Fatal paraneoplastic embolisms in both circulations in a patient with poorly differentiated neuroendocrine tumour.

Arterial embolism with lower limb ischemia is a rare manifestation of paraneoplastic hypercoagulability in cancer patients. We report a unique case of fatal thromboembolism involving both circulations associated with a poorly differentiated neuroendocrine tumor of the lung with rapid progress despite high doses of unfractioned heparin and review the current literature on anticoagulative regimen in tumour patients.

Clinical characteristics of pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Northern Bavaria, Germany.

Background: The 2009 pandemic influenza A (H1N1) (PIA) virus infected large parts of the pediatric population with a wide clinical spectrum and an initially unknown complication rate. The aims of our study were to define clinical characteristics and outcome of pandemic influenza A (H1N1) 2009-associated hospitalizations (PIAH) in children <18 years of age. All hospitalized cases of children <18 years of age with laboratory-confirmed pandemic influenza A (H1N1) 2009 in the region of Wuerzburg (Northern Bavaria, Germany) between July 2009 and March 2010 were identified.

In situ guided tissue regeneration in musculoskeletal diseases and aging : Implementing pathology into tailored tissue engineering strategies.

In situ guided tissue regeneration, also addressed as in situ tissue engineering or endogenous regeneration, has a great potential for population-wide "minimal invasive" applications. During the last two decades, tissue engineering has been developed with remarkable in vitro and preclinical success but still the number of applications in clinical routine is extremely small. Moreover, the vision of population-wide applications of ex vivo tissue engineered constructs based on cells, growth and differentiation factors and scaffolds, must probably be deemed unrealistic for economic and regulation-related issues.

Popliteal entrapment syndrome caused by fibular osteochondroma.

Osteochondromas are the most common tumors of bone. In adolescence, they usually present as a painless growing mass. Femoropopliteal vascular complications associated with an osteochondroma are rare, with most cases involving pseudoaneurysms.

Explantation of totally implantable venous access ports of the forearm: reasons for removal and observed complications.

Purpose: To evaluate indications for, and complications during, explantation of interventionally placed totally implantable venous access ports (TIVAPs) of the forearm.

Background: Many studies analyze the explantation procedure of pectorally placed TIVAPs. The literature on TIVAPs in the forearm is limited, and the explantation procedure of these devices in the forearm has not been sufficiently evaluated yet.

Composition of OSCS-contaminated heparin occurring in 2008 in batches on the German market.

In 2008, some 900 cases of adverse events associated with the use of heparin were reported to the Food and Drug Administration of USA and the Federal Institute of Drugs and Medical Devices in Germany. 238 patients died from heparin in the USA. In March 2008, oversulfated chondroitin sulfate (OSCS) was identified to be responsible for these cases.

Reoperations after gastric banding: replacement or alternative procedures?

Background: Laparoscopic gastric banding (LAGB) is the most popular surgical procedure for morbid obesity in Europe. Long-term complications like slippage of the band or pouch dilatation are well known and lead to reoperations in a substantial number of patients. In this study, results and follow-ups of patients with reoperations after gastric banding were analyzed.

Comparison of 60cobalt and 192iridium sources in high dose rate afterloading brachytherapy.

Purpose: (60)Co sources with dimensions identical to those of (192)Ir have recently been made available in clinical brachytherapy. A longer half time reduces demands on logistics and quality assurance and perhaps costs.

Material And Methods: Comparison of the physical properties of (60)Co and (192)Ir with regard to brachytherapy.

Who benefits from gastric banding?

Background: In the present study, criteria were investigated to predict major benefit after laparoscopic adjustable gastric banding (LAGB).

Materials And Methods: 85 morbidly obese patients were operated with LAGB between 1999 and 2005. Seventy-one of these patients were analyzed according to several possible predictive characteristics for success as the primary endpoint.

Anti-cancer therapies targeting the tumor stroma.

For anti-tumor therapy different strategies have been employed, e.g., radiotherapy, chemotherapy, or immunotherapy.

Precision of image-guided radiotherapy (IGRT) in six degrees of freedom and limitations in clinical practice.

Purpose: To evaluate the precision of image-guided radiotherapy (IGRT) using cone-beam computed tomography (CB-CT) for volume imaging and a robotic couch for correcting setup errors in six degrees of freedom.

Patients And Methods: 47 consecutive patients with 372 fractions were classified according to whether a patient fixation device was used (pat(fix): n = 28) or not (pat(non-fix): n = 19). Prior to treatment a CB-CT was acquired and translational and rotational setup errors were corrected online without an action level using a robotic couch (HexaPOD).

Is a single respiratory correlated 4D-CT study sufficient for evaluation of breathing motion?

Purpose: Respiratory correlated computed tomography has been shown to be effective for evaluation of breathing-induced motion of pulmonary tumors. This study investigated whether a single four-dimensional CT study (4D-CT) is representative and sufficient for treatment planning in stereotactic body radiotherapy (SBRT).

Methods And Materials: Four repeated helical 4D-CT studies were acquired every 10 min for 10 patients with 14 pulmonary metastases.

Depression as a manifestation of latent chronic hypoparathyroidism.

The exact cause of depression in cases of hypoparathyroidism is not known. We report the first case of an elderly patient with a long history of major depression as a complication of an undiagnosed chronic hypoparathyroidism following surgery on a parathyroid adenoma. Her depression was completely eliminated by calcium supplementation therapy to restore the calcium homeostasis in serum.

Intra-fractional uncertainties in cone-beam CT based image-guided radiotherapy (IGRT) of pulmonary tumors.

Purpose: Intra-fractional variability of tumor position and breathing motion was evaluated in cone-beam CT (CB-CT) based image-guided radiotherapy (IGRT) of pulmonary tumors.

Materials And Methods: Twenty-four patients (27 lesions: prim. NSCLC n=6; metastases n=21) were treated with stereotactic body radiotherapy (SBRT) (one to eight fractions).

Left ventricular non-compaction associated with a genetic variant of the CYP2C9 gene.

Polymorphisms in the CYP2C9 gene can have a significant impact on drug therapy by affecting the pharmacokinetics of frequently prescribed drugs, such as phenprocoumon and warfarin. It is essential therefore that genetic CYP2C9 variants are excluded in patients with a suspected intolerance of anticoagulant therapy. Here we present the first report of a case of left ventricular non-compaction syndrome associated with a genetic variant of the CYP2C9 gene in a 45-year-old woman with myocardial insufficiency who was scheduled for implantation of a cardioverter defibrillator.

The influence of the weather and the phase of the moon on post-operative nausea and vomiting.

Background: Post-operative nausea and vomiting (PONV) is believed and previously reported to be influenced by the weather and the phase of the moon. We therefore determined the effects of specific and general weather patterns as well as the lunar phase on PONV in adults undergoing balanced inhalation anaesthesia.

Methods: The incidence of PONV was prospectively evaluated in 1801 patients undergoing elective surgical, urologic and head and neck procedures.

Influence of curing methods and matrix type on the marginal seal of class II resin-based composite restorations in vitro.

This study determined the influence of light curing protocols and matrix type on the margin quality and marginal seal of Class II resin-based composite restorations. In extracted human molars, box-shaped MOD cavities with 1 mm wide interproximal bevels were prepared with cervical margins located at least 1 mm coronal to the cemento-enamel junction. The prepared teeth were mounted in a jig featuring artificial training teeth that served as adjacent teeth.

Muscle-derived positive and negative regulators of the immune response.

Purpose Of Review: Recent characterization of the expression and functioning of muscle-derived positive and negative regulators of the immune response will be highlighted in view of the concept that muscle cells can act as facultative antigen-presenting cells and should be considered as active participants rather than passive targets of immune reactions.

Recent Findings: Although lacking detectable major histocompatibility complex expression under physiologic conditions, under pathologic conditions muscle cells can express a variety of immunologically important molecules. Advances were made in characterizing the expression and functioning of classical and nonclassical major histocompatibility complex, adhesion, and costimulatory molecules.

Tumor stroma-associated antigens for anti-cancer immunotherapy.

Immunotherapy has been widely investigated for its potential use in cancer therapy and it becomes more and more apparent that the selection of target antigens is essential for its efficacy. Indeed, limited clinical efficacy is partly due to immune evasion mechanisms of neoplastic cells, e.g.

State-of-the-art in phosphoproteomics.

Presently, phosphorylation of proteins is the most studied and best understood PTM. However, the analysis of phosphoproteins and phosphopeptides is still one of the most challenging tasks in contemporary proteome research. Since not every phosphoprotein is accessible by a certain method and identification of the phosphorylated amino acid residue is required in the majority of cases, various strategies for the detection and localization of phosphorylations have been developed.

The human platelet membrane proteome reveals several new potential membrane proteins.

We present the first focused proteome study on human platelet membranes. Due to the removal of highly abundant cytoskeletal proteins a wide spectrum of known platelet membrane proteins and several new and hypothetical proteins were accessible. In contrast to other proteome studies we focused on prefractionation and purification of membranes from human platelets according to published protocols to reduce sample complexity and enrich interesting membrane proteins.

Challenges in mass spectrometry-based proteomics.

During the last decade, protein analysis and proteomics have been established as new tools for understanding various biological problems. As the identification of proteins after classical separation techniques, such as two-dimensional gel electrophoresis, have become standard methods, new challenges arise in the field of proteomics. The development of "functional proteomics" combines functional characterization, like regulation, localization and modification, with the identification of proteins for deeper insight into cellular functions.

Influence of curing methods and materials on the marginal seal of class V composite restorations in vitro.

The study tests the hypothesis that soft-start irradiation improves, whereas, high intensity irradiation compromises the margin quality and marginal seal of Class V resin based composite [RBC] restorations. Box-shaped Class V cavities were prepared in extracted, human third molars with cervical margins located apical to the CEJ. Cavities were restored using a multi-step bonding agent (Optibond FL, Kerr), a thin layer of flowable resin composite and two increments of fine hybrid resin composite (Filtek Flow/Filtek Z250, 3M ESPE; Revolution f2/Herculite XRV, Kerr).

Guidance of shrinkage vectors vs irradiation at reduced intensity for improving marginal seal of class V resin-based composite restorations in vitro.

This study evaluated the influence of radiation intensity on polymerization of a resin-based composite (RBC) and compared the influence of guidance of shrinkage vectors vs irradiation at reduced light intensity on the marginal seal of Class V RBC restorations in vitro. The degree of cure was studied indirectly by measuring the Vickers hardness (1.96 N, 30 seconds) at the bottom of disc-shaped specimens 2 mm in height at different periods of time after light irradiation.