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Medulloblastoma is a rare brain malignancy. Patients after puberty are rare and bear an intermediate prognosis. Standard treatment consists of maximal resection plus radio-chemotherapy. Treatment toxicity is high and produces disabling long-term side effects. The sonic hedgehog (SHH) subgroup is highly overrepresented in the post-pubertal and adult population and can be targeted by smoothened (SMO) inhibitors. No practice-changing prospective randomized data have been generated in adults. The EORTC 1634-BTG/NOA-23 trial will randomize patients between standard-dose vs. reduced-dosed craniospinal radiotherapy and SHH-subgroup patients between the SMO inhibitor sonidegib (OdomzoTM, Sun Pharmaceuticals Industries, Inc., New York, USA) in addition to standard radio-chemotherapy vs. standard radio-chemotherapy alone to improve outcomes in view of decreased radiotherapy-related toxicity and increased efficacy. We will further investigate tumor tissue, blood, and cerebrospinal fluid as well as magnetic resonance imaging and radiotherapy plans to generate information that helps to further improve treatment outcomes. Given that treatment side effects typically occur late, long-term follow-up will monitor classic side effects of therapy, but also health-related quality of life, cognition, social and professional outcome, and reproduction and fertility. In summary, we will generate unprecedented data that will be translated into treatment changes in post-pubertal patients with medulloblastoma and will help to design future clinical trials.
Carbene transfer from aliphatic diazoalkanes upon coordinatively unsaturated metal centers is a general synthetic concept that provides straight-forward routes into organo-metallic hydrocarbon chemistry. A comparison focussing on several key reactions of general applicability demonstrates that mononuclear organometal substrates add carbenes that may act as bridging ligands (e.g., compound 6) if they arise from ω,ω'-bisdiazoalkanes. By way of contrast, metal-metal double bonds cleanly form dimetallacyclo-propane-type derivatives under very mild conditions (7-9). The broadest variety of structures is finally encountered with metal-metal triply bonded precursors such as the molybdenum compounds 3: here, the initial diazoalkane adducts are subject to further rearrangement processes commonly leading to metal-metal single bonds (11) or causing irreversible cleavage of the dinuclear metal systems (10).
Standardisierung ist der bedeutendste Ansatz zu Qualitätssteigerung und Kostensenkung in der Technischen Dokumentation. Es gibt eine Reihe von Standardisierungsansätzen: Modularisierung, Informationsstrukturen, Terminologie, Sprachstrukturen. Dennoch werden diese Ebenen meist getrennt voneinander beschrieben. Wir untersuchen, wie Standardisierungen im Informationsmodell, in der Terminologie und in den sprachlichen Strukturen verknüpft werden und miteinander interagieren.