[Pharmacokinetics of systemic, regional and topical drugs for therapy of intraocular inflammation]. / Pharmakokinetik systemischer, regionaler und lokaler Medikamente in der Therapie intraokularer Entzündungen.

A broad spectrum of anti-inflammatory drugs with different mechanisms is available for the treatment of intraocular inflammation. Corticosteroids are the mainstay of therapy. Mechanisms of action are quite well understood for most drugs in particular taken from animal research studies. However, pharmacokinetic evidence for treatment of ocular disease is generally limited for the human eye and especially for ocular inflammation. The bioavailability of a particular drug in an inflamed eye is expected to be faster due to a barrier breakdown. Therefore, intraocular level of effective substances should be lowered more rapidly than in a non-inflamed eye due to improved drainage. This article reviews current knowledge firstly about local, regional and systemic anti-inflammatory therapy of uveitis and finally on immuosuppressive systemic therapy.

Device-related complications of long-term intrathecal drug therapy via implanted pumps.

STUDY DESIGN: Case series. OBJECTIVES: To evaluate the risk of pump- and catheter-related complications of intrathecal drug delivery systems. SETTING: Tertiary care center in Switzerland. METHODS: The medical records of all in- and out-patient adults treated at our institution during a 12-year period were reviewed. All patients that had received intrathecal drug therapy via an implanted pump were invited to a structured interview. RESULTS: One hundred patients, representing therapy with 175 implanted pumps and 132 intrathecal catheters over 552 years, participated in the study. During the observation period, 217 surgical procedures (including 100 primary pump implants) and 5863 pump refills were performed. The annual rate for complications requiring surgical measures was 10.5%, with 35% being pump related and 65% being catheter related. The incidence of infections in our patients was 0.7% per year; all infections appeared during the first 3 months after implantation of the first pump. CONCLUSIONS: Complication rates of the patients treated in our center, where we have long-term experience with the indication, implantation and continuous care of patients with intrathecal infusion systems, are in the lowest ranges when compared with other published studies. We consider intrathecal testing before implantation, standardized perioperative procedures and consequent long-term care of the patients in a specialized outpatient clinic to be essential factors for the avoidance of complications.

[Infiltrating lymphadenosis benigna cutis as borreliosis of the skin]. / Infiltrative Lymphadenosis benigna cutis als Borreliose der Haut.

Forms of lymphadenosis benigna cutis (Lbc) which run an unusual course may present considerable problems and are sometimes difficult to distinguish from malignant lymphomas of the skin on the basis of the clinical and histological picture. The case of a female patient is reported, who presented with plaque-like infiltrative lesions on both lower arms. The lesions were interpreted as being malignant lymphomas of the skin. After a progressive course of 6 years' duration, the diagnosis of an unusual plaque-like infiltrative form of Lbc caused by Borrelia was serologically confirmed by the demonstration of anti-Borrelia burgdorferi antibodies. Immunohistochemical examinations yielded the picture of a follicular pseudolymphoma with the formation of germ centres. After several weeks of penicillin therapy the skin lesions cleared completely.

[Early pancreatic lesions induced by N-nitroso-bis(2-hydroxypropyl) amine in the golden Syrian hamster]. / Lésions pancréatiques précoces induites par le N-nitroso-bis (2 hydroxy propyl) amine chez le syrian golden hamster.

Early lesions of the exocrine pancreas of the Syrian Golden Hamster induced by lifetime weekly oral or subcutaneous administration of N-nitroso-bis (2 hydroxy propyl) amine (250 mg/kg) were studied by light and electron microscopy and autoradiography. There were no pathological differences according to the way of administration. The histogenesis of induced pancreatic neoplasms may be summed up as follows: hyperplasia of ductular cells with new islet cell formation that lead to the development of peri or intra insular cystic ductules which become cystedenomas and carcinomas.