Optical biopsy systems for the diagnosis and monitoring of superficial cancer and precancer

Histopathology is the gold standard in the diagnosis of cancer and dysplasia. Screening for the disease in high-risk populations(6,15) and choosing the correct site for biopsy have implications for the choice of follow-up intervals and therapy. Sully & Field(12) suggest that molecular genetic analysis, such as the polymerase chain reaction, for detecting progressive loss of heterozygosity, may be a more accurate predictor of the clinical course of oral cancer. This technique is now semi-automated and compares favourably with the time taken for histopathology (commonly 1-2 weeks). Recent developments suggest that the fluorescent and spectroscopic features may distinguish diseased from healthy tissue, and below follows an introduction for the clinician to this fascinating and complex field. It is possible to obtain a diagnosis in real-time and, with the appropriate use of photochemicals and image enhancement, it may be possible to treat and monitor the effects of treatment in real-time.     

Respiratory health among quartz-exposed slate workers--a problem even today

BACKGROUND: Quartz and dust are known to cause respiratory problems. Slate workers in Alta, Norway are exposed to these compounds even today, and the need for improvement of their work environment was evaluated. METHODS: Respiratory health was examined using chest X-ray, lung function tests and a self-administered questionnaire in a cross-sectional study. RESULTS: The prevalence of silicosis among the slate workers varied between 1.9 and 6.5%. The slate workers had significantly more respiratory symptoms than the controls when adjusted for smoking. Peak expiratory flow was significantly lower among slate workers than among controls. CONCLUSION: The work environment of the slate workers may cause adverse effects in their airways. Improvements to their work environment are indicated.     

Biochips in bladder cancer research

The techniques of DNA microarrays, protein arrays, and tissue microarrays complement one another and in the future the combination of these methods will possibly enable the detection of genes specific for bladder cancer. The SELDI technology (surface-enhanced laser desorption/ionization) will then be used to prove if the genes are translated into proteins and if those proteins have a relevant effect on the development and progression of the cancer disease. The consequence is the facilitation of the development of prognostic markers for this disease entity, which can then be easily tested in a large study population by tissue microarray. Beyond the gain of new insights into the biological understanding of the development and progression of bladder cancer, these techniques will hopefully enable the design of new therapeutic concepts, which apply to the individual biology of the tumor.     

Komplementär- und Alternativmedizin in der Uroonkologe

Zusammenfassung Die große Gruppe von Phytotherapeutika, homöopathischen und antroposophischen Medikamenten unterliegt den Bestimmungen der besonderen Therapierichtung und impliziert ein vereinfachtes Zulassungsverfahren. Im Vergleich zu konventionellen Therapeutika auf dem Gebiet der Onkologie werden unkonventionelle Medikamente z. T. ohne Prüfung auf Qualität, Unbedenklichkeit und Wirksamkeit im Rahmen von Anwendungsbeobachtungen verabreicht und durchlaufen nicht die klassische onkologische Prüfung. Unkonventionelle Therapeutika sind nicht mit Placebopräparaten gleichzusetzen. Aufgrund eines möglichen immunmodulierenden Effekts sind Langzeitnebenwirkungen, auch auf die Progression von Tumoren nicht immer sicher auszuschließen. Eine Indikation zur routinemäßigen Anwendung unkonventioneller Therapeutika ist zur Zeit in der urologischen Onkologie nicht belegt. Eine wissenschaftliche Prüfung gemäß den Kriterien der Evidence-Based Medicine (EBM) wird gefordert.Gesicherte Ergebnisse zur Behandlung mit unkonventionellen Medikamenten in der Uroonkologie werden im vorliegenden Beitrag vor dem Hintergrund des jeweiligen Methodenspektrums dargestellt.     

Adaptive adjustment of the adolescent porcine mandibular condyle

The effect of occlusal support during primary dentition on the mandibular condyle remains controversial. We sought to determine whether unilateral loss of occlusal support leads to quantifiable adaptive changes of the condyle. Quantitative analysis of condylar growth and spongy bone volume after unilateral removal of teeth on the left side in adolescent minipigs was examined over a period of 4 months. Serial sagittal sections of the temporomandibular joint were examined using microradiography, fluorescence microscopy, and light microscopy. The condyles on the nonextracted side showed a higher growth rate than those on the extracted side, with a 1.56-fold thicker (p = 0.003) additional vertical bone layer. This factor was greater ventrally than dorsally (p = 0.0311), increasing from dorsomedial (1.33) to ventrolateral (2.38). There was therefore a reciprocal change of the condylar surface curve between the left and right condyles. Increased condylar growth correlated with a lower subchondral spongy bone volume (7.38% difference, p = 0.002). The amount of mineralized bone matrix generated was estimated to be about 1.33-fold higher in the nonextraction side condyles compared with those on the extraction side. Thus, unilateral loss of occlusal support was shown to lead to quantifiable alterations of condylar vertical growth and spongy bone volume in minipigs.     

Wie informieren sich die Menschen in Deutschland zum Thema Gesundheit? Erkenntnisse aus der ersten Welle von HINTS Germany

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Die dynamischen Entwicklungen im Gesundheitssystem gehen mit einer aktiveren und stärker partizipativen Patientenrolle...     

Depressed interleukin-12 production by peripheral blood mononuclear cells after in vitro stimulation with the 30-kDa antigen in recurrent pulmonary tuberculosis patients

Some patients develop recurrent tuberculosis (R-TB), even after successfully completing initial anti-tubercular treatment. Although R-TB may be caused by relapse or exogenous reinfection, little is known about the underlying host responses associated with R-TB. This study investigated the profile of cytokines [interferon (IFN)-gamma, interleukin (IL)-12, tumor necrosis factor (TNF)-alpha, IL-6, and IL-10] present in peripheral blood mononuclear cells (PBMCs) of 17 R-TB patients after stimulation with the 30-kDa antigen (Ag) or purified protein derivative (PPD) Ag of Mycobacterium tuberculosis. These data were compared with data obtained from 15 patients with newly diagnosed pulmonary TB (N-TB), 22 patients with treatment failure (TF-TB), and 19 healthy tuberculin reactors (HTR). N-TB and R-TB patients were enrolled in this study within 1 month of beginning anti-tubercular chemotherapy. ELISA results showed that IFN-gamma production following stimulation with the 30-kDa Ag was significantly lower in each group of TB patients than in the HTR controls. In addition, patients with R-TB showed the most significant IL-12 depression among the subject groups after in vitro stimulation with either Ag. Furthermore, a significant decrease in TNF-alpha and IL-10 levels was observed in R-TB patients relative to N-TB patients. However, there was no statistical difference in TNF-alpha and IL-10 production between R-TB patients, TF-TB patients, and HTR controls. Our findings suggest that the underlying mechanisms of cytokine regulation might differ between N-TB and R-TB patients, and that decreased IL-12 production in response to the 30-kDa or PPD Ag might be involved in the immunopathogenesis of human R-TB.     

The relation of hydration status to cognitive performance in healthy older adults.

Little is known about the relation of hydration status to cognitive performance in older adults, who may be more vulnerable to poor hydration and cognitive impairment. We examined whether hydration status was related to cognitive functioning in 28 healthy community-dwelling older adults. Hierarchical regression models demonstrated that lower hydration status was related to slowed psychomotor processing speed and poorer attention/memory performance, after controlling for demographic variables and blood pressure.     

Depressed interleukin-12 (IL-12), but not IL-18, production in response to a 30- or 32-kilodalton mycobacterial antigen in patients with active pulmonary tuberculosis

The secreted 30-kDa antigen (Ag) of Mycobacterium tuberculosis directly stimulates Th1-type protective cytokine responses in healthy tuberculin reactors but not in patients with active tuberculosis (TB). To examine the cytokine profiles attributable to Th1 suppression associated with active TB, interleukin-12 (IL-12), IL-18, and IL-10 production in response to a 30- or 32-kDa Ag in 16 patients with active pulmonary TB and 24 healthy controls was investigated by enzyme-linked immunosorbent assay. In TB patients, production of IL-12 p40, as well as gamma interferon (IFN-gamma), by 30- or 32-kDa Ag-stimulated peripheral blood mononuclear cells (PBMC) was significantly decreased compared with that in healthy tuberculin reactors. There were no significant differences in IL-18 production between patients and controls early during stimulation (16 h). However, PBMC from patients showed significantly enhanced IL-18 proteins after 96 h of stimulation. Similarly, higher IL-10 production was observed in the TB patients than in healthy tuberculin reactors. After 2 months of anti-TB therapy, the mean IFN-gamma and IL-12 p40 production and the mean blastogenic responses were significantly increased in PBMC in the 10 TB patients who were followed up. Our findings provide evidence that depressed IL-12 in response to the 30- or 32-kDa Ag is involved in the immunopathogenesis of human active pulmonary TB.     

99mTc-DPD uptake reflects amyloid fibril composition in hereditary transthyretin amyloidosis

Aims

In transthyretin amyloid (ATTR) amyloidosis various principal phenotypes have been described: cardiac, neuropathic, or a mixed cardiac and neuropathic. In addition, two different types of amyloid fibrils have been identified (type A and type B). Type B fibrils have thus far only been found in predominantly early-onset V30M and in patients carrying the Y114C mutation, whereas type A is noted in all other mutations currently examined as well as in wild-type ATTR amyloidosis. The fibril type is a determinant of the ATTR V30M disease phenotype. ^99mTc-DPD scintigraphy is a highly sensitive method for diagnosing heart involvement in ATTR amyloidosis. The objective of this study was to determine the relationship between ATTR fibril composition and ^99mTc-DPD scintigraphy outcome in patients with biopsy-proven ATTR amyloidosis.

Methods

Altogether 55 patients with biopsy-proven diagnosis of ATTR amyloidosis and amyloid fibril composition determined were examined by ^99mTc-DPD scintigraphy. The patients were grouped and compared according to their type of amyloid fibrils. Cardiovascular evaluation included ECG, echocardiography, and cardiac biomarkers. The medical records were scrutinized to identify subjects with hypertension or other diseases that have an impact on cardiac dimensions.

Results

A total of 97% with type A and none of the patients with type B fibrils displayed ^99mTc-DPD uptake at scintigraphy (p < 0.001). Findings from analyses of cardiac biomarkers, ECG, and echocardiography, though significantly different, could not differentiate between type A and B fibrils in individual patients.

Conclusion

In ATTR amyloidosis, the outcome of ^99mTc-DPD scintigraphy is strongly related to the patients’ transthyretin amyloid fibril composition.