381. Die operative Therapie beim Thoraxtrauma — eine retrospektive Studie

Zusammenfassung Nach multiplem Trauma sinken intracelluläre Aktivität und Konzentration der Elastase in polymorphkernigen Leukocyten (PMNL), die aus Blut ( = 67 U und 6154 g/10⁹ PMNL) und bronchoalveolärer Lavage (BAL)-Flüssigkeit ( = 44 U und 5957 g/10⁹ PMNL) isoliert wurden im Vergleich zu PMNL Gesunder ( = 106 U und 9962 g/10⁹ PMNL). Gleichzeitig wurde ein Anstieg der extracellulären Elastase-Konzentration in Plasma von = 84 g/1 auf = 399 g/1 und in BAL Flüssigkeit von = 8 g/1 auf = 561 g/1 beobachtet. Die durch Stimulation freigesetzte Elastase wird teilweise von einem spezifischen Receptor auf PMNL erneut gebunden. Die Ergebnisse unterstützen die PMNL-vermittelte ARDS-Pathogenese.     

Penetration of cefazolin,ceftriaxone, cefoperazone,and ceftazidime into human gallbladder tissue and bile

Forty patients underwent elective cholecystectomy following administration of a single intravenous dose of cefazolin, ceftriaxone, cefoperazone, or ceftazidime. Mean gallbladder bile concentrations of cefoperazone (398.8 g/ml and ceftriaxone (153.4 g/ml) were significantly higher than those of cefazolin (12.3 g/ml) and ceftazidime (3.08 g/ml) (p<0.008). Mean gallbladder tissue levels of cefazolin (30.1 g/g), ceftriaxone (50.5 g/g), and cefoperazone (91.0 g/g) exceeded that of ceftazidime (7.25 g/g) (p<0.001). When adjusted for known in vitro activity against biliary pathogens, these data suggest that cefoperazone and ceftriaxone are superior to ceftazidime and cefazolin for prophylaxis in elective biliary surgery.

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Resumen Las nuevas cefalosporinas de tercera generación poseen actividad contra una variedad de bacterias, incluso la mayoría de los patógenos biliares comunes. Hemos realizado un estudio prospectivo sobre el grado de penetración de la cefazolina, la ceftriaxona, la cefoperazona, y la ceftazidima en el tejido y la bilis de la vesícula biliar en pacientes sometidos a colecistectomía electiva.Cuarenta pacientes recibieron una dosis única de la cefalosporina dentro de la hora anterior a la colecistectomía. Las concentraciones medias en la bilis de la vesícula biliar fueron significativamente mayores para la cefoperazona (398.8g/ml) y la ceftriaxona (153.4g/ml) que para la cefazolina (12.3g/ml) y la ceftazidima (3.08g/ml) (p<0.008). Los niveles medios en el tejido de la vesícula biliar fueron superiores para la cefalozina (30.1g/g), la ceftriaxona (50.5g/g), y la cefoperazona (91.0g/g que para la ceftazidima (7.25g/g) (p<0.001). Al ajustar estos datos contra valores conocidos de actividad in vitro contra patógenos biliares, aparece que la cefoperazona y la ceftriaxona son superiores a la ceftazidima y la cefazolina en cuanto a profilaxis en cirugía biliar electiva.

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Résumé Quarante patients ont été cholécystectomisés après administration intraveineuse d'une dose unique de céfazoline, de ceftriaxone, de céfapérazone ou de ceftazidine. La concentration moyenne de la bile vésiculaire en céfopérazone (398.8g/ml) et en ceftriaxone (153.4g/ml) était significativement plus élevée que la concentration en céfazoline (12.3g/ml) et en ceftazidine (3.08g/ml) (p<0.008). Les concentrations tissulaires vésiculaires moyennes de céfazoline (30.1g/g), de ceftriaxone (50.5g/g), et de céfopérazone (91.0g/g) étaient plus importantes que la concentration de ceftazidine (7.25g/g) (p<0.001). Lorsque ces antibiotiques sont sensibles in vitro contre des germes pathogènes, nos résultats suggèrent que le céfopérazone et la ceftriaxone sont meilleurs que la ceftazidine et la céfazoline dans la prophylaxie antibiotique de la chirurgie biliaire élective.

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Presented at the Société Internationale de Chirurgie in Sydney, Australia, September, 1987.     

Sutureless anastomosis of blood vessels using cyanoacrylate adhesives

On the assumption that the remaining suture threads of the anastomotic line play an important role in the progression of anastomotic neointimal hyperplasia, we performed an experimental study on the sutureless anastomosis of blood vessels. An expanded polytetrafluoroethylene graft, 5 mm in diameter and 2 cm in length, was implanted on the abdominal aorta of mongrel adult using one of three methods of anastomosis, namely; a continuous suture, a stay suture, or sutureless anastomosis. Overall patency rates were 83.3 per cent, 91.7 per cent and 75.0 per cent respectively. The thickness of the pannus in the distal anastomotic line after 12 months was 107 m in one graft in the continuous suture group, 106 m and 222 m in 2 grafts each in the stay suture group, and 41 m and 117 m in 2 grafts each in the sutureless group. Because there were cases of patency even after 12 months with a very small pannus thickness, sutureless anastomosis is considered to be a useful method of preventing anastomotic neointimal hyperplasia.     

In comparison: 1.064 μm-1.318 μm Nd-YAG continuous wave lasers. In vitro and in vivo experiments for endoscopic tumour therapy in the gastrointestinal tract

In in vitro and animal experiments the tissue effects of the 1.318m Nd-YAG laser were compared to those of the standard 1.064m Nd-YAG laser in order to evaluate the advantages of the new wavelength with a ten times higher absorption in water for gastroenterological tumour treatment. Under irradiation parameters related to clinical endoscopic practice, the laser of the wavelength 1.318m needs for both vaporization and coagulation significantly less energy than the 1.064m laser. Since vaporization at 1.318m is always accompanied by a higher coagulation effect compared to 1.064m the risk of late necrosis and resulting perforation appears to be increased.     

A comparative study of coagulation effects on the cortex of the rat using Nd-YAG (1.32 μm), Nd-YAG (1.06 μm) and CO2 lasers

This paper represents a comparative study on brain tissue of three lasers: Nd-YAG (1.32m); Nd-YAG (1.06 m); and CO₂ laser. The experimental studies were performed on rats. They consisted of a comparison between the thermal effects and the consequent histological lesions produced. The surface temperature of the cortex induced by each laser shot was measured with an infrared camera. The results show that there exists an excellent correlation between surface temperature and the histology of the lesions produced. It appears that for equivalent surface temperatures the cortical lesions 8 days after irradiation were similar for Nd-YAG (1.32m) and for CO₂ lasers but significantly different for the Nd-YAG (1.06m) laser. For example the depth of coagulation necrosis varied between 20 to 250m with the CO₂ laser using the power of 3 to 10 W at an exposure of 0.05 s with a fluence of 5J/cm² and varied from 210 to 260m using the Nd-YAG (1.32m) with the power of 5 to 14 W with an exposure of 0.4 s with a fluence of 50–170 J/cm². With the Nd-YAG (1.06m) the depth of coagulation necrosis varied from 490m to 550m using a power of 12 to 19 W with an exposure of 0.4 s with a fluence of 150–250 J/cm². It would appear that the Nd-YAG laser at a wavelength of 1.32m should be valuable in neurosurgery as this wavelength is highly absorbed by brain parenchyma and is transmissible with a fibre optic delivery system.

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Résumé Les auteurs presentent une étude comparative de la coagulation du parenchyme cérébral au moyen de différents lasers. Les études expérimentales ont été effectuées sur le cortex du rat. Elles ont consisté à comparer les effets thermiques et histologiques de 3 longueurs d'onde: Nd-YAG (1.32m), Nd-YAG (1.06m) et CO₂ (10.6m). La température corticale de surface induite par le tir laser a été mesurée au moyen d'une caméra infrarouge. Les courbes du profil thermique de chaque tir et de son évolution au cours du temps ont ainsi été obtenues. Les résultats montrent qu'il existe une excellente corrélation entre les données thermiques et les données histologiques recueillies pour chaque tir. Il apparaît ainsi que pour des augmentations de température équivalentes, les lésions corticales 8 jours après le tir sont similaires pour les lasers Nd-YAG (1.32m) et CO₂, mais significativement différentes pour le laser Nd-YAG (1.06m).Par exemple, le profondeur de nécrose varie entre 200 et 250m pour le laser CO₂ utilisé avec une puissance de 3 à 10 W, un temps d'exposition de 0.05 s et une fluence de 5 J/cm². La profondeur de nécrose varie entre 210m et 260m lorsqu'on utilise le laser Nd-YAG (1.32m) avec une puissance de 5 à 14 W, un temps d'exposition de 0.4 s et une fluence de 50 à 170 J/cm². Avec le laser Nd-YAG (1.06m), la profondeur de nécrose est beaucoup plus importante. Elle varie entre 490m et 550m pour une puissance comprise entre 12 et 19 W, un temps d'exposition de 0.4 s et une fluence de 150 à 250 J/cm².Ces résultats expérimentaux montrent que la longueur d'onde 1.32m est bien adaptée à la neurochirurgie puisqu'elle est bien asbsorbée par le parenchyme cérébral et qu'elle est transmissible par une fibre optique.

     

Serum hippuric acid concentration in renal allograft rejection,ureter obstruction,and tubular necrosis

Plasma from 35 renal allograft recipients (21 males and 14 females) was sampled daily and analyzed for hippuric acid (HA) by highperformance liquid chromatography (HPLC) and serum creatinine. Twelve of these patients experienced an acute renal allograft rejection or a ureter obstruction as proven by clinical signs and biopsy, as well as by radiography or ultrasound, respectively. Two patients suffered from tubular necrosis followed by rejection during the postoperative period. Mean serum HA increased by 39.9 mol/l from baseline (range 20.4–115.5 mol/l) in patients with acute rejection 3 days after an initial increase that was observed 24 h before the mean serum creatinine increased by 107.1 mol/l (range 21–193 mol/l). In cases of ureter obstruction, HA rose by 1.6 mol/l (range 1–8.2 mol/l), significantly less than elevations due to rejection. The increase in creatinine, however, amounted to 65.3 mol/l (range 22–140 mol/l) and was not different from the change in rejecting patients. Successful antirejection treatment coincided with a decrease in serum HA starting 24 h earlier than the decrease in the serum creatinine concentration. Of special interest was the observation of a parallel decrease in HA with creatinine concentration in patients with tubular necrosis after allotransplantation; HA increased in cases of an additional rejection. Our data suggest that HA, which is excreted by tubular secretion and glomerular filtration, could be a sensitive and early marker of acute allograft rejection. Furthermore, it seems to discriminate between acute renal allograft rejection and ureter obstruction. It might, therefore, be of value in the diagnosis of rejection complicating tubular necrosis after transplantation.     

Secretory territories and rate of matrix production of osteoblasts

The secretory territories of rat osteoblasts on the parietal bone were measured directly using scanning electron microscopy. The mean territory of 4620 cells in 19 fields was 154 m² per osteoblast. The range for the fields was 136 to 177 m² per osteoblast. Four hundred cells were measured individually—for these the mean value per osteoblast was 143 m² with a standard deviation of 33. The daily rate of apposition over an 8 day period was 3.12 m (standard deviation 0.22) measured by tetracycline marking of the mineral front. This gave a daily matrix production rate of approximately 470 m³ per osteoblast.

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Zusammenfassung Die Ausscheidungsbereiche von Ratten-Osteoblasten des Scheitelbeines wurden mit dem Raster-Elektronenmikroskop direkt gemessen. Der durchschnittliche Bereich von 4620 Zellen in 19 Gesichtsfeldern war 154 m² per osteoblast. Der Streubereich lag in den verschiedenen Gesichtsfeldern zwischen 136 und 177 m² per Osteoblast. 400 Zellen wurden einzeln gemessen. Bei diesen war der Durchschnittswert per Osteoblast 143 m², mit einer Standard-Abweichung von 33. Die tägliche Anlagerungsrate während einer Periode von 8 Tagen war 3,12 m (Standard-Abweichung 0,22); sie wurde mittels Tetracyclinmarkierung der Mineralisierungsfront gemessen. Dies ergab eine tägliche Produktionsrate der Matrix von etwa 470 m³ per Osteoblast.

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Résumé Les territoires sécrétoires des ostéoblastes d'os pariétal de rats sont déterminées en utilisant la microscopie électronique à balayage. Le territoire moyen de 4.620 cellules, dans 19 territoires, est de 154 m² par ostéoblaste. Les valeurs extrêmes par champ varient de 136 à 177 m² par ostéoblaste. Quatre cent cellules sont mesurées individuellement; la valeur moyenne par ostéoblaste est de 143 m³ avec une déviation standard de 33. Le taux d'apposition journalier, mesuré par la tétracycline pendant 8 jours, est de 3.12 m (déviation standard 0.22). Ce qui correspond à une production matricielle journalière d'environ 470 m³ par ostéoblaste.

     

Taxol inhibits osteoclastic bone resorption

Summary We have examined the effect of the anti-tumor compound taxol, on osteoclastic bone resorption. In the bone slice assay, taxol (0.1–0.001 M) dose-dependently inhibited bone resorption with an IC₅₀ of 0.08 M. Osteoclast survival on bone slices was unaffected by 0.01–1 M taxol, but 10 M was cytotoxic. Taxol (1 M) also ihibited osteoclast spreading (45%) on fibronectin-coated slides. The antiproliterative effects of taxol are due to its unique ability to stabilize microtubules. Primary osteoclasts are nonproliferating end cells, so taxol probably inhibits bone resorption by intertering with other microtubule-dependent functions such as cell polarization, motility or vesicle exocytosis. Since these inhibitory effects on osteoclasts in vitro are seen with therapeutically relevant concentrations, taxol therapy may have beneficial side-effects e.g. inhibition of hyperealcemia and bone metastases.     

Blood levels and half-life of methylmethacrylate after tourniquet release during knee arthroplasty

Summary The blood levels and the half-life of monomeric methylmethacrylate after tourniquet release were studied in nine patients with osteoarthrosis or rheumatoid arthritis of the knee joint, treated with the Townley prosthesis under spinal anesthesia. Several ventricular extrasystoles were monitored in one patient with high blood levels of monomeric methylmethacrylate (119.80 g/ml). The blood levels of monomeric methylmethacrylate ranged between 0.10 and 1.44 g/ml in the rest of the patients. The half-life of monomeric methylmethacrylate in vivo was 47–55 min.     

Comparison of serial S-100 and NSE serum measurements after severe head injury

Summary We investigated the time course of neuron specific enolase (NSE) and S-100 protein after severe head injury in correlation to outcome. We included 30 patients (GCS<9), who had been admitted within 5 hours after injury, in a prospective study. Blood samples were taken on admission, 6, 12. and 24 hours and every 24 hours up to the fifth day after injury. The outcome was estimated on discharge using the Glasgow Outcome Scale. 70% reached a good outcome. All concentrations of NSE and 83% of the S-100 samples were elevated concerning the first probe (30.2 g/l NSE mean and 2.6 g/l S-100 mean). Patients with bad outcome had an NSE concentration of 38 g/l (mean) compared with 26.9 g/l (mean) in patients with good outcome. Patients with bad outcome had an S-100 concentration of 4.9 g/l (mean) compared with 1.7 g/l (mean) in patients with good outcome (p<0.05). The mean values of NSE and S-100 decreased during the first 5 days. Four patients with increasing intracranial pressure showed a quick increasing concentration of NSE, in two patients the S-100 level showed a slower rise. The NSE serum levels did not correlate with intracranial pressure values. Our results show that the first serum concentration of S-100 seems to be predictive for outcome after severe head injury.     

Demonstration of calmodulin-sensitive calcium translocation by isolated osteoclast plasma membrane vesicles

Summary Plasma membrane vesicles were prepared from chicken osteoclasts, and active calcium transport was demonstrated in a spectrofluorimetric assay using the fluorescent calcium concentration indicator, fura-2. Transport activity was inhibited by quercetin (10 M), sodium vanadate (10 M), and the anticalmodulin agents, compound 48/80 (20 and 200 g/ml) and calmidazolium (10 and 20 M). The transport rate (V_max, 1.3 nmol/mg protein/min) was not altered in the presence of the protonophore, nigericin (1 M), indicating that proton transport was not driving calcium transport. Release of accumulated calcium in the vesicles occurred with the addition of bromo-A23187 (5 M) or ionomycin (5 M). Increasing calcium transport occurred with increasing calcium concentration. Finally, the calmodulin content of the vesicles was demonstrated to be 54–134 U/mg protein. These results demonstrate that a calmodulin-sensitive, ATP-dependent calcium transporter is present in the osteoclast plasma membrane.     

Effect of second messenger systems on oxalate uptake in renal epithelial cells

The oxalate transport system along with protein phosphorylation appears to be deranged in stone formers. This study was undertaken to characterize in LLC-PK₁ cells in culture the effect of altering specific intracellular second messenger systems on oxalate uptake. Cellular uptake experiments were performed at 37°C in buffer [265 mM mannitol, 5 mM NaOH, 5 mM KOH, 10 mM Ca-EGTA, 25 mM HEPES/TRIS, pH=7.4 or in Hank's balanced salt solution (HBSS)] containing 200 M labeled oxalate (1-¹⁴C, 0.3 Ci). Cells were preincubated with DAG (final concentration of 100 M), phorbol myristate acetate (10 M), forskolin (50 M), 8-bromo-cyclic AMP (50 M), trifluoroperazine (20 M) and low molecular weight heparin (1 mg/ml) for 10 min in the presence and absence of the anion transport inhibitor DIDS (100 M) and the effect(s) on oxalate uptake at 10, 25 and 45 min incubation were determined. Chemicals (DAG, forskolin, TPA and 8-bromo-cAMP) which stimulate protein kinase A or C activity resulted in an increased uptake of oxalate while inhibitors of these systems (trifluoroperazine and low molecular weight heparin) resulted in decreased oxalate uptake. The results dernonstrate that oxalate uptake in renal tubular cells is modulated by protein kinase C and A dependent mechanisms.     

Metaphyseal aspects of stapling

Summary Blount stapling of the growth plate induced changes in the metaphyseal architecture, which progressed in correlation to the postoperative follow-up. The stereological investigations revealed a subtile reaction of the medial stapled tibial plate in a total of 37 domestic pigs (10 weeks old) during the postoperative follow-up (up to 17 weeks). Zone 1,380–1120 m distal to the plate representing bone modelling, and zone 2, 1180–2360 distally representing bone remodelling, were investigated separately. The findings in zone 2 were very similar to zone 1 but were less extensive. The parameter most sensitive to stapling was the surface density; the trabecular distance showed parallel but less impressive findings. The specific surface and trabecular diameter changed with some delay. The last parameter to change was the volume density.Supported by the Deutsche Forschungsgemeinschaft     

Determination of the glial fibrillary acidic protein in human cerebrospinal fluid and in cyst fluid of brain tumors

Summary The glial fibrillary acidic protein (GFAP) have been quantitatively determinated in over 200 samples of liquid content of brain tumours and in cerebrospinal fluid (CSF) of cases with various tumours of the cerebral nervous system. For establishing the GFAP value, the rocket radioimmunoelectrophoresis was used. The studies were performed in three series of patients. The GFAP value of fluids from 26 cysts of both neoplastic and non-neoplastic type had a wide range of 0,6 g/ml to 40 g/ml. Significant elevation of GFAP was usually recorded in fluid from cysts of anaplastic tumour with astroglial differentiation. In this series of 24 cases with various brain tumours, the GFAP value of the CSF ranged from 0,2 g/ml to 50 g/ml. In gliomas, as in astrocytoma and glioblastoma, these values were on a higher level, of over 4 g/ml. In other tumours and in cerebral lesions of other aetiology, the GFAP values were lower, below 3 g/ml and 0,3 g/ml respectively.In another series of 32 patients with brain tumour treated surgically, a significant increase of GFAP (to 30 g/ml) was noted in the CSF during the first week after operation, and that was always associated with an increase of the total protein of the CSF. During the second and third week after operation, when the total protein of the CSF was reduced to a normal level, the values of GFAP were still elevated, first of all in those cases of astrocytoma and glioblastoma which were not radically excised. These findings suggest that investigation of GFAP in the CSF of patients with brain tumour may be helpfull in diagnosis and prognosis.Presented at the XV Congress of the Polish Society of Neurosurgeons Szczecin/Poland, September 27–29, 1985.     

The distribution of extracellular matrix vesicles in healing of rat tibial bone three days after intramedullary injury

Summary The distribution of extracellular matrix vesicles on the third day of bone healing was studied by morphometric analysis of transmission electron micrographs. Detection and grouping of the vesicles was performed according to type, diameter, and distance from the calcified front. The different types were selected as follows: vesicles with electron-lucent contents (empty), vesicles with amorphous electron-opaque contents (amorphic), vesicles containing crystalline depositions (crystal), and vesicles containing crystalline structures with ruptured membranes (rupture). The majority of vesicles were between 0.07 µm and 0.12 m in diameter and were located at less than 3 m from the calcified front. The distribution of the empty, amorphic, crystal, and rupture vesicles was 23.2%, 74%, 2.5%, and 0.3% respectively. Their sequence of arrangement according to diameter was as follows: empty, amorphic, crystal, and rupture, the empty vesicles constituting the smallest and the rupture the largest type. Distances from the calcified front were similar for the empty, amorphic, and crystal vesicles, while the rupture type was located nearest to the front. The present observations support the widely acknowledged hypothesis on the role of extracellular matrix vesicles in mineralization. It is thought that the secretion of empty vesicles from the cell is followed by intravscular accumulation of amorphous Ca and Pi to form a hydroxyapatite crystal that, in turn, ruptures the vesicle's membrane. The maturation process is accompanied by an increase of the vesicular diameter and its approximation to the calcifying front.     

Study of the microstructure of renal stones: Uric acid and calcium oxalate

This paper represents the results of experimental study on the microstructure of uric acid and calcium oxalate crystallites in renal stones. The size distribution parameters and morphological characteristics of the microcrystals forming the stone were determined using SEM and image analysing system. Information on the fabric of the renal stones examined indicates that the mean volume diameter is 15.5 m for uric acid and 32 m for calcium oxalate stones. The polydispersity index , the shape factor , and the distribution of particle shape show close similarity. Quantitative studies on stone microstructure could furnish valuable information on stone genesis.This work was supported by the Kidney Foundation and by the Medical Research Council of Canada.     

Pharmacokinetics of methylmethacrylate monomer during total hip replacement in man

Summary The concentration of methylmethacrylate monomer (MMA) in the blood stream after implantation of the components of 15 total hip prostheses using bone cement was determined in the pulmonary artery, the radial artery, and the superior vena cava after cement application, and correlated with the observed drop in blood pressure and the increase in the pulmonary arterial pressure. In all samples MMA was found. The values ranged from 0.02 g/ml to 59 gg/ml. The mean maximum value after implantation of the stem was measured to be 7.8g/ml in the pulmonary artery, 4.6 g/ml in the radial artery, and 1.75 g/ml in the superior vena cava. After implantation of the cup the values were clearly lower. The simultaneously recorded blood pressure decreased slightly during the first 3 min and then returned to previous values. The pulmonary arterial mean pressure increased from 18 to 20mmHg during the first 10 min. Although in some patients a drop in blood pressure started at the same time as MMA reached maximum values, high concentrations did not result in a greater effect on the circulatory parameters. Statistical analysis by the Spearman test revealed no correlation between MMA concentrations and the decrease in blood pressure or the increase in the pulmonary arterial pressure.

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Zusammenfassung Während der Implantation von fünfzehn Totalendoprothesen mit Knochenzement wurden die Konzentrationen von Methylmethacrylatmonomer (MMA) in der Arteria pulmonalis, der Arteria radialis and der Vena cava superior bestimmt und mit dem beobachteten Blutdruckabfall and dem Anstieg des pulmonalarteriellen Druckes korreliert. In den Proben konnten MMA-Konzentrationen zwischen 0,02 g/ml and 59 g/ml nachgewiesen werden. Die mittlere Maximalkonzentration betrug nach Implantation des Schaftes 7,8 g/ml in der Pulmonal-, 4,6 g/ml in der Radialarterie und 1,75 g/ml in der Vena cava superior. Die Konzentrationen nach Implantation der Pfanne waren deutlich geringer. Der gleichzeitig aufgezeichnete Blutdruck fiel geringgradig während der ersten drei Minuten and kehrte dann auf Ausgangswerte zuriick. Der pulmonalarterielle Mitteldruck stieg von 18 auf 20 mm Hg während der ersten zehn Minuten. Obwohl bei einigen Patienten der Blutdruckabfall mit dem Auftreten maximaler MMA-Konzentrationen zusammenfiel, hatten höhere MMA-Konzentrationen keinen größeren Effekt auf die zirkulatorischen Parameter. Bei der statistischen Analyse mit dem Spearman Test bestand keine statistische Korrelation zwischen den MMA-Konzentrationen und dem Abfall des Blutdruckes bzw. dem Anstieg des pulmonalarteriellen Druckes.

     

Serum immunosuppresive acidic protein in renal cell carcinoma

Summary Serum immunosuppresive acidic protein (IAP) was determined in 45 patients with renal cell carcinoma (20 preoperative and 25 postoperative) and 12 healthy adults. The mean values of serum IAP in patients with renal cell carcinoma of low stage (566.3±197.7 g/ml) and high stage (936.9±208.8 g/ml) were statistically higher than those of controls (368.8±84.5 g/ml). Positive rate of IAP levels was found in 58.3% and 100% of patients with low stage and high stage, respectively. The mean value of serum IAP was 756.4±361.0 g/ml in patients with metastases, while patients without metastases had a value of 434.7±170.9 g/ml. There was a statistically significant difference between the two populations. These results suggest that IAP levels appear to provide a useful diagnostic and followup marker in renal cell carcinoma patients.     

Effects of vitamin D and retinoic acid on human glioblastoma cell lines

Summary The biological significance of vitamin D receptors expressed by glioblastoma and other glial tumours is still unclear. In an effort to clarify this issue we studied the effects of increasing concentrations of 25-dihydroxyvitamin D₃ and its metabolite 1 , 25-dihydroxyvitamin D₃ on two human glioblastoma cell lines. Both substances were capable of inducing a significant (> 50%) reduction in growth of the two glioblastoma cell lines at dosages over 5 M. When the HU 70 cell line was treated by increasing dilutions of 25-dihydroxyvitamin D₃ combined with 1 M all trans-retinoic acid, significant inhibition was apparent even after addition of 25-dihydroxyvitamin D³ in the nanomolar range. Reduction of growth index was mainly due to induced cell death.Our results providein vitro evidence that vitamin D metabolites alone or in combination with retinoids may be potentially useful agents in the differentiation therapy of human malignant gliomas.