Untersuchungen über das Verhalten einiger nichtionisierbaren oberflächenaktiven Tumorauslösersubstanzen zum Kollagen des Dermas beim Kaninchen

Summary A study was made of the behaviour of certain selected non-ionic surface active agents (sorbitan fatty acid esters, and polyoxyethylene sorbitan fatty acid esters) — both those found to be highly potent tumour promoters, and those which were ineffective — towards skin collagen of the rabbit. Collagen obtained from rat tail tendons served as further comparison.First some motivations are given about the reasons why the present investigation was carried out.The composition of the amino acids of the presipitated collagen was analyzed paperchromatographically. The molecular structure of the collagen was studied with wide-angle X-ray diffraction technique as well as infra-red spectrographically. The appearance of the corresponding cutaneous structures was examined histologically.It was demonstrated that no compounds tested (not even the most potent tumour promoter) produced any detectable alterations in the skin collagen of the rabbit.The results are discussed with special emphasis on the observation that the new type tumour promoters exert the effect by way of their molecular orientation rather than by chemical means.

---

---

Mit 5 Textabbildungen

---

Diese Untersuchung wurde teilweise unterstützt durch Zuschüsse von folgenden Institutionen und Fonds: Aus den Vereinigten Staaten von Amerika National Institutes of Health, Public Health Service, Forschungsstipendium C-2930 M & G, erteilt nach Empfehlung des National Advisory Cancer Council, und Damon Runyon Memorial Fund for Cancer Research, Inc., Forschungsstipendium DRG-292; aus Finnland Pehr Oscar Klingendahl Foundation, Sigrid Juselius' stiftelse, Unterrichtsministerium des finnischen Staates und Staatliche naturwissenschaftliche Kommission.     

Meconium aspiration induces neuronal injury in piglets

Aim: Meconium aspiration-induced hypertensive lung injury, especially when connected with perinatal asphyxia, has been associated with brain damage. We aimed to determine the neuronal injury induced by pulmonary meconium contamination alone and with concurrent asphyxia. Methods: 36 anaesthetized and ventilated newborn piglets were haemodynamically monitored for 6 h. Seven piglets without concurrent asphyxia and seven piglets with asphyxia were instilled with a bolus of human meconium intratracheally. Seven piglets had only asphyxia and 15 piglets served as controls. The brains were studied histologically. Results: Meconium aspiration did not change systemic haemodynamics acutely, while its combination with asphyxia diminished the abrupt postasphyxic systemic hypertensive peak and resulted in a transient increase in carotid artery flow, not seen after isolated asphyxia. Systemic pressure declined after 4 h in all insulted groups, but only isolated asphyxia was associated with a sustained decrease in carotid artery flow. Arterial oxygenation remained normal, except during the acute insults. Brain examination after meconium instillation indicated neuronal injury, especially in the CA3 region of the hippocampus. Asphyxia resulted in neuronal injury in the cortical, cerebellar and hippocampal hilus regions.
Conclusion: Severe meconium aspiration itself may result in hippocampal neuronal injury.     

Childhood adversities experienced by working-aged coronary heart disease patients

OBJECTIVE: The aim of this study is to investigate associations between childhood adversities and coronary heart disease (CHD). METHODS: This was a case-control study based on a postal questionnaire addressed to randomly selected working-aged Finns, and response rate was 39% (N = 15,477). The sample comprised 319 CHD patients. Four age- and gender-matched controls were selected for every patient. The participants were asked in six questions to think about their childhood adversities. RESULTS: Fear of some family member and someone in the family being seriously or chronically ill were more common during childhood among working-aged CHD patients than among controls. Likewise, among female CHD patients, serious conflicts in the family and someone in the family having had alcohol problems and, among male CHD patients, long-lasting financial problems were more common than among controls. Odds ratios (OR) varied between 1.27 and 2.66. Adjustment for education had no influence among women, but it had an influence among men. Upon adjustment for conventional risk factors (smoking, obesity, and hypertension), the association mostly disappeared. A family member having been seriously or chronically ill was statistically significant after full adjustment among both genders. CONCLUSION: Working-aged CHD patients have experienced more dramatic events during their childhood than did the control population. This issue cannot be solved in doctors' offices. Health-promoting social policies are of vital importance.     

Nursing students' knowledge of and views about children in pain

It is important to evaluate the outcomes of the given education to gain knowledge about the abilities of our students to meet the needs of nursing practice. Pain associated with different illnesses and procedures is one of the most common symptoms that children experience in the hospital. The purpose of this study was to evaluate the views and knowledge base of graduating nursing students in the area of taking care of children in pain. The data were collected with a purpose-designed Likert-type instrument from all nursing students that graduated during one year from the child nurse specializing program in Finland (n = 85), with a response rate of 86%. Results indicate that students have mainly positive views and attitudes towards taking care of children in pain. The views and attitudes differ when older and younger students and students from different schools are compared. Students lack knowledge especially in the area of pain medications as well as in the assessment of pain. In the knowledge section, the results did not differ greatly when different schools, younger and older students or previous working experience and no working experience were compared. In some of the researched schools, many of the students felt a lack of confidence about their knowledge. There is a need for more detailed education in the area of taking care of children with pain.     

Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study.

This randomized study assessed if intravenous iron improves hemoglobin (Hb) response and permits decreased epoetin dose in anemic (Hb 9-11 g/dl), transfusion-independent patients with stainable iron in the bone marrow and lymphoproliferative malignancies not receiving chemotherapy. Patients (n=67) were randomized to subcutaneous epoetin beta 30 000 IU once weekly for 16 weeks with or without concomitant intravenous iron supplementation. There was a significantly (P<0.05) greater increase in mean Hb from week 8 onwards in the iron group and the percentage of patients with Hb increase >or=2 g/dl was significantly higher in the iron group (93%) than in the no-iron group (53%) (per-protocol population; P=0.001). Higher serum ferritin and transferrin saturation in the iron group indicated that iron availability accounted for the Hb response difference. The mean weekly patient epoetin dose was significantly lower after 13 weeks of therapy (P=0.029) and after 15 weeks approximately 10 000 IU (>25%) lower in the iron group, as was the total epoetin dose (P=0.051). In conclusion, the Hb increase and response rate were significantly greater with the addition of intravenous iron to epoetin treatment in iron-replete patients and a lower dose of epoetin was required.     

Liposome-encapsulated doxorubicin in combination with standard agents (cyclophosphamide, vincristine, prednisone) in patients with newly diagnosed AIDS-related non-Hodgkin's lymphoma: results of therapy and correlates of response.

PURPOSE: To evaluate the safety and efficacy of liposomal doxorubicin (Myocet; Medeus Pharma Ltd, Herts,UK) when substituted for doxorubicin in the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, prednisone) in patients with newly diagnosed AIDS-related non-Hodgkin's lymphoma (AIDS-NHL). Secondary objectives were to assess the impact of HIV viral control on response and survival, and to correlate MDR-1 expression with outcome. PATIENTS AND METHODS: Liposomal doxorubicin at doses of 40, 50, 60, and 80 mg/m(2) was given with fixed doses of cyclophosphamide, vincristine, and prednisone every 21 days. All patients received concurrent highly active antiretroviral therapy. NHL tissues were evaluated for multidrug resistance (MDR-1) expression. RESULTS: Twenty-four patients were accrued. 67% had high or high-intermediate International Prognostic Index scores; the median CD4 lymphocyte count was 112/mm(3) (range, 19/mm(3) to 791/mm(3)). No dose-limiting toxicities were observed at any level, with myelosuppression being the most frequent toxicity. Overall response rate was 88%, with 75% complete responses (CRs), and 13% partial responses. The median duration of CR was 15.6+ months (range, 1.7 to 43.5+ months). Effective HIV viral control during chemotherapy was associated with significantly improved survival (P =.027), but CRs were attained independent of HIV viral control. MDR-1 expression did not correlate with response, suggesting that the liposomal doxorubicin may evade this resistance mechanism. CONCLUSION: Liposomal doxorubicin in combination with cyclophosphamide, vincristine, and prednisone is active in AIDS-NHL, with complete remissions achieved in 75% independent of HIV viral control or tissue MDR-1 expression. HIV viral control is associated with a significant improvement in survival. Additional studies are warranted.     

Ascorbic acid against reperfusion injury in human renal transplantation

The cadaveric renal graft is exposed to ischaemic injury during preservation and to oxidative damage during reperfusion. Both these mechanisms are known to cause cell damage, which may impair graft function. Reperfusion injury (RPI) is mediated by reactive oxygen species (ROS). Ascorbic acid (AA) is a potent physiological extracellular scavenger of ROS. We perfused 31 renal grafts immediately before implantation with a solution of Euro-Collins containing 0.5 mg/ml of AA to diminish RPI. From every donor, the contralateral kidney served as a control. The control grafts were perfused with the same perfusion as those of the AA group, only without the AA substitution. We assessed the effect of AA by recording serum creatinine, creatinine clearance, initial graft function and early rejections. The incidence of delayed graft function (DGF) was 32% in the AA group, and 29% in the control group. Other parameters were also similar in both groups, except for the length of DGF, which showed a trend towards a shorter duration in the AA group. The pre-operative systemic AA concentration was significantly ( P=0.01) lower in the haemodialysis patients than in those on peritoneal dialysis. In conclusion, this clinical study could not demonstrate significant benefits of AA in renal transplantation.