr. Müller. This system also allows time for physicians and nursing staff to get to know each patient, and their individual needs, during the course of treatment and even continuing into the aftercare phase, which takes place in the adjacent Stem Cell Transplant Policlinic. Five pediatric specialists and 14 nursing staff run the SCT ward. The anteroom system, which is separate from the patient rooms, allows for improved patient contact and processes.

 “Each anteroom has its own computer, which allows staff to spend more time close to the children while completing the necessary documentation,” says Prof. Ingo Müller. The Perfusor pumps from which all infusions are administered, are also situated in the anteroom, with the advantage that children and their parents are less disturbed when an alarm sounds, or a cylinder or bottle needs changing. The danger of bacterial infection is also reduced.

The new ward allows staff to be in close proximity not only to the patient but also to the hematologists, metabolism and neuropediatric specialists. “This proximity allows for improved cooperation and exchanging of information between all of the physicians involved,” explains Prof. Müller. The fact that the intensive care unit and operating rooms are situated directly adjacent to the ward allows for faster intervention in emergency situations too. Prof. Müller and his team of specialists aim to improve the already excellent levels of services and treatment for both patients and their families on the new ward.

Press Release December 1st 2017

The Martini Klinik Continues to Grow

The Martini Klinik, already the world’s largest prostate center, continues to report increasing numbers of interested patients from all over the world. This requires the specialist clinic to increase its capacity to deal with the demand. The new building, which will be situated on the east side of the UKE campus, is currently in the planning stage and is due to be completed by the end of 2021.

An extension to the existing building, using prefabricated modules, is currently being constructed. This temporary solution will allow for an immediate increase in capacity and will offer room for up to 14 more inpatients at a time. The prefabricated modules, which are 11 meters long by 3.90 meters wide, are delivered by truck and put into place using a massive crane. The seven new patient rooms are due to be completed by the end of this year and will be fully operational by January 2018. The modules are connected directly to the Martini Klinik and will be a fully integrated part of the clinic.

Press Release September 14th 2017

New UKE Pediatric Clinic

After three years of construction, the Werner and Michael Otto University Pediatric Clinic was officially opened today by the Mayor of Hamburg, Olaf Scholz. The opening ceremony was attended by several hundred guests, including Katharina Fegebank, senator for science, research and equality, and many of the clinic’s donors. Religious leaders from various denominations came together to offer the new clinic their blessings.

The UKE Pediatric Clinic is the most modern pediatric clinic in Northern Germany and from the start it has been built with the needs of sick children and adolescents in mind. The clinic offers all of the fundamental areas of pediatric care under one roof. 

The construction of the UKE Pediatric Clinic cost 69.5 million Euros, a third of which was raised through donations.

Mayor of the Free and Hanseatic City of Hamburg, Olaf Scholz, said: “The new UKE Pediatric Clinic was designed to represent children and to generate feelings of safety and optimism. The wishes and experiences of sick children were considered during the clinic’s development phase, which impressed me deeply. “The UKE Pediatric Clinic offers the perfect environment for state-of-the-art medical care while offering an excellent place for UKE’s compassionate specialist medical care staff to work. I am delighted we were able to complete this project through co-operation between the city, the UKE and private donors. “Something very special has been constructed around the tree at the heart of this clinic and I offer my profound thanks to all those involved.”

Prof. Dr. Burkhard Göke, UKE’s Clinical Director and Managing Director said: “The new UKE Pediatric Clinic is a modern and landmark building project that will allow us to care for young patients, and their parents, even better than before. “I am delighted that the project was completed within the timeframe and budget determined when it began and I wish to thank all those who supported the construction with their donations, ideas and support and helped ensure we turned possibility into reality.”

Businessman Dr. Michael Otto said: “The new UKE Pediatric Clinic will not only improve our city but the whole of Northern Germany. The clinic will be a place for cutting edge medical research and the state-of-the-art treatment of our children, and importantly, that will take place in surroundings designed to make children feel as comfortable as possible.

“The clinic, which was built using the most modern standards, will offer children and their families all the support they need during difficult times. It is my pleasure to support this UKE project. My donation was given in co-operation with my longstanding work with my father’s medical foundation, which was his lifelong philanthropic project.”

Dr. Otto donated 11.6 million Euros to the project.

More than 12,000 individual and institutional donors supported the UKE Pediatric Clinic’s construction financially. Other major individual donors included Hamburg businesswoman Ute Louis, and the Association for the Pediatric Cancer Center in Hamburg.

Treatment at the UKE Pediatric Clinic

The new clinic has a total of 148 beds. It will offer treatment for all of the fundamental illnesses that affect children and young people. The clinic will have a special focus on severe, rare, complex and unexplained illnesses, such as metabolic illnesses, neurological illnesses, cancers and liver, kidney and bone marrows transplantations. Medical Technology The UKE Pediatric Clinic will utilize the most modern medical technology. It has its own MRI machine, which allows physicians to better plan appointment for their young patients. At the new Emergency Room, internal medical specialists and experienced surgeons will co-operate to offer the highest standards of care. The new clinic is also connected to UKE’s pneumatic post delivery system, which means samples can be sent for evaluation immediately and the results returned to physicians faster.

A Special Atmosphere

The UKE Pediatric Clinic’s design concept was based wholly on the needs of young patients and their families. There are spaces for all age groups, with communal areas with comfortable seating and refreshments for parents, play areas for younger patients and their siblings, and areas especially designed for older patients.

The various wards are better connected than they were in the previous clinic too. One special feature of the new clinic is the 128-year-old hornbeam tree that stands at the entrance to the inner courtyard. The clinical departments have been constructed in such a way that patients, visitors and staff will all have an enjoyable view of the tree.

Moving into the New Clinic

The process of relocating to the new clinic will begin on Thursday, September 21 with the current clinic remaining fully operational. Non-patient areas will be equipped and set-up first, such as administrative offices, followed by wards and policlinics. The process will be completed by Friday, September 29. Around 600 UKE staff will work at the new UKE Pediatric Clinic.

UKE Pediatric Clinic Web Presence

For the first time the UKE Pediatric Clinic will have a website especially designed for children and adolescents (www.kinder-uke.de) It will use cartoons and illustrations to target the various age groups, present the clinic and explain how it works. A cartoon squirrel will guide the younger patients through the various UKE departments and respond to any worries or doubts they may have. The illustrations are taken from the children’s book “How does a pediatric clinic work?” by Alexandra Langenbeck, published by UKE co-operation partner Friedrich Oetinger. Family members and referring physicians will find all relevant information on the UKE Pediatric Clinic at www.uke.de/kinder-uke.

Press Release September 1st 2017

Precedent-Setting Clinical Studies

Catheter or Surgery: Which of the two is the best option for cardiac valve replacement? Cardiac insufficiency and iron deficiency: Can the chances of the survival be improved? These are two of the cutting edge studies currently taking place at the University Heart Center (UHZ). The findings of these studies will have a great effect on thousands of patients with heart problems.

One of the most common heart conditions in people over the age of seventy-five is aortic valve stenosis. “There are currently two principle options. One is the surgical opening of the patient’s chest cavity and the implantation of a biological cardiac valve with the help of a heart-lung machine. The other is the TAVI (Transcatheter Aortic Valve Implantation) procedure, which enables the implantation of the new valve using a catheter inserted, for example, through the femoral artery and then placed in the heart,” explains UHZ Chief Physician Prof. Dr. Dr. Hermann Reichenspurner.

Several years ago, very old patients, or those with multimorbidity, had very little chance of having a new cardiac valve implanted. “Since 2002 the new TAVI minimally-invasive technique has been applied with great success, especially in those patients who are at higher surgical risk,” says Prof. Dr. Stefan Blankenberg, Head of the Clinic for General and Interventional Cardiology.

Can Younger Patients Also Benefit from TAVI? For many years, the less invasive TAVI was only available for those patients considered at higher risk from surgery. However, there is now a new trend of also treating younger and healthier patients using this technique, although there are still no confirmed long-term findings for this procedure. TAVI is not risk-free: the catheter can cause release deposits from the vascular walls, which in turn can cause strokes or heart attacks. Also, the durability of the TAVI valve, which opens like an umbrella in the stenotic aortic valve has not yet been definitively proven. The UHZ is leading a multi-center study named DEDICATE to determine all aspects of the catheter method on patients with moderate to low risk from surgery. Only patients who are theoretically candidates for both procedures are able to participate in the study, and they will be randomly assigned to two different groups and be monitored and evaluated repeatedly over a period of five years. “The study will have a total of 1,600 patients from thirty heart centers throughout Germany,” explained Prof. Blankenberg.  

Iron deficiency: Fatigue and more susceptible to illness

The second major study focuses on cardiac insufficiency and iron deficiency. Up to 60 per cent of patients with pathological heart insufficiency also suffer from high-grade iron deficiency. The consequences of this are fatigue, reduced performance and problems concentrating. The organism is also more susceptible to illness. The FAIR-HF-2 study will now investigate whether treatment with intravenous ferric carboxymaltose will help increase the survival rate and reduce the numbers of patients who require inpatient medical treatment. “Preliminary studies have shown that symptoms and quality of life improve when these patients receive treatment for iron deficiency,” says Dr. Mahir Karakas from the Clinic for General and Interventional Cardiology, which is heading the multi-center study in co-operation with the University Clinic in Gottingen.

Does Iron Deficiency Treatment Lengthen the Lives of Heart Patients? In the current study, 1,200 patients with at least moderate cardiac insufficiency are to be studied. “If our hypothesis is confirmed then the iron deficiency treatment will lengthen the life of the patient and reduce the need for inpatient stays in hospital. If this is the case, these finding will be included in the standard treatment guidelines,” explains Dr. Mahir. Each patient will then receive the necessary intravenous therapy, which will lead to an improved prognosis for the majority.

Both studies are being supported with several million Euros from the German Center for Cardiovascular Research (DZHK). The first results are expected to be available in 2018. The specialists at the UHZ are certain that the findings will have a direct positive effect on the treatment of thousands of heart patients.

Press Release August 1st 2017

Always a Step Ahead

Bottlenecks in the Supply of Pharmaceuticals

Around 12,000 individually-packaged medications leave the hospital pharmacy every day to be delivered to various wards. Delays in pharmaceutical company deliveries often leave both buyers and pharmacists facing an array of ever-changing challenges. To ensure 1,700 inpatients receive the medications they need requires good nationwide contracts and a lot of negotiating skills.

The UKE uses a fully-automated system to order medications electronically whenever they are required. As soon as the stock of a certain medication falls below a pre-determined level, the digital logistics system sends an order request to the UKE’s pharmaceutical buyers: Irmgard Hohr and Maren Kummich. Prior to re-ordering, usage level is analyzed and, if necessary, the amount ordered is reduced or increased. If a certain type of medication is unavailable, the buyers research and evaluate other options. “Our first step is to search for a replacement product from a different company or different package sizes, dosage forms or dosages – always in close cooperation with those who use the medication and the pharmacists on the wards,” explains Ms. Hohr. Buyers and pharmacists are constantly evaluating the safety and quality of the order of pharmaceutical products. Products are ordered directly from the manufacturer and re-imports from abroad are strictly prohibited. Along with six other major university clinics in Northern Germany, the UKE is a member of the Common Purchasing Group of University Medical Center Pharmacies of Northern Germany (Gemeinschaftlicher Einkauf Norddeutscher Universitätsapotheken), known as GENUA. This is a co-operation project between the major university clinics to collectively procure the best possible prices from pharmaceutical companies, while negotiating long-term contracts to obtain delivery and logistical guarantees to ensure products are available when they are needed. UKE’s responsibilities include the procurement of antibiotics and plasma products. “We are in constant contact with the buyers at our partner clinics,” explains Ms. Hohr. “If one clinic has problems procuring certain products then GENUA members will provide that clinic with the products it needs from their own stock.”

Press Release April 1st 2017

Obesity Taskforce

The University Obesity Center at the UKE is a specialist center for those suffering from pathological obesity. Approximately 20 physicians and therapists from various specialist fields cooperate to provide each patient with the tailored treatment he or she needs to see long-term benefits.

Friday morning, 08:15 am: A team of ten surgeons, hormone specialists, dieticians, psychotherapists and psychosomatic specialists are sat together on the UKE Obesity Board to discuss the case of Bernd H, who is 63-years old, 175 cm and weighs 170 kg; “It’s a course of treatment focusing solely on movement and is diet an option?” is the question. “That would be difficult,” is the answer from the young specialist for internal medicine. At the first examination the patient was barely able to stand on the scales, He also suffers from diabetes and high blood pressure.” We also diagnosed the patient with a severe eating disorder during the psychosomatic evaluation,” added a specialist for psychosomatic problems.

In the case of Bernd H. the board decided upon a multi-modal course of treatment consisting of dietary and psychotherapy as well as a gastric sleeve operation. A further nine cases will be discussed on this same morning. Around 2500 severely obese patients undergo treatment each year at the UKE – many of these patients have a BMI (Body Mass Index) of between 40 and 50.

 “Along with the actual obesity, the accompanying illnesses such as diabetes, high blood pressure and dyslipidemia are major dangers for the patients,” warns Priv-Doz. Dr. Jens Aberle, Head of Internal Medicine at the UKE Obesity Center. “The risk of developing type-2 diabetes is 90% when a patient’s BMI is above 35,” Dr. Aberle adds. “These patients require a great deal of support and require individual solutions tailored to their case.”

The UKE Obesity Clinic has developed a stage-by-stage concept (see below). “The key component of the concept is the interdisciplinary cooperation between the various specialists which we offer from the first appointment onwards at our weekly Obesity Outpatient Clinic,” explains Prof. Dr. Oliver Mann, the Head of Surgery at the Obesity Center. “If we are able to identify the reasons for the obesity and the possible accompanying illnesses, then we are able to create a suitable therapy plan,” adds the Professor. For patients with a BMI of more than 40 the therapy normally consists of a multi-modal course of treatment lasting 6 months consisting of nutrition, exercise and psychosomatic treatments.

How big is a normal portion of pasta? Where are the calories hidden? During the nutritional courses the dieticians teach the patients basic information relating to a healthy diet. The training also includes a course on how to shop for food and cooking events. The aim is to share practical information, “For example, we show the patient how to prepare a simple, cheap and nutritious meal without much effort,” says Inga Petrusch, dietician at the UKE Obesity Center. The success of treatment depending largely on the psychological status of the patient, “It is common for obese patients to also have psychological problems,” explains Senior Physician Dr. Verena Faude-Land from the Institute and Policlinic for Psychosomatic Medicine and Psychotherapy. In some cases depression or anxiety disorders can be the cause of overeating. Dr. Faude-Land adds: “During the initial psychosomatic consultation we attempt to determine if there are underlying psychological causes for the patient’s condition.”

The Obesity Center also uses group therapy sessions to help the patients reflect on their overeating issues. The UKE Athleticum decided on a case-by-case basis if exercise –based therapy is suitable for patients; “depending on the physical condition of the patient, we carry out a stress-ECG using a bicycle ergometer or a crank handle along with other medical tests” explains Dr. Percy Marshall. If the patient is found to be suitable then the patient can begin with group training at the policlinic.

If, despite treatment, the patient’s weight doesn’t drop then there is an option of operative therapy. Approximately 300 patients each year undergo surgery for obesity at the UKE. The most common procedures are the gastric bypass and sleeve gastrectomy. These treatments also help alleviate the secondary illnesses such as diabetes. Can surgery alone cure obesity? “No,” says the specialist for endocrinology Dr. Aberle, “Adiposity is not purely a physical affliction. Aftercare is also of the utmost importance.” Around one-third of the patients are suffering from depression, anxiety or eating disorders and require intensive psychological care at the UKE. The self-help group founded by ex-patient Marlies Wupper 15 years ago offers a place for current patients to share their experiences, “To have long-term success in this treatment one must be ready to change one’s lifestyle” says Ms.Wupper. “It can be very motivating to hear how other patients were able to manage it.” she adds and is now looking forward to welcoming Bernd H.to the group.

Taken care of from A to Z: The Multimodal Stage-by-Stage Concept

The stage-by-stage concept is a long-term therapy concept which was developed at the UKE Obesity Center and is individually tailored to suit each patient’s case.

Stage 1: Physicians and care-specialists explainthe therapeutic possibilities available to the patient.

Stage 2: Development of tailored treatment plans.

Stage 3: Interdisciplinary Adiposity Board uses an individual therapy recommended for the patient.

Stage 4: Planning of the course of therapy with the patient.

Stage 5: Preparing documents for treatment.

Stage 6: Inpatient aftercare. The patient usually stays for 6 days at the clinic after the OP. The patient will receive consultations covering nutritional build-up and diet as well as exercise therapy.

Stage 7: Outpatient aftercare. The long-term success of the treatment mainly depends on continual aftercare. Nutritional status and accompanying illnesses require regular monitoring. This will take place every three months during the first year and every six months during the second year.

Further information is available at University Obesity Center www.uke-io.de/medicalservices/medical-treatment/minimally-invasive-surgery/obesity.html

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, andhas 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.

Safety First

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.

Individually Packaged

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).

Completely Sterile

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.

Killing Germs

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.

University Heart Center

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

New impulses for the brain

Physicians at the UKE use deep brain stimulation to treat movement disorders such as Parkinson’s disease and dystonia. This requires the insertion of needle-thin electrodes into a pea-sized area of the brain and optimally setting the level of stimulation using the electric fields.

No-one wants to have a hole made in their head. But what if it offers the best (and perhaps only) chance to successfully treat previously untreatable movement disorders, such as uncontrollable muscle cramps, the slowing of your movements and tremors? “For the patient the operation is a special moment. At times, they’re awake and must actively participate to make sure the operation is successful,” says Priv.-Doz. Dr. Monika Pötter-Nerger. The senior physician belongs to a team made up of neurologists, neurophysiologists and neurosurgeons who carry out extraordinary surgical procedures at the UKE Head and Neurocenter. During such a procedure, which can take several hours, the specialists implant one or two electrodes into the patient’s brain and connect these electrodes with cables that run along the neck below the skin. The cables connect to a small box, which is usually placed near the clavicula. This device is known as a neurostimulator and it is where the batteries for the electrodes are situated as well as the electronic control unit. “Women who are thinner and wish to have the device in a less conspicuous part of the body can choose to have the impulse generator implanted into their abdominal cavity. This poses no problem from a surgical-technical standpoint,” says Dr. Pötter-Nerger.


Precision: The insertion of the brain electrodes.

Once the impulse generator has been put in place the team has already completed the biggest surgical hurdle - the insertion of an approximately 1.3-millimeter thin electrode into the pea-sized target area deep in the brain. To ensure that this part of the procedure is successful, the patient’s head is fixated using a stereotactic frame – allowing for zero range of movement. The target area, and the path to the target area, are predetermined using a navigation program and there is very little margin for error. “The MRI images from inside the brain help us with planning,” says Dr. Pötter-Nerger. However, the margin of error can be up to 1 millimeter. “When one knows that the brain swims in cerebral fluid and can be displaced by 1 millimeter when the electrode is inserted, then this is overall too great a margin.” To determine the best approach and position for the electrodes, surgeons use two further sources of information. During the operation, three to five microelectrodes are inserted into the brain to allow them to listen in on nerve activity. And the intraoperative stimulation allows one to determine exactly where in the subthalamic nucleus one is during the procedure, according to Dr. Pötter-Nerger. She goes on: “The electrode is then implanted in the area where both the best electrode conduction with the least side-effects are found.”

It has not been fully determined as to how exactly deep brain stimulation works. One hypothesis is that the disease-causing activity in the nerves is overridden by the high-frequency electrical impulses. However, the therapeutic effects and side-effects may only be seen after days or weeks – this is evidence of previously unknown transformation processes that take place inside the human brain.


The Setting of the Stimulation Parameters

During the OP the team begins with the fine adjustment of the electrical fields around the electrodes. Postoperative, and with patient participation, Monika Pötter-Nerger and her team optimize the effectiveness of the neurostimulator. Using an antenna, the implanted impulse generator can be read and programmed via telemetry. Impulse frequency amplitude, impulse width and, therefore, the exact form and position of the electrical fields around the electrodes can be changed and adjusted using an external control unit to suit the patient’s individual needs. The aim is to maximize the effectiveness of the operation and brain stimulation without affecting the neighboring structures.

Occasionally, the UKE specialists will call on the patient’s participation during the operation. During a study, carried out by special research group 936, the effects of stimulation on the networks in the brain were examined. Some patients – while lying on the operation table – carried out tasks such as footstep motion on an exercise stepper. “The stepper was specially built for intraoperative tests. This allows us to use the unique opportunity to listen in on nerve activity during the operation to find out more about the role the basal ganglia cells play in the control of footstep movement,” says Dr. Pötter-Nerger. The tests extend the duration of the eight to ten hours procedure by approximately a further thirty minutes. Only specially selected patients are suitable candidates for the physical nature of these tests. “The specially selected patients have to consent to undergoing the operation whilst remaining awake, have a low enough level of tremors and be fit enough for the intraoperative step motion test,” says Dr. Pötter-Nerger. Deep Brain Stimulation

Deep Brain Stimulation (DBS) is an option for treating various forms of movement disorders, such as essential tremors, dystonia or for Parkinson’s disease. These conditions are triggered defective firing of nerve cells in the brain. The most important criterium that must be fulfilled before undergoing DBS is severe functional impairment in one’s everyday life, once conventional therapies have proven ineffective. The most common indication for undergoing DBS is Parkinson’s disease – especially when coupled with Dopaminergic long-term effects or medication intolerance. In certain cases, deep brain stimulation of the subthalamic nucleus can reduce the need for medication by up to half.

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 providedthe 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 MartiniKlinik 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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