Reduced tumor growth in vivo and increased c-Abl activity in PC3 prostate cancer cells overexpressing the Shb adapter protein

Background  

Induction of apoptosis is one strategy for treatment of prostate cancer. The Shb adapter protein has been found to regulate apoptosis in various cell types and consequently human prostate cancer 3 (PC3) cells were transfected to obtain cells overexpressing Shb in order to increase our understanding of the mechanisms regulating PC3 cell apoptosis.     

Winkelstabile Plattenfixation

There are fundamental biomechanical differences between fixed-angle plate systems, also referred to as internal fixators, and conventional plate-screw fixation systems. Fixed-angle systems have rapidly gained widespread acceptance in recent years for almost all indications and anatomical sites. This contribution presents tips and tricks on their implantation and on the management of complications. Much of the information has already been presented elsewhere, in print or orally. Some of it is based on the authors’ own experience in their hospitals. The tips and tricks presented here are intended to help surgeons find pragmatic solutions to intraoperative problems.     

Diagnostische videoassistierte Thorakoskopie

Modern radiologic diagnostics show a variety of pathological changes in the mediastinum, pleura, and lung but no evidence on their histogenesis. Transbronchial and transthoracal fine-needle aspiration biopsy usually cannot yield detailed diagnostic results because of its small size. Sufficient and representative material can be obtained by thoracoscopy. Video-assisted thoracoscopy allows safe and fast diagnosis of diffuse lung diseases, pleural diseases including malignant mesothelioma, indeterminate peripheral lung nodule, and mediastinal masses. This gentle diagnostic method can give invaluable information guiding further management of the thoracic injury. Video-assisted thoracoscopy is a safe and effective guiding tool if performed by experienced thoracic surgeons able to convert to thoracotomy. It is to be noted that interpretation of intraoperative findings plays a decisive role in interdisciplinary diagnostics of intrathoracal diseases.     

Die Skelettszintigraphie beim neu diagnostizierten Prostatakarzinom

ZusammenfassungHintergrund Die Indikationsstellung zur Skelettszintigraphie beim neu diagnostizierten, unbehandelten Prostatakarzinom ist kontrovers.Patienten und Methoden In der vorliegenden retrospektiven Studie untersuchten wir 406 Patienten, die unabhängig von PSA-Wert und Histologie eine Staging-Skelettszintigraphie erhielten. Aus dem Patientengut evaluierten wir verschiedene Leitlinien und Empfehlungen bezüglich ihrer Vorhersagekraft. Die Kosten wurden gemäß EBM und GOÄ kalkuliert. Bei der Klassifikation von Skelettmetastasen prüften wir die Einteilungen nach Soloway, Crawford und Rigaud.Ergebnisse Eine positive Skelettszintigraphie im Sinne einer Skelettmetastasierung fanden wir bei 41 (10%) der 406 Patienten. Die Leitlinie der EAU hat sich sowohl hinsichtlich ihrer klinischen Wertigkeit als auch der Kosteneffizienz als wertvollste Empfehlung herausgestellt. Als Klassifikationssystem erwies sich die Rigaud-Klassifikation den anderen Einteilungen überlegen.Schlussfolgerung Gemäß der EAU-Leitlinie 2005 scheint die Skelettszintigraphie bei asymptomatischen Patienten mit einem PSA>20 ng/ml (G1/G2) sowie unabhängig vom PSA-Wert bei einem G3-Karzinom und lokal fortgeschrittenem Tumor indiziert. Als bestes Klassifikationssystem für Skelettmetastasen im Skelettszintigramm erwies sich die Einteilung nach Rigaud.     

Cabergoline compared to levodopa in the treatment of patients with severe restless legs syndrome: results from a multi-center, randomized, active controlled trial.

We report the first large-scale double-blind, randomly assigned study to compare two active dopaminergic therapies for Restless Legs Syndrome (RLS), the dopamine agonist cabergoline (CAB) and levodopa/benserazide (levodopa). Patients with idiopathic RLS were treated with fixed daily doses of 2 or 3 mg CAB or 200 or 300 mg levodopa for 30 weeks. Efficacy was assessed by changes in the IRLS (International RLS Severity Scale) and by time to discontinuation of treatment due to loss of efficacy or augmentation. 361 of 418 screened patients (age 58 +/- 12 years, 71% females) were randomly assigned and treated (CAB: n = 178; levodopa: n = 183) in 51 centers of four European countries. Baseline IRLS total score was 25.7 +/- 6.8. The baseline-adjusted mean change from baseline to week 6 in IRLS sum score was d = -16.1 in the CAB group and d = -9.5 in the levodopa group (d = -6.6, P < 0.0001). More patients in the levodopa group (24.0%) than in the CAB group (11.9%, P = 0.0029, log-rank test) discontinued because of loss of efficacy (14.2% vs. 7.9%, P = 0.0290) or augmentation (9.8% vs. 4.0%, P = 0.0412). Adverse events (AEs) occurred in 83.1% of the CAB group and in 77.6% of the levodopa group. In both groups, most frequent AEs were gastrointestinal symptoms (CAB: 55.6%, levodopa: 30.6%, P < 0.0001). This first large-scale active controlled study in RLS showed superior efficacy of cabergoline versus levodopa after a 30-week long-term therapy. Tolerability was found more favorable with levodopa than with cabergoline.     

Tissue engineering of bone for mandibular augmentation in immunocompetent minipigs: preliminary study.

Large mandibular defects caused by trauma, infection or resection of a tumour are still a major problem for plastic and maxillofacial surgeons. The modern concept of tissue engineering combines the osteoinductive effects of osteogenic cells with a suitable scaffold structure to promote differentiation of osteoblasts and optimal matrix production. Critical size mandibular bone defects were therefore made to investigate the osteogenic potential of periosteal cells and a bioabsorbable polymer fleece (Ethisorb 510) in minipigs. Periosteal cells were isolated from four minipigs, expanded in vitro and seeded with fibrin glue into Ethisorb 510 fleeces. Tissue constructs were used to repair critical size mandibular defects and compared with two minipigs with untreated bone defects. Bone healing was evaluated after 90 and 180 days by radiographs and a histological scoring system. The radiographs showed increased radiodensity of defects filled with the cell-fibrin-fleece-constructs compared with the untreated control group after 90 and 180 days in vivo. The defects repaired by the cell-fibrin-scaffolds (180 days in vivo) obtained the highest histological mean score 2.9 (range 2-3), while defects filled by cell-fibrin-scaffolds (90 days in vivo) achieved a mean score of 2.1 (range 2-3). In contrast, the control group (n = 2) scored 1 and 2. The results show that a combination of periosteal cells and polymer fleeces may be a promising approach for clinical mandibular augmentation.     

Komplikationen nach arthroskopischer Rotatorenmanschettennaht

Rotator cuff tears are increasingly treated arthroscopically, preferentially with suture anchors since a stable anchorage in bone is possible, simple and rapid. However, the restricted view, especially with longer operating times, conceals a danger of misplacement. Such risks can be determined rapidly with experience and should be corrected as soon as possible, e.g. through a change to open procedures. In our case report, the migration of a metal anchor could be corrected in a later operation and a revision of the re-rupture was then carried out using mini-open technique.