Hypertension in long-term survivors of childhood cancer: a nested case-control study.

AIM OF THE STUDY: To examine risk factors for developing hypertension in childhood cancer survivors (CCS). METHODS: We conducted a nested case-control study of risk for hypertension within a cohort of 1362 childhood cancer survivors treated between 1966 and 1996 in the Emma's Children's Hospital/Academic Medical Center in the Netherlands. Detailed information on treatment and several lifestyle factors was collected for 44 cases with hypertension and 123 matched controls. Odds ratios (ORs) for hypertension were calculated by conditional logistic regression analysis. RESULTS: Body Mass Index (BMI) was the only significant risk factor associated with the occurrence of hypertension (OR 3.95; 95% confidence interval (CI) 1.7-9.1 for BMI25kg/m(2) compared to BMI<25kg/m(2)). However, cisplatin, cyclophosphamide and radiotherapy (RT) to the abdominal region were all associated with non-significant risk increases (ORs of 4.3, 2.1, and 1.8, respectively). CONCLUSION: Our results show that BMI is the most important risk factor for hypertension following treatment of childhood cancer, emphasising the need for CCS to maintain a normal weight.

The distribution of the unoccupied volume in glassy polymers.

The aim of this paper is to present an improved method to describe the unoccupied volume in glassy polymers. The method is able to treat atoms with non-spherical symmetry. The fineness of the raster points scanning the unit cell can be as small as 0.01 nm. This method was used to determine the unoccupied volume of molecular dynamic simulations of poly(amide imide) unit cells by probing it with a tracer atom. Since the reachable unoccupied volume strongly depends on the tracer radius, we used tracer radii between 0.03 and 0.17 nm. The poly(amide imide)s were used in the present work because they are well characterized, especially there already exist free volume data determined by positron lifetime experiments.

Isotretinoin alleviates renal damage in rat chronic glomerulonephritis.

BACKGROUND: Retinoids, derivatives of vitamin A, have strong anti-inflammatory and antiproliferative properties. We previously demonstrated that the pan-agonists all-transretinoic acid (RA) and isotretinoin (13-cis RA) alleviate renal damage in rat acute glomerulonephritis (GN) induced by anti-Thy-1.1 mAb OX-7. METHODS: The present study examined the effects of low dose and high dose treatment with isotretinoin in the chronic glomerulonephritis model, Thy-GN. Thy-GN was induced by a single intravenous injection of monoclonal antibody (mAb) 1-22-3 in uninephrectomized Wistar rats (N = 7 to 10 per group). Control and nephritic groups were treated with vehicle (veh), low dose isotretinoin (2 mg/kg body wt), or high dose isotretinoin (10 mg/kg body wt). The experiment was terminated 60 days after induction of Thy-GN. RESULTS: In animals with Thy-GN, isotretinoin abrogated the increase in blood pressure and significantly reduced albuminuria. Glomerulosclerosis index, glomerular and interstitial cell counts, as well as the area of the interstitial space were significantly lower in nephritic rats treated with low and high dose isotretinoin compared to vehicle-treated nephritic controls. Treatment with isotretinoin also significantly reduced the number of glomerular and interstitial macrophages. The increase of transforming growth factor (TGF)-beta1, TGF receptor II and prepro-endothelin-1 gene expression in vehicle-treated nephritic rats was significantly attenuated by isotretinoin. CONCLUSIONS: Treatment with isotretinoin significantly reduces glomerular and interstitial damage in rats with chronic glomerulonephritis as indicated by different functional and histological markers. Retinoids may provide a novel therapeutic option for the treatment of glomerulonephritis.

Steroid metabolism with intestinal microorganisms.

As a result of the metabolic activities of numerous anaerobic microorganisms with sterols, bile acids and steroid hormones as substrates in connection with the enterohepatic circulation of these compounds, the intestine may be considered as an "endocrine" active site or organ. The review summarizes transformations of steroids by anaerobic intestinal bacteria, the physiological and supposed pathophysiological meaning thereof. The aim is to recommend further investigation in this field with respect to both the elucidation of the reactions and biological responses.

Obesity can be treated by suction lipoplasty when combined with other procedures.

The development of serial suction lipoplasty enables us to remove substantial amounts of subcutaneous fat safely and dependably on an outpatient basis, and free our patients of the worry of exogenous blood transfusion. Many practitioners and researchers do not advocate suction for the treatment of obesity, but rather regard it as a means of treating localized small deposits of fat or "figure faults." The reason for their caution is that the amounts of fat to be removed from the obese patient would require extensive hospitalization, transfusion, and increased risk of complications. Liposuction, when performed as a series, can make the treatment of obesity as safe as the treatment of smaller figure faults. We now use serial suction as an adjunct to other surgical and dietary methods for the control of obesity.

Subcutaneous pseudobursa secondary to suction and surgery.

Suction lipectomy has been used throughout the regions of the body to remove vast amounts of subcutaneous fat. The blunt technique allows for a multiplicity of small (4 to 6 mm) channels to be created and the fat removed by suction with little disturbance of the overlying skin, the supporting septa, vessels, or nerves. Abdominolipectomy has been successfully performed for decades, in which large amounts of skin and subcutaneous fat are removed by sharp dissection. The undermining involved in an adbominolipectomy extending from the xiphoid to pubis and laterally to the level of the iliac crest and then supplemented by the suction technique has led to the formation, in some cases, of chronic seromas not relieved by multiple aspirations. Healing and contractions of these seromas causes a deformity of the overlying skin, because it is puckered and drawn upon itself. This results in the formation of a subcutaneous pseudobursa lined by collagen sheets but no epithelial cells. We present 9 patients who have demonstrated this phenomenon. We suggest that in the largest resections, safety is best served by waiting a period of at least 6 weeks between suction and subsequent resection.

[Studies on the reaction of the maxillary sinus mucosa to trauma]. / Untersuchungen zur Reaktion der Kieferhöhlenschleimhaut auf ein Trauma.

In an animal experiment the middle face of sheeps was fractionated. The reaction of the maxillary mucosa was histologically examined in determined temporal intervals and compared with the reactions of the mucosa of sinus maxillary in man after an accident with fractures in the middle face. In contrast to other authors it could be proved unambiguously that the maxillary mucosa of the sheep as well as the maxillary mucosa in man react with a reparative curable inflammation after fractures in the middle face. Therefore a sanitation because of inflammation prophylactic reasons is not indicated.

[Experimental studies of stabilization of refixation following median sternotomy]. / Experimentelle Untersuchungen zur Stabilisierung der Refixation nach medianer Sternotomie.

So far several methods have been established for refixing the sternum halves after longitudinal sternotomy like steel wire or steel strap according to Parham. The use of twisted absorbable PDS-strings is new. During experimental investigations in corpse sterna during tension load the different refixing methods were compared. As a result we found an increased tension stability of the sternum refixation as well as the reversibility of suture dehiscences, if occurred, after employment of the elastic PDS-string. Polydioxanon is a suggestive alternative compared with the usual not absorbable materials for refixation of the sternum.

[Contribution to the problem of preventing recurrences of oxalate and phosphate urinary caluli: active modification of citrate excretion and Ca++-binding capacity in the urine of Wistar rats]. / Beitrag zum Problem der Rezidivprophylaxe von Oxalat- und Phosphatharnsteinen: Aktive Beeinflussung der Zitratausschidung und der Ca++-bindungs-kapazität im Harn bei Wistarratten.

Citric acid may well be, quantitatively and in terms of complex chemistry, the most important of the organic acids capable of binding Ca++ in urine. Since the quantitative determination of citrates in urine became a routine method in many research-orientated urological laboratories thanks to the introduction of standardized enzymatic tests, reports of a reduced excretion of citrates in patients with (recurrent) (oxalate) calculi have become frequent. During our long-term study of patients with recurrent formation of calculi we also observed a clear deficit of citrates in their morning, midday and evening urine. The conspicuous incidence of calculi when there is a concurrence of hypocitraturia and alkaline urine (RTA, in animal experiments: acetazolamide) clearly suggests the lithoprotective significance of citric acid. By quantitatively testing a large number of organic compounds which are interesting both structurally and in terms of complex chemistry, it has been possible to find some substances which restrict crystallization, raise the level of citrates and bind Ca++. A few have also found to restrict the excretion of oxalate in Wistar rats.

Estrogen biosynthesis and its inhibition--a review.

A short review is given about extragonadal sources of estrogens via androgen aromatization; the possible importance of this aromatization; the mechanism of aromatization, the inhibition of androgen aromatization by steroidal compounds; the importance and possible usefulness of such an inhibition.

[Postovulatory and post-implantation inhibition of fertility--general account (author's transl)]. / Postovulatorische und postimplantatorische Fertilitätshemmung.

Latest knowledge about interception and induced menstruation is discussed. Interception (postovulatory inhibition of fertility) can be undertaken by using oestrogens, anti-oestrogens and gestagens as well as non-steroid compounds. Induced menstruation is discussed as a method of post-implantation inhibition of fertility. Induction of menstruation, that is post-implantation contraception, will be feasible by means of anti-gestagens or inhibitors ov ovarian steroid biosynthesis. While most various research efforts have been undertaken, no practicable procedure has become available as yet.

[On the surgical therapy of basaliomata and carcinomata of the facial skin]. / Zur chirurgischen Therapie der Basaliome und Karzinome der Gesichtshaut.

Following surgical therapy, skin carcinomata as well as basaliomata require strict aftercare. Most careful attention should be given especially to dedifferentiated, nonkeratinizing squamous cell carcinomata that usually show a higher rate of relapsing and metastasizing. (2) The relatively high rate of metastasizing of 10 to 20%, which is evident from the literature and could be confirmed by the author for his own patient stock, requires uncompromising removal of the dependent lymphatic region in the form indicated for tumors with the formula T1 N1-2 Mo, T2-3 No Mo, for relapsing carcinomata, and for histologically evident nonkeratinizing squamous cell carcinomata. Only very old age or a poor general condition admit of exceptions to be made.