The chorioallantoic membrane (CAM) is a useful model for the fluorescence diagnosis of experimentally induced endometriosis. In our experimental setup 75.7% of the histologically examined tissue preparations were viable and only 24.3% showed signs of necrosis on the CAM after various periods of incubation. Best results were obtained when grafting to the CAM was performed between days 7 and 9 and when implants were left on the CAM for 3-5 days (P < 0.05). We were able to demonstrate that 5-aminolaevulinic acid (ALA) is stored selectively in ectopic endometrium. The subsequent fluorescence of the endometrium shows a rapid increase that reaches a peak after 10-14 h which can be clearly differentiated from the weaker fluorescence of grafted normal peritoneum and fimbriae (P < 0.01).
1. The carrier-mediated uptake of labelled 5-hydroxytryptamine (3H-5-HT) in rabbit platelets (defined as the difference between uptake observed in the absence and presence of 10 mumol l-1 imipramine) was studied after inhibition of monoamine oxidase and after a 1:13 dilution of the platelet-rich plasma (PRP) with Tris-containing buffer. 2. Irrespective of whether the rabbits were pretreated with reserpine or not, initial rates of 3H-5-HT uptake were maintained for at least 15 s. 3. Analysis of the saturation kinetics of 3H-5-HT uptake using Hill's equation yielded Km, Vmax and nH values of 130 nmol l-1, 116 pmol 10(8) platelets-1 min-1 and 1.40, respectively. Pretreatment of the animals with reserpine did not affect any of these kinetic parameters, but depleted more than 99% of the platelets' 5-HT stores. 4. The nH value remained greater than unity when the duration of incubation with 3H-5-HT was extended from 15 to 30 s and when the uptake of 3H-5-HT was inhibited by the presence of imipramine (10-40 nmol l-1). However, it was reduced to unity (with a consequential increase in Km) when 300 nmol l-1 ketanserin was present. This concentration of ketanserin did not affect 3H-5-HT uptake at substrate concentrations far below Km. 5. Imipramine inhibited 3H-5-HT uptake by increasing the Km for 3H-5-HT without changing Vmax. The Ki for this interaction was 18 nmol l-1.(ABSTRACT TRUNCATED AT 250 WORDS)
Inflammatory carcinoma has the highest mortality rate amongst the locally progressed cancers of the female breast. To define it, clinical, pathological and biological criteria have to be considered. The crucial finding is tumour-cell embolism in the subdermal lymphatics of the affected breast. 30 patients with inflammatory breast cancer were treated with three different concepts of therapy. In the first group, initial surgery (mastectomy with axillary dissection) was followed first by 6 cycles of chemotherapy, then by radiation of the thoracic wall, axilla and supraclavicular lymph nodes. The second concept included primary chemotherapy (6 cycles) with mastectomy/axillary dissection after the second or third cycles. In the third group, primary radiation of breast and axilla was performed, followed by 6 cycles of chemotherapy. From all three groups, 9 patients showed receptor-positive tumours; additional tamoxifen therapy (if postmenopausal) or GNRH-analogues (if premenopausal) were given. None of the three therapy managements could improve the average time of survival. Only the patients with hormonal therapy showed a better prognosis, which might well have been the result of a higher differentiation of the tumour. The study proves, that our efforts in therapy have so far been insufficient. Mastectomy, in particular as a psychically traumatizing procedure, fails to improve the patient's prognosis. It might regain its importance, when new, satisfactory methods of therapy of the systemic disease "inflammatory breast cancer" have been found. It is still uncertain, whether better prognosis can be achieved by a treatment with GNRH-analogues.
Wir berichten über eine 25jährige Patientin mit einem malignen Hämangioperizytom des Uterus. Sie wurde unter der Verdachtsdiagnose eines schnell wachsenden Uterus myomatosus mit begleitender Anämie zur operativen Therapie eingewiesen. Die histologische Diagnose eines malignen Hämangioperizytoms erfordert neben der Erfahrung des Pathologen eine differenzierte histologische und immunhistochemische Aufarbeitung des Tumors. Eine Aussage über die Dignität war im Schnellschnitt nicht sicher zu treffen. Der klinische Verlauf ist vielgestaltig und über die Behandlung dieser seltenen Tumorentität gibt es keine in Studien gesicherten Daten.
Bei eine r 19jäh rigen Erstgravida mit Gorlin-Goltz-Syndrom. einer selte ne n erblichen Erkrankung (1 : 57 000) , die geh äuft mit be nigne n. selten auch mit malignen Ovarialtumoren einherg eht. wurde in der 8. SSW retrouterin ein solider, stark vaskularisierte r Tumor von knapp 10 cm Durchmes ser festgestellt. 50nographi sch gesteuerte Stanzbiopsien in der 9. SSW ergaben fibromuskuläres Gewebe. In den folgend en Woch en zeigte der Tumor rasch e Wachstumstendenz und führte ab der 26.SSW bei sub jektivem Wohlbefinden zu ma ssivem Aszites , Pleuraerg üssen und ein em rechtsseitige n Harnstau 11.-111. 0. Trotz de s be nignen Biopsiebefundes und einer Pun ktionszytologie des Aszites ohn e Nachweis mal igner Zellen bestand in Anbetracht de r raschen Größenzunahme. d er ausgeprägten Ergußbildung und exzessiv angestiegener CA 12-5 Wer te über 4000 U/ml d er dringende Verdacht auf ein Malig no m. Unt e r Abwägung mütte rlicher und kindliche r Risiken wurde nac h medika me nt öse r Lungenreifung mit Betamethason in der 29.SSW der ele kt ive Kaise rsc hnitt per l ängsschn ittlapa rotomie vor ge no mme n. Nachfolgend w urde de r mass iv vas kular isierte und breitflächig mit Darm und Ute rus verwachse ne, ca. 20 cm große Tumor operativ entfernt. Histolog isch er gab sich ein zellreich es. wa hrsche inlich vo m rechten Ovar ausgeh e ndes leiomyom mit größe ren fibro ma töse n Anteilen. Anhand des Falles w ird das diagn ost ische und th erapeutische Vorgehen be i malignomverdächtigen Unterbauchtumoren in der Schwangerschaft diskutiert.
Background and Aims In the primary hyperoxalurias (PH; types 1-3) recurrent urolithiasis (UL) and/or progressive nephrocalcinosis (NC) are the clinical hallmarks. Three different enzyme defects lead to endogenous oxalate overproduction and to extremely elevated urinary oxalate excretion (UOx). Thus, it seems logical that urine is supersaturated for calcium-oxalate (CaOx). It was, hence, speculated that urinary CaOx saturation (ßCaOx), calculated by computed programs, is significantly higher as compared to that of patients with idiopathic CaOx stones. We now aimed to evaluate and calculate urinary ßCaOx in PH patients according to type, as well as in non-PH patients with UL or NC. Method The computed equilibrium program EQUIL2 was used for the calculation of ßCaOx. For this, 24 h urine specimen of 70 patients with non-PH NC (46 male, 24 female, median age 6.06 (range 0.3-31.4 years)), of 149 idiopathic CaOx UL (90/59 m/f, age 8.5 (0.1-68.6)), of 51 PH 1 patients (31/21, age 12.33 (0.8-63.8)), of 5 PH 2 patients (3/2, age 5.41 (4.3-12.9)) and of 14 PH 3 patients (8/6, age 8.5 (2.9-29.3)) were analyzed for all necessary components. All patients were in stable kidney function (eGFR > 45 ml/min). Results Uox was higher in the PH patients as compared to the non-PH UL or NC patients (p < 0.05). However, there was no statistical difference between the Uox in PH 1 vs PH 2 or PH 3 patients, although, a clear effect of B6 medication was visible in PH1 patients. Urinary calcium excretion was lower (not significant) in PH patients as compared to NC/UL. There was no difference in ßCaOx when PH were compared to non-PH patients and it mostly remained in the normal range. Conclusion Urine ßCaOx is similar in PH and non-PH stone formers. Therefore, calculation of ßCaOx using computed programs is not a reliable parameter to define the definitively extreme CaOx supersaturation of urine from PH patients. This miscalculation is related to a rather lowish urinary calcium excretion in PH as compared to other UL/NC patients. Therefore, we recommend not to use such programs to express the risk of recurrent stone disease or nephrocalcinosis in PH.
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