Changes in retinoblastoma gene expression during cervical cancer progression

The role of tumour suppressor genes in the development of human cancers has been studied extensively. In viral carcinogenesis, the inactivation of suppressor proteins such as retinoblastoma (pRb) and p53, and cellular oncogenes overexpression, such as c-myc, has been the subject of a number of investigations. In uterine-cervix carcinomas, where high-risk human papillomavirus (HPV) plays an important role, pRb and p53 are inactivated by E7 and E6 viral oncoproteins, respectively. However, little is known about the in situ expression of some of these proteins in pre-malignant and malignant cervical tissues. On the other hand, it has also been demonstrated that c-myc is involved in cervical carcinogenesis, and that pRb participates in the control of c-myc gene expression. By using immunostaining techniques, we investigated pRb immunodetection pattern in normal tissues, squamous intraepithelial lesions (SILs) and invasive carcinomas from the uterine cervix. Our data show low pRb detection in both normal cervical tissue and invasive lesions, but a higher expression in SILs. C-Myc protein was observed in most of the cellular nuclei of the invasive lesions, while in SILs was low. These findings indicate a heterogeneous pRb immunostaining during the different stages of cervical carcinogenesis, and suggest that this staining pattern could be a common feature implicated in the pathogenesis of uterine-cervix carcinoma.     

Materialtechnische Besonderheiten orthodontischer Nickel-Titan-Drähte

Zusammenfassung Seit ihrer Einführung 1971 finden Nickel-Titan-Legierungen in großem Umfang Anwendung in der Kieferorthopädie. Heute existiert ein breites Angebot weiterentwickelter Legierungen, deren besondere Eigenschaften beschrieben werden. Orthodontische NiTi-Drähte gehören zu den Formgedächtnislegierungen. Neben dem Memory-Effekt zeichnen sie sich durch besondere Elastizitätseigenschaften aus, die durch niedriges Elastizitätsmodul, sehr hohes Deflektionsvermögen und Pseudoelastizität gekennzeichnet sind. Diese Merkmale basieren auf der Tatsache, daß diese Legierungen in Abhängigkeit von Temperatur und mechanischer Spannung in zwei Kristallstrukturen vorliegen: Martensit und Austenit. Der Übergang zwischen diesen Phasen, die martensitische Transformation, ist verantwortlich für den Memoryeffekt, bei dem ein Einweg- und ein Zweiwegeffekt unterschieden werden kann. Die für kieferorthopädische Anwendungen besonders günstig erscheinende Eigenschaft der Pseudoelastizität (Superelastizität) beruht auf der Erzeugung spannungsinduzierten Martensits. Die verfügbaren Drähte können in die Kategorien aufgehärteter Martensit und pseudoelastische Legierung eingeordnet werden. NiTi-Legierungen besitzen eine gute Biokompatibilität, die sie auch als Implantatmaterial geeignet erscheinen läßt.

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Summary Since their introduction in 1971 nickel-titanium wires have been widely used in orthodontics. Today, there is a multitude of new NiTi-alloys, whose properties are described. Beside the memory effect, these alloys have particular elastic properties, which can be characterized by a low modulus of elasticity, excellent springback, and pseudoelasticity (superelasticity). These properties are a consequence of the fact that depending on temperature and mechanical stress NiTi-alloys have two crystalline structures: martensite and austenite. The transition between these two phases, called martensitic transformation, is responsible for the memory effect, where a one way and a two way effect can be distinguished. For orthodontic applications pseudoelasticity is regarded as a highly favourable property. Pseudoelastic behavior is caused by stress induced martensite. Analysing the elastic properties of the available wires two categories can be distinguished: work hardended martensite and pseudoelastic alloy. The biocompatibility of NiTi is sufficient, it can be used as an implant material.

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Diese Arbeit wurde gefördert durch die Deutsche Forschungsgemeinschaft (Dr 196/1).     

Die Beeinflussung des Wachstums mit der Vorschubdoppelplatte im Vergleich zu anderen funktionskieferorthopädischen Geräten

Zusammenfassung Der dentale und skelettale Einfluß der Vorschubdoppelplatte konnte im Vergleich zu anderen funktionskieferorthopädischen Geräten gezeigt werden. Dabei ergaben sich folgende Besonderheiten: 1. Die Vorschubdoppelplatte übt einen skelettalen Einfluß auf den Oberkiefer aus. Dieser ist vergleichbar mit der Wirkung, die funktionskieferorthopädische Geräte in Kombination mit extraoralen Kräften zeigen (SNA-Winkel). 2. Der Einfluß auf den Unterkiefer (SNB-Winkel) entsprach in der Größenordnung dem elastisch offenen Aktivator nach Klammt und dem Teuscher-Aktivator. 3. Die Reduzierung des ANB-Winkels war bei der Vorschubdoppelplatte, verglichen mit den anderen Geräten, am größten. 4. Die Beeinflussung der Neigung der Spinaebene zur Nasion-Sella-Linie war nahezu Null. 5. Die Neigung der Unterkieferschneidezähne zur Gonion-Menton-Ebene wurde praktisch nicht beeinflußt. 6. Im Oberkiefer fand eine Retrusion der Schneidezähne statt. 7. Die Veränderung des Winkels UK zu NB im Vergleich zu UK zu GoMe zeigt, daß tatsächlich eine Vorverlagerung des Unterkiefers stattgefunden hat. Die besondere Wirkung der Vorschubdoppelplatte gegenüber anderen funktionskieferorthopädischen Geräten erklärt sich aus folgenden Aspekten: a) Durch die langen Stege ist auch bei einer größeren Mundöffnung eine sagittale Beeinflussung des Unterkiefers vorhanden [29]. b) Die Reibung zwischen den Stegen und der schiefen Ebene des Unterkiefers ist außerordentlich gering und nicht zu vergleichen mit der Reibung zwischen den Zähnen und dem Kunststoff bei sonstigen funktionskieferorthopädischen Geräten [28]. c) Patienten, die mit der Vorschubdoppelplatte im Munde sprechen, nehmen eine Position des Unterkiefers ein, die weiter sagittal liegt, als es der Konstruktionsbiß vorgibt [30].

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Summary The bite-jumping-appliance BJA is a special functional appliance which affects the upper jaw comparably to activator-headgear combinations (SNA angle). Concerning its influence on the lower jaw (SNB angle) the BJA can be compared with the Teuscher-activator and the Klammt-activator. The change in the inclination of the upper jaw (ANS-PNS to Nasion-Sella) proved to be negligible because the vector of the force passed through the center of resistance of the upper jaw. The extend of the dental influence was the largest with the activator, the smallest with the Fränkel II appliance. The inclination of the lower incisors ( to Gonion-Menton) was hardly affected. The upper incisors were retruded however not be the same extend as with the Teuscher-activator which even has torque springs (to avoid the retrusion). The treatment of all the patients ended in all cases excepting those that were treated with an activator in a nearly ideal IIW angle. Our findings encourage us to say that the BJA is an appliance with a far better working mechanism than the working mechanism of other functional appliances.

     

Parameters influencing piezoelectric shock wave lithotripsy of biliary calculi

A total of 225 human gallbladder stones were divided into sets of two, three, or four identical calculi (with maximum diameters of 6-26 mm) and submitted to piezoelectric shock wave lithotripsy in vitro in order to investigate the influence of the following parameters on stone disintegration: shock wave intensity, pulse frequency, and various physicochemical parameters such as the volume and viscosity of the fluid surrounding the stone, the hardness of the calculus, and its chemical composition. The fragmentation efficacy increased with enhanced shock wave energy (P less than 0.01). If the volume of the fluid (30 mL) surrounding the calculus was small, the disintegration end-point (defined by maximum fragment diameters less than or equal to 4 mm) was achieved after a lower number of pulses (median: 250 pulses) than in the case of a large fluid volume (80 mL) (500 pulses; P less than 0.01). On the other hand, however, factors such as the shock wave pulse rate (0.9 Hz vs 1.6 Hz), variations in viscosity of a water-jelly mixture surrounding the stone, the chemical composition of the stones as determined by X-ray diffractometry, and stone hardness were found to have no significant influence on the fragmentation efficacy.     

Einfluβ bildgebender diagnostischer verfahren auf therapiewahl und prognose traumatischer pankreas- und duodenalverletzungen

27 patients with pancreatic and 8 with duodenal injuries were studied, 66% of whom had associated abdominal injuries. Peritoneal lavage was performed in 10 cases, and ultrasonography in 15. Laparotomy was considered to be indicated on the basis of the results in 9 cases of peritoneal lavage and in 12 cases of ultrasound examination, but in only 1 case and 2 cases, respectively, did the findings constitute the only reason for performing a laparotomy. Pancreatic and duodenal injuries were directly confirmed by ultrasonography and computer tomography only in a minority of cases. The morbiditiy of pancreatic and duodenal injuries was 66% and 25%, respectively, and lethality, 19% and 25%. Despite modern imaging techniques, clinical examination is of paramount importance for the decision as to whether operative therapy is indicated; delay leads to increased morbidity and lethality.     

The distally based subcutaneous tarsometatarsal flap

Injuries to the distal part of the foot, or even the toes, can still provide reconstructive problems. It is not always wise to amputate the damaged, distal part of the foot. Some surgeons have stated that reconstruction of the distal foot is not necessary, but it is our opinion that it has a similar priority to reconstruction of the hand. While large defects are mostly reconstructed by free flaps, minor defects should also be considered for reconstruction. As in a previous paper, Small toe muscles for defect coverage [12], we are presenting a new way to reconstruct damaged tissue distal to the tarsometatarsal region.Correspondence to: G. Wechselberger     

Intracerebral haemorrhages in surfactant treated neonates with severe respiratory distress syndrome: age at diagnosis,severity and risk factors

Within a randomized European multicentre trial the time of onset, severity and progression of intracerebral haemorrhages (ICH) were investigated prospectively by serial cranial ultrasonography in 343 ventilated infants with severe respiratory distress syndrome (RDS) following instillation of single or multiple doses of a natural porcine surfactant (Curosurf). In 148/343 infants (43%) ICH was diagnosed (grade I or II: 22%, grade III or IV: 21%). In 26 cases (8%) ICH was present on the ultrasound scan prior to surfactant instillation at a median age of 6h. Incidence and severity of ICH was similar after single- or multiple-dose surfactant treatment. Using a logistic regression model the following risk factors predictive of ICH were defined: low birth weight, allocation to certain hospitals, vaginal delivery, Apgar score6, rectal temperature on admission 36°C, primary anaemia, acidosis prior to treatment, RDS grade IV in pre-treatment chest films and poor response to surfactant treatmentOur study provides supportive evidence that multiple doses of Curosurf do not increase the risk for ICH as compared to single-dose administration.A preliminary report of this work was presented at 8th International Workshop on Surfactant Replacement, Oslo, Norway, May 21 1993. The study was supported by grants of the German government (BMFT 93 607 27) and the German Research Council (Deutsche Forschungsgemeinschaft He 2072: 1–2). The surfactant used in the trial was prepared ang tested in Stockholm with the skilful technical assistance of Elin Arvesen, Bim Linderholm. Eva Lundberg, Gunhild Nilsson and Petru Popa (supported by the Swedish Medical Research Council (Project No. 3351) and Oscar II:s Jubileumsfond)Dedicated to the memory of Edgar (Eddi) Laufkötter, one of the most active trial collaborators, who died under tragic circumstances on April 10, 1994.     

Effect on nasal resistance of an external nasal splint and isotonic exercise

OBJECTIVES: The now commonplace wearing of external nasal splints by sportsmen and athletes has never been scientifically evaluated. The present study looks into the effect of isotonic exercise on nasal resistance, and examines whether this effect is altered by the wearing of an external nasal splint. METHODS: Twenty subjects not suffering from rhinitis were tested. Nasal resistance measurements were recorded using an anterior rhinomanometer before and after isotonic exercise with and without an external nasal splint. Pulse and blood pressure were measured before and after exercise. RESULTS: Significant changes were observed in pulse (p < 0.001) and both systolic (p < 0.002) and diastolic (p < 0.001) blood pressure in response to exercise. Significant differences were seen in nasal resistance when the splint was applied (p < 0.001) and after exercise (p < 0.003). No significant difference was observed after exercise when the splint was worn (p = 0.167). CONCLUSIONS: External nasal splints decrease nasal resistance at rest but are of little value during isotonic exercise.