Current status of therapeutic targeting of developmental signalling pathways in oncology.

Signalling pathways such as Hedgehog (Hh), Wnt, Notch, bone morphogenetic protein (BMP) and transforming growth factor-β (TGF-β) hold a central position in regulation of vertebrate development by controlling vital processes such as migration, differentiation and proliferation. Insights into the mechanistic aspects of cancer initiation and progression have pointed to striking similarities between tumourigenesis and embryonic development. These observations can partly be explained by the fact that similar cellular signalling mechanisms are employed in both situations.

Fibrin formation is more impaired than thrombin generation and platelets immediately following cardiac surgery.

Introduction: Cardiac surgery performed on cardio-pulmonary bypass (CPB) may be complicated by coagulopathy and bleeding. This prospective observational study investigated the CPB-induced changes in thrombin generation, fibrin formation, and in the platelet component of the whole blood clot elasticity. The effects of haemostatic therapy with fresh frozen plasma (FFP) and platelet concentrate on these parameters were also evaluated.

A comparison of fibrinogen measurement methods with fibrin clot elasticity assessed by thromboelastometry, before and after administration of fibrinogen concentrate in cardiac surgery patients.

Background: Fibrinogen concentrate administration can be guided by measuring fibrinogen concentration or quality of the fibrin-based clot. This study compared different fibrinogen concentration measurement methods with maximum clot firmness (MCF) of the fibrin clot, assessed by thromboelastometry (FIBTEM), in 33 cardiovascular surgery patients receiving fibrinogen concentrate for hemostatic therapy.

Study Design And Methods: Blood samples were collected after cardiopulmonary bypass (CPB) and after fibrinogen concentrate administration.

Acquired type 2A von Willebrand syndrome caused by aortic valve disease corrects during valve surgery.

Background: Aortic valve (AV) defects can destroy high molecular weight multimers (HMWM) of von Willebrand factor (VWF), leading to acquired von Willebrand syndrome (aVWS) type IIA. This syndrome is considered a cause for increased perioperative bleeding in AV surgery. If diagnosed before operation, administration of VWF/FVIII concentrates is recommended.

Advances in photodynamic therapy for the treatment of hilar biliary tract cancer.

The prognosis of patients with nonresectable hilar biliary tract cancer (hBTC) is poor. Responsiveness to chemotherapy or radiochemotherapy is moderate at best, and patients are at a high risk of dying early from complications of local tumor infiltration (e.g.

[Pigment nevi in children].

Almost all fair-skinned children demonstrate one or more pigment nevi at the integument. These usually develop in the first two decades of life as a result of an endogenous disposition and exogenous stimulants. While most pigmented nevi are per se harmless, congenital and atypical (dysplastic) nevi are considered as precursors of melanoma and risk indicators.

Primary testicular lymphoma: a strictly homogeneous hematological disease?

Primary testicular lymphomas display mostly aggressive diffuse large cell B-cell lymphomas, which could be further subclassified into germinal center B-cell-like and an activated B-cell phenotype via immunohistochemistry. A retrospective analysis of primary testicular lymphomas diagnosed at the Institute of Pathology, Salzburger Landeskliniken (SALK) between January 1997 and December 2008 was done. Immunohistochemical staining and complete clinical data evaluation was carried out and linked to overall survival time.

Uptake and phototoxicity of meso-tetrahydroxyphenyl chlorine are highly variable in human biliary tract cancer cell lines and correlate with markers of differentiation and proliferation.

Photodynamic therapy (PDT) using Photofrin and, recently, Foscan has gained broad acceptance for palliative treatment of non-resectable cholangiocarcinoma (CC). No information, however, is available whether the phenotype of CC tumour cells has an effect on the efficiency of the treatment. Using a well-characterised set of n = 9 biliary tract cancer cell lines this study investigated the uptake, phototoxicity, and release of meso-tetrahydroxyphenyl chlorine (mTHPC, Foscan) after incubation with 200 or 400 ng ml(-1) mTHPC.

Active Wnt signalling is associated with low differentiation and high proliferation in human biliary tract cancer in vitro and in vivo and is sensitive to pharmacological inhibition.

Activation of developmental pathways has been recognized as a key mechanism for tumourigenesis and, hence, might be a valuable target for otherwise difficult to treat tumour entities such as biliary tract cancer (BTC). Therefore, we performed a comprehensive analysis of the Wnt signalling pathway in 9 BTC cell lines on cell blocks, xenograft tumours and on human tissue microarrays by real-time reverse transcription PCR and by immunochemistry. Furthermore, the effects of pharmacological pathway inhibition were investigated.

[Orogenital and conjunctival involvement in hereditary and autoimmune blistering diseases].

Chronic involvement of orogenital and conjunctival mucosa in the course of either genetically based (epidermolysis bullosa hereditaria) or auto-immunologically mediated (as for example pemphigus vulgaris, mucous membrane pemphigoid or epidermolysis bullosa acquisita) blistering diseases can cause significant morbidity. To provide accurate care, recognition of clinical, pathogenic and diagnostic features as well as awareness of recent advances in the development of new therapeutic modalities are mandatory and thus will be discussed in this review.

Differential diagnostic challenge of chronic neutrophilic leukemia in a patient with prolonged leukocytosis.

Our interesting case deals with the clinical and morphological aspects of a chronic neutrophilic leukemia and the critical evaluation of differential diagnosis of leukemoid reaction in bone marrow biopsies.

Amphotericin B lozengers: prophylaxis for esophagitis in thoracic radiotherapy: a prospective study.

Background And Purpose: Esophagitis is an important side effect in thoracic radiotherapy, no preventive drug therapy has been established yet. The aim of the present study was to prospectively evaluate the effectiveness of prophylactic antimycotic treatment with amphotericin B lozengers.

Patients And Methods: 40 consecutive patients with high-dose thoracic radiotherapy for lung cancer were investigated in a nonrandomized study.

[Medico-legal pitfalls in surgical dermatology. Instructive examples and practical consequences].

In principle, all surgical interventions should only be carried out if the surgeon can show that he/she has actually received training for the intervention. However, the most important factor is probably the surgical information sheet signed by the patient and the consent form. Preoperative photo documentation can be very important and should be compiled before any cosmetic surgery and, if possible, before all other operations too.

Polypharmacy and inappropriate prescribing in elderly internal-medicine patients in Austria.

Objective: The aim of the study was to assess the prevalence of polypharmacy and inappropriate drug use in elderly internal-medicine patients in one Austrian center and to define the impact of these and other identified predictors on the occurrence of adverse drug events.

Methods: All patients>or=75 years admitted to selected internal wards of a university hospital were included in a monocentric prospective cohort study over a period of three months. The pre-admission medication of the patients was analyzed with respect to appropriateness by a multidisciplinary team consisting of pharmacists and physicians trained in internal medicine.

[Cognitive dysfunction as a hidden multiple sclerosis related symptom relevant for an expert appraisal].

We report on a patient with multiple sclerosis (MS), who had severe cognitive dysfunction despite only mild changes in cerebral magnetic resonance imaging (cMRI). The severe MS-related cognitive deficits were disclosed only in a comprehensive neuropsychological evaluation. A previous appraiser was not able to detect these neuropsychological deficits as he did not conduct an appropriate neuropsychological assessment.

Congenital obstructive distal urethral membrane.

We present a rare case of complete distal urethral obstruction caused by a distal meatal membrane in a newborn boy. A cystic lesion of the distal penis was detected and excised, revealing a hypospadiac urethra. Further examination showed bilateral vesico-ureteral reflux with a dilated posterior urethra and urethral lesion, suggesting posterior urethral valves (PUV); these were confirmed at 2 months and resected endoscopically.

Iatrogenic urethral strictures following pull-through procedures: buccal mucosa inlay repair.

Background: Damage to the male urethra following pelvic surgery for anorectal malformations (ARM) is a well known problem, usually seen in boys with rectourethral fistulas. Urethral strictures located in the posterior urethra are difficult to treat because surgical exposure of the posterior urethra is difficult and conventional reconstructive procedures do not consistently yield good results. Free buccal mucosa grafts placed either ventrally or dorsally have shown superior results to other techniques.

Rotundum psoas hitch: a new method for colpohysteropexy in girls with bladder exstrophy.

Female patients with bladder exstrophy frequently suffer from uterine prolapse, which is due to a defective pelvic floor anatomy. Different techniques for the correction of procidentia in this patient population have been described; however, since the numbers of patients are very small and no series with long-term follow-up exists, it is unclear which technique yields superior results. We describe here a new technique for uteropexy in girls and women with bladder exstrophy.

Evaluation of urinary and faecal continent stomas.

Objectives: To evaluate the outcome and complications of urinary and faecal continent catheterizable stomas.

Patients And Methods: Retrospective record review of all patients operated on in our institution within the last 6 years.

Results: Fifty-five children received 63 stomas.

[Comparison of central corneal thickness in patients participating in a glaucoma screening programme and those who were examined in the glaucoma unit].

Background: The aim of this study was to compare central corneal thickness (CCT) and intraocular pressure in patients participating in a glaucoma screening programme and patients who were examined in the glaucoma unit.

Materials And Methods: 406 patients of a glaucoma screening programme (Salzburg-Moorfields collaborative glaucoma study) were included in this study. In addition a group of 406 patients who were admitted to the glaucoma clinic for a detailed glaucoma examination was included (outpatient clinic group).

Spontaneous automaticity arising from a successfully ablated Mahaim fiber.

The authors describe a 22-year-old woman with regular and irregular arrhythmias exhibiting left bundle branch block (LBBB) morphology at various heart rates. An atriofascicular fiber was diagnosed as the underlying mechanism for the antidromic reciprocating tachycardia. In addition, spontaneous automaticity of the Mahaim fiber was present during electrophysiologic study.

Gender-specific effect of metabolic syndrome on rate adjusted QT interval in middle-aged participants of an atherosclerosis prevention program.

Introduction: The metabolic syndrome is a matter of immense public concern for atherosclerosis prevention. Key features are visceral obesity, dyslipidemia, hyperglycemia in the non-diabetic range, and arterial hypertension. Subclinical atherosclerosis is the clinical consequence of metabolic syndrome, which may influence the QT interval.