[The physician's bag and emergency case. What should be in it?]. / Arzttasche und Notfallkoffer. Was muss rein?

The contents of the doctor's bag will be determined by the doctor concerned and will depend on his medical training and specialization, on local conditions, the nature of his field of activity, and on the organization of medical emergency services. A selection of commonly employed preparations, classified by indication is proposed and discussed. In addition to the "drug collection", the essential "hardware" (syringes, stethoscope, etc.) and "software" (prescription forms, accounting forms, list of hospital telephone numbers, etc.) are also listed. The specific demands to be met by the contents of an emergency kit are discussed separately.

[Hyperglycemia and ketoacidosis associated with olanzapine]. / Hyperglykämie und Ketoazidose unter Olanzapin.

Two psychotic patients developed hyperglycaemia several weeks after starting olanzapine. In one case the elevated glucose concentrations returned to normal soon after withdrawal of olanzapine. In the second case severe ketoacidosis with lethal outcome occurred.

Deposition of collagen fibril bundles by long-term culture of fibroblasts in a collagen sponge.

Human fibroblasts cultured for 10 days in a collagen sponge migrated through the pores of the sponge and expressed a moderate mitotic activity, which stabilized after 10 days, and a high collagen and protein synthesis. Between 10 and 27 days, the newly synthesized collagen filled the pores of the sponge. This matrix accumulation induced a delayed decrease of collagen and protein synthesis. Finally, after 27 days of culture, the fibroblasts expressed low biosynthetic activities similar to the ones exhibited in vivo. The newly synthesized matrix was highly differentiated, as shown by the presence of a dense network of quarter-staggered collagen fibrils (42 nm +/- 6 nm in diameter) surrounding the cells. The size and the shape of these fibrils demonstrated that the newly synthesized procollagen was fully processed in collagen by removal of their N- and C-terminal propeptides. Moreover, these fibrils were packed in bundles organized into an interwoven network that mimics the pattern of the papillary dermis. These findings show that fibroblasts cultured for one month in a collagen sponge construct large amounts of a highly differentiated connective tissue.

Optimization of thickness, pore size and mechanical properties of a biomaterial designed for deep burn coverage.

A collagen and chondroitins 4-, 6-sulphate biomaterial designed for the coverage of severe burns was optimized in terms of mechanical strength by addition of 20% (wt/vol) of chitosan to the starting material. Chitosan should create ionic bonds with collagen and thus increase the tensile strength and Young's modulus of the sponge. On the other hand, sterilization by h-irradiation of the biomaterial induced a decrease in its mechanical properties that could be avoided by sterilization using beta-irradiation. The thickness, pore size and morphology of the biomaterial were optimized before freeze-drying by freezing the mixture at -60 degrees C at a weight/volume concentration of 1.25% and a volume of 270 mul/cm2. The biomaterial obtained under these conditions may further the vascularization and cellular colonization of the porous structure by the host cells of the wound bed and therefore may accelerate the regeneration of a new dermis.

Collagen synthesis by fibroblasts cultured within a collagen sponge.

We prepared a collagen sponge made of type I and III bovine collagen, glycosaminoglycans (GAG) and chitosan. Fibroblasts grown within the collagen sponge express a sixfold increase of their collagen synthesis, compared with fibroblasts embedded in a collagen gel. Moreover, collagen synthesis is twice as high in the collagen sponge than in a monolayer culture. The collagen sponge culture system promotes a dynamic model for us to perform studies on the regulations of collagen synthesis. Increased collagen production within the collagen sponge leads fibroblasts to reconstitute their own extracellular matrix, which should be more physiological than a bovine collagen gel.

[Use of strontium-89 in the analgesic treatment of bone metastases]. / Emploi du strontium-89 dans le traitement antalgique des métastases osseuses.

The analgesic properties of 89Sr were investigated in 17 patients with multiple painful bone metastases. 89Sr is a radioisotope, the metabolism of which in the body is comparable to that of calcium. It is a pure beta emitter and its half-life is 51 days. When injected intravenously it is captured by bone, especially at locations where the turnover is increased. Each patient received 1--2 mCi of 89Sr. Bone scans and hematological investigations were performed before, and 2 months after, treatment. No significant changes were found. Shealy's method was used to assess pain, initially twice a week and then at more prolonged intervals. One patient suffering from multiple myeloma showed a spectacular improvement and 6 others responded favourably. Improvement generally occurred within 3--7 days, but was sometimes delayed for up to 3 weeks. Relief lasted for up to several months. Five patients had an increase of pain during the 24 hours immediately after treatment. An average of 28% of the administered radioactive dose was found in the urine collections during the first 48 hours. Although the treatment was not successful in every case, the use of 89Sr as a long acting analgesic in multiple bone metastases should be considered more frequently, especially as there are no side effects.

Respiratory activity and maintenance of cell suspensions of rat liver.

Previous experimentation involving the use of dispersed rat liver cells have utilized suspending media common to fractionation and slicing methods. Cells in these media have not remained viable for prolonged periods of time and they have resisted culturing techniques. Suspensions of dispersed parenchymal cells were prepared from rat livers which had been perfused in situ via the dorsal aorta with an EDTA-sucrose solution. The maintenance of surviving cells was attempted in three different media: sucrose buffered with Tris-HCl, Waymouth medium, and Waymouth medium supplemented with 30% calf serum. Cells suspended in sucrose and buffered with Tris-HCl oxidized citrate, succinate, and alpha-kegoglutarate but did not respire in the presence of other citric acid cycle intermediates. When cells were suspended in Waymouth medium without glucose, they oxidized malate and glutamate plus the above-mentioned substrates. Glucose and pyruvate did not stimulate oxygen uptake in either medium. Cells exhibited respiratory activity for up to 8 hr when incubated in Waymouth medium supplemented with calf serum. Both the ability to oxidize succinate and the morphological integrity of the cells were retained for this period of time. When cells were incubated in Waymouth medium alone, the time interval was reduced to 6 hr. Sucrose-Tris-HCl in the presence of succinate was not satisfactory as an incubation medium, since many of the cells underwent breakdown.