Short-term results of combined radioimmunotherapy in inoperable lung cancer.

Fifty-three inoperable lung cancer patients were treated with radiotherapy combined with immunostimulation with BCG. A good response was obtained in 30 patients (56%); the results were not significantly different than those obtained with a control group of 50 lung cancer patients matched by age, sex and stage of the disease (24 out of 50 equals 46%). These short-term results were compared with the immunologic "status" of patients evaluated before treatment by the parameters monitoring in vivo and in vitro delayed type hypersensitivity. The good response to therapy was documented in a higher percentage of patients with positive skin tests to recall and standard antigens and with normal values of lymphocyte transformation with PHA and Rosette E-forming cells, in comparison with patients with low levels of immunocompetence. An impairment of the cell-mediated immune response was found after combined therapy, presumably due to radiotherapy. BCG was not able to restore the patient's immunocompetence, no effect on host's immune reactivity was demonstrated. As regards humoral immunity, the patients with low levels of IgG before treatment (12/14) showed a good response.     

Torsion of the greater omentum as a rare cause of acute abdomen

Taking as their starting point a case of greater omental torsion recently observed in their surgical department, the authors carefully review the topic and the relevant literature data. This is a rare condition, which though presenting diagnostic difficulties which make it hard to identify preoperatively, poses no problems of a therapeutic nature.     

Prospective comparison of child asthma education in the emergency department and at scheduled follow-up consultation]

OBJECTIVES: To assess asthma control in asthmatic children attending the emergency department and to compare it with that for children with scheduled specialist follow-up. POPULATION AND METHODS: Between September 2002 and September 2003, we included asthmatic children aged 6 to 16 years, attending the emergency department (group U) or pulmonology follow-up appointments (group C) at Necker Hospital, Paris, France. We used the Asthma Therapy Assessment Questionnaire (ATAQ), completed by the parents and children aged 10 years and over. RESULTS: We interviewed 156 families and included 144 (92%) in the final analysis (77 in group U). The 2 groups did not differ in age, sex ratio, age at onset and asthma diagnosis and the frequency of asthma attacks. Children in group U received less daily maintenance treatment (P<0.01) but reported more severe asthma (P<0.05). They had also experienced fewer investigations for their asthma (fewer lung function tests P=0.01 and allergy tests P=0.001). The children in group C had better controlled asthma, as assessed by both the children themselves and their parents. They also had fewer problems relating to the behavior, communication and treatment control domains. The assessment of children and parents were similar in all areas except communication. The children considered their communication problems to be more serious than their parents did. Age-related differences were observed, with older children's parents having more difficulties in all domains investigated. CONCLUSION: Clinicians should consider assessing asthma control in children attending the emergency department. There is clearly an opportunity to improve the quality of asthma education for these children. Clinicians could provide children with a written plan of action for asthma attacks and information about daily self-management. Improving communication between children, their parents and doctors should be considered a key educational project.     

Phase I trial of 17-allylamino-17-demethoxygeldanamycin in patients with advanced cancer.

PURPOSE: We determined the maximum-tolerated dose (MTD) and the dose-limiting toxicities (DLT) of 17-allylamino-17-demethoxygeldanamycin (17-AAG) when infused on days 1, 8, and 15 of a 28-day cycle in advanced solid tumor patients. We also characterized the pharmacokinetics of 17-AAG, its effect on chaperone and client proteins, and whether cytochrome P450 (CYP) 3A5 and NAD(P)H:quinone oxidoreductase 1 (NQO1) polymorphisms affected 17-AAG disposition or toxicity. PATIENTS AND METHODS: An accelerated titration design was used. Biomarkers were measured in peripheral-blood mononuclear cells (PBMCs) at baseline and on days 1 and 15, and pharmacokinetic analysis was performed on day 1 of cycle 1. CYP3A5*3 and NQO1*2 genotypes were determined and correlated with pharmacokinetics and toxicity. RESULTS: Twenty-one patients received 52 courses at 11 dose levels. DLTs at 431 mg/m(2) were grade 3 bilirubin (n = 1), AST (n = 1), anemia (n = 1), nausea (n = 1), vomiting (n = 1), and myalgias (n = 1). No tumor responses were seen. 17-AAG consistently increased heat shock protein (Hsp) 70 levels in PBMCs. At the MTD, the clearance and half-life (t(1/2)) of 17-AAG were 11.6 L/h/m(2) and 4.15 hours, respectively; whereas the active metabolite 17-aminogeldanamycin had a t(1/2) of 7.63 hours. The CYP3A5*3 and NQO1*2 polymorphisms were not associated with 17-AAG toxicity. The CYP3A5*3 polymorphism was associated with higher 17-AAG clearance. CONCLUSION: The MTD of weekly 17-AAG is 308 mg/m(2). 17-AAG induced Hsp70 in PBMCs, indicating that Hsp90 has been affected. Further evaluation of 17-AAG is ongoing using a twice-weekly regimen, and this schedule of 17-AAG is being tested in combination with chemotherapy.     

Histological evidence concerning the osseointegration of titanium implants in the fractured rabbit femur

Stabilization of the broken bone is achieved using biocompatible materials. Since histology is still considered the gold standard technique for the assessment of bone formation around metallic implants, this report investigated the titanium implant integration in the accidentally broken bone in rabbits. The experimental protocol was reviewed and approved by the Ethical Committee of the Faculty of Medicine and Pharmacy Oradea, Romania. Holes were drilled in the diaphysis of the femur, and titanium implants were inserted in the created bone defect. In two subjects, fractures occurred on days two and three after the metallic alloy implantation. The other two rabbits presented no fractures following the surgical procedure. The rabbits were euthanized and the bones (with metallic implants) were harvested for histopathological investigation. Following decalcification, the bone samples were processed using the standard paraffin technique and stained by Goldner’s trichrome procedure. In subjects with a perfect immobilization of the titanium implants, the osseointegration occurred with minimal callus formation (i.e. primary cortical healing). In rabbits with bone fractures, the callus was more exuberant. A progressive replacement of the granulation tissue with hyaline cartilage and woven bone occurred soon after. The former aspects suggested an indirect metaplasia in the created callus. In all subjects, no inflammatory cells were identified in the created callus. The bone regeneration occurred either by primary cortical healing (in perfectly immobilized titanium implants) or by a process similar to the endochondral ossification (in poorly immobilized titanium implants following accidental post-implantation bones fracture).     

Collagen-Carboxymethylcellulose Biocomposite Wound-Dressings with Antimicrobial Activity

Microbial infections associated with skin diseases are frequently investigated since they impact on the progress of pathology and healing. The present work proposes the development of freeze-dried, glutaraldehyde cross-linked, and non-cross-linked biocomposite dressings with a porous structure, which may assist the reepithelization process through the presence of collagen and carboxymethylcellulose, along with a therapeutic antimicrobial effect, due to silver nanoparticles (AgNPs) addition. Phisyco-chemical characterization revealed the porous morphology of the obtained freeze-dried composites, the presence of high crystalline silver nanoparticles with truncated triangular and polyhedral morphologies, as well as the characteristic absorption bands of collagen, silver, and carboxymethylcellulose. In vitro tests also assessed the stability, functionality, and the degradability rate of the obtained wound-dressings. Antimicrobial assay performed on Gram-negative (Escherichia coli), Gram-positive (Staphyloccocus aureus) bacteria, and yeast (Candida albicans) models demonstrated that composite wound dressings based on collagen, carboxymethylcellulose, and AgNPs are suitable for skin lesions because they prevent the risk of infection and have prospective wound healing capacity. Moreover, the cell toxicity studies proved that the obtained materials can be used in long time treatments, with no cytotoxic effects.     

Network of telocytes in the temporomandibular joint disc of rats

The phenotypes of the temporomandibular joint (TMJ) disc cells range from fibroblasts to chondrocytes. There are relatively few reported studies using transmission electron microscopy (TEM) to determine the ultrastructural features of these cells. It was hypothesized that at least a subpopulation of TMJ stromal cells could be represented by the telocytes, cells with telopodes. In this regard a TEM study was performed on rat TMJ samples. Collagen-embedded networks were found built-up by cells with telopodes with subplasmalemmal caveolae, moderate content in matrix secretory organelles and well-represented intermediate filaments. Appositions of cell bodies were found. Prolongations of such cells were closely related to nerves and microvessels. Our study indicates that the TMJ disc attachment seems equipped with telocytes capable of stromal signaling. However, further studies are needed to assess whether the telocytes belong to a renewed cell population derived from circulating precursors.     

The Role of Optical Coherence Tomography in Clarifying the Mechanisms for Dobutamine Stress Echocardiography‐Induced Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy is a clinical disorder characterized by a transient dilatation and akynesis or dyskinesis of the left ventricular (LV) apex, mimicking an anterior wall acute myocardial infarction in the absence of significant coronary artery disease (CAD). It typically occurs during an episode of severe emotional or physical stress. Recent reports suggested the potential of dobutamine stress echocardiography (DSE) in inducing the aforementioned syndrome. The transient dysfunction of the LV does not fit any known coronary distribution. Furthermore, there is no obstructive CAD demonstrated at angiography to account for the observed dysfunction. Consequently, the pathophysiology of this syndrome is still undetermined. Here, we report a case of DSE‐induced Takotsubo cardiomyopathy in which high‐resolution intracoronary imaging was utilized to exclude possible vessel alterations to help provide potential mechanistic explanations for the development of this condition.     

Balancing orbital volume reduction and redistribution for a tailored surgical treatment in Graves’ ophthalmopathy

Graefe's Archive for Clinical and Experimental Ophthalmology - The purpose of this study is to share our experience on the use of different orbital decompression techniques, as well as the...