Informationen zur Weiterbildung psychodramatische Supervision

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Comparison of different quantitative approaches to 18F-fluoride PET scans.

The aim of this study was to evaluate the relationship between 18F-fluoride bone metabolic measures obtained by nonlinear regression (NLR), Patlak analysis, and standardized uptake value (SUV) for a wide range of normal and pathologic bone conditions. In patients imaged twice, changes in metabolic rates were determined using the different quantitation methods. METHODS: In 33 patients 2-51 mo after resection of a bone tumor of the limbs, a total of 42 dynamic PET scans were performed after injection of 250-350 MBq 18F-fluoride. SUV, fluoride bone influx rate obtained by Patlak analysis (KPat), and fluoride bone influx rate obtained by NLR (KNLR) were calculated in each patient for the bone graft, the contralateral normal side, and the spine, if within the field of view. RESULTS: SUV ranged from 0.4 to 9.9, KPat from 0.0035 to 0.0742 mL/min/mL, and KNLR from 0.0027 to 0.0737 mL/min/mL. Significant linear correlations were found between KPat and KNLR (r = 0.99), KPat and SUV (r = 0.95), and KNLR and SUV (r = 0.93). Eight patients have been imaged twice within 6 mo. Changes in metabolic values of the grafts were significantly correlated for KPat and KNLR (r = 0.96), KPat and SUV (r = 0.88), and KNLR and SUV (r = 0.79). The 95% ranges of normal change in limb bones were +/-58.0% for SUV, +/-23.0% for KPat, and +/-20.2% for KNLR; the corresponding 95% ranges in the spine were +/-8.6%, +/-7.6%, and +/-19.6%. CONCLUSION: The results of this study show that 18F-fluoride metabolic values as well as changes in bone metabolism measured by SUV and Patlak analysis were strongly correlated with NLR findings. The high 95% range of normal change of SUV in limb bones, however, indicates that this parameter is of limited value in areas with low metabolic activity. The range of spontaneous bone metabolic rate fluctuations presented in this study may be used as an estimate for assessing changes in bone metabolic activity, and the normal values for limb bones provide a basis for further studies on 18F-fluoride bone metabolism.     

Ergebnisse der Strahlentherapie von Wirbelk?rperangiomen

Fragestellung: Analyse unserer Therapieergebnisse bei der Behandlung von symptomatischen Wirbelkörperangiomen und Bewertung der Literatur. Patienten und Methode: Die Daten von zehn im Zeitraum von 1974 bis 1997 bestrahlten Patienten mit symptomatischen Wirbelkörperangiomen wurden retrospektiv ausgewertet. Als Kriterium für den Therapieerfolg wurde die Besserung der Schmerz- und der neurologischen Beschwerdesymptomatik gewertet. Ergebnisse: Bei vier von zehn Patienten wurde eine dauerhafte Schmerzfreiheit, bei weiteren vier eine Schmerzlinderung erzielt. Die initial bestehenden neurologischen Symptome bei drei Fällen bildeten sich bei zwei Patienten komplett und bei einem teilweise zurück. Die akuten Nebenwirkungen waren geringfügig. Spätnebenwirkungen traten nicht auf. Eine Dosis-Wirkungs-Beziehung wurde nicht nachgewiesen. In keinem Fall kam es zu einem Rezidiv. Schlußfolgerung: Wir empfehlen eine Bestrahlung von 30 Gy bei symptomatischen Angiomen als primäre Therapie. Bei beginnender Querschnittssymptomatik mit notwendiger operativer Entlastung ist eine Strahlentherapie auch bei postoperativer Symptomfreiheit zur Verhinderung eines Progresses bzw. Rezidivs sinnvoll. Purpose: Assessment of treatment results of symptomatic vertebral hemangiomas and review of the literature (Table 3). Patients and Methods: Ten patients treated between 1974 to 1997 were retrospectively analyzed. Efficacy of treatment was determined according to improvement of pain and/or neurological symptoms (Table 1). Results: Improvement was achieved in 8 of 10 patients. The initially existing neurological symptoms of 3 patients disappeared completely in 2 cases and improved in 1 case. Acute side effects were slight. Late side effects were not seen. A dose-effect relationship could not be assessed. There was no relapse. Conclusion: Radiotherapy with 30 Gy for symptomatic vertebral angioma as primary therapy is indicated. In case of neurological symptoms a radiotherapy after operative therapy is recommendable even if the patient is free of symptoms to prevent progress or relapse.     

From the Cover: Visually evoked activity in cortical cells imaged in freely moving animals

We describe a miniaturized head-mounted multiphoton microscope and its use for recording Ca²⁺ transients from the somata of layer 2/3 neurons in the visual cortex of awake, freely moving rats. Images contained up to 20 neurons and were stable enough to record continuously for >5 min per trial and 20 trials per imaging session, even as the animal was running at velocities of up to 0.6 m/s. Neuronal Ca²⁺ transients were readily detected, and responses to various static visual stimuli were observed during free movement on a running track. Neuronal activity was sparse and increased when the animal swept its gaze across a visual stimulus. Neurons showing preferential activation by specific stimuli were observed in freely moving animals. These results demonstrate that the multiphoton fiberscope is suitable for functional imaging in awake and freely moving animals.     

Mengensteuerung durch Budgetregelungen unter Einbeziehung des Globalbudgets

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The tumor suppressor TSLC1/NECL-2 triggers NK-cell and CD8+ T-cell responses through the cell-surface receptor CRTAM

The tumor suppressor in lung cancer-1 (TSLC1) gene is frequently silenced in human lung carcinomas, and its expression suppresses tumorigenesis in nude mice. TSLC1 encodes a cell-surface protein called Necl-2 that belongs to the Nectin and Nectin-like (Necl) family of molecules. Necl-2 mediates epithelial cell junctions by homotypic contacts and/or heterotypic interactions with other Nectins and Necls. Thus, it inhibits tumorigenesis by ensuring that epithelial cells grow in organized layers. Here, we demonstrate that natural killer (NK) cells and CD8+ T cells recognize Necl-2 through a receptor known as class I-restricted T-cell-associated molecule (CRTAM), which is expressed only on activated cells. CRTAM-Necl-2 interactions promote cytotoxicity of NK cells and interferon gamma (IFN-gamma) secretion of CD8+ T cells in vitro as well as NK cell-mediated rejection of tumors expressing Necl-2 in vivo. These results provide evidence for an additional mechanism of tumor suppression mediated by TSLC1 that involves cytotoxic lymphocytes. Furthermore, they reveal Necl-2 as one of the molecular targets that allows the immunosurveillance network to distinguish tumor cells from normal cells.     

Influence of HMG-CoA reductase inhibitors on markers of coagulation, systemic inflammation and soluble cell adhesion.

BACKGROUND: Beneath its lipid-lowering properties additional non-lipid effects of statin therapy are discussed. We therefore examined the impact of statins on laboratory markers of coagulation, inflammation and soluble cell adhesion to further explore these effects in 950 hospitalised patients with angiographically proven CAD. METHODS AND RESULTS: Although no significant differences were found in total cholesterol, LDL and HDL and triglyceride levels a statistically lower value in 277 statin-treated patients was found for von Willebrand factor [162(130/224) vs. 208(154/283)%, P=0.0001], leukocyte count [6.9(5.8/8.4) vs. 7.3(6.1/9.4)/nl, P=0.0005], high sensitive CRP [4.3(1.8/10.8) vs. 7.6(2.8/20.0) mg/dl, P=0.0001], interleukin-6 [9.5(5.1/18.7) vs. 14.4(7.2/28.1) mg/dl, P=0.0001] and soluble p-selectin [112.6(82.0/146.0) vs. 127.8(93.8/162.4) mg/dl, P=0.001] compared to 673 patients without statin therapy. This result was confirmed in a subgroup of 510 patients matched for age, gender and percentage of acute coronary syndromes. CONCLUSIONS: In statin treated patients significantly lower levels of coagulation, systemic inflammation and soluble cell adhesion markers were found. Therefore the effect of statin therapy may also be mediated by additional non-lipid-lowering effects.