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  • Electronic Resource  (2)
  • 1995-1999  (2)
  • Key words:Arthritis, Arthroscopy, Histology, Synovitis  (1)
  • Prognose  (1)
  • 1
    ISSN: 1433-0458
    Keywords: Schüsselwörter Tonsillenkarzinome ; Onkogene humane Papillomaviren (HPV) ; Retinoblastomprotein (pRb) ; Prognose ; Key words Tonsillar squamous cell carcinomas ; Oncogenic human papillomavirus ; Retinoblastoma protein ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In order to identify squamous cell carcinomas of the head and neck (HNSCC) with common biological and clinical features, we investigated the incidence and properties of carcinomas lacking retinoblastoma protein (pR6) cell cycle control. Of 208 HNSCC investigated, 23 (11%) showed a lack of pRb expression. The majority of these tumors (65%) were tonsillar carcinomas. The pRb-negative tonsillar tumors were all stage IV, had metastasized to lymph nodes at the time of diagnosis and were in general poorly differentiated or undifferentiated. Very significantly, the pRb-negative phenotype was strongly associated with the presence of oncogenic human papilloma viruses, implying a viral etiology and functional inactivation of pRb by the viral E7 oncoprotein. Despite the very adverse histopathological factors, patients with pRb-negative tonsillar carcinomas had a better clinical outcome, which was consistent with a uniform favorable responsiveness of these tumors to postoperative radiation therapy.
    Notes: Zusammenfassung Hinsichtlich biologischer Tumorcharakteristika, Genese und klinischen Eigenschaften von Plattenepithelkarzinomen im Kopf-Hals-Bereich bestehen viele Unklarheiten. Zur besseren Charakterisierung dieser Karzinome wurde geprüft, ob es Tumoren mit Defekten im Retinoblastomstoffwechsel gibt und ob weitere molekulare und klinische Gemeinsamkeiten vorliegen. Bei 11% der untersuchten Plattenepithelkarzinome des Kopf-Hals-Bereichs (23 von 208) lag ein Defekt im Retinoblastomstoffwechsel vor; 15 dieser 23 Tumoren (65%) waren in der Tonsille lokalisiert. Die pRb-negativen Tumoren lagen überwiegend als Stadium IV (UICC) vor, hatten bereits in regionäre Lymphknoten metastasiert und wiesen eine geringgradige Differenzierung auf. Dagegen waren klinische Verläufe und Gesamtüberlebenszeiten nach Operation und Strahlentherapie günstig. Die molekularbiologischen Analysen zeigten folgende Gemeinsamkeiten innerhalb dieser Gruppe der Tonsillenkarzinome: Der Retinoblastom-Protein (pRb)- und Cyclin-D1-Spiegel waren erniedrigt, p16INK4a erhöht. Es zeigte sich eine starke Assoziation mit onkogenen humanen Papillomaviren (HPV), durch deren Onkogen E7 wahrscheinlich die pRb-Inaktivierung erfolgt. Damit kommt den Papillomaviren eine wesentliche Rolle für die Entstehung und besonderen klinischen Eigenschaften dieser Tonsillenkarzinome zu.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1434-9949
    Keywords: Key words:Arthritis, Arthroscopy, Histology, Synovitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Needle arthroscopy is an office-based technique allowing direct visualisation of the knee cavity and selective sampling of the synovial membrane. We performed needle arthroscopy in 150 patients with synovitis of the knee (1) to evaluate the diagnostic potential in early arthritis, (2) to perform therapeutic lavage in persistent inflammatory synovitis and (3) to assess the balance between technical feasibility, safety and patient comfort on the one hand, and the relevance of the obtained macro- and microscopic information for diagnosis and research purposes on the other. After disinfection of the leg and local anaesthesia of the skin and joint, a 1.8–2.7 mm needle arthroscope was introduced into the knee. Synovial fluid was aspirated and lavage of the joint cavity was performed to allow macroscopic evaluation of hyperaemia and hypertrophy of the synovial membrane. Biopsies were taken at inflamed sites, followed by another lavage to remove blood and debris. Needle arthroscopy of the knee is a simple and easy to perform technique made particularly attractive by the local anaesthesia and the ambulatory setting. It allows good macroscopic evaluation of synovial inflammation and selective sampling of the synovial membrane. Biopsies are suitable for RNA and DNA extraction, bacterial or lymphocyte culture, and cell isolation. Because samples were sometimes too small for representative histology, we switched from a 1.8 mm to a 2.7 mm biopsy forceps with good results. In nearly all cases the arthroscopy was well tolerated. Moreover, some patients reported relief of symptoms and even improvement of mobility after lavage of the inflamed joint. No major complications were noted. It was concluded that needle arthroscopy of the knee is a simple, safe and well-tolerated technique, with promising perspectives as a diagnostic, scientific and possibly therapeutic tool in rheumatic diseases.
    Type of Medium: Electronic Resource
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