Sexualisierte Gewalt in der Erfahrung Jugendlicher: Ergebnisse einer repräsentativen Befragung

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Seit 1998 erhebt die Bundeszentrale für gesundheitliche Aufklärung (BZgA) im Rahmen ihrer Repräsentativbefragung...     

Treatment of R-3327 prostate tumors with a somatostatin analogue (somatuline) as adjuvant therapy following surgical castration

This study addresses, in an animal tumor model, the clinical problem of "escape from castration inhibition." Somatuline (BIM-23014C), an octapeptide analogue of somatostatin with enhanced potency and longer duration of biological activity was administered as a therapeutic agent, over a period of 90 and 197 days, to male Copenhagen rats bearing syngeneic Dunning R-3327-H prostate tumors. Androgen sensitivity was confirmed by the response of tumors to castration and by the significant inhibition of tumor growth in intact animals by treatment with a luteinizing hormone-releasing hormone antagonist (BIM-21009). Inhibition of tumor growth resulting from castration persisted for 102 days, after which progressive regrowth occurred, indicating an escape from castration inhibition. When Somatuline treatment was initiated as an adjuvant therapy 5 days after castration, the rate of tumor regrowth during escape was significantly retarded. During the period of 197 days postcastration, tumors in the vehicle-treated, intact controls grew to an average diameter of 38.6 +/- 7.6 mm and tumors in vehicle-treated castrate controls grew to an average diameter of 23.3 +/- 4.1 mm (60% test/control). Treatment with the luteinizing hormone-releasing hormone antagonist induced no significant additional tumor inhibitory effects in castrated animals which developed tumors having an average diameter of 30.2 +/- 8.2 mm (78% test/control). Treatment of tumors in castrate animals with Somatuline, on the other hand, induced a significant (P less than 0.01) tumor-inhibitory effect that was greater than that produced by castration alone, developing an average tumor diameter of only 14.3 +/- 2.6 mm, (37% test/control). A growth inhibitory effect was also inducible in animals having tumors that had already escaped castration inhibition. The relative nontoxicity of a somatostatin analogue such as Somatuline suggests that chronic or maintenance therapy of slow-growing prostate cancers may be both feasible and acceptable in a clinical setting.     

Chronic mild stress-induced anhedonia model of depression; sleep abnormalities and curative effects of electroshock treatment

A core symptom of human depressive disorder is anhedonia, the loss of interest or pleasure in daily activities. Anhedonia, measured as subsensitivity to reward, can be induced in rats by a regimen of repeated, mild, unpredictable stressors. Here, the hedonic state of rats was assessed using an intracranial self-stimulation (ICSS) procedure. The ICSS frequency threshold was determined before, during and after a period of exposure to the stress regimens. After 13 days of repeated mild stress, the ICSS threshold was significantly increased, suggesting a gradual decrease of sensitivity to reward. This anhedonic state lasted throughout the stress period. When stressed anhedonic animals were given electroshock treatment, the stress-induced increase in ICSS threshold was rapidly and completely reversed. Moreover, biological markers of human depression such as reduced latency to the first REM sleep episode or increased time spent in REM sleep were also found in electroencephalographic recordings of chronically stressed animals. These sleep abnormalities were observed beginning in the second week of a three-week stress regimen and progressively disappeared after termination of stress. In conclusion, these data provide further evidence supporting stress-induced anhedonia in rats as a unique animal model of human depression combining convergent elements of biological, etiological, symptomatological and therapeutic validity.     

Frontal sinus approach to olfactory groove meningiomas

We report on our experience of the frontal sinus approach for removing olfactory groove meningiomas. Five tumors were operated on, one unilateral, four bilateral. Osteotomy of the anterior wall of the frontal sinus was performed with an oscillating saw without any burr hole. The posterior wall of the sinus was resected and the tumor was attacked along the plane of the anterior skull base. Ethmoidal blood supply was controlled at the initial stage of the operation, allowing avascular tumor debulking. Olfactory nerves, invaded by the tumor, usually cannot be spared. Tumor extensions towards the sella and the optic canals were removed without any brain retraction, nor opening of the sylvian fissure, nor dissection of the carotid arteries. The frontal sinus approach is technically easy to achieve. Osteotomy and reconstruction of the anterior wall of the frontal sinus are rapidly performed. When the frontal sinus is small, image guided surgery allows to delineate precisely its limits and the flap includes the calvarial outer layer, tangenitally cut from one supra-orbital canal to the other. Cosmetic result is perfect. The frontal sinus approach gives access to the medial part of the orbital roofs and to the central anterior skull base from the crista galli to the tuberculum sellae and the anterior clinoids. The frontal sinus approach represents an alternative to conventional craniotomies for tumors developed in the central anterior skull base, especially for olfactory groove meningiomas.     

Limb salvage surgery in bone tumour with modular endoprosthesis

 Thirty-three patients with bone tumours were treated by resection of the growth and reconstruction with a Kotz modular endoprosthesis. The average follow-up was for 50 months, ranging from 14 to 79 months. At the last review, 12 patients (36%) had died due to the tumour and 9 others (27%) had metastases. All 4 patients with proximal tibial reconstruction had poor functional results, due to an extension lag or to knee stiffness. Four of the six tumours of the proximal femur were complicated by local recurrence or dislocation of the hip, and had poor or fair functional results. Of the patients with distal femoral reconstruction, 17 out of 22 had excellent or good functional results. Reconstruction with a modular prosthesis after resection of a tumour gives excellent or good functional results in more than three-fourths of the cases of distal femur reconstruction, but it should be used with caution in the proximal tibia and proximal femur.

---

Resumé  33 patients avec une tumeur(s) osseuse(s) ont ete traites par résection chirurgicale suivie d’une reconstruction avec endoprothese modulaire de Kotz. Les patients étaient suivis pour une periode allant de 14 a 79 mois (50 mois). Au dernier bilan 12 malades (36%) avaient une mort liee a la-tumeur. Le resultat fonctionnel a ete insatisfaisant chez tous les patients ayant subi une reconstruction tibiale proximale: soit un deficit de l’extension due genou ou la raideur. Dans les deux-tiers des cas (4 sur 6) avec reconstruction femorale proximale, des complications ont été observees: recidive locale, luxation de la tete femorale et mauvais voir mediocre resultat fonctionnel. Plus des trois quarts des patients avec reconstruction femorale distale (17/22) ont eu un bon voir excellent resultat fonctionnel. Le type de reconstruction avec prothèse modulaire apres résection tumorale parait bien indiquée chez des patients avec grosse tumeur osseuse et souhaitant preserver une mobilité adequate. Cette chirurgie peut donner un bon ou excellent resultat fonctionnel dans plus de 3/4 des cas de reconstruction distale du femur, mais elle doit être utilisée avec précaution dans la reconstruction tibiale et femorale proximales vu le risque de complications a type de luxation de la tête femorale et de déficit de l’extension.

---

---

Accepted: 8 July 1998     

Vaccination and HIV: a review of the literature

People with HIV are at risk for a variety of infections both at home and abroad. Recent studies have reported conflicting data concerning potential harmful effects following several inactivated vaccines. Antigenic stimulation by vaccines designed to prevent secondary infections may promote HIV-1 replication in certain patients. In HIV-positive subjects, immune response worsens with progression of the HIV infection. When vaccination is considered, administration of the vaccine must be performed as early as possible in the course of HIV infection because an HIV-infected patient's response to inactivated vaccines is closely related to HIV infection stage. A minority of subjects have a protective antibody response to vaccination. Consequently, specific antibody titers should be measured after vaccination to ensure immune protection. Immune response is improved by highly active antiretroviral therapy.Some live attenuated vaccines are considered as beneficial in some specific indications and if administered in the early stages of AIDS. However, viral load variations following administration of live attenuated vaccines have not been studied yet.     

Wagner vitreoretinal degeneration with genetic linkage refinement on chromosome 5q13-q14

· Background: It has been previously described that Wagner disease is linked to chromosome 5q13-q14. This study was carried out to describe the ophthalmological aspects and report the results of genetic linkage analysis in a large pedigree affected by Wagner disease. · Methods: Fourty members of one same family agreed to be examined. · Results: Twenty patients presented vitreoretinal degeneration in both eyes without any extra-ocular abnormalities. In young patients, visual acuity was usually normal after correction of frequent mild myopia. Presenile cataracts progressed by the third decade and required removal for visual rehabilitation. The primary disorder involved an abnormal vitreous. A few avascular vitreous bands were usually the only optical feature in the mostly empty vitreous cavity. A circumferential vitreous condensation formed in contact with the retina on many spots. Less common retinal findings included retinal detachment, abnormal retinal pigmentation, progressive atrophy of the RPE simulating choroideremia and lattice degeneration. Genetic analysis revealed a highly significant linkage (lod score >5.0) between the disease and 10 markers of the chromosome 5q13-q14 region. Two recombination events allowed us to refine the linked interval to 20 cM between the D5S650 and D5S618 markers. · Conclusion: Ophthalmological aspects of Wagner’s disease appear to progress with age. Regular ophthalmological examination is important for detecting retinal abnormalities. The gene involved in Wagner’s disease lies in a 20 cM interval on chromosome 5q13-q14. Received: 30 June 1998 Revised version received: 5 October 1998 Accepted: 6 October 1998     

A new vaccine concept: polysaccharide conjugate vaccines]

Polysaccharide-based vaccines such as the vaccines against Neisseiria meningitidis group A and C or Streptococcus pneumoniae have proved their efficacy in children and adults. Nevertheless they induce B cell mediated immunological response and therefore fail to protect infants. In the eighties appeared a new concept of Polysaccharide based vaccine for infants: Polysaccharide conjugate vaccines. Coupling polysaccharide to carrier protein transforms the T-independent antigen into T-dependant antigen. The first conjugate vaccines for the prevention of infections caused by Haemophilus influenzae type b were a success, with a 95% efficacy. A worldwide vaccination program might lead to the eradication of that bacterial disease. New vaccines are currently under development, the next conjugate vaccine should be one against Streptococcus pneumoniae. First published clinical data are very promising and confirmed the potential of the polysaccharide conjugate vaccine approach against bacterial infections.