Operative Therapie von akral lokalisierten Melanomen

Zusammenfassung: Akrolentiginöse Melanome (ALM) umfassen 4-10% der kutanen Melanome bei Hellhäutigen. Patienten mit ALM wird oft eine schlechtere Prognose zugeschrieben, meist aufgrund zu später Diagnosestellung. Unter Einsatz der 3D-Histologie können akral lokalisierte Melanome mit kontinuierlichem Ausbreitungsmuster lokal chirurgisch mit kleineren Sicherheitsabständen und einem guten funktionellen und kosmetischen Ergebnis behandelt werden. In einer Studie wurden bei 244Patienten mit ALM die konventionelle Histologie vs. 3D-Histologie neben anderen prognostischen Parametern verglichen. Klinische und chirurgische Risikofaktoren beeinflussen die Prognose des ALM. Tumordicke und Ulzeration sind die wichtigsten Risikofaktoren. Die 3D-Histologie in Paraffintechnik ermöglicht es, Sicherheitsabstände zu reduzieren und Lokalrezidive zu vermeiden. Subunguale Melanome machen nur etwa 2-3% der kutanen Melanome beim kaukasischen und etwa 20% der Melanome beim afrikanischen oder asiatischen Hauttyp aus und werden klinisch häufig fehldiagnostiziert. Sie sind oft an Daumen und Großzehe lokalisiert. Die Entfernung von subungualen Melanomen mit 3D-Histologie und tumorfreien Schnitträndern unter Einschluss der Nagelmatrix kann als sichere Strategie angesehen werden, welche die Prognose nicht beeinträchtigt. Funktion und Kosmetik eines Fingers oder Zehs bleiben erhalten. Amputationen bei subungualen Melanomen sollten fortgeschrittenen Verläufen mit Knochen- oder Gelenkbefall vorbehalten bleibe

Indomethacin decreases viscosity of gallbladder bile in patients with cholesterol gallstone disease

There is experimental evidence that inhibition of cyclooxygenase with nonsteroidal anti-inflammatory drugs may decrease cholesterol gall-stone formation and mitigate biliary pain in gall-stone patients. The mechanisms by which NSAIDs exert these effect are unclear. In a prospective, controlled clinical trial we examined the effects of oral indomethacin on the composition of human gall-bladder bile. The study included 28 patients with symptomatic cholesterol or mixed gallstones. Of these, 8 were treated with 3 × 25 mg indomethacin daily for 7 days prior to elective cholecystectomy while 20 received no treatment and served as controls. Bile and tissue samples from the gallbladder were obtained during cholecystectomy. Indomethacin tissue levels in the gallbladder mucosa, as assessed by HPLC, were 1.05±0.4 ng/mg wet weight, a concentration known to inhibit effectively cyclooxygenase activity. Nevertheless, no differences between the treated and untreated groups were found in the concentrations of biliary mucus glycoprotein (0.94±0.27 versus 0.93±0.32 mg/ml) or total protein (5.8±0.9 versus 6.4±1.3 mg/ml), cholesterol saturation (1.3±0.2 versus 1.5±0.2), or nucleation time (2.0±3.0 versus 1.5±2.0 days). However, biliary viscosity, measured using a low-shear rotation viscosimeter, was significantly lower in patients receiving indomethacin treatment (2.9±0.6 versus 5.6±1.2 mPa.s; P < 0.02). In conclusion, in man oral indomethacin decreases bile viscosity without alteration of bile lithogenicity or biliary mucus glycoprotein content. Since mucus glycoproteins are major determinants of bile viscosity, an alteration in mucin macromolecular composition may conceivably cause the indomethacin-induced decrease in biliary viscosity and explain the beneficial effects of nonsteroidal anti-inflammatory drugs in gallstone disease

Nonlinear dynamics of semiconductor lasers with active optical feedback

An in-depth theoretical as well as experimental analysis of the nonlinear dynamics in semiconductor lasers with active optical feedback is presented. Use of a monolithically integrated multi-section device of sub-mm total length provides access to the short-cavity regime. By introducing an amplifier section as novel feature, phase and strength of the feedback can be separately tuned. In this way, the number of modes involved in the laser action can be adjusted. We predict and observe specific dynamical scenarios. Bifurcations mediate various transitions in the device output, from single-mode steady-state to self-pulsation and between different kinds of self-pulsations, reaching eventually chaotic behavior in the multi-mode limit

Abstracts from the 8th International Conference on cGMP Generators, Effectors and Therapeutic Implications

This work was supported by a restricted research grant of Bayer AG

Cloning and heterologous expression of the entire set of structural genes for nikkomycin synthesis from Streptomyces tendae Tü901 in Streptomyces lividans.

A genomic library from Streptomyces tendae raised in shuttle cosmid vector pKC505 was screened with a previously isolated 8-kb DNA fragment containing the orfP1 gene, which is involved in nikkomycin biosynthesis. The entire set of structural genes for nikkomycin synthesis was heterologously expressed in S. lividans TK23 by introducing recombinant cosmids p24/32 and p9/43-2, carrying inserts of about 31 and 27 kb, respectively, overlapping by 15 kb. S. lividans transformants synthesized nikkomycins X, Z, I, and J, which were identified by high-pressure liquid chromatography analyses of culture filtrates

Integration of InP-based optoelectronics with silicon waveguides

Compound semiconductors provide state-of-the-art performance in optoelectronics, while silicon-on-insulator (SOI) is an ideal platform for many passive functions in integrated optics. By combining them one can realise optical devices with high performance and low cost. This paper discusses the various applications and technologies for integrating InP chips with SOI waveguides. Bonding of lasers, SOA arrays and detectors for practical applications is described. Experimental results are given for visually aligned thermo-compression bonding and self-aligned flip-chip bonding with indium bumps. Flip-chip bonding is reported directly on SOI chips, as well as on a separate silicon-optical-bench