In vivo study of the distribution, affinity for cartilage and metabolism of glycosaminoglycan polysulphate (GAGPS, Arteparon)

37 patients suffering from osteoarthritis and 10 arthritic patients received intramuscular (i.m.), partly also intraarticular (i.ac.) injections of GAGPS; whereupon pharmacokinetics in serum, synovial fluid, urine, and cartilage were investigated. Cartilage was obtained during endoprosthetic hip surgery. The concentrations were determined by radiochemistry, partly after gel chromatography and electrophoresis respectively. Serum levels in patients with osteoarthritis after i.m. administration of 50 mg were 0.55 microgram/ml 3 hrs later, and 0.11 microgram/ml 24 hrs later. Patients with arthritis showed similar serum levels which were slightly higher after i.ac. injection, and which rose proportionally when the dosage was increased to 125 mg. With the arthritic patients, also the concentrations in the synovium were comparable, in the cases with osteoarthritis concentrations were slightly higher, which in both cases suggests that the synovial membrane is promptly penetrated. However, the concentrations in cartilage following a dosage of 50 mg within 24 hours rose as high as 1.45 micrograms/g which corresponds roughly to three times the serum level 3 hours after application. According to biochemical data, injections of 1 to 2 micrograms/ml should yield chondroprotective effects. Hitherto therapy has relied mainly on i.ac. injections; it may now be expanded by the i.m. route of administration. GAGPS was bound to serum proteins, in the synovia, however, it was found unbound. The main portion of the compound excreted via urine within 12 hrs (30 to 40 percent) was mainly unaltered; later, a partial degradation of the chain length and of the degree of sulfation was observed. Animal experiments on rats showed an increased affinity of GAGPS to inflamed tissues (Freund's adjuvant, carageenan edema).     

Tumoroxygenierung unter kombinierter Ganzkörperhyperthermie und Polychemotherapie Untersuchungen am Beispiel eines Rezidivkarzinoms der Mundhöhle

Background and objective. Previous studies have reported synergistic effects of combined hyperthermia and chemotherapy and/or irradiation. The response to irradiation and chemotherapy of well-oxygenated and vascularized tumors generally is better than that of hypoxic tumors. Therefore, tumor oxygenation is recognized as an important predictive factor in the therapy of malignant tumors. In practice, the head and neck area remains outside of the hyperthermia chamber during whole-body hyperthermia. It was the aim of this study to evaluate if the head and neck region receives sufficient warmth and, if so, if tumor oxygenation increases accordingly. Patients/methods. Whole-body hyperthermia, as heat radiation (Enthermics Medical Systems RHS-7500), was applied to the narcotised 60-year-old male patient with a local recurrence tumor pT₃ pN_2b M₀ squamous cell carcinoma of the oral cavity. Tumor oxygenation and temperature were measured by LICOX catheters via one-point measurement during the entire hyperthermia treatment (3.5 h). Parallelly, chemotherapy (ifosfamide/Carboplatin) was given in four cycles (one cycle/month). Results. With a latency of 10 min the increase of intratumoral temperature was comparable to temperatures achieved in the esophagus. The maximum intratumoral temperature was 41.8°C. The average increase in tumor oxygenation was more than 100%. The clinical outcome in the case presented was a partial tumor remission (PR). Conclusions. During combined whole-body hyperthermia and polychemotherapy, tumor oxygenation is also significantly improved in the head and neck area, despite the fact that the head and neck area remained outside the hyperthermia chamber. The intratumoral temperature was comparable to esophageal and rectal temperatures.     

A Rare Congenital Finding in an Elderly Lady—Scimitar Syndrome with Dextrocardia in a 79 Year Old

We present a case of a 79-year-old African-American woman with scimitar syndrome and associated dextrocardia. This case represents, to our knowledge, the oldest living patient described in the literature with scimitar syndrome.     

胃癌癌前病变癌变机制及其逆转的研究进展

胃癌癌前病变与胃癌的发生关系,日益受到重视,近几年来特别强调幽门螺杆菌为引起慢性萎缩性胃炎与胃癌的重要危险因子.因此,许多学者进一步深入研究幽门螺杆菌感染对发生胃癌的危险性,胃癌癌前病变发生癌变的机制以及如何使其逆转,是预防和降低胃癌发病的重要课题.     

MR vascular imaging with a fast gradient refocusing pulse sequence and reformatted images from transaxial sections

The authors present a method for obtaining magnetic resonance (MR) images of intra- and extracranial vessels from thin contiguous transaxial sections. A section-selective gradient refocusing pulse sequence with a short repetition time caused flow-related enhancement from spins that flowed perpendicular to the transaxial sections. The signal was further enhanced by means of flow compensation gradients to rephase any phase shifts resulting from moving spins in the presence of the imaging gradients. Coronal and sagittal sections, reformatted from multiple transaxial sections, are shown to have excellent vessel contrast without the use of contrast material. These images were obtained in 12 minutes of acquisition time from as many as 60 sections of 3-mm thickness. Such a technique shows significant promise for MR angiography.     

Tumoroxygenierung unter kombinierter Ganzk?rperhyperthermie und Polychemotherapie Untersuchungen am Beispiel eines Rezidivkarzinoms der Mundh?hle Untersuchungen am Beispiel eines Rezidivkarzinoms der Mundh?hle

Hintergrund und Fragestellung. Die Wirksamkeit der Hyperthermie in der Kombinationsbehandlung mit ionisierender Strahlung und/oder Chemotherapie ist in zahlreichen Studien postuliert worden. Der Wirkungsmechanismus ist derzeit nicht vollst?ndig gekl?rt. Eine Hyperthermie führt zu einer Erh?hung der Durchblutung und sollte dadurch eine Erh?hung der Tumoroxygenierung bewirken, die ein wichtiger prognostischer Faktor in der Behandlung maligner Tumoren ist. Diese Untersuchung sollte kl?ren, ob unter den Bedingungen der Ganzk?rperhyperthermie des Rumpfes au?erhalb der W?rmekammer gelegene Regionen wie das Kopf-Hals-Gebiet ad?quat erw?rmt werden und welchen Einfluss dies auf die Tumoroxygenierung hat.     

瘦素有望成为诊治肿瘤的一个关键点

对瘦素与肿瘤的最新研究进展进行综述，并阐明瘦素参与调节肿瘤发生、发展的可能机制，它可能有望成为早期诊治肿瘤的一个关键点。     

Project Muskan: Social responsibility of the plastic surgeon

Although exact statistics are not available, Indian plastic surgeons see around 7,00,000–8,00,000 burn admissions annually with around 10,00,000 cleft patients yet to be operated. In spite of this voluminous load, India does not have national health programs for the various deformities Indian plastic surgeons typically treat. As Plastic Surgeons, it is our social responsibility to treat these patients and bring ‘muskan’ (smile in Hindi) back into their lives. Project Muskan was initiated as an innovative model for targeting these patients and is probably one of its kind in the field of plastic surgery in our country. It is unique because it is a perfect collaboration of government institutions, a Non Government Organization (NGO), and cooperative sectors providing free health care at the doorstep. Identification of the patients was done with the help of the extensive milk dairy network in the state of Gujarat. Provision of transport and other facilities was done by the NGOs and quality health care provision was taken care of by the government hospital. Project Muskan started from a single village but now covers around 3000 villages and tribal areas of Gujarat. It is a system that can be easily reproducible in all hospitals and has reestablished the faith of the common man in government institutes.