Bone metastasis in endometrial cancer: evaluation of treatment approaches by factors affecting prognosis.

OBJECTIVE: The purposes of this study were to present an endometrial cancer case with a first sign of bone metastasis, and to reveal factors affecting survival and the appropriate treatment methods for bone metastases. MATERIALS AND METHODS: A total of 101 case reports that presented with bone metastasis of endometrial cancer were reviewed in this study. RESULTS: Survival time in the patients without surgical treatment for bone metastasis was found to be 12 months (95% CI = 5.89 - 18.10) and 42 months in patients who underwent surgical treatment in addition to one or more of chemo-radio-hormonotherapies (95% CI = 16.58 - 67.41) (p = .006). Histological type of cancer, extra-osseous metastasis, and lack of surgery were the factors significantly affecting survival (p = 0.012, p = 0.002, and p = 0.038, respectively). CONCLUSION: Histological type and the presence of extra-osseous involvement are important prognostic markers in endometrial cancer patients with bone metastasis. It may be appropriate to implement combination therapies including surgery in the treatment of bone metastases.

Exclusively breastfed infants at risk for false negative double blind placebo controlled milk challenge.

The double blind placebo controlled food challenge (DBPCFC) is the gold standard for diagnosing cow's milk allergy (CMA). However, false-negative DBPCFC have been reported. We present 2 cases with a false negative DBPCFC in exclusively breastfed infants suspected of CMA. These cases highlight the occurrence of severe allergic reactions of infants who were exclusively breastfed. Several reported causes of a false negative DBPCFC will be discussed. However, there is currently no clear understanding of the cause of a false negative DBPCFC. This paper highlights that a negative outcome of a DBFCFC must be interpreted with caution, because a severe allergic reaction might occur upon re-introduction of cow's milk. Therefore, an additional open food challenge under medical supervision is recommended in exclusively breastfed infants with a negative DBPCFC.

[Biophysics of nerve excitation].

The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the adaptation to changing conditions, the liquidation of consequences of paralogical processes, the formation of mechanisms of "memory", etc.

Fractures of the condylar process: surgical versus nonsurgical treatment.

PURPOSE: The purpose of this study was to compare outcomes from surgical and nonsurgical treatment of condylar process fractures. PATIENTS AND METHODS: Two hundred thirty-four patients with fractures of the mandibular condylar process were treated by open or closed methods. In the follow-up study, 150 patients with a mean follow-up time of 2.5 years were analyzed using radiologic and objective and subjective clinical examinations. RESULTS: No significant difference in mobility, joint problems, occlusion, muscle pain, or nerve disorders were observed when the surgically and nonsurgically treated patients were compared. The only significant difference was in subjective discomfort. Surgically treated patients showed significantly more weather sensitivity and pain on maximum mouth opening. CONCLUSION: Because of its disadvantages, open surgery is only indicated in patients with severely dislocated condylar process fractures.