Effect of radiotherapy on brain glucose metabolism in patients operated on for low grade astrocytoma.

OBJECTIVE: To assess the effect of postoperative radiotherapy on brain glucose metabolism (CMRGlu) of operated patients with low grade astrocytomas. METHODS: PET and 18F-fluorodeoxyglucose was used to measure absolute CMRGlu in patients with fibrillary astrocytoma (WHO II) of the frontal lobe, who did (n=7) or did not (n=12) receive radiotherapy subsequent to first debulking tumour resection. In addition, statistical parametric mapping (SPM95) was applied to assess the pattern of relative CMRGlu associated with the frontal tumour. Data were compared with 12 healthy controls. RESULTS: A global reduction of absolute CMRGlu was found when either patients with or without radiotherapy were compared with controls (ROI analysis). Brain areas of relative CMRGlu reduction were found in the brain ipsilateral and contralateral to the tumour, comparing both patient groups with controls by SPM ("tumour diaschisis effect"). Superimposed, absolute CMRGlu in the contralateral frontal, parietal, occipital cortex as well as in the white matter was on average 17% lower in patients receiving radiotherapy than in patients who did not. CONCLUSIONS: The data discriminate a tumour effect from a radiotherapy effect, and support the view of adverse effects of radiotherapy on brain not directly involved by tumour.

Prevention of heterotopic ossification in hip arthroplasties by means of an early single-dose radiotherapy (6 Gy).

Radiotherapy has proven to be efficient in the prevention of heterotopic bone formation. Its importance is increasing in the treatment of uncemented implants in prosthetic hip surgery, where a localized irradiation field is applied to cover the bone-implant interface. In a prospective study the efficiency of two radiation concepts using two different doses to prevent heterotopic ossifications after total hip arthroplasties or revision arthroplasties was compared. In 7 patients after fractioned irradiation (5 x 2 Gy), two recurrences of periarticular ossification occurred, whilst in 17 patients after a single-shot irradiation of 6 Gy on the first postoperative day, no recurrences were seen. There were no side-effects from the radiation. Radiological signs of lucent cement-free implants or delayed wound-healing were absent. Thus, a single shot of 6 Gy applied within 24 h postoperatively reliably prevents heterotopic bone formation. It is safer than 5 x 2 Gy and facilitates the management of the patient.

[Behavior the lipid spectrum following complete ovariectomy and subsequent substitution with estradiol valerate or norethisterone acetate]. / Zum Verhalten des Lipidspektrums nach kompletter Ovarektomie und nachfolgender Substitution mit Estradiolvalerat oder Norethisteronazetat.

In a prospective trial the effects of oophorectomy and following administration of estradiol valerate (2,0 mg/day) or norethisterone acetate (5,0 mg/day) on the blood lipids were investigated during the late postoophorectomy time. After complete ovarectomy 52 women (42-49 years old) were randomized in two groups and substituted with these steroids from the 7. to 12. month after operation. Before total estrogen excretion/24 h urine, serum levels of estradiol and testosterone and the maturation value were studied. The blood levels of total-, HDL- nnd LDL cholesterol and triglycerides were markedly higher 2 and 6 months after castration than before. Norethisterone acetate depressed transitorily the total cholesterol and longer the HDL cholesterol, the triglycerides were increased 6 months after administration. A long lasting norethisterone acetate substitution in postmenopausal women should be below 5 mg/day.

[Incidence of phagotypes of Mycobacterium tuberculosis in Czechoslovakia and East Germany and of Mycobacterium bovis in Czechoslovakia and Argentina]. / Untersuchungen über das Vorkommen von Phagotypen des Mycobacterium tuberculosis in der CSSR und der DDR sowie des Mycobacterium bovis in der CSSR und Argentinien.

The following study gives review of the results of the phagetyping of M. tuberculosis strains in different localities of Czechoslovakia and German Democratic Republic (165 strains from Czechoslovakia and 102 strains from GDR) and the comparison of the occurrence of phage subgroups of M. bovis strains in two different localities of Czechoslovakia (62 strains) and Argentina (93 strains). The results of the phagetyping of the Czechoslovak M. tuberculosis strains show that this group comprises all the 6 phage subgroups and agree very well in subgroups Ax, A2, B and C with the M. tuberculosis strains from GDR. Both groups of strains differ in subgroups A2 (9) and D. The results with the fresh isolated Argentinian M. bovis strains show that this group has only subgroups Ax and D in comparison with the old laboratory strains of M. bovis which have subgroups Ax, A2(9), and D. The phagetyping of the M. tuberculosis and M. bovis strains was undertaken with the help of 11 international mycobacterial phages. The use of mycobacterial phages in 1 RTD (Routine Test Dilution) and 10 RTD concentrations (in contrary to the 1 RTD and concentrated phage suspensions used previously) decreased the number of the "unspecific" reactions.