Reirradiation is a treatment option for recurrent high-grade glioma with proven but limited effectiveness. Therapies directed against vascular endothelial growth factor have been shown to exert ...certain efficacy in combination with chemotherapy and have been safely tested in combination with radiotherapy in a small cohort of patients. To study the feasibility of reirradiation combined with bevacizumab treatment, the toxicity and treatment outcomes of this approach were analyzed retrospectively.
After previous treatment with standard radiotherapy (with or without temozolomide) patients with recurrent malignant glioma received bevacizumab (10 mg/kg intravenous) on Day 1 and Day 15 during radiotherapy. Maintenance therapy was selected based on individual considerations, and mainly bevacizumab-containing regimens were chosen. Patients received 36 Gy in 18 fractions.
The data of the medical charts of the 30 patients were analyzed retrospectively. All were irradiated in a single institution and received either bevacizumab (n = 20), no additional substance (n = 7), or temozolomide (n = 3). Reirradiation was tolerated well, regardless of the added drug. In 1 patient treated with bevacizumab, a wound dehiscence occurred. Overall survival was significantly better in patients receiving bevacizumab (p = 0.03, log-rank test). In a multivariate proportional hazards Cox model, bevacizumab, Karnovsky performance status, and World Health Organization grade at relapse turned out to be the most important predictors for overall survival.
Reirradiation with bevacizumab is a feasible and effective treatment for patients with recurrent high-grade gliomas. A randomized trial is warranted to finally answer the question whether bevacizumab adds substantial benefit to a radiotherapeutic retreatment setting.
Historically, psychiatry and clinical psychology focused on understanding how stressful life conditions led to psychiatric disorders. With the rise of positive psychology, the focus shifted to ...thriving through adversity and to concepts such as resilience. However, the number of mental disorders is still increasing. Due to a neoliberal Western decontextualizing stance in psychology, the concept of resilience is at risk of reproducing power imbalances and discrimination within our society. Resilience is analysed from a critical perspective, mostly with a Marxist point of view, including Foucauldian discursive approaches, as well as a biomedical critique of the current mental health system, to illustrate the shortcomings of Western psychologies. This article illustrates how a contextualized understanding of resilience that accounts for political, historical, and socioeconomic contexts at analytical levels besides the individual may overcome this ethnocentric and neoliberal bias.
Iodine-125 brachytherapy has been applied to brain tumours since 1979. Even though the physical and biological characteristics make these implants particularly attractive for minimal invasive ...treatment, the place for stereotactic brachytherapy is still poorly defined.An extensive review of the literature has been performed, especially concerning indications, results and complications. Iodine-125 seeds have been implanted in astrocytomas I-III, glioblastomas, metastases and several other tumour entities. Outcome data given in the literature are summarized. Complications are rare in carefully selected patients.All in all, for highly selected patients with newly diagnosed or recurrent primary or metastatic tumours, this method provides encouraging survival rates with relatively low complication rates and a good quality of life.
In 2004, a representative study on violence against women was published for the first time in Germany and demonstrated its large extent. Affected women have to deal with manifold health consequences. ...Violence mostly takes place in the domestic sphere. It is usually the male partner who commits violence disclosing strucutal gender inequalities that continue to exist. In this article, I review the psychological effects of violence in intimate relationships from a clinical and critical perspective. I close with considerations on psychotherapeutic consequences for the treatment of domestic violence. Focus is on understandings of health and illness, related diagnostic challenges and therapeutic techniques.
Damage of cartilage structures in the head and neck region as well as in orthopedic sites are frequently caused by trauma, tumor resection, or congenital defects. Despite a high demand in many ...clinical fields, until today, no adequate cartilage replacement matrix is available for these fields of application. Materials that are clinically applied for joint cartilage repair still need optimization due to difficult intraoperative handling and risk of early mechanical damage. We have developed and applied a novel chemical process to completely decellularize and sterilize human and porcine cartilage tissues (meniscus cartilage and nasal septum) to generate a new type of bioimplant matrix. To characterize this matrix and to determine the effect of the decellularization process, the content of denatured collagen (w(D)) and the content of glycosaminoglycans (GAGs) (w(G)) were determined. Possible cytotoxic effects and cellular compatibility of the matrix in vitro have been examined by seeding processed cartilage biomatrices with human primary chondrocytes as well as murine fibroblasts (L929). Vitality and state of metabolism of cells were measured using MTS assays. Both cell types adhered to scaffold surfaces and proliferated. No areas of growth inhibition or cytotoxic effects were detected. New synthesis of cartilage-specific extracellular matrix was observed. By histological staining, electron microscopy, and μCT analysis, an increase of matrix porosity, complete cell elimination, and high GAG removal were demonstrated. Being from natural-origin, processed xenogenic and allogeneic cartilage biomatrices are highly versatile with regard to shape, size, and biomechanics, making them promising candidates for various biomedical applications.
The iliotibial band (ITB) is a suitable scaffold for anterior cruciate ligament (ACL) reconstruction, providing a sufficient mechanical resistance to loading. Hence, ITB-derived fibroblasts attract ...interest for ligament tissue engineering but have so far not been characterized. This present study aimed at characterizing ITB fibroblasts before, during, and after emigration from cadaveric ITB explants to decipher the emigration behavior and to utilize their migratory capacity for seeding biomaterials. ITB and, for comparison, ACL tissues were assessed for the content of alpha smooth muscle actin (αSMA) expressing fibroblasts and degeneration. The cell survival and αSMA expression were monitored in explants used for cell isolation, monolayer, self-assembled ITB spheroids, and spheroids seeded in polyglycolic acid (PGA) scaffolds. The protein expression profile of targets typically expressed by ligamentocytes (collagen types I-III, elastin, lubricin, decorin, aggrecan, fibronectin, tenascin C, CD44, β1-integrins, vimentin, F-actin, αSMA, and vascular endothelial growth factor A VEGFA) was compared between ITB and ACL fibroblasts. A donor- and age-dependent differing percentage of αSMA positive cells could be detected, which was similar in ITB and ACL tissues despite the grade of degeneration being significantly higher in the ACL due to harvesting them from OA knees. ITB fibroblasts survived for several months in an explant culture, continuously forming monolayers with VEGFA and an increased αSMA expression. They shared their expression profile with ACL fibroblasts. αSMA decreased during the monolayer to spheroid/scaffold transition. Using self-assembled spheroids, the migratory capacity of reversible myofibroblastic ITB cells can be utilized for colonizing biomaterials for ACL tissue engineering and to support ligament healing.
Langjährig erfolgreiche SängerInnen müssen in der Lage sein, ihr Potential über einen Karriereverlauf durchgehend auf hohem Niveau abzurufen und sowohl die eigenen als auch fremden Erwartungen an die ...künstlerische Leistung miteinander in Einklang bringen. Die Einschätzung von sängerischer Bestleistung divergiert dabei in hohem Maße. Eine langjährige, professionelle Gesangskarriere setzt deswegen neben körperlicher Belastbarkeit und künstlerischer Exzellenz auch mentale Stärke voraus, um mit den teils widersprüchlichen Erwartungshaltungen von Publikum, AgentInnen, musikalischen PartnerInnen, Casting DirektorInnen oder Coaches umzugehen und die eigene Leistungsfähigkeit langfristig auf hohem Niveau zu erhalten. Professionelle SportlerInnen nutzen mentale Trainingstechniken als Ergänzung zum physischen Training seit Jahrzehnten, da die Vorteile eines kombinierten mentalen und praktischen Trainings wissenschaftlich belegt sind. Die vorliegende Arbeit fokussiert die Gütemaßstäbe, mit denen langjährig erfolgreiche SängerInnen ihre Bestleistung definieren und führt auf, welche Strategien sie zur Erreichung derselben nennen. Die Ergebnisse der Interviewstudie zeigen, dass soziale, körperliche, situative und mentale Determinanten das Erreichen der Bestleistung beeinflussen. Entsprechend der positiven oder negativen Selbstbewertung dieser Determinanten wird das Erreichen der persönlichen Bestleistung begünstigt oder gestört. Die Studie zeigt, dass die SängerInnen ihre Bestleistung auf unterschiedliche Weise definieren, entweder mit Idealbezug, Realbezug oder Defizitbezug. Je nach Bezug nennen SängerInnen unterschiedliche mentale Strategien, um ihre Befindlichkeit und ihren Tonus zu regulieren. Dadurch aktivieren und erhalten sie ihre Fokussierungsfähigkeit, ihre Selbstkompetenzüberzeugung und ihre Handlungsfähigkeit.
Vitrification of endothelial cells (MHECT-5) has not previously been compared with controlled slow freezing methods under standardized conditions. To identify the best cryopreservation technique, we ...evaluated vitrification and standardized controlled-rate -1°C/minute cell freezing in a -80°C freezer and tested four cryoprotective agents (CPA), namely dimethyl sulfoxide (DMSO), ethylene glycol (EG), propylene glycol (PG), and glycerol (GLY), and two media, namely Dulbecco's modified Eagle medium Ham's F-12 (DMEM)and K+-modified TiProtec (K+TiP), which is a high-potassium-containing medium. Numbers of viable cells in proliferation were evaluated by the CellTiter 96® AQueous One Solution Cell Proliferation Assay (Promega Corporation, Mannheim, Germany). To detect the exact frozen cell number per cryo vial, DNA content was measured by using Hoechst 33258 dye prior to analysis. Thus, results could be evaluated unconstrained by absolute cell number. Thawed cells were cultured in 25 cm2 cell culture flasks to confluence and examined daily by phase contrast imaging. With regard to cell recovery immediately after thawing, DMSO was the most suitable CPA combined with K+TiP in vitrification (99 ±0.5%) and with DMEM in slow freezing (92 ±1.6%). The most viable cells in proliferation after three days of culture were obtained in cells vitrificated by using GLY with K+TiP (308 ±34%) and PG with DMEM in slow freezing (280 ±27%).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The association between osteoarthritis (OA), obesity and metabolic syndrome suggests an interrelation between OA and diabetes mellitus (DM). Little is known about the role of anti-inflammatory ...cytokine interleukin (IL)-10 in the interrelation between OA and DM. Hence, the effects of IL-10 under hyperglycemia (HG) and hyperinsulinemia (HI) in human articular chondrocytes (hAC) and chondrosarcoma cell line Okayama University Medical School (OUMS)-27 were examined. HAC and OUMS-27, cultured in normoglycemic (NG) and HG conditions were stimulated with insulin and/or IL-10. Cell survival, metabolic activity, proliferation and extracellular matrix (ECM) synthesis were immunocytochemically examined. No significant differences in vitality of hAC neither in pure NG (NG
) nor HG (HG
) conditions were found. Applying HI and/or IL-10 in both conditions reduced significantly the vitality of hAC but not of OUMS-27. HG impaired significantly hAC metabolism. When combined with HI + IL-10 or IL-10 alone it decreased also significantly hAC proliferation compared to NG
. In OUMS-27 it induced only a trend of impaired proliferation compared to NG
. hAC but not OUMS-27 reduced significantly their collagen type (col) I, SOX9 and proteoglycan (PG) synthesis in HG combined with HI +/- IL-10 compared to NG
. IL-10 could not moderate HI and HG effects. In contrast to hAC OUMS-27 showed limited sensitivity as DM model.
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