Diagnosis and therapy of injuries of the lamina fibrocartilaginea of the hand (palmar plate)

Authors studied a frequent injury of the finger joints. The anatomy, the mechanism of the injuries, the diagnostic possibilities of the lamina fibrocartilaginea ("palmar plate") and of the palmar ligaments of the joints are described. In the diagnosis a special significance is attached to the stressed and tangential X-ray pictures. They take the part of the conservative treatment of the injury. In cases of dislocations, that cannot be reduced, of open "palmar plate" injuries and of major hyperextension and dislocations of the broken bone scale, operative treatment is thought necessary. In the treatment of the injuries of the "palmar plate" of the PIP joint they use the so called rein method, that keeps the palmar cartilaginous joint capsule, torn at the injury, on its original place, it enables however the active joint movements, the gymnastics and hinders this way the development of the joint contracture.     

Peripheral nerve injuries as a rare complication of cervical lymph node excision for diagnostic purposes

During the last 3 years 263 patients were admitted who underwent diagnostic lymph node biopsy. Complications were observed only in 4 cases. In these cases, following cervical lymph node excision from the supraclavicular region, sectioning the spinal accessory nerve and branches of brachial plexus resulted in the "shoulder syndrome" which is characterized by a weakened, deformed, and often painful shoulder. Attention is called to the possibility of nerve injury during diagnostic excision of cervical lymph nodes. Most often the spinal accessory nerve and branches of brachial plexus are transected with subsequent deformity and decreased range of motion of the shoulder, which could influence deeply the quality of patient's life.     

A study on prostaglandin F2α in photodermatoses

Summary Prostaglandin F₂ (PGF₂) as a possible mediator was studied. Its plasma content was determined by radioimmunoassay. Changes in the DNA synthesis were followed by autoradiography. In active polymorphous light eruption (PLE) and porphyria cutanea tarda (PCT) a remarkable increase (over 300 pg/ml) in plasma content occurred, especially in cases involving large skin areas. Values returned to normal in remission. PGF₂ administered i.d., significantly increased the DNA synthesis of the epidermal cells 48 h after injection similar to the effect of three minimal erythema dosis UV-irradiation. This was more pronounced in PLE patients than in controls. These findings suggest some role of PGF₂ in producing the inflammatory and perhaps proliferative components of the skin symptoms in PLE. PGF₂ — in parallel to literary data concerning PGE — seems to be a mediator of UV-induced changes in DNA synthesis of the epidermal cells. Offprint requests to: Irene Horkay, MD (address see above)     

Effect of antioxidants on the oxidative stress of red blood cells]

Antioxidant nomination covers a substance group of great variety, therefore, the determination of action mechanism of new antioxidants requires a complicated test system. The present work demonstrates this labour and time consuming procedure conducted on human red blood cells (RBCs) exposing them to "stress effect" with diluted hydrogen peroxide. It was studied how did these oxidative stress conditions affect the filtration parameters, lipid peroxidation, reduced glutathione content and superoxide dismutase activity of RBCs. It was attempted to reverse or influence the significant changes caused by "oxidative stress" with known antioxidants (vitamin E and uric acid).     

Nucleic acid and protein biosynthesis in the androgen-sensitive organs of intact male rats given the nonsteroid antiandrogen niftolide

In experiments on adult male rats it was found that the oral injection of non-steroid antiandrogen 4-nitro-3-trifluoromethylisobutyranilide (niftolide) in a dose of 25 mg/kg during 8 or 30 days induces atrophy of the accessory genital glands and the levator ani muscle and a decrease in the nucleic acid and protein content. Niftolide "castration" effect is realized through its ability to inhibit biosynthesis of these compounds in androgen-sensitive organs. The antiandrogen dose used exerted a potent prolonged antiandrogenic action, despite its stimulating effect upon the hypothalamic-hypophyseal-gonadal system.     

Clinical and biochemical features of sporadic and hereditary phaeochromocytomas: an analysis of 41 cases investigated in a single endocrine centre.

The aims of this study were to estimate the prevalence of phaeochromocytomas among adrenal tumours and to analyse the clinical and biochemical features of sporadic and hereditary tumours. Our series of 609 adrenal tumours evaluated between January 1995 and July 2003 was reviewed. Catecholamine content in phaeochromocytoma tissues was also determined and correlated with clinical behaviour and biochemical parameters of patients. Forty-one (6.7%) of the 609 patients had phaeochromocytomas, of which 28 were sporadic (25 benign and three malignant) and 13 (all benign) were associated with hereditary diseases (multiple endocrine neoplasia type 2A in seven cases from four unrelated families carrying mutations of the RET gene, von Hippel-Lindau disease in two unrelated cases with mutations of the VHL gene, and type 1 neurofibromatosis in four unrelated cases). Bilateral tumours were found in three patients with hereditary syndromes and in one sporadic case. Tumour diameter was slightly but not significantly greater in patients with hereditary than in those with sporadic tumours. Systolic but not diastolic blood pressure was significantly higher in patients with sporadic compared with those with hereditary tumours, but comparison of other clinical data and biochemical parameters indicated an absence of significant differences in the mean age, presenting symptoms, heart rate, or fasting serum glucose levels. Tissue catecholamine content measured in 8 sporadic and 5 hereditary phaeochromocytomas was highly variable and it failed to show significant differences between hereditary and sporadic tumours. These results indicate a high proportion of hereditary diseases among patients with phaeochromocytomas. Genetic and clinical testing for hereditary diseases may be of great help to offer an appropriate treatment, follow-up and family screening for these patients.     

Longitudinal monthly body measurements from 1 to 12 months of age: a study by practitioners for practitioners

A longitudinal growth study with monthly measurements during the 1st year of life was conducted by nine paediatricians working in private practice in Zurich. Of 92 children, none was lost to the study and only 32 of 1104 planned visits were missed; the quality of the measurements was comparable to that of a specialised university clinic. Compared to the Zurich Longitudinal Growth Studies, children of this study were considerably heavier and taller. In 92% of the subjects, growth velocity was at least once outside the reference range (3rd–97th percentile). For weight increments, the corresponding proportion was 87%. Conclusions The data indicate that current standards for the 1st year of life for the Zurich area might no longer be appropriate and need to be updated. The currently used velocity percentiles based on 3-monthly measurements are not suitable to assess individual height and weight increments calculated from monthly measurements. Received: 9 June 1997 / Accepted in revised form: 21 November 1997     

Inhibitory effect of antagonists of bombesin and growth hormone-releasing hormone on orthotopic and intraosseous growth and invasiveness of PC-3 human prostate cancer in nude mice.

PURPOSE: To determine whether antagonists of growth hormone-releasing hormone (GHRH) and bombesin/gastrin-releasing peptide (BN/GRP) can inhibit the orthotopic and metastatic growth of PC-3 human androgen-independent prostate cancers. EXPERIMENTAL DESIGN: The effects of administration of GHRH antagonist MZ-J-7-118, BN/GRP antagonist RC-3940-II, and their combination on the growth and metastatic spread of PC-3 tumors implanted orthotopically into nude mice were evaluated. The efficacy of this treatment on PC-3 tumors implanted intratibially and s.c. was also determined. RESULTS: Treatment with MZ-J-7-118, RC-3940-II, or their combination significantly inhibited the growth of PC-3 tumors implanted orthotopically, intraosseously, and s.c. The combination of the two antagonists had the greatest effect, inhibiting orthotopic tumor growth by 77%, intratibially implanted tumors by 86%, and s.c. tumors by 86%. The therapy with BN/GRP and GHRH antagonists, especially in combination, also reduced the local tumor spread and distant metastases in animals bearing orthotopic tumors. Combination therapy was likewise the most effective in reducing the incidence and severity of tibial osteolytic lesions and pathologic fractures in intraosseously implanted tumors. High-affinity binding sites for BN/GRP and GHRH were found in s.c. and orthotopic PC-3 tumor samples. MZ-J-7-118, RC-3940-II, and the combination of both compounds inhibited in vitro growth of PC-3 cells. CONCLUSIONS: Our findings show the efficacy of BN/GRP antagonists and GHRH antagonists for the treatment of advanced prostate cancer in preclinical metastatic models. As BN/GRP antagonists are already in clinical trials and GHRH antagonists are effective in androgen-independent prostate cancer models, these analogues could be considered for the management of advanced prostate carcinoma.     

Primary prevention of disc degeneration-related symptoms

Introduction

It has been shown previously that a history of low back pain often begins in childhood or adulthood. Indeed, the prevalence of severe back symptoms among schoolchildren is not insignificant. Possibilities for the primary prevention of intervertebral disc degeneration-related conditions are poorly reported in the literature despite the assumed socio-economical impact of the prevention of these conditions.

Methods

In this review, the authors have collated published data on the prevalence and risk factors of childhood low back pain as well as the structure and results of published primary prevention programs.

Results

The prevalence of self-reported low back pain is 7–65 % among children and it increases with age. Several lifestyle factors have been reported as significant risk factors for back pain, many of which are related to the schools. Current educational primary prevention programs in schools show no clear or long-term stable effect.

Conclusion

Considering the growing evidence about the importance of normal and bad posture, an exercise-based posture correction program is suggested as a school-based primary prevention of disc degeneration-related symptoms. Further, prospective randomized studies with more than 20 years follow-up, however, are strongly required to confirm it.