TACE can be used for sufficient downstaging of liver metastatic lesions of breast cancer to allow laser-induced thermotherapy. A combination of mitomycin C and gemcitabine seems to improve the reduction achieved with TACE.

Background:To evaluate a treatment protocol with repeated transarterial-chemoembolisation (TACE) downsizing before MR-guided laser-induced interstitial thermotherapy (LITT) using different chemotherapeutic combinations in patients with unresectable colorectal cancer (CRC) liver metastases.Methods:Two hundred and twenty-four patients were included in the current study. Transarterial-chemoembolisation (mean 3.4 sessions per patient) was performed as a downsizing treatment to meet the LITT requirements (number⩽5, diameter <5 cm). The intra-arterial protocol consisted of either Irinotecan and Mitomycin (n=77), Gemcitabine and Mitomycin (n=49) or Mitomycin alone (n=98) in addition to Lipiodol and Embocept in all patients. Post TACE, all patients underwent LITT (mean 2.2 sessions per patient).Results:Overall, TACE resulted in a mean reduction in diameter of the target lesions of 21.4%. The median time to progression was 8 months, calculated from the start of therapy and the median local tumour control rate was 7.5 months, calculated as of therapy completion. Median survival of patients calculated from the beginning of TACE was 23 months (range 4–110 months), in patients treated with Irinotecan and Mitomycin the median was 22.5 months, Gemcitabine and Mitomycin 23 months and Mitomycin only 24 months with a statistically significant difference between the groups (P<0.01).Conclusion:Repeated TACE offers adequate downsizing of CRC liver metastases to allow further treatment with LITT. The combined treatment illustrates substantial survival rates and high local tumour control with statistically significant differences between the three protocols used. Further randomised trials addressing the current study results are required.

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Introduction: For clinical assessment of neoadjuvant radiochemotherapy of esophageal cancer reliable in-vivo methods are necessary. Therefore, the capabilities of F-18-Fluorodesoxyglucose-PET in comparison to histomorphological grading of tumor regression were studied. Methods: In 33 patients with locally advanced esophageal carcinoma (uT3, uN0-1, cM0) F-18-FDG-PET was performed before and 2 weeks after radiochemotherapy. All tumors were resected by transthoracic en-bloc esophagectomy 3-4 weeks after induction therapy. A subgroup of 11 patients underwent weekly PET scan during neoadjuvant therapy. PET was performed in a dedicated scanner 1.3 h after administration of 370 MBq F-18-FDG. Data analysis based on maximum SUV data derived from individual regions of interest in pre-and posttherapeutic images. PET data were compared to histomorphological grading parameters for tumor regression whithin the resected tissues. Results: The comparison of histopathological tumor regression after neoadjuvant therapy and PET SUV differences showed a significant χ 2 P -value of 0.006. There was a significant decrease of the SUV data from 9.1±3.5 to 4.3±1.9 (P <0.0001). In therapy responders SUV was diminished by 59 % and in non-responders by 34 %. Longitudinal SUV measurement during neoadjuvant therapy showed a strong SUV decrease already after one and two weeks (P =0.021 and 0.003). Conclusion: The recent data of the FDG-PET follow-up after neoadjuvant therapy show that PET is able to predict therapy response. Longitudinal PET data advocate that it may be possible to recognize response also very early during radiochemotherapy.

Background Septic arthritis often occurs in young calves when the passive transfer of maternal immunoglobulins has failed, which results in hypogammaglobulinaemia in the calf. Another important cause is suboptimal herd health management which often leads to general health impairment and, subsequently, to septic arthritis. Case presentation A dairy farmer consulted the Herd Health Service of the University Clinic reporting general herd health impairment, a high incidence of respiratory diseases, unsatisfactory weight gain and arthritis in calves, as well as mastitis and high milk cell counts. Clinical examinations were performed, and diagnostic measures were taken. A transtracheal lavage (TTL) was performed, and synovial swab samples were taken from the carpal joint and the subcutaneous tarsal bursae of two calves. Microbiological examinations of synovial swabs revealed co-infections of Trueperella pyogenes and Helcococcus ovis in one calf and Helcococcus ovis in pure culture in the other. The TTLs confirmed the presence of Mycoplasma spp. associated with respiratory diseases. Conclusions Helcococcus ovis is currently regarded as a co-infective bacterial agent. However, it seems to play a significant role as the primary pathogen in this case.

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