Die kondyläre Metastasierung: Literaturrecherche und ein Fallbericht

Zusammenfassung: Hintergrund: Kondyläre Metastasen sind eine Rarität. In der Literaturrecherche entsprachen nur 23 der insgesamt 69 gefundenen Fälle den Kriterien von Meyer u. Shklar. Fallbericht: Bei einem 48-jährigen Mann mit Schmerzen im linken Kiefergelenk wurde im linken Kondylus eine solitäre Metastase eines kurz zuvor operierten Lungenkarzinoms gefunden. Aufgrund der ausgedehnten Umgebungsinfiltration erfolgte eine kurative Radiatio. Im Verlauf traten weitere Skelettmetastasen auf. Diskussion: Kieferköpfchenmetastasen unterscheiden sich bezüglich ihres Verlaufs kaum von den Metastasen des extraartikulären Kieferbereiches. Unter den metastasierenden Tumoren rangiert das Mammakarzinom als Primärtumor an erster Stelle, gefolgt vom Lungenkarzinom. Klinisch und radiologisch können keine spezifischen Parameter für eine Diagnosestellung angegeben werden. Bei der Differenzialdiagnostik der Gelenkserkrankungen sollte jedoch insbesondere bei Patienten mit bekannten Primärtumoren und Gelenksbeschwerden sowie radiologischen Auffälligkeiten eine mögliche Metastasierung berücksichtigt werden. Die Diagnose sollte für eine entsprechende Therapieplanung histologisch gesichert werden. Das therapeutische Vorgehen ist in der Regel palliativ, da die Grunderkrankung bei Diagnosestellung einer Kieferköpfchenmetastase zumeist weit fortgeschritten is

Phase II trial of trimelamol in refractory ovarian cancer

Trimelamol is an analogue of hexamethymelamine which exhibited activity against refractory ovarian cancer in phase I clinical trial. The dose limiting toxicity was leukopenia. In a phase II study, 42 patients with recurrent, or platinum-complex resistant, advanced ovarian cancer were treated using the dose schedule 800 mg m-2 i.v. daily for 3 days. There were one complete, three partial and five minor responses, objective response rate: 9.5%. The main toxicity observed was nausea and vomiting, myelosuppression was minor. The role of Trimelamol in the treatment of ovarian cancer remains to be defined, but its activity is limited in refractory disease

Internal plate fixation of fractures: short history and recent developments

Metal plates for internal fixation of fractures have been used for more than 100 years. Although initial shortcomings such as corrosion and insufficient strength have been overcome, more recent designs have not solved all problems. Further research is needed to develop a plate that accelerates fracture healing while not interfering with bone physiology

'I just want a job' : what do we really know about young people in jobs without training?

Over recent years, a central concern of policy has been to drive up post-16 participation rates in full-time education and address the needs of young people not in education, employment or training (NEET). As a result, young people who enter work which is classified as 'without training' at 16/17 have largely been ignored. However, the decision to Raise the Participation Age (RPA) for continuing in learning for all 17-year olds from 2013 and for all 18-year olds from 2015 in England, together with a growing unease about the impact of the current recession on youth unemployment rates, have revived interest in the 'jobs without training' (JWT) group. This paper draws on the findings from two studies: first, a qualitative study in two contrasting local labour markets, of young people in JWT, together with their employers and parents; and second, an evaluation of the Learning Agreement Pilots (LAP), which was the first policy initiative in England targeted at the JWT group. Both studies reveal a dearth of understanding about early labour market entrants and a lack of policy intervention and infrastructure to support the needs of the JWT group throughout the UK. From this, it is concluded that questionable assumptions have been made about the composition and the aspirations of young people in JWT, and their employers, on the basis of little or no evidence. As a consequence, a policy 'quick fix' to satisfy the RPA agenda will not easily be achieved. If the decision to raise the participation age is adopted also by the Welsh and Scottish parliaments, similar challenges may have to be faced

Phase II study of docetaxel in combination with epirubicin and protracted venous infusion 5-fluorouracil (ETF) in patients with recurrent or metastatic breast cancer. A Yorkshire breast cancer research group study

This study was originally designed as a phase I/II study, with a dose escalation of docetaxel in combination with epirubicin 50 mg m⁻² and 5-fluorouracil (5-FU) 200 mg m⁻² day⁻¹. However, as dose escalation was not possible, the study is reported as a phase II study of the combination to assess response and toxicity. A total of 51 patients with locally advanced or metastatic breast cancer were treated on this phase II study, with doses of docetaxel 50 mg m⁻², epirubicin 50 mg m⁻² and infusional 5-FU 200 mg m⁻² day⁻¹ for 21 days. The main toxicity of this combination was neutropenia with 89% of patients having grade 3 and 4 neutropenia, and 39% of patients experiencing febrile neutropenia. Nonhaematological toxicity was mild. The overall response rate in the assessable patients was 64%, with median progression-free survival of 38 weeks, and median survival of 70 weeks. The ETF regimen was found to be toxic, and it was not possible to escalate the dose of docetaxel above the first dose level. This regimen has therefore not been taken any further, but as a development of this a new study is ongoing, combining 3-weekly epirubicin, weekly docetaxel and capecitabine, days 1-14

Direct thrust measurement of a permanent magnet helicon double layer thruster

Direct thrust measurements of a permanent magnet helicon double layer thruster have been made using a pendulum thrust balance and a high sensitivity laser displacement sensor. At the low pressures used (0.08 Pa) an ion beam is detected downstream of the thruster exit, and a maximum thrust force of about 3 mN is measured for argon with an rf input power of about 700 W. The measured thrust is proportional to the upstream plasma density and is in good agreement with the theoretical thrust based on the maximum upstream electron pressure

The prophylactic role of intravenous and long-term oral acyclovir after allogeneic bone marrow transplantation.

Eighty-two patients were randomly allocated to receive intravenous acyclovir 5 mg kg-1 t.d.s. for 23 days followed by oral acyclovir 800 mg 6-hourly for 6 months or matching placebos after allogeneic bone marrow transplantation. Herpes simplex and varicella zoster virus infections were significantly reduced during the period of administration of acyclovir. No reduction in cytomegalovirus infection was demonstrated. The drug was not toxic