Adjuvante Chemotherapie mit Carboplatin/Epirubicin beim radikal operierten Ovarialkarzinom

Ohne Zusammenfassung     

Radiosensitivity Patterns of Four Human Ovarian Cancer Cell Linesin Vitro

Clinical evidence and the majority of experimental data suggest a cross-resistance between cisplatin and radiation in ovarian cancer. The authors are not aware of any report of a human ovarian cancer cell line for which the dose–response relationships to both radiation and chemotherapy including paclitaxel and cisplatin have been evaluated with the same methodology. The present study investigated the radiosensitivity profiles of four established human ovarian cancer cell linesin vitrousing the ATP assay, which measures total cell kill. The CAOV-3 cell line showed the highest degree of radiosensitivity of the four cell lines. SKOV-3 cells were the most resistant. The BG-1 cell line, previously shown to be highly resistant to cisplatin but sensitive to paclitaxel, was distinctly sensitive to radiation. This was particularly true for the lower dosages (2–6 Gy). The four cell lines tested are a good representation of cell lines with different radiosensitivities. The different response patterns to cytotoxic agents and radiation, make the BG-1 cell line in particular an interesting candidate for future studies on mechanisms of resistance and combination effects between radiation and chemotherapy.     

Prognostic implications of thrombocytosis in patients with stage III and IV cervical cancer

Gücer F, Tamussino K, Panzitt T, Taucher A, Haas J, Petru E, Winter R. Prognostic implications of thrombocytosis in patients with stage III and IV cervical cancer. Int J Gynecol Cancer 1998; 8 : 369–373.
The purpose of this study was to evaluate the prognostic significance of thrombocytosis in patients with advanced (stage III and IV) cervical cancer. A total of 128 patients without conditions associated with thrombocytosis who received a diagnosis of stage III or IV cervical carcinoma at our department between 1985 and 1993 were included in the study. Thrombocytosis was defined as a platelet count above 400,000/μl. Ninety-two of 128 patients (72 %) had stage III and 36 (28%) had stage IV disease. Squamous cell carcinomas accounted for 109 (85%) of the carcinomas. Median follow-up was 11 months (range 1–106 months). Thrombocytosis was present in 33 of 128 (26%) patients. The mean pretreatment platelet count ± standard deviation ( SD ) was 345,000 ± 135,000. The estimated overall five-year survival rate was 16%. The five-year survival rate of the 33 patients with thrombocytosis was significantly worse than that of the 95 patients with a platelet count <400,000/μl (3.5 % vs 22%, P = 0.035). In patients with stage III disease and thrombocytosis, the five-year survival rate was significantly lower than in those without thrombocytosis (5% vs 26%, P = 0.036). In stage IV patients, there was no significant difference (0% vs 6%, P > 0.05). In multivariate analysis, age, hemoglobin, and treatment (vs palliation) were significantly associated with prognosis, whereas thrombocytosis was not. Thrombocytosis is not an independent prognostic factor in advanced stage cervical cancer.     

Nongenital cancers metastatic to the ovary.

We review our experience with 82 patients with nongenital cancers metastatic to the ovary. All patients were referred for evaluation of an ovarian mass. The patients had primary carcinoma of the breast (n = 28), colon (n = 23), stomach (n = 22), pancreas (n = 7), or gallbladder (n = 2). The overall actuarial 5-year survival rate was 10%. Five-year survival in patients with metastatic colon cancer was significantly higher (23%) than that in patients with metastatic cancer of the breast, stomach, gallbladder, or pancreas, all of whom died within 58 months (P less than 0.05). Patients with unilateral metastatic ovarian involvement had a 5-year survival significantly better than that of those with bilateral involvement (28% vs 5%; p = 0.003). Five-year survival in patients with disease limited to the pelvis was significantly higher than that in those with abdominal spread (22% vs 6%; P less than 0.04). The 5-year survival of patients with residual disease less than 2 cm or greater than 2 cm in diameter was 18% or 4%, respectively (P = 0.002). This pattern applied mainly to differences in patients with primary cancer of the breast or colon (P less than 0.008). These data suggest that an aggressive surgical effort seems to be indicated in colon cancer metastatic to the ovary, as some of these patients may survive 5 years.     

Footprints of atherosclerotic coronary heart disease in children.

Formerly viewed as a bland lipid storage disease mainly affecting adults, atherosclerosis is nowadays recognized to be a chronic inflammatory disease that begins much earlier, probably already during fetal life. There has inevitably been reorientation from the traditional risk factor cholesterol to a broad category of factors, including those triggering chronic inflammation, such as infections. In addition, major advances in the field of vascular biology have led to a reassessment of our perception and understanding of the pathogenesis of atherosclerosis. A key role in this process is now attributed to vascular endothelium.     

Bradykinin preconditions postischemic arterial endothelial function in humans

BACKGROUND: Arterial endothelial dysfunction is an important mechanism of tissue injury caused by ischemia-reperfusion (I/R). Earlier studies of I/R have shown that intracoronary preinfusion with 2.5-5 microg/mL bradykinin (BK) could alleviate the postischemic myocardial damage. Using an experimental human model of I/R, we investigated whether preceding infusion with BK could prevent the I/R-induced arterial endothelial dysfunction. METHODS: The left radial artery (LRA) from 16 healthy male adults, 18 to 30 years old, was submitted to I/R by completely occluding the left brachial artery with a pressure tourniquet for 20 minutes (ischemia), followed by its release (reperfusion). Prior to I/R, half of the subjects were randomly assigned to receive either BK (5 microg/mL) or saline, both being infused into the left brachial artery (0.5 mL/min, 10 min). The infusion was followed by a 10-minute drug-free period. The endothelial function of the LRA was studied by measuring the flow-mediated dilation (FMD) at baseline (prior to drug infusion), and at 15 minutes of reperfusion. In addition, baseline radial artery diameter, plasma nitrate, and von Willebrand factor were measured at these time points, and immediately before I/R (pre-I/R). RESULTS: BK had no effect on the pre-I/R plasma nitrate (p > 0.5 vs. saline) and diameter of LRA (p > 0.5 vs. baseline). At 15 minutes of reperfusion, FMD was significantly decreased in the saline group as compared to baseline (absolute dilation: 0.08 +/- 0.03 vs. 3.02 +/- 0.8 mm, respectively, p < 0.01; percentage dilation: 3 +/- 0.6 vs. 8 +/- 0.6%, respectively, p < 0.001), but it remained unaffected in the BK group (absolute dilation: 3.06 +/- 0.9 vs. 3.27 +/- 0.8 mm, respectively, p > 0.5; percentage dilation: 7 +/- 0.7 vs. 8 +/- 0.8%, respectively, p > 0.5). A similar trend was observed with regard to plasma nitrate, which remained unchanged in the BK group (37.01 +/- 4.14 vs. 39.14 +/- 4.49 micromol/L, p > 0.5) but decreased in the saline group (35.91 +/- 3.03 vs. 28.91 +/- 2.81 micromol/L, p < 0.1). CONCLUSION: Infusion of BK could protect the arterial endothelial function against I/R injury in humans, possibly in part by preserving the endothelial NO availability. The findings support the use of BK in the prevention of tissue injury due to I/R and might reveal an additional mechanism whereby ACE inhibitors exert their preconditioning effects on myocardium.     

Pill esophagitis

Pill esophagitis is a rare clinical diagnosis. We report a series of two patients who experienced ulcerative esophagitis while taking doxycycline (patient 1) and alendronate (patient 2). Both patients presented with retrosternal pain, odynophagia and dysphagia. Symptoms developed after 3 days of treatment with doxycycline in patient 1 and after 3 months of treatment with alendronate in patient 2. Endoscopy revealed ulcerative lesions in the mid-esophagus, sparing the distal esophagus. Biopsies showed inflammatory infiltrate (patient 1) and ulceration and hyperplastic cells (patient 2). Patient 1 recovered completely endoscopically after discontinuation of the antibiotic and a one month course of sucralfate treatment. Patient 2 did not accept the discontinuation of alendronate therapy. She also had a course of one month treatment with sucralfate. At one, two and even at seven months after the first diagnosis, endoscopy still showed the persistence of millimetric defects of epithelisation. She is still under endoscopical survey. In conclusion, doxycycline and alendronate can cause chemical esophagitis when taken improperly. In adults and elderly patients exclusion of esophageal carcinoma by histology is necessary. Continuation of treatment with the offending drug can delay healing. Pill esophagitis is a preventable cause of morbidity that consists of giving simple advice of how and when to take medication.     

Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance

Objectives: The study aimed to clarify whether cognitive and psychomotor performance, which are important for occupational and traffic safety, are impaired by working permanent night shifts (NSs) compared with early–late two shifts (TSs) and whether age and chronobiological type influences the relationship between shift and performance. Methods: The study included 44 male automobile workers, 20 working TSs and 24 working NSs. Chronobiological type was determined by questionnaire (D-MEQ). Each subject was tested at the beginning and end of the shift for alertness [by a visual analogue scale (VAS)]; feeling of well-being (Basler); concentration and accuracy (d2); reaction speed, orientation and reaction to stress (Vienna System). Results: TS workers were more frequently morning types whereas the NS workers were more frequently evening types. In the performance tests, the TS and NS workers did not differ at shift start or shift end. Over the course of the shift, concentration and accuracy improved in both groups, as did reaction to stress. Chronobiological type alone or in combination with shift type had no effect on performance. Conclusions: The results of this study indicate that—if chosen voluntarily—working NSs has no immediate negative effects on cognitive and psychomotor performance when compared with working TSs. There was no indication of an increased risk of accidents after working NSs. The unequal distribution of the circadian types in the shift groups may indicate selection.