Analyseversuch der anatomischen veränderungen am rheuma-vorfuß und der biomechanischen folgen der resektion von metatarsalköpfchen

Zusammenfassung Deformitäten des Vorfußes hgen von verschiedenen mechanischen Faktoren ab sowie von der anatomischen Struktur des Fußes und der Suffizienz der einzelnen statisch-dynamischen Elemente. Die cP befällt primär die kleinen Gelenke und beschleunigt die deformativen Prozesse des Vorfußes. In einer Literaturiibersicht und anhand eigener Beobachtungen werden die verschiedenen Ursachen der Deformitäten analysiert, und die biomechanischen Konsequenzen nach Resektion der Metatarsalköpfchen werden aufgezeigt.

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An analysis of the anatomical changes of the RA forefoot and the biomechanical consequences after the resection of the metatarsal heads

Summary Deformities of the forefoot depend on various mechanical factors as well as on the anatomical structure of the foot and the sufficiency of its individual static-dynamics elements. RA affects primarily the small joints and at the some time accelerates the deformative process of the forefoot. Reviewing literatur and using his own observations as a basis the author discusses various causes of deformities and conducts an analysis of the biomechanical consequences after the resection of the metatarsal heads.

     

P21WAF1, P27KIP1, TP53 and C-MYC analysis in 204 ovarian carcinomas treated with platinum-based regimens.

BACKGROUND: The prognostic and predictive value of cell cycle regulatory proteins in ovarian cancer has not been established. We evaluated the clinical and biological significance of P21(WAF1), P27(KIP1), C-MYC, TP53 and Ki67 expressions in ovarian cancer patients. MATERIALS AND METHODS: Immunohistochemical analysis was performed on 204 ovarian carcinomas of International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IV treated with platinum-based chemotherapy. Multivariate analysis with Cox and logistic regression models was performed in the whole group, and in the TP53-negative and TP53-positive subgroups. RESULTS: High P21(WAF1) labeling index (LI) was an independent positive predictor of platinum-sensitive response (P = 0.02). Overall survival was positively influenced by P21(WAF1) LI (P = 0.02) or by P21(WAF1) plus P27(KIP1) LI (P = 0.004) in the TP53-negative group only. Ki67 LI showed borderline association with disease-free survival (P = 0.05). Growth fraction was negatively associated with P21(WAF1) and P27(KIP1) indices in the TP53-negative group (P = 0.023 and 0.008, respectively), and these associations were borderline or lost in the TP53-positive group. Endometrioid and clear cell carcinomas differed from other carcinomas by having a low incidence of TP53 accumulation, a high incidence of C-MYC overexpression (70%) and a low median Ki67 LI (all with P <0.001). CONCLUSIONS: We have shown an independent predictive value of P21(WAF1) LI in ovarian carcinoma patients. The prognostic value of P21(WAF1) and P21(WAF1) plus P27(KIP1) LI was determined by TP53 status. A high frequency of C-MYC overexpression in endometrioid and clear cell carcinomas may suggest its role in the development of these tumor types.     

Update on Biologic Therapy in the Management of Axial Spondyloarthritis

Axial spondyloarthritis, which includes ankylosing spondylitis and psoriatic spondyloarthritis, is an important subtype of the spondyloarthritides. Tumor necrosis factor (TNF) antagonists are effective therapies for this partially heterogeneous group of rheumatic diseases in terms of signs, symptoms, and functioning, but they do not seem to substantially inhibit radiographic progression, which is mainly new bone formation in ankylosing spondylitis. However, they clearly reduce inflammation, as shown by MRI. TNF blockers are also efficacious in the treatment of extraspinal features of spondyloarthritis. In addition, evidence indicates that anti-TNF therapy works well in early axial disease. Other biologics are currently being investigated, as alternatives are needed for patients who fail anti-TNF therapy.     

Synthese und Acylierungen des 1-Hydroxylamino-adamantans 43. Mitt. über Hydroxylamin-Derivate

Synthesis and Acylations of 1-Hydroxylamino-adamantane 1-Benzoyloxy-adamantane obtained from 1-amino-adamantane and dibenzoyl peroxide could be hydrolyzed to azoxy-1,1′-adamantane and 1-hydroxylamino-adamantane. The latter was transferred to various acyl-derivatives.     

Highly Epidemic Strains of Methicillin-Resistant Staphylococcus aureus Not Distinguished by Capsule Formation, Protein A Content or Adherence to HEp-2 Cells

 In order to investigate whether highly epidemic methicillin-resistant Staphylococcus aureus (EMRSA) strains possess special properties that favour their dissemination and survival, a study was undertaken that examined methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus isolated in the UK. Included in the study were EMRSA types 1, 2, 3, 15 and 16. Phage types EMRSA-15 and -16, in particular, have emerged as significant hospital pathogens in the UK, resisting standard methods of control and spreading widely, while the incidence of other epidemic types has either declined or not changed. All of the strains included in the study were examined for capsule formation, the amount of bound protein A produced, and quantitative adherence to the human continuous epithelial cell line HEp-2. Although all of these properties varied amongst the strains examined, there was no relationship between any of them and methicillin resistance or epidemic type and, incidentally, no relationship between cell wall-bound protein A content and adherence.     

Characteristics of rhegmatogenous retinal detachment in pseudophakic and phakic eyes

AimsTo investigate whether pseudophakic and phakic rhegmatogenous retinal detachment (RRD) patterns differ.MethodsRetrospective review of electronic database of patients, aged 50 years or over, presenting to our vitreoretinal service. Data included baseline characteristics, digital drawings, and outcomes. Retinal drawings were analysed in a masked fashion for site, size, and number of retinal breaks. Comparisons were made between the following groups and subgroups: pseudophakic eyes, phakic eyes, phakic eyes with cataract, and phakic eyes without cataract.ResultsOf 500 eyes included, 146 were pseudophakic; 177 of the phakic eyes had cataract. The following were significant by univariate analysis: pseudophakic patients were older than phakic patients in general, but the same age as patients with cataract; in the pseudophakic group, there were lower proportions of females and of patients presenting with vitreous haemorrhage or with large or superotemporal breaks; higher proportions of pseudophakic eyes had small breaks and inferonasal breaks. Some differences remained significant when comparing pseudophakia eyes with cataract. Multivariate analysis comparing pseudophakia with phakia confirmed a lower chance in pseudophakia of large breaks, vitreous haemorrhage and superotemporal breaks, but higher chance of detached inferior breaks. Some variables were age dependent.ConclusionDifferences were found between pseudophakic and phakic RRD patterns. These suggest special pathogenetic mechanisms in pseudophakic retinal detachment, which could help explain increased incidences of RRD after cataract surgery.