Frieder Berr - Academia.edu (original) (raw)

Papers by Frieder Berr

Research paper thumbnail of Neoadjuvant Down-Sizing of Hilar Cholangiocarcinoma with Photodynamic Therapy—Long-Term Outcome of a Phase II Pilot Study

International Journal of Molecular Sciences, 2015

Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahep... more Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0) recurrence can be as high as 70%. Photodynamic therapy (PDT) is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0) performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years) with initially non-resectable hilar CC. Photofrin was injected intravenously 24-48 h before laser light irradiation of the tumor stenoses and the adjacent bile duct segments. Major resective surgery was done with curative intention six weeks after PDT. All seven patients had been curatively (R0) resected and there were no undue early or late complications for the neoadjuvant PDT and surgery. Six of seven patients died from tumor recurrence at a median of 3.2 years after resection, the five-year survival rate was 43%. These results are comparable with published data for patients resected R0 without pre-treatment, indicating that neoadjuvant PDT is feasible and could improve overall survival of patients considered non-curatively resectable because of initial tumor extension in bile duct branches/segments-however, this concept needs to be validated in a larger trial.

Research paper thumbnail of Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopy

Main RecommendationThere is a need for well-organized comprehensive strategies to achieve good tr... more Main RecommendationThere is a need for well-organized comprehensive strategies to achieve good training in ESD. In this context, the European Society of Gastrointestinal Endoscopy (ESGE) have developed a European core curriculum for ESD practice across Europe with the aim of high quality ESD training.Advanced endoscopy diagnostic practice is advised before initiating ESD training. Proficiency in endoscopic mucosal resection (EMR) and adverse event management is recommended before starting ESD trainingESGE discourages the starting of initial ESD training in humans. Practice on animal and/or ex vivo models is useful to gain the basic ESD skills. ESGE recommends performing at least 20 ESD procedures in these models before human practice, with the goal of at least eight en bloc complete resections in the last 10 training cases, with no perforation. ESGE recommends observation of experts performing ESD in tertiary referral centers. Performance of ESD in humans should start on carefully s...

Research paper thumbnail of Rectal reconstruction after endoscopic submucosal dissection for removal of a giant rectal lesion

Research paper thumbnail of Single-center implementation of endoscopic submucosal dissection (ESD) in colorectum: Low recurrence rate after intention-to-treat ESD

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, Jan 8, 2017

Colorectal endoscopic submucosal dissection (ESD) shows higher R0 resection and lower local recur... more Colorectal endoscopic submucosal dissection (ESD) shows higher R0 resection and lower local recurrence rates than endoscopic mucosal resection (EMR) in Japan. In Europe, independent learning of ESD in colorectum is feasible, but yet to be analyzed for curative resection and recurrence rates. After experimental training under supervision by Japanese experts (T.O., N.Y.), three endoscopists independently performed 83 ESD procedures intention-to-treat for lesions in the entire colorectum of 67 patients in a prospective registry (Nov. 2009 to June 2016). ESD was feasible in 80 (96%) of colorectal neoplasias (mean diameter 33.6 (±1.8) mm), and three more required conversion to piecemeal EMR. The lesions were adenomas, in 66% with low-grade intraepithelial neoplasia (LGIN), 29% with high-grade intraepithelial neoplasia, and 5% with carcinomas (G2, pT1). ESD had to be facilitated by the final use of snaring (Hybrid-ESD, n=45), especially in the initial learning period. The en-bloc resectio...

Research paper thumbnail of Relevance of MicroRNA200 Family and MicroRNA205 for Epithelial to Mesenchymal Transition and Clinical Outcome in Biliary Tract Cancer Patients

International journal of molecular sciences, Jan 7, 2016

Extensive stromal interaction is one reason for the dismal outcome of biliary tract cancer (BTC) ... more Extensive stromal interaction is one reason for the dismal outcome of biliary tract cancer (BTC) patients. Epithelial to mesenchymal transition (EMT) is involved in tumor invasion and metastasis and is partly regulated by microRNAs (miRs). This study explores the expression of anti-EMT miR200 family (miR141, -200a/b/c, -429) and miR205 as well as the EMT-related proteins E-cadherin and vimentin in a panel of BTC cell lines and clinical specimens by quantitative real-time polymerase chain reaction, Western blot and immunohistochemistry, respectively. MicroRNA expression was correlated to (i) the expression patterns of E-cadherin and vimentin; (ii) clinicopathological characteristics; and (iii) survival data. MicroRNA-200 family and miR205 were expressed in all BTC cells and clinical specimens. E-cadherin and vimentin showed a mutually exclusive expression pattern in both, in vitro and in vivo. Expression of miR200 family members positively correlated with E-cadherin and negatively wi...

Research paper thumbnail of Neue Porphyrine und ihre Verwendung New porphyrins and their use

Research paper thumbnail of Biliary secretion of phospholipids and apolipoprotein A-I: Evidence for intracellular supply of phospholipids by a non-vesicular transport route

Research paper thumbnail of Staging of hilar bile duct carcinomas with ERC & endoluminal ultrasound (EUS) or magnetic resonance cholangiography (MRC)

Research paper thumbnail of Porphyrins and their use as photosensitizer

Research paper thumbnail of Photophysics and photochemistry of photodynamic therapy: fundamental aspects

Lasers in Medical Science, 2009

Photodynamic therapy (PDT) is a treatment modality for cancer and various other diseases. The cli... more Photodynamic therapy (PDT) is a treatment modality for cancer and various other diseases. The clinical protocol covers the illumination of target cells (or tissue), which have been loaded with a photoactive drug (photosensitizer). In this review we describe the photophysical and primary photochemical processes that occur during PDT. Interaction of light with tissue results in attenuation of the incident light energy due to reflectance, absorption, scattering, and refraction. Refraction and reflection are reduced by perpendicular light application, whereas absorption can be minimized by the choice of a photosensitizer that absorbs in the far red region of the electromagnetic spectrum. Interaction of light and the photosensitizer can result in degradation, modification or relocalization of the drug, which differently affect the effectiveness of PDT. Photodynamic therapy itself, however, employs the light-induced chemical reactions of the activated photosensitizer (triplet state), resulting in the production of various reactive oxygen species, amongst them singlet oxygen as the primary photochemical product. Based on these considerations, the properties of an ideal photosensitizer for PDT are discussed. According to the clinical experience with PDT, it is proposed that the innovative concept of PDT is most successfully implemented into the mainstream of anticancer therapies by following an application -, i.e. tumor-centered approach with a focus on the actual clinical requirements of the respective tumor type.

Research paper thumbnail of Pyoderma gangraenosum und Pfortaderthrombose bei einer 33j�hrigen Patientin

Deut Med Wochenschr, 1999

Research paper thumbnail of Perkutane transhepatische Cholangiografie und -drainage

Gastroenterologie Up2date, Dec 1, 2008

Research paper thumbnail of Die perkutane Drainagebehandlung prim�rer Leberabszesse

Rofo Fortschr Rontgenstrahl, 1989

Research paper thumbnail of Effect of dietary fatty acids on biliary lipid secretion in the hamster

J Hepatol, 1989

ENDOTOXEMIA iN ALCOHOLIC LIVER DISEASE: RESULTS OBTAINED EY USING AN IMPROVE8 QUANTITATIVE METHOD... more ENDOTOXEMIA iN ALCOHOLIC LIVER DISEASE: RESULTS OBTAINED EY USING AN IMPROVE8 QUANTITATIVE METHOD Ch.Bode. H.Fukui*. B.B~&r;ner. J.Ch. Bode Abteilung lnnen Medizin I 7Gastroenterologie), Robert-Bosch-Krankenhaur. Stuttgart, F.R.G., and * 3rd Dept. of internal Ikdicine, Nara Medical Unlverrity. NW&.. Japan Endotoxemia ml ht lay an im ortant wle liver disease PALO!. !' in the pathogenesfs and the course of alcoholic Since e mrnatvm of plasma inhibitors for the determination of endotoxin (ET) is still a" unsolved problem, studies on the quantitative deternination of ET in cirrhoticr lead to conflicting results. We report on ET determination in plasma of patients with ALD by using a" irnproved quantitative nethod. PATIENTS AND METHODS: Blood frca 4g atients with ALD: 6 fatty liver (FL), 8 alcoholic hepatitis (AH) 35 alcoholic cirrhosis (AC! and 10 healthy controls (Cl were studied. The plasma factors di&rbi"g the test were elimfnated by addition of 0.32 m perchloric acid (PA). the resipitate was suspended I" p S8

Research paper thumbnail of New Porphyrins and Their Use

Research paper thumbnail of Perfusionsverhalten und Sofortfunktion von Hundenieren bei pulsierender und nichtpulsierender hypothermer Perfusion zur Nierenkonservierung : eine Vergleichsuntersuchung /

Research paper thumbnail of Ethinylestradiol impairs bile salt uptake and Na-K function of rat hepatocytes

The American journal of physiology

ABSTRACT

Research paper thumbnail of Berr, F., Meier, P. J. & Stieger, B. Evidence for the presence of a phosphatidylcholine translocator in isolated rat liver canalicular plasma membrane vesicles. J. Biol. Chem. 268, 3976-3979

Journal of Biological Chemistry

ABSTRACT

Research paper thumbnail of Die perkutane Drainagebehandlung primärer Leberabszesse

RöFo - Fortschritte auf dem Gebiet der R

Research paper thumbnail of How to establish endoscopic submucosal dissection in Western countries

World journal of gastroenterology, Jan 28, 2015

Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure o... more Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second st...

Research paper thumbnail of Neoadjuvant Down-Sizing of Hilar Cholangiocarcinoma with Photodynamic Therapy—Long-Term Outcome of a Phase II Pilot Study

International Journal of Molecular Sciences, 2015

Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahep... more Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0) recurrence can be as high as 70%. Photodynamic therapy (PDT) is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0) performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years) with initially non-resectable hilar CC. Photofrin was injected intravenously 24-48 h before laser light irradiation of the tumor stenoses and the adjacent bile duct segments. Major resective surgery was done with curative intention six weeks after PDT. All seven patients had been curatively (R0) resected and there were no undue early or late complications for the neoadjuvant PDT and surgery. Six of seven patients died from tumor recurrence at a median of 3.2 years after resection, the five-year survival rate was 43%. These results are comparable with published data for patients resected R0 without pre-treatment, indicating that neoadjuvant PDT is feasible and could improve overall survival of patients considered non-curatively resectable because of initial tumor extension in bile duct branches/segments-however, this concept needs to be validated in a larger trial.

Research paper thumbnail of Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopy

Main RecommendationThere is a need for well-organized comprehensive strategies to achieve good tr... more Main RecommendationThere is a need for well-organized comprehensive strategies to achieve good training in ESD. In this context, the European Society of Gastrointestinal Endoscopy (ESGE) have developed a European core curriculum for ESD practice across Europe with the aim of high quality ESD training.Advanced endoscopy diagnostic practice is advised before initiating ESD training. Proficiency in endoscopic mucosal resection (EMR) and adverse event management is recommended before starting ESD trainingESGE discourages the starting of initial ESD training in humans. Practice on animal and/or ex vivo models is useful to gain the basic ESD skills. ESGE recommends performing at least 20 ESD procedures in these models before human practice, with the goal of at least eight en bloc complete resections in the last 10 training cases, with no perforation. ESGE recommends observation of experts performing ESD in tertiary referral centers. Performance of ESD in humans should start on carefully s...

Research paper thumbnail of Rectal reconstruction after endoscopic submucosal dissection for removal of a giant rectal lesion

Research paper thumbnail of Single-center implementation of endoscopic submucosal dissection (ESD) in colorectum: Low recurrence rate after intention-to-treat ESD

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, Jan 8, 2017

Colorectal endoscopic submucosal dissection (ESD) shows higher R0 resection and lower local recur... more Colorectal endoscopic submucosal dissection (ESD) shows higher R0 resection and lower local recurrence rates than endoscopic mucosal resection (EMR) in Japan. In Europe, independent learning of ESD in colorectum is feasible, but yet to be analyzed for curative resection and recurrence rates. After experimental training under supervision by Japanese experts (T.O., N.Y.), three endoscopists independently performed 83 ESD procedures intention-to-treat for lesions in the entire colorectum of 67 patients in a prospective registry (Nov. 2009 to June 2016). ESD was feasible in 80 (96%) of colorectal neoplasias (mean diameter 33.6 (±1.8) mm), and three more required conversion to piecemeal EMR. The lesions were adenomas, in 66% with low-grade intraepithelial neoplasia (LGIN), 29% with high-grade intraepithelial neoplasia, and 5% with carcinomas (G2, pT1). ESD had to be facilitated by the final use of snaring (Hybrid-ESD, n=45), especially in the initial learning period. The en-bloc resectio...

Research paper thumbnail of Relevance of MicroRNA200 Family and MicroRNA205 for Epithelial to Mesenchymal Transition and Clinical Outcome in Biliary Tract Cancer Patients

International journal of molecular sciences, Jan 7, 2016

Extensive stromal interaction is one reason for the dismal outcome of biliary tract cancer (BTC) ... more Extensive stromal interaction is one reason for the dismal outcome of biliary tract cancer (BTC) patients. Epithelial to mesenchymal transition (EMT) is involved in tumor invasion and metastasis and is partly regulated by microRNAs (miRs). This study explores the expression of anti-EMT miR200 family (miR141, -200a/b/c, -429) and miR205 as well as the EMT-related proteins E-cadherin and vimentin in a panel of BTC cell lines and clinical specimens by quantitative real-time polymerase chain reaction, Western blot and immunohistochemistry, respectively. MicroRNA expression was correlated to (i) the expression patterns of E-cadherin and vimentin; (ii) clinicopathological characteristics; and (iii) survival data. MicroRNA-200 family and miR205 were expressed in all BTC cells and clinical specimens. E-cadherin and vimentin showed a mutually exclusive expression pattern in both, in vitro and in vivo. Expression of miR200 family members positively correlated with E-cadherin and negatively wi...

Research paper thumbnail of Neue Porphyrine und ihre Verwendung New porphyrins and their use

Research paper thumbnail of Biliary secretion of phospholipids and apolipoprotein A-I: Evidence for intracellular supply of phospholipids by a non-vesicular transport route

Research paper thumbnail of Staging of hilar bile duct carcinomas with ERC & endoluminal ultrasound (EUS) or magnetic resonance cholangiography (MRC)

Research paper thumbnail of Porphyrins and their use as photosensitizer

Research paper thumbnail of Photophysics and photochemistry of photodynamic therapy: fundamental aspects

Lasers in Medical Science, 2009

Photodynamic therapy (PDT) is a treatment modality for cancer and various other diseases. The cli... more Photodynamic therapy (PDT) is a treatment modality for cancer and various other diseases. The clinical protocol covers the illumination of target cells (or tissue), which have been loaded with a photoactive drug (photosensitizer). In this review we describe the photophysical and primary photochemical processes that occur during PDT. Interaction of light with tissue results in attenuation of the incident light energy due to reflectance, absorption, scattering, and refraction. Refraction and reflection are reduced by perpendicular light application, whereas absorption can be minimized by the choice of a photosensitizer that absorbs in the far red region of the electromagnetic spectrum. Interaction of light and the photosensitizer can result in degradation, modification or relocalization of the drug, which differently affect the effectiveness of PDT. Photodynamic therapy itself, however, employs the light-induced chemical reactions of the activated photosensitizer (triplet state), resulting in the production of various reactive oxygen species, amongst them singlet oxygen as the primary photochemical product. Based on these considerations, the properties of an ideal photosensitizer for PDT are discussed. According to the clinical experience with PDT, it is proposed that the innovative concept of PDT is most successfully implemented into the mainstream of anticancer therapies by following an application -, i.e. tumor-centered approach with a focus on the actual clinical requirements of the respective tumor type.

Research paper thumbnail of Pyoderma gangraenosum und Pfortaderthrombose bei einer 33j�hrigen Patientin

Deut Med Wochenschr, 1999

Research paper thumbnail of Perkutane transhepatische Cholangiografie und -drainage

Gastroenterologie Up2date, Dec 1, 2008

Research paper thumbnail of Die perkutane Drainagebehandlung prim�rer Leberabszesse

Rofo Fortschr Rontgenstrahl, 1989

Research paper thumbnail of Effect of dietary fatty acids on biliary lipid secretion in the hamster

J Hepatol, 1989

ENDOTOXEMIA iN ALCOHOLIC LIVER DISEASE: RESULTS OBTAINED EY USING AN IMPROVE8 QUANTITATIVE METHOD... more ENDOTOXEMIA iN ALCOHOLIC LIVER DISEASE: RESULTS OBTAINED EY USING AN IMPROVE8 QUANTITATIVE METHOD Ch.Bode. H.Fukui*. B.B~&r;ner. J.Ch. Bode Abteilung lnnen Medizin I 7Gastroenterologie), Robert-Bosch-Krankenhaur. Stuttgart, F.R.G., and * 3rd Dept. of internal Ikdicine, Nara Medical Unlverrity. NW&.. Japan Endotoxemia ml ht lay an im ortant wle liver disease PALO!. !' in the pathogenesfs and the course of alcoholic Since e mrnatvm of plasma inhibitors for the determination of endotoxin (ET) is still a" unsolved problem, studies on the quantitative deternination of ET in cirrhoticr lead to conflicting results. We report on ET determination in plasma of patients with ALD by using a" irnproved quantitative nethod. PATIENTS AND METHODS: Blood frca 4g atients with ALD: 6 fatty liver (FL), 8 alcoholic hepatitis (AH) 35 alcoholic cirrhosis (AC! and 10 healthy controls (Cl were studied. The plasma factors di&rbi"g the test were elimfnated by addition of 0.32 m perchloric acid (PA). the resipitate was suspended I" p S8

Research paper thumbnail of New Porphyrins and Their Use

Research paper thumbnail of Perfusionsverhalten und Sofortfunktion von Hundenieren bei pulsierender und nichtpulsierender hypothermer Perfusion zur Nierenkonservierung : eine Vergleichsuntersuchung /

Research paper thumbnail of Ethinylestradiol impairs bile salt uptake and Na-K function of rat hepatocytes

The American journal of physiology

ABSTRACT

Research paper thumbnail of Berr, F., Meier, P. J. & Stieger, B. Evidence for the presence of a phosphatidylcholine translocator in isolated rat liver canalicular plasma membrane vesicles. J. Biol. Chem. 268, 3976-3979

Journal of Biological Chemistry

ABSTRACT

Research paper thumbnail of Die perkutane Drainagebehandlung primärer Leberabszesse

RöFo - Fortschritte auf dem Gebiet der R

Research paper thumbnail of How to establish endoscopic submucosal dissection in Western countries

World journal of gastroenterology, Jan 28, 2015

Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure o... more Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second st...