Disparate effects of adalimumab and fumaric acid esters on cardiovascular risk factors in psoriasis patients: results from a prospective, randomized, observer-blinded head-to-head trial.

BACKGROUND: The effect of adalimumab and fumaric acid esters (FAE) on the cardiovascular risk associated with psoriasis has only been investigated scarcely in randomized controlled studies. OBJECTIVE: The aim of this prospective, randomized controlled head-to-head trial was to compare the influence of adalimumab and FAE on cardiovascular disease markers in psoriasis patients. METHODS: Sixty-five patients with moderate to severe plaque psoriasis were randomly assigned to adalimumab or FAE treatment for 6 months. Cardiovascular haemodynamic parameters [flow-mediated dilation (FMD), nitro-glycerine mediated dilation (NMD) and carotid intima-media thickness (CIMT), blood pressure] were assessed at baseline (v0) and after 6 months (v6). Cutaneous disease severity, inflammatory and lipid cardiovascular risk markers were analysed at baseline(v0), after 3 (v3) and 6 months (v6). RESULTS: After 6 months of treatment FMD in the adalimumab group increased significantly [v0 5.9% (6.4% SD), v6 8.0% (4.8% SD), P = 0.048) but not in the FAE group. (v0 7.0% (4.1% SD), v6 8.4% (6.1% SD), P = 0.753]. This was paralleled by a significant decrease of high sensitive C-reactive protein (hsCRP) in the adalimumab group in comparison to the FAE group (v0: 0.39 mg/dL (0.38 SD), v6: 0.39 mg/dL (0.48 SD), P = 0.043). No significant changes were observed in any other haemodynamic parameters. FAE, however, additionally decreased total cholesterol (P = 0.046) and apolipoprotein B (P = 0.041) levels compared to adalimumab. Mean Psoriasis Area and Severity Index (psoriasis area severity score) reduction was greater but not significant (P = 0.116) under adalimumab treatment compared to FAE treatment [-71.1% (29.9 SD) vs. -54.6% (45.7%)]. CONCLUSION: In our study, both treatments were documented to exert effects on the cardiovascular system. While adalimumab showed anti-inflammatory effects and improved FMD, FAE interacted favourably with the cholesterol metabolism.

Microstructural analysis of subchondral bone in knee osteoarthritis.

The results of this study show increased formation of bone in the subchondral areas in advanced stages of osteoarthritis of the knee. These changes seem to be influenced by mechanical factors. INTRODUCTION: Subchondral bone changes seem to contribute to the progression of knee osteoarthritis (OA). This study aimed to analyze subchondral bone microstructure in specimens of late-stage knee OA in respect to articular cartilage damage, meniscus integrity, and knee joint alignment. METHODS: Thirty proximal tibiae of 30 patients (20 female and 10 male) with late-stage OA retrieved during total knee arthroplasty were scanned using a high-resolution micro-computed tomography. The scans were semi-automatically segmented into five volumes of interest. The volumes of interest were then further analyzed using commercially available software. The degree of articular cartilage damage was assessed semi-quantitatively by magnetic resonance imaging before surgery. RESULTS: The mean bone fraction volume (bone volume/total volume (BV/TV)) in all weight-bearing locations was significantly higher compared to the non-weight-bearing reference point below the anterior cruciate ligament (p = 0.000). The mean BV/TV in the medial compartment was significantly higher compared to the lateral compartment (p = 0.007). As for the BV/TV in intact menisci, there was a significantly lower subchondral bone fraction volume compared to subluxated or luxated menisci in the medial (p = 0.020) and lateral compartment (p = 0.005). Varus alignment had a significantly higher subchondral BV/TV in the medial compartment, whereas valgus alignment had a significantly higher subchondral BV/TV in the lateral compartment (p = 0.011). CONCLUSIONS: The results show significant differences of subchondral bone microstructural parameters in respect to cartilage damage, meniscus' structural integrity, and knee joint alignment. Therefore, subchondral bone changes seem to be a secondary process in the late-stage OA of the knee caused by mechanical changes.

Bone health in childhood cancer: review of the literature and recommendations for the management of bone health in childhood cancer survivors.

In the past decades, new cancer treatment approaches for children and adolescents have led to a decrease in recurrence rates and an increase in long-term survival. Recent studies have focused on the evaluation of the late effects on bone of pediatric cancer-related treatments, such as chemotherapy, radiation and surgery. Treatment of childhood cancer can impair the attainment of peak bone mass, predisposing to premature onset of low bone mineral density, or causing other bone side-effects, such as bone quality impairment or avascular necrosis of bone. Lower bone mineral density and microarchitectural deterioration can persist during adulthood, thereby increasing fracture risk. Overall, long-term follow-up of childhood cancer survivors is essential to define specific groups at higher risk of long-term bone complications, identify unrecognized long-term adverse effects, and improve patient care. Children and adolescents with a cancer history should be carefully monitored, and patients should be informed of possible late complications of their previous medical treatment. The International Osteoporosis Foundation convened a working group to review the bone complications of pediatric cancer survivors, outlining recommendations for the management of bone health, in order to prevent and treat these complications.

Randomized controlled trial comparing 35% trichloroacetic acid peel and 5-aminolaevulinic acid photodynamic therapy for treating multiple actinic keratosis.

BACKGROUND: Photodynamic therapy (PDT) and chemical peels with trichloroacetic acid (TCA) can be applied to large skin areas and thus are suitable treatment options for patients with multiple actinic keratosis (AK). However, despite its long use, TCA has been investigated only rarely in this indication. OBJECTIVES: This randomized, observer-blinded, intrapatient comparative study sought to investigate the efficacy and safety of 35% TCA vs. aminolaevulinic acid 20% (ALA) PDT in patients with extensive field cancerization and multiple AKs in the face or on the scalp. METHODS: Twenty-eight patients with at least five AKs in two comparable anatomical areas on the head were treated with 35% TCA and ALA PDT randomly assigned to each area. Their therapeutic efficacy, adverse events and cosmetic outcome were assessed by a blinded investigator at 1, 3, 6 and 12 months after treatment. RESULTS: After 12-months' follow-up TCA and ALA PDT reduced the total lesion count, the primary outcome, by 31% and 58%, respectively (P = 0·006). Complete clearance of pre-existing AKs were 49% for TCA and 74% for ALA PDT (P = 0·011). Treatment failure (number of AKs greater than 50% of the baseline count) was observed in seven patients (25%) after TCA and in two patients (7%) after PDT treatment. Treatment-related pain was significantly higher for ALA PDT (visual analogue scale 7·5 ± 2·3 vs. TCA: 5·1 ± 2·6; P = 0·04), whereas scarring (n = 6, 21%) was seen only in TCA treated patients. CONCLUSIONS: ALA PDT provided better clinical results than TCA in the treatment of patients with extensive field cancerization and multiple AKs.

[Cutaneous manifestations of metabolic syndrome]. / Hautmanifestationen beim metabolischen Syndrom.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of risk factors which increase the risk of developing cardiovascular diseases and type II diabetes mellitus. High blood pressure, hyperglycemia, dyslipidemia, and central obesity are the main risk factors. While MetS is not a dermatological diagnosis per se, several cutaneous manifestations can serve as a clinical indicator for impending MetS and facilitate an early diagnosis and therapy in order to prevent its long-term sequelae. CUTANEOUS MANIFESTATIONS: Acanthosis nigricans and multiple skin tags can be signs of insulin resistance and impaired glucose tolerance, xanthoma and xanthelasma signs of dyslipidemia. Patients with type II diabetes can display numerous more or less specific dermatoses. Psoriasis and Hidradenitis suppurativa are frequently associated with MetS and obesity. Acne and hirsutism are highly prevalent signs of cutaneous hyperandrogenism due to polycystic ovary syndrome (PCOS). Hyperinsulinemia plays a major pathophysiological role in PCOS; MetS is thus an integral part of PCOS CONCLUSION: Emerging scientific evidence points to close associations between MetS and common dermatological diseases necessitating to integrate this perspective into clinical management of these diseases. The dermatologist is a key player in early detection of MetS.

The effect of a flexible pylon system on functional mobility of transtibial amputees. A prospective randomized study.

BACKGROUND: Prosthetic component selection strongly influences the functional mobility of transtibial amputees. Until now, little attention has been paid to the connection between the prosthetic socket and the foot component. AIM AND DESIGN: Aim of this study was to compare a novel flexible with a conventional rigid pylon system in a prospective randomized trial in transtibial amputees to determine effects on gait and mobility. SETTING: The study was performed in a rehabilitation centre for geriatric amputees. POPULATION: Twenty-eight geriatric unilateral transtibial amputees (8 female, 20 male) with low degree of mobility were included. METHODS: At admission to the rehabilitation centre objective and subjective parameters were assessed including demographic data and levels of daily activity using standardized questionnaires. Three months after prosthetic fitting a follow-up was performed and additional parameters such as walking speed, step length and vertical ground reaction forces were examined using a dynamic gait analysis. RESULTS: The study revealed a significant improvement in step length (P=0.03), in using mobility aids (P=0.04) and benefits concerning the self-selected gait speed, the mobility and gait disorders using the flexible device. CONCLUSION: The results demonstrate advantages for the flexible system, resulting in a positive effect on the patient's gait accomplishments in a geriatric population. CLINICAL REHABILITATION IMPACT: The advantages of the dynamic pylon may improve clinical rehabilitation, especially for geriatric patients with vascular disorders, as it provides comfort and better prosthetic performance during gait as a short-term benefit and thus gives a better quality of life in the long-term.

3,5-T2 is an alternative ligand for the thyroid hormone receptor ß1.

Several liganded nuclear receptors have alternative ligands acting in a tissue-specific fashion and playing important biological roles. We present evidence that 3,5-diiodothyronine (T(2)), a naturally occurring iodothyronine that results from T(3) outer-ring deiodination, is an alternative ligand for thyroid hormone receptor ß1 (TRß1). In tilapia, 2 TRß isoforms differing by 9 amino acids in the ligand-binding domain were cloned. Binding and transactivation studies showed that T(2) activates the human and the long tilapia TRß1 isoform, but not the short one. A chimeric human TRß1 (hTRß1) that contained the 9-amino-acid insert showed no response to T(2), suggesting that the conformation of the hTRß1 naturally allows T(2) binding and that other regions of the receptor are implicated in TR activation by T(2). Indeed, further analysis showed that the N terminus is essential for T(2)-mediated transactivation but not for that by T(3) in the long and hTRß1, suggesting a functional interaction between the N-terminal domain and the insertion in the ligand-binding domain. To establish the functional relevance of T(2)-mediated TRß1 binding and activation, mRNA expression and its regulation by T(2) and T(3) was evaluated for both isoforms. Our data show that long TRß1expression is 10(6)-fold higher than that of the short isoform, and T(3) and T(2) differentially regulate the expression of these 2 TRß1 isoforms in vivo. Taken together, our results prompted a reevaluation of the role and mechanism of action of thyroid hormone metabolites previously believed to be inactive. More generally, we propose that classical liganded receptors are only partially locked to very specific ligands and that alternative ligands may play a role in the tissue-specific action of receptors.

[The significance of osteoporosis for orthopaedic and trauma surgeons]. / Die Bedeutung der Osteoporose für den Orthopäden und Unfallchirurgen.

This refresher is concerned with several aspects: to give an overview over the latest considerations concerning the definition of osteoporosis related to fractures as well as to discuss up-to-date diagnostic possibilities in order to estimate the future fraction risk of the individual patient. Furthermore, it gives a summary of medical treatment options particularly under a orthopaedic and trauma surgery point of view. This topic publication can only be a recurrent presentation synopsis for the purpose of revising, as there are several publications and guidelines for advanced subject-specific training (e.g. S3-Richtlinie zur Diagnose und Therapie der Osteoporose des DVO, http://www.osteoporose-portal.de/arzt/leitlinen).

Imaging of highly malignant osteosarcoma with iodine-123-vascular endothelial growth factor.

OBJECTIVE: Vascular endothelial growth factor (VEGF) is an important angiogenic factor, and its receptors have been shown to be overexpressed in various human carcinomas. In this study, we investigated the role of scanning with iodine-123 ((123)I)-labelled VEGF(165) in patients with highly malignant osteosarcoma. METHODS: Two patients (a 15-year-old female and a 14-year-old male) with osteosarcoma were injected with 140 MBq [<130 pmol (<5 µg) VEGF(165) per patient] of (123)I-VEGF(165). Dynamic acquisition was initiated immediately after administration and carried out until 30 min after injection. Whole-body images were done in anterior and posterior views at various time points. All patients underwent single-photon emission tomography imaging. RESULTS: (123)I-VEGF(165) scans were positive in these patients. Sequential images clearly showed increased (123)I-VEGF(165) activity in osteosarcoma lesions. The tumour lesions were still visualized in whole-body images and single-photon emission tomography examinations 2 h after injection. Intravenous injection of (123)I-VEGF(165) did not cause any side effects. CONCLUSION: Our results suggest that (123)I-VEGF(165) receptor scintigraphy may be useful for the visualization of highly malignant osteosarcoma and/or metastasis and the angiogenic activity of the tumour.

[Collagenase Clostridum histolyticum in the management of Dupuytren's contracture]. / Kollagenase Clostridium histolyticum im Management der Dupuytrenschen Kontraktur.

Dupuytren's contracture is a fibroproliferate disease of the palmar aponeurosis with a formation of nodules and cords. Surgical treatment is the gold standard for Dupuytren's contracture at the moment. A short while ago Collagenase clostridium histolyticum was licensed as a non-surgical method to treat Dupuytren's contracture. Collagenase clostridium histolyticum is injected directly into the Dupuytren's cord and after 24 h the contracture is distended by manual rupturing. Collagenase clostridium histolyticum causes a depletion of collagen, however neurovascular structures are spared. 2 clinical phase III studies showed that contractures could be effectively reduced when using Collagenase clostridium histolyticum. However, there are no long-term results regarding effectiveness and side effects, or comparative studies using surgical methods. This paper presents a review of Collagenase clostridium histolyticum and its role in the management of Dupuytren's contracture. Indication, technical procedure, treatment results and complications are described.

5-Methoxypsoralen plus ultraviolet (UV) A is superior to medium-dose UVA1 in the treatment of severe atopic dermatitis: a randomized crossover trial.

BACKGROUND: Ultraviolet (UV) A1 and psoralen plus UVA (PUVA) are effective treatment options for severe atopic dermatitis (AD); however, their relative efficacy has not yet been determined in a head-to-head study. OBJECTIVES: To compare UVA1 and oral 5-methoxypsoralen (5-MOP) plus UVA with respect to efficacy, tolerability and duration of response in patients with severe generalized AD. METHODS: Forty patients were included in this randomized observer-blinded crossover trial. The patients received either 15 exposures to medium-dose UVA1 as the first treatment and, in cases of relapse, another 15 exposures to 5-MOP plus UVA as the second treatment, or vice versa. All patients were followed until 12 months after discontinuation of the last treatment. The SCORAD score was determined by a blinded investigator at baseline, after 10 and 15 treatments each and during the follow-up period. In addition, all adverse events were recorded during the whole study period. RESULTS: Twenty-three patients completed the crossover treatment. Both phototherapies resulted in clinical improvement; however, PUVA reduced the baseline SCORAD score to a significantly greater extent than UVA1 (mean +/- SD 54.3 +/- 25.7% vs. 37.7 +/- 22.8%; P = 0.041). The median length of remission was 4 weeks (interquartile range 4-12) after UVA1 and 12 weeks (interquartile range 4-26) after PUVA therapy (P = 0.012). CONCLUSIONS: PUVA provides a better short- and long-term response than medium-dose UVA1 in patients with severe AD.

Photoepilation with variable pulsed light in non-facial body areas: evaluation of efficacy and safety.

BACKGROUND: Variable Pulsed Light (VPL) is a new intensity pulse light (IPL) system. We evaluated VPL for safety and long-term efficacy in non-facial hair removal. STUDY DESIGN/MATERIAL AND METHODS: The Variable Pulsed Light [VPL System (Energist Limited, UK), 610-950 nm] system was used for the removal of unwanted non-facial dark pigmented body hair in 42 volunteers (40 females, two males, age: 18-43 years, mean: 30.4 +/- 7.4 years) with Fitzpatrick skin phototype (SPT) II (33.3%), III (38.1%) and IV (28.6%), and brown (43.8%) or black (56.2%) fine (19.0%), medium (47.6%) or coarse (9.4%) body hair. Minimum follow-up period was 12 months (mean: 13.14 +/- 2.38). Treatment parameters were as follows: number x duration of micropulses: 15 x 5-15 x 7 ms, pulse delay: 1-8 ms, fluence: 30-45 J/cm(2). RESULTS: Very good (> or =76% hair reduction) and good treatment efficacies (hair reduction: 51-75%) were observed in the majority of treated patients (n = 18; 42.9%; n = 14; 33.3% respectively), four patients (9.5%) had only moderate (hair reduction: 26-50%) and six (14.3%) patients had no (hair reduction < or =25%) treatment response. Side-effects (reversible erythema, leukotrichia) were sparse. More favourable long-term therapy outcomes were observed for higher SPT (III and IV), medium or coarse black hair and younger patients. CONCLUSION: The VPL System is a relatively efficient and safe treatment for long-term hair removal. Higher SPT (III and IV) with black and medium to coarse hair, and younger age of the patients appear to be factors of significant importance predicting long-term efficacy.

[Bisphosphonates for malignant bone tumors]. / Bisphosphonate bei malignen Knochentumoren.

Bisphosphonates (BPs) are able to prevent, reduce, or delay skeletal complications caused by tumors. Since the introduction of BPs, there has been a marked reduction of skeletal events. Today we can choose from a variety of BPs with different potency, efficacy, dosing, and administration regimens, as well as BPs for different indications. For patients with tumors who have a risk of developing osteoporosis induced by the tumor or antitumor treatment, we should think of prevention. In general, BPs are well tolerated. But there are also side effects: flulike syndrome, arthralgias, or, when administered orally, gastrointestinal symptoms. In a number of cases, the dosing regime must be adjusted according to renal function and baseline creatinine clearance. This paper reviews the current evidence-based use of BPs in solid tumors and the recommendations for treatment.

Evaluation of safety and efficacy of variable pulsed light in the treatment of unwanted hair in 77 volunteers.

BACKGROUND: Several studies on hair removal with intense pulsed light (IPL) and various laser sources have been done, but adequate data on long-term follow up are scarce. The present uncontrolled prospective pilot study evaluated safety and long-term efficacy of variable pulsed light (VPL) on hair removal in the face for medical and/or cosmetic indications. STUDY DESIGN/MATERIAL AND METHODS: The VPL system (Energist Ltd, UK) was used for the treatment of hypertrichosis in the face, mainly hirsutism, in 77 female volunteers. The minimum follow-up time after the last treatment was 9 months (mean: 12.74 +/- 2.87 months). RESULTS: Over 50% of hair clearance was observed in 68 (88.3%) of all cases. Erythema and leucotrichia were the most often associated side-effects encountered. Transient pigmentary changes were not reported. CONCLUSION: The VPL System presents as a relatively efficient and safe treatment alternative for long-term removal of unwanted hair. It seems to be particularly effective in fair-skinned patients with dark hair (skin types II-III-IV). Adverse effects were minimal and transient and, in no patient, significant enough to interrupt treatment.

Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women: results from a double-blind, vehicle-controlled, randomized study.

BACKGROUND: For many years topical progesterone has been prescribed by gynaecologists as an antiageing and skin-firming treatment, without any clinical scientific evidence of its effects, tolerability and safety when applied to skin. OBJECTIVES: To evaluate the influence of 2% progesterone cream on function and texture of the skin in peri- and postmenopausal women. METHODS: A double-blind, randomized, vehicle-controlled study was conducted in 40 subjects. Objective methods for measuring skin elasticity, epidermal hydration and skin surface lipids, clinical monitoring and self-assessment, and determination of blood hormone levels (luteinizing hormone, follicle-stimulating hormone, oestrogen and progesterone) were used to determine effects and side-effects of this treatment at four visits over a 16-week period. RESULTS: The study demonstrated a significant (P < or = 0.05) increase of the elastic skin properties in the treatment group, as demonstrated by objective measurements of three skin elasticity parameters, whereas in the control group no such effect was observed. This effect in the treatment group was further paralleled by the results of the clinical monitoring, where the 2% progesterone cream yielded consistent superiority over vehicle in counteracting different signs of ageing in the skin of peri- and postmenopausal women. Clinical monitoring showed a greater reduction in wrinkle counts (29.10% vs. 16.50%) and wrinkle depth (9.72% vs. 7.35%) around the right eye, a greater decrease in nasolabial wrinkle depth (9.72% vs. 6.62%) and a significantly higher (P < 0.05) increase in skin firmness (23.61% vs. 13.24%) in the treatment group. Epidermal hydration and skin surface lipids did not change significantly in either group during the study. Progesterone was well absorbed in the systemic circulation: mean blood levels rose minimally, but statistically significantly (P = 0.001), by 0.53 ng mL(-1). No serious side-effects of the treatment were observed. CONCLUSIONS: The results of this study demonstrate that topical 2% progesterone acts primarily in increasing elasticity and firmness in the skin of peri- and postmenopausal women. These effects in combination with good tolerability make progesterone a possible treatment agent for slowing down the ageing process of female skin after onset of the menopause.

Soluble p185(HER-2) in patients with malignant bone tumours.

BACKGROUND: This study was initiated to test the hypothesis that soluble p185(HER-2) could be of value as a diagnostic or predictive marker for patients with malignant bone tumours. PROCEDURE: Sera of 35 patients with high-grade malignant osteosarcoma (n = 27) and Ewing Sarcoma (n = 8) were tested at the time of diagnosis by ELISA and compared with sera of controls (n = 38) and clinical data. RESULTS: In patients with osteosarcoma and Ewing Sarcoma, levels of sp185(HER-2) did not differ significantly from levels in controls. These results were irrespective of the type of tumour, survival chemotherapy or other clinical variables. CONCLUSION: p185(HER-2) serum levels do not appear to be of diagnostic or predictive value for differentiation of high-grade osteosarcoma and Ewing Sarcoma.

Vaccinia viral/retroviral chimeric vectors.

Retroviral vectors have become important tools in gene therapy due to a number of desirable properties, including efficient gene delivery and stable genomic integration. Some shortcomings, however, still remain to be solved. Retroviral vectors cannot be grown to as high titers as for example adenoviruses or vaccinia viruses, they tend to be unstable and are sensitive to lysis by complement when transfused into patients. The search for more robust retroviral delivery systems has led to the development of hybrid viral vectors trying to combine the broadly estimated features of retroviral vectors with advantageous properties of a second viral vector system. Chimeric systems with retroviruses and adeno-alphavirus and herpesviruses have been reported. This review is dedicated to vaccinia virus, a widely used vector in molecular and cell biology, as a chimeric carrier for retroviral vector units. In the first poxviral/retroviral constructs, retroviral vector units integrated into a defective vaccinia vector, gave rise to transduction competent particles. Due to the high insertion capacity of the vaccinia system, also the packaging components could be inserted into the carrier virus resulting in a system that is independent of retroviral packaging cell lines. Moreover, since vaccinia is a cytoplasmic virus that does not recognize nuclear transcription and processing signals, retroviral vectors with introns and internal transcription stops could be constructed that transduce complex gene cassettes. The topic of this review is the vaccinia viral / retroviral vector system and possible applications to gene therapy.

X-Ray Spectrometry of Copper: New Results on an Old Subject.

We review recent, and some less recent, measurements of several emission spectra of copper. The results are discussed with special emphasis on elucidating the structure of the Kα 1,2 and Kß 1,3 diagram lines and their underlying transitions. These lines are found to contain ≈30 % contribution from 3d spectator hole transitions. Other multielectronic transitions, the 2p spectator hole (satellites) and 1s spectator hole (hypersatellites) transitions were also measured. They are discussed paying special attention to the evolution of the lineshapes and intensities from the excitation threshold to saturation. Trends in the measured quantities depending on the spectator hole's shell and subshell are also discussed.

Serum levels of TNF-beta and sTNF-R in patients with malignant bone tumours.

OBJECTIVE: To determine serum levels of TNF-beta and soluble TNF-R in patients with primary highly malignant bone tumours. PATIENTS AND METHODS: Sera of 27 patients with highly malignant osteosarcoma and Ewing sarcoma were taken at the time of diagnosis and analysed by ELISA. RESULTS: Both TNF-beta and sTNF-R levels were lower in sera from osteosarcoma patients as compared to those from Ewing sarcoma. In patients with high-grade osteosarcoma, but not Ewing sarcoma, high levels of TNF-beta correlated with bad response to neoadjuvant chemotherapy. CONCLUSION: In patients with high-grade osteosarcoma TNF-beta levels seem to be of predictive value and both TNF-beta and sTNF-R seem to be of diagnostic value for differentiation between high-grade osteosarcoma and Ewing sarcoma.