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PubMed1978

Suppressor cell activity in cancer patients: a possible role for thymic hormones.

We have identified the presence of suppressor cell activity in the peripheral blood of immunosuppressed stage IV cancer patients. The patients' cells had a diminished mitogenic response to phytohemagglutinin (PHA) and suppressed the PHA mitogenic response of a normal donor's peripheral blood lymphocytes (PBL). Thus, PBL from a cancer patient whose PHA mitogenic response was 3932 counts per minute (cpm), cultured together with a normal donor's PBL with a PHA mitogenic response of 82,865 net cpm, caused a greater than 50% reduction in the latter (37,651 net cpm). Suppressor cell activity was present in 12 of 14 patients tested. This effect was partially mitigated by irradiation with 4000 rads in nine of 14 patients. Preincubation of the patients' cells with thymosin followed by the addition of thymosin to the co-cultured cells mitigated the suppressor activity in five of ten patients and thymic humoral factor did the same in four of 11 patients. A radiosensitive and thymic hormone-responsive suppressor cell may be present in the peripheral blood of cancer patients. Confirmation of this preliminary observation and further characterization of the cell or cells is currently being undertaken.

Female↗
PubMed2004

Odour management plans: a risk-based approach using stakeholder data.

Annoyance is a familiar reaction to odours arising from wastewater treatment sites, a reaction which can result in complaints and prosecutions. Odour management plans can be used to assess the extent of nuisance caused and prioritise mitigation measures. Often, these plans have been developed purely on the basis of technical assessments of emission and dispersion, with the general aim of limiting odour concentrations to a specific threshold at some distance from the works. They have often been prepared with inconsistent communication between the site staff and consultant during the development process, and may not directly refer to the affected population. This paper describes a risk-based approach to developing odour management plans, in which mitigation measures are assessed and prioritised on the basis of the likely frequency and intensity of odour exposure. A key element of the approach is the use of knowledge from data gained from key stakeholder groups: customers, staff, and regulators. Emphasis is placed on the development of clear communications between these groups, which helps both in terms of raising awareness amongst operators as to the significance of odour problems, and also in managing the expectations of customers and regulators. The practical application of this approach is demonstrated by the development of odour management plans for wastewater treatment sites by Yorkshire Water Services Ltd. These have used data from staff, customers and regulators to develop risk grids, which are then used to prioritise remediation measures. Involving staff in the data collection operations has been successful in raising awareness of the significance of odours, and has in turn led to low-cost emission reductions through improved housekeeping. Improved communications between operators, customers and regulators has led to more realistic expectations with regard to odour problems, a situation which can reduce conflict and prevent the imposition of stringent and sometimes unrealistic odour standards.

Communication↗
PubMedDate not supplied

Care after chaos: use of critical incident stress debriefing after traumatic workplace events.

CISD is a specific model of group debriefing, which can be used to accelerate recovery from traumatic work-place events. The impact of critical incidents may be debilitating-from recurrent intrusive images, persistent fear, displaced anger, guilt, and isolation. CISD can accomplish psychological closure, prevention, and mitigation of traumatic stress, and promote return to normalcy, benefiting the individual, organization, and the community at large. The field of critical incident stress management is open to advanced practice nurses who seek to apply their crisis-intervention expertise within a nontraditional role and workplace setting. With specialized training, the advanced practice nurse may pursue a career as a crisis-response provider, working independently or with an established CISM team. Practice requirements include CISM certification, along with the acquisition of a referral source. The prevention and mitigation of traumatic stress can yield a rewarding career in CISM.

Crisis Intervention↗
PubMed2005

[Effect of tea polyphenols on alcoholic liver injury].

OBJECTIVE: To reproduce an experimental model of alcoholic liver disease in rats and to investigate the preventive and treatment effects of tea polyphenols on alcoholic liver disease. METHODS: 68 male Sprague-Dawley rats were randomly divided into 3 groups: alcohol group (gastrically infused with 56% of ethanol once a day with a dose of 7 g/kg body weight for 4, 12 and 24 weeks), tea polyphenols group (gastric infusion with alcohol same as in the alcohol group and with tea polyphenols at 0.25 g/kg bw) and control group (gastric infusion with normal saline). At the end of 4, 12 and 24 weeks, blood samples were collected and then the rats were sacrificed. Liver samples were obtained for routine histological examination and the degree of hepatic steatosis and alcoholic hepatitis were examined. Blood specimens were used for evaluation of alanine transaminase (ALT) and aspartate aminotransferase (AST). RESULTS: (1) The levels of the two transaminases were elevated with the increase of the duration of ethanol feeding and the difference is significant. TP significantly mitigated the increase of ALT and AST activities induced by the alcohol. (2) Histological changes of the liver injury indicated that piecemeal or focal necrosis of hepatocytes was present in the centrilobular area. As fibrosis advanced, broader septa were formed with central-central and centra-portal bridging necrosis. In the TP infusion group, the severity of the pathological changes was significantly milder. CONCLUSION: The results of this study revealed that TP mitigated the development of alcoholic liver disease, and TP may be a potential drug for treatment of alcoholic liver disease.

Animals↗
PubMed2004

The promise of e-health--a Canadian perspective.

Canadians value their health care system above any other social programme. Canada's system of health care faces significant financial and population pressures, relating to cost, access, quality, accountability, and the intergration of information and communication technologies (ICTs). The health-system also faces certain unique challenges that include care delivery within a highly decentralised system of financing and accountability, and care delivery to a significant portion of the population sparsely distributed across a land mass of 10 million square kilometres, in areas of extreme climatic conditions. All of these challenges are significant catalysts in the development of technologies that aim to significantly mitigate or eliminate these selfsame challenges. The system is undergoing widespread review, nationally and within each province and territory, where the bulk of care provision is financed and managed. The challenges are being addressed by national, regional and provincial initiatives in the public, private and not-for-profit sectors. The promise of e-health lies in the manner and degree to which it can mitigate or resolve these challenges to the health system and build on advancements in ICTs supporting the development of a health infostructure. Canada is actively developing and implementing technological solutions to deliver health information and health care services across the country. These solutions, while exciting and promising, also present new challenges, particularly in regard to acceptable standards, choice of technologies, overcoming traditional jurisdictional boundaries, up-front investment, and privacy and confidentiality. Many organizations and governments are working to address these challenges. Canada Health Infoway, a not-for-profit corporation, was founded by the first ministers in 2001 to accelerate the establishment of an interoperable, pan-Canadian electronic health record. It works with partners in the federal, provincial and territorial jurisdictions to define replicable solutions for establishment of the major elements necessary to achieve this goal. The Canadian Institute for Health Information (CIHI) will also continue to play an increasingly significant role in these initiatives, as the management of health information becomes a more crucial factor in the successful delivery of health care services in the new millennium.

Access to Information↗
PubMed2005

Impact of the media on adolescent sexual attitudes and behaviors.

BACKGROUND: Adolescents in the United States are engaging in sexual activity at early ages and with multiple partners. The mass media have been shown to affect a broad range of adolescent health-related attitudes and behaviors including violence, eating disorders, and tobacco and alcohol use. One largely unexplored factor that may contribute to adolescents' sexual activity is their exposure to mass media. OBJECTIVE: We sought to determine of what is and is not known on a scientific basis of the effects of mass media on adolescent sexual attitudes and behaviors. Method. We performed an extensive, systematic review of the relevant biomedical and social science literature and other sources on the sexual content of various mass media, the exposure of adolescents to that media, the effects of that exposure on the adolescents' sexual attitudes and behaviors, and ways to mitigate those effects. Inclusion criteria were: published in 1983-2004, inclusive; published in English; peer-reviewed (for effects) or otherwise authoritative (for content and exposure); and a study population of American adolescents 11 to 19 years old or comparable groups in other postindustrial English-speaking countries. Excluded from the study were populations drawn from college students. RESULTS: Although television is subject to ongoing tracking of its sexual content, other media are terra incognita. Data regarding adolescent exposure to various media are, for the most part, severely dated. Few studies have examined the effects of mass media on adolescent sexual attitudes and behaviors: only 12 of 2522 research-related documents (<1%) involving media and youth addressed effects, 10 of which were peer reviewed. None can serve as the grounding for evidence-based public policy. These studies are limited in their generalizability by their cross-sectional study designs, limited sampling designs, and small sample sizes. In addition, we do not know the long-term effectiveness of various social-cultural, technologic, and media approaches to minimizing that exposure (eg, V-Chips on television, Internet-filtering-software, parental supervision, rating systems) or minimizing the effects of that exposure (eg, media-literacy programs). CONCLUSIONS: Research needs to include development of well-specified and robust research measures and methodologies; ongoing national surveillance of the sexual content of media and the exposure of various demographic subgroups of adolescents to that content; and longitudinal studies of the effects of that exposure on the sexual decision-making, attitudes, and behaviors of those subgroups. Additional specific research foci involve the success of various types of controls in limiting exposure and the mitigative effects of, for example, parental influence and best-practice media-literacy programs.

Adolescent↗
PubMed2005

Diet as a factor in behavioral radiation protection following exposure to heavy particles.

Major risks associated with radiation exposures on deep space missions include carcinogenesis due to heavy-particle exposure of cancer-prone tissues and performance decrements due to neurological damage produced by heavy particles. Because exposure to heavy particles can cause oxidative stress, it is possible that antioxidants can be used to mitigate these risks (and possibly some health risks of microgravity). To assess the capacity of antioxidant diets to mitigate the effects of exposure to heavy particles, rats were maintained on antioxidant diets containing 2% blueberry or strawberry extract or a control diet for 8 weeks prior to exposure to 1.5 or 2.0 Gy of accelerated iron particles at Brookhaven National Laboratory. Following irradiation rats were tested on a series of behavioral tasks: amphetamine-induced taste aversion learning, operant responding and spatial learning and memory. The results indicated that the performance of the irradiated rats maintained on the antioxidant diets was, in general, significantly better than that of the control animals, although the effectiveness of the diets ameliorating the radiation-induced deterioration in performance varied as a function of both the specific diet and the specific endpoint. In addition, animals fed antioxidant diets prior to exposure showed reduced heavy particle-induced tumorigenesis one year after exposure compared to the animals fed the control diet. These results suggest that antioxidant diets have the potential to serve as part of a system designed to provide protection to astronauts against the effects of heavy particles on exploratory missions outside the magnetic field of the earth.

Aging↗
PubMed2005

On the significance of reducing the need for stroke patients to visit the emergency department.

We studied the care-provider paths followed by 3,946 patients in Quebec in 2001. We showed that the patients flow during the three months preceding discharge from hospital can be represented by a Markov model with memory. This model enables study of four major scenarios to improve health outcomes, workloads and cost efficiency in the overall community-based care delivery system. Based on the field data, we establish that increasing the availability of specialists, family physicians and general practitioners to mitigate the need for ER visits would be an effective strategy for improvement. A comprehensive policy to support stroke patients needs to incorporate both hospital-based and community-based care delivery processes. The seamless flow of patients through the healthcare providers in such an integrated system is crucial for achieving successful outcomes. Emergency rooms (ER) have a crucial role in this context, since in many cases ER acts as the hospital's "gate keeper", determining if a patient needs to be (re)admitted. In this paper, we establish (based on field data) that mitigating the ER visits of stroke patients improves health outcomes, distribution of workload across the healthcare system as well as associated costs. To this end, we make use of a Markov modeling framework, where the aggregate patient flow information is represented in a compact form through the use of a transition-probability matrix. This allows us to investigate the system-wide impact of several plausible scenarios with regards to the delivery of community-based care to stroke patients who are recently discharged from hospital.

Community Health Centers↗
PubMed2006

Control and management of hospital indoor air quality.

BACKGROUND: The complex hospital environment requires special attention to ensure healthful indoor air quality (IAQ) to protect patients and healthcare workers against hospital-acquired (nosocomial) infections and occupational diseases. The aim here is to recommend effective guidelines for the control and management of hospital IAQ. MATERIAL/METHODS: The authors have done an extensive literature review and conducted comprehensive IAQ assessments in nine hospitals. It is noted that the IAQ measurements are not presented in this paper because of confidentiality. However, the IAQ analysis was studied carefully in the development of the recommendations given in this paper. RESULTS: The airborne chemical and microbiological contaminants of concern for hospitals have been identified and the major emission sources, monitoring methods, and exposure limits have been well documented and are reviewed here. Proper engineering system designs and operations are also reviewed, with recommendations for effective dilution and removal of the contaminants. The control and mitigation measures cover mechanical ventilation, filtration, differential pressure control, directional airflow control, local exhaust ventilation, and ultraviolet germicidal irradiation (UVGI) disinfection. Their applications in critical environments, such as operating theatres, isolation rooms, and other typical units, such as outpatient departments and laboratories, are also considered. CONCLUSIONS: Effective IAQ monitoring methods and mitigation measures suitable for the hospital environment have been identified. Accordingly, strategies for the implementation of a hospital indoor air quality management system are recommended. Healthcare workers, hospital engineers, and administrative staff can use the above as guidelines to manage and run their hospitals with healthful indoor air quality.

Air Microbiology↗
PubMed2005

Cascading costs: an economic nitrogen cycle.

The chemical nitrogen cycle is becoming better characterized in terms of fluxes and reservoirs on a variety of scales. Galloway has demonstrated that reactive nitrogen can cascade through multiple ecosystems causing environmental damage at each stage before being denitrified to N2. We propose to construct a parallel economic nitrogen cascade (ENC) in which economic impacts of nitrogen fluxes can be estimated by the costs associated with each stage of the chemical cascade. Using economic data for the benefits of damage avoided and costs of mitigation in the Chesapeake Bay basin, we have constructed an economic nitrogen cascade for the region. Since a single tonne of nitrogen can cascade through the system, the costs also cascade. Therefore evaluating the benefits of mitigating a tonne of reactive nitrogen released needs to consider the damage avoided in all of the ecosystems through which that tonne would cascade. The analysis reveals that it is most cost effective to remove a tonne of nitrogen coming from combustion since it has the greatest impact on human health and creates cascading damage through the atmospheric, terrestrial, aquatic and coastal ecosystems. We will discuss the implications of this analysis for determining the most cost effective policy option for achieving environmental quality goals.

Animals↗
PubMed2006

The extent and impact of mental health problems after disaster.

Disasters are events that challenge the individual's ability to adapt, which carries the risk of adverse mental health outcomes including serious posttraumatic psychopathologies. While risk is related to degree of exposure to psychological toxins, the unique vulnerabilities of special populations within the affected community as well as secondary stressors play an important role in determining the nature and amount of morbidity. Disasters in developing countries and those associated with substantial community destruction are associated with worse outcome. Although acute responses are ubiquitous, few disasters lead to posttraumatic psychopathology in the majority of people exposed. However, the shortage of human resources in psychiatry, particularly in developing countries, places a considerable burden on psychiatric services even without the additional constraints imposed by disaster. Hence, disasters are events that invite a public health approach to mental health that better serves the needs of the individual and the affected community. Such an approach considers all available human resources and is intended to mitigate the effects of disaster before serious psychopathologic sequelae arise. This community mental health strategy allows peripheral mental health workers to mediate between survivors and specialized mental health professionals while assisting in removing barriers to treatment. To be effective when disaster occurs, this approach requires careful planning in conjunction with community consultation before implementation of formal disaster mitigation policies.

Community Mental Health Services↗
PubMed1991

[Requisite muscle relaxation using vecuronium for tracheobronchial suction in neurosurgical intensive care patients].

Coordination of respiratory care with protection of the brain is critical in neurosurgical intensive care. Therefore, in addition to hyperventilation, adequate sedation and muscle relaxation are applied to mitigate the difficulties with control of intracranial pressure (ICP) during routine tracheobronchial suctioning (TBS). Although hypnotics have been shown to be effective in mitigating increases in ICP in response to endotracheal suctioning in paralyzed patients, brisk bucking and coughing with further increases in ICP may occur without muscle relaxation. Long-term neuromuscular (nm) paralysis may be undesirable in neurosurgical critical care because clinical evaluation with early detection of neurological deterioration will be impossible in the paralyzed patient. Therefore, the effects of TBS without and after nm blockade with an intermediate-acting nondepolarizing muscle relaxant on ICP were studied. PATIENTS AND METHODS. Nine patients with moderate increases in mean ICP of 19.2 +/- 8 mmHg due to head injuries and spontaneous subarachnoid hemorrhage were investigated. All patients were on-line sedated with midazolam and sufentanil and controlled ventilation was adjusted to maintain a paCO2 of 30 +/- 2 mmHg. Respiratory and hemodynamic parameters and ICP (epidural probe) were continuously monitored and recorded on an integrated data bank. After a bolus dose of propofol, routine TBS was performed without the use of muscle relaxants. Before the next TBS, nm monitoring was initiated and train-of-four (TOF) stimulation was imposed at the ulnar nerve using supramaximal pulses. The response of the adductor pollicis muscle was recorded by accelerometry. After supramaximal stimulation had been achieved, a bolus dose of 2 times the ED95 of vecuronium (0.12 mg/kg) was given. Depth of nm blockade was quantified by the posttetanic count (PTC). ICP and CPP were measured before, during, and after TBS. Diaphragmatic movement, bucking, and coughing were registered by visual observation and graded as absent, slight, moderate, or severe. STATISTICS. Student's t-test and the Wilcoxon test for paired data (P less than 0.05; values as mean +/- SD) were used. RESULTS. (see Table and Figure). Despite adequate sedation, moderate to severe diaphragmatic movements in response to carinal stimulation with significant increases in ICP (18.2 +/-7 to 24 +/- 8 mmHg) an d subsequent decreases in cerebral perfusion pressure (CPP) (68.9 +/- 2 to 62.4 +/- 8 mmHg) could be observed without muscle relaxation. After a bolus of vecuronium, profound nm paralysis quantified by a PTC of 5 was observed after an onset time of 4.2 +/- 1 min. ICP (20.2 +/- 8 vs. 20.1 +/- 8 mmHg) and CPP (64.0 +/- 13 vs. 64.8 +/- 13 mmHg) remained unchanged. Slight diaphragmatic movements could be elicited in only two patients during TBS. DISCUSSION. TBS is a potent trigger of diaphragmatic movement, bucking, and coughing by reflex activation of the phrenic nerve. A major determinant of the magnitude of ICP increase during TBS is the transmission of the cough-induced increase in intrathoracic pressure to the cerebral venous system. Vecuronium was utilized for nm blockade because of its proven lack of cerebral and cardiovascular side effects, its relatively short onset, and its intermediate duration of action. Despite the postulated faster onset of nm blockade in the diaphragm, suppression of thumb-twitch response to TOF stimulation does not necessarily predict absence of diaphragmatic movement elicited by excessive tracheal stimulation. As demonstrated, intense nm blockade quantified by a PTC of 5 is necessary to rule out any bucking and coughing, i.e., to ensure total diaphragmatic paralysis in response to tracheal stimulation. On-line neurological evaluation, one of the essentials in the approach to the neurosurgical patient, will not be prevented by the intermittent bolus regime utilized in this study.

Adult↗
PubMed2006

Clinical potential of milnacipran, a serotonin and norepinephrine reuptake inhibitor, in pain.

Milnacipran is a serotonin (5-HT) and norepinephrine (NE) reuptake inhibitor currently available for use as an antidepressant in several countries. Phase III clinical trials are currently underway to assess its potential role in the treatment of fibromyalgia syndrome, and in pursuit of US Food and Drug Administration approval for this indication. Evidence has accumulated suggesting that in animal models, milnacipran may exert pain-mitigating influences involving NE- and 5-HT-related processes at supraspinal, spinal and peripheral levels of pain transmission. Preliminary evidence suggests that milnacipran may be useful in mitigating pain and fatigue associated with fibromyalgia. However, its role in addressing comorbidities associated with fibromyalgia, including visceral pain and migraine, has yet to be investigated.

Adrenergic Uptake Inhibitors↗
PubMed2006

Arsenic exposure in pregnancy: a population-based study in Matlab, Bangladesh.

This study assessed the exposure of pregnant women to arsenic in Matlab, Bangladesh, an area with highly-elevated concentrations of arsenic in tubewells, by measuring concentrations of arsenic in urine. In a defined administrative area, all new pregnancies were identified by urine test in gestational week 6-8, and women were asked to participate in the assessment of arsenic exposure. Urine for analysis of arsenic was collected immediately and in gestational week 30. In total, 3,426 pregnant women provided urine samples during January 2002-March 2003. There was a considerable variation in urinary concentrations of arsenic (total range 1-1,470 microg/L, adjusted to specific gravity 1.012 g/mL), with an overall median concentration of 80 microg/L (25th and 75th percentiles were 37 and 208 microg/L respectively). Similar concentrations were found in gestational week 30, indicating no trend of decreasing exposure, despite the initiation of mitigation activities in the area. Arsenic exposure was negatively associated with socioeconomic classes and achieved educational level. There were marked geographical variations in exposure. The results emphasize the urgent need for efficient mitigation activities and investigations of arsenic-related reproductive effects.

Adolescent↗
PubMed2006

[Dynamic monitoring of serum pepsinogen among high risk populations of gastric cancer in Zhuanghe county].

OBJECTIVE: To investigate the dynamic changes of serum pepsinogen (PG) among the high risk populations of gastric cancer. METHODS: Peripheral blood samples were collected from 444 subjects in the high risk areas of gastric cancer in Zhuanghe county, Liaoning province, who underwent screening of gastric cancer, 225 males and 219 females, aged 48.31 (21 - 76). ELISA was used to measure the serum PG I and PG II. The PG I/II ratio was calculated. Gastroscopy was conducted to take 4 pieces of biopsy specimens from each subject to undergo pathological examination. Histological examination and serum Hp-IgG antibody determination by ELISA were performed to detect the infection of Helicobacter pylori (Hp). The above mentioned examinations were carried out at the first screening and 6, 12, and 30 months later during follow-up. RESULTS: (1) In the age group 51 - 60, the percentage change in PG II of 6-month follow-up was 0.84, significantly lower than those of the 12-month follow-up (1.22, P = 0.019) and 30-month follow-up (1.24, P = 0.004), and the percentage change in PG I/II of the 6-month follow-up was 1.09, significantly higher than those of the 12-month follow-up (0.75, P = 0.027) and 30-month follow-up (0.69, P = 0.001). However, there were no significant differences in serum PG I, serum PG II, and PG I/II ratio in other age groups. (2) The percentage change in serum PG I of the patients of superficial gastritis (SG) with mitigation of the 6-month follow-up was 0.69, significantly lower than that of the 12-month follow-up (0.97, P = 0.002). The percentage change in PG I/II of the patients of atrophic gastritis (AG) with mitigation of the 6-month follow-up was 1.13, significantly higher than that of the 12-month follow-up (0.75, P = 0.042). (3) The percentage change in PG I of the SG-->NOR (normal) group was 0.94, significantly higher than that of the SG-->AG group (0.79, P = 0.002). The percentage changes in PG I and PG II of the AG-->NOR group were 0.43 and 0.60 respectively, both significantly lower than those of the AG-->SG group (0.87, P = 0.000, and 1.11, P = 0.010). (4) The percentage change in PG I of the Hp negative-->Hp positive group was 0.94, significantly higher than that of the Hp negative-->Hp negative group (0.81, P = 0.026). The percentage changes in PG I and PG II of the Hp positive-->Hp negative group were 0.74 and 0.86 respectively, both significantly lower than those of Hp positive-->Hp positive group (0.93 and 1.15 respectively, both P = 0.000), and the percentage change in PG I/II of the Hp positive-->Hp negative group was 0.90, significantly higher than that of the Hp positive-->Hp positive group (0.70, P = 0.022). CONCLUSION: The percentage change of serum PG is correlated with time of follow-up, feature of stomach disease, and status of Hp infection. Dynamic detection of serum PG can be applied in monitoring the populations in high risk area of gastric cancer.

Adult↗
PubMed1990

[Treatment of tinnitus by Neolidocatone administered by iontophoresis into the middle ear].

The authors describe a possible therapeutic approach mitigating tinnitus. It is not causal treatment but only symptomatic and extends the group of methods which influence tinnitus. The authors describe their own experience with iontophoresis of the middle ear with Neolidocatone-a derivate of Lidocaine which was done with a SANOMATIC apparatus, using galvanic current 1.5 mA. In one third of the patients it proved possible to mitigate the tinnitus permanently, in the remaining patients it persisted in the original intensity. The group of patients was heterogeneous from idiopathic tinnitus without impaired hearing, patients with otosclerosis, cervicocranial syndrome to those with Ménière's disease. The cause of tinnitus did not influence the therapeutic results.

Ear, Middle↗
PubMed1990

[Indications for and results of radiotherapy of plasmacytomas].

In therapy of plasmocytoma the radiotherapy has a well established place in addition to chemotherapy. At the Clinic and Policlinic for Radiology of the Medical Academy Erfurt 42 patients with a plasmocytoma were treated in the years 1967 to 1987, 38 of them were included into the presented study. In radiotherapy roentgen depth-therapy was used with total surface dose of 30 to 40 Gy as well as telecobalt therapy with TD of 40 to 50 Gy. 8 patients had a solitary plasmocytoma, in three times with extramedullary manifestation in mucosa of cheek and nose and in gingiva and five times with bone localisation. In 30 patients with a multiple plasmocytoma we irradiated 37 painful bone lesions; for 29 of these irradiated findings the patients stated painlessness or distinct mitigation. In two bone manifestations a pathological fracture existed additionally, in which a complete painlessness and a clear callus formation could be attained. 4 patients with an incomplete cross-section syndrome in consequence of vertebral destruction with extradural tumor spreading responded with clear mitigation and regression of paresis. Furthermore an infiltration into soft parts was diagnosed at 9 bone foci, that were reduced in part (6 infiltrations) or regressed completely (3 findings) after radiotherapy. Additionally to osseous manifestations an extramedullary tumor (peribronchial lymph-nodes, hypophysis) existed in 2 patients, that regressed completely after termination of radiotherapy. The following indications can be mentioned for radiotherapy in plasmocytoma: 1. Curative postoperative radiotherapy after exstirpation of a solitary extramedullary plasmocytoma, 2. Curative sole radiotherapy of a solitary extramedullary of medullary plasmocytoma after its histological proving.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Neoplasms↗
PubMed1989

Effects of exogenous vasoconstrictors on coronary vascular resistance and prostacyclin production of the quiescent heart: the inhibitory effect of aspirin.

The in situ heart is exposed to blood-borne vasoconstrictor agents (e.g., vasopressin) which, if unopposed, may cause radically increased coronary vascular resistance (CVR). Release of endogenous vasodilator, such as prostacyclin (PGI2), is a possible mitigating mechanism. We investigated the ability of the heart to maintain CVR within a narrow range when exposed to exogenous vasoconstrictors. The isolated rat heart was perfused at constant flow rate (5-6 ml/min) with oxygenated Krebs-Ringer bicarbonate solution (37 degrees C, pH 7.4), and was rendered quiescent by a local injection of lidocaine to the atrio-ventricular node. Changes of perfusion pressure, indicating changes of CVR, were monitored and the cardiac effluent was collected for analysis of 6-keto PGF1 alpha and thromboxane B2 (stable metabolites of PGI2 and thromboxane A2, respectively) by radioimmunoassay. Hearts were infused with four different vasoconstrictors (i.e., serotonin, vasopressin, angiotensin II and the thromboxane A2/PGH2 mimetic, U46619). There was a linear relationship between the dose-dependent increase in CVR and PGI2 production in serotonin, U46619 and vasopressin-infused quiescent heart. Vasoconstriction induced by angiotensin II was not dose-dependent and was unrelated to PGI2 production. Thus, PGI2 is produced in response to coronary vessel constriction, presumably to mitigate the constriction. No detectable thromboxane B2 was released by any of these vasoconstrictors. Partial inhibition (approximately 50%) of PGI2 production by aspirin (5.6 microM) treatment resulted in a paradoxically decreased vasoconstriction except at the lowest level of serotonin and vasopressin. Aspirin (1 mM) greatly reduced PGI2 production (approximately 90%) but the fall in CVR persisted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗