Characterisation and predictive value of epidermal growth factor receptor status using quantitative real-time PCR combined with immunohistochemistry on non-small cell lung cancer specimens

The frequency of increased EGFR-mRNA expression was determined in 57 patients suffering from NSCLC by applying quantitative real-time PCR. The findings were correlated with clinical parameters and the immunohistochemical (IHC) markers EGFR, c-erbB-2, c-erbB-3, Ki-67 and p53 on cryostat sections. Of the patients 46% showed increased EGFR-mRNA, 35% revealed an increased IHC-EGFR expression; 16% of the patients showed a combined positivity and 35% a combined negativity when applying both methods, and 17 (30%) of the cases revealed increased EGFR-mRNA without IHC-EGFR expression. This subgroup was characterised by p53 coexpression and the highest frequency of deaths (35% vs. 20%) indicating a more aggressive tumour type. In contrast to IHC - where positivity was seen predominantly in squamous cell carcinomas (48% vs. 27%) - EGFR-mRNA expression was observed equally in both histological subtypes (48% vs. 43%). PCR-EGFR and IHC-EGFR tumour typing identifies different tumour characteristics with different clinical courses. Whether this combined typing could help to identify patients who respond to anti-EGFR therapies is worth further testing.     

Drug users and HIV-combination therapy (HAART): factors which impede or facilitate adherence

The current highly active antiretroviral therapy (HAART), i.e., triple combination treatment including a protease inhibitor, allows for long-term suppression of HIV-replication. The intake guidelines, however, are very strict and, like many other HIV positive patients, drug users have problems in achieving good therapy compliance. As a result, the effectiveness of the medication therapy is seriously jeopardized. This qualitative study, involving in-depth interviews with 27 "hard drug" users in Amsterdam, seeks to provide better insights into the extent of adherence to HAART. In addition, factors that impede or facilitate adherence have been listed in order to develop and improve strategies. The study shows that almost half of the "hard drug" users interviewed do not adhere to the therapy. A large number of determinants for adherence were identified at the level of medication, the individual, and the environment. Many of these determinants can be influenced, which means that they can provide clues for the effective implementation of measures that may enhance effectiveness of treatment.     

Orthopaedic surgery in hemophilic patients

Summary Since 1970 we performed 18 operations in hemophilic patients: 7 synovectomies, 2 elongations of the achilles-tendon, 1 hip arthrodesis, 2 endoprosthetic replacements of the hip, 2 intertrochanteric flexion- and varus-osteotomies, 1 excision of a pseudo-tumor and 2 removals of hematomas of the knee joint. The synovectomies were done only in joints affected by frequent hemorrhages. The bleeding frequency could be reduced considerably and the range of motion could be improved. The indication for several other orthopaedic procedures depended on the orthopaedic symptoms. The results were satisfactory without major complications during the healing period. During surgery and the following postoperative care the antihemophilic factor was substituted up to levels between 60 and 120%. The factor VIII or IX was controlled daily and Hb, GOT, GPT and the Australia antigen-antibody on a weekly base. The length of the substitution regimen was dependent on the individual wound healing and the postoperative treatment.Zusammenfassung Seit 1970 wurden an der Orthopädischen Universitätsklinik Frankfurt/M. in Zusammenarbeit mit der Abteilung für Angiologie des Zentrums für Innere Medizin der Johann-WolfgangGoethe-Universität Frankfurt/M. 18 orthopädische Operationen bei Blutern vorgenommen. Es handelte sich dabei um 7 Synovektomien, 2 Achillessehnenverlängerungen, 1 Hüftarthrodese, 2 Hüftgelenktotalendoprothesen, 2 intertrochantere Umstellungsosteotomien, 1 Ausräumung eines Pseudotumors sowie 2 Haematomausräumungen am Kniegelenk.Synovektomien nehmen wir nur vor, wenn Blutungen gehäuft in kurzen Abständen in einem einzigen oder einzelnen Gelenken vorkommen. Dadurch konnte die Blutungsneigung im operierten Gelenk drastisch verringert und eine Besserung der Beweglichkeit erzielt werden. Die Indikation zu anderen operativen Eingriffen wurde entsprechend den orthopädischen Krankheitsbildern gestellt; auch hier waren wir mit den Ergebnissen sehr zufrieden und Wundheilungsstörungen wurden nicht beobachtet.Die Substitution unter der Operation und in den nachfolgenden Tagen wurde so hoch dosiert, daß ein Faktorenspiegel von 60–120% erreicht wurde. Täglich wurden Faktor VIII oder IX und wöchentlich Hb, GOT und GPT, Australia-Antigen-Antikörper kontrolliert. Die Mindestdauer der Substitutionstherapie richtete sich nach der Dauer der jeweiligen Wundheilung und der erforderlichen Nachbehandlung.Dedicated to Professor Dr. W. Heipertz on the occasion of his 60th birthday     

Complications of total hip-replacement arthorplasty in patients with rheumatoid arthritis.

During the period 1969 through 1974, 716 total hip-replacement arthorplasties were performed. The results of the surgery in 275 cases of rheumatoid arthritis as regards complications were compared with those in 382 procedures in cases of osteoarthritis. In contrast to the reports of others,the incidence of deep would infection in the two groups was found to be equal. Patients undergoing total hip-replacement arthroplasty as a revision of a previous operation had a substantially increased risk of infection. Patients with rheumatoid arthritis, however, were more subject to certain other complication (intraoperative fracture, difficulties with anesthesia, and malposition of prosthetic components), in addition to the complications that were predictable because of the involvement of multiple joints and the systemic disease process.     

Kniegelenksverstauchung und Abriß des medialen Seitenbandes

Ohne Zusammenfassung (Mit 22 Abbildungen.)     

Zur Ätiologie der angeborenen Hüftgelenksverrenkung

Ohne Zusammenfassung     

Fluoridprophylaxe – ein Review

Pädiatrie & Pädologie - Alles spricht für die Kariesprophylaxe durch die richtige Verwendung fluoridhaltiger Zahnpasten: Sie ist effektiv, sicher und dringend anzuraten....     

Effects of Escherichia coli and Bacteroides fragilis on peritoneal host defenses.

Escherichia coli and Bacteroides fragilis are common copathogens in clinical intra-abdominal sepsis, yet it is unclear how they interact synergistically in vivo. We sought to determine whether E. coli and B. fragilis, in combination but not alone, could exert a detrimental effect on the peritoneal host defenses of translymphatic absorption and bacterial phagocytosis. Our data indicated that nonviable E. coli (O18ab:K56/K7:- and O111:B4), Klebsiella pneumoniae, B. fragilis, and Bacteroides thetaiotaomicron were handled in a similar fashion by both host defenses of the peritoneal cavity. The use of 2 X 10(8) nonviable radiolabeled E. coli as a tracer and either 2 X 10(9) B. fragilis or 2 X 10(9) E. coli (either viable or nonviable) as a competing agent to inhibit host defenses demonstrated that although clearance and phagocytosis could be inhibited, the inhibition occurred to a similar degree with either E. coli or B. fragilis. Thus, B. fragilis did not compete to any greater extent than E. coli did for peritoneal clearance or opsonization and phagocytosis in vivo. These data indicate that bacterial synergy probably does not occur on the basis of reduced peritoneal clearance or by a reduction in the opsonization and phagocytosis of either organism by the copathogen. These results provide indirect support for the hypothesis that in bacterial synergy, one organism directly stimulates the growth of the other, perhaps by providing a growth factor.