Selective internal radiation therapy (SIRT) in primary or secondary liver cancer.

Most patients with a history of common solid tumors will in the end develop liver metastases. Next to that, primary liver cancer, is a frequent cancer with fatal liver failure in the majority of patients. Selective internal radiation therapy (SIRT), has gradually been introduced over the recent years and is a promising, innovative albeit palliative treatment modality. The specific clinical background with regard to the indication and methodology of SIRT is presented and discussed in this paper.

Statin-sensitive dysregulated AT1 receptor function and density in hypercholesterolemic men.

BACKGROUND: Hypercholesterolemia causes an upregulation of vascular angiotensin II type 1 (AT1) receptor expression in cell culture and animal models. The presented studies were undertaken to examine AT1 receptor overexpression in hypercholesterolemic men and therapeutic interventions thereof by HMG CoA reductase inhibitors (statins). METHODS AND RESULTS: Effects of AT1 receptor activation were measured by assessing the blood pressure increase after infusion of angiotensin II in normo- (cholesterol 181+/-11 mg/dL) and hypercholesterolemic (cholesterol 294+/-10 mg/dL) men (n=19 and 20, respectively). AT1 receptor expression was assessed on isolated platelets. Some patients were investigated before and after cholesterol-lowering therapy with statins. Hypercholesterolemia led to a significant increase of angiotensin II-induced blood pressure elevation. AT1 receptor expression was significantly enhanced in hypercholesterolemic individuals (B(max)=5.2+/-1.2 fmol/mg protein) compared with normocholesterolemic men (B(max)=2.1+/-0.2 fmol/mg protein). Cholesterol-lowering treatment with statins reversed the elevated blood pressure response to angiotensin II infusion (P<0.05) and downregulated AT1 receptor density (P<0.05). CONCLUSIONS: Hypercholesterolemia induces AT1 receptor overexpression and enhances biological effects of angiotensin II in men. These findings provide novel insights into the pathogenesis of hypertension and atherosclerosis and may initiate rational and new therapeutic concepts.

[Heart tumors: magnetic resonance imaging and multislice spiral CT]. / Herztumoren: Magnetresonanztomographie und Mehrschicht-Spiral-CT.

Transthoracic echocardiography is usually the initial diagnostic test in patients with a suspected cardiac mass. However, this technique is restricted by its small field of views and insufficient acoustic window in some patients. Magnetic resonance imaging (MRI) and, since its introduction, multislice spiral computed tomography allow for detailed delineation of intra and pericardiac tumors, their extent, and their influence on cardiac function. Primary benign and malignant cardiac tumors have several characteristic features in MR imaging. Assessment of such features may narrow down the differential diagnosis or even allow for reliable diagnosis in selected cases. Many such features can also be assessed using MSCT. This article provides an overview of examination protocols of MRI and CT for cases in which a cardiac mass is suspected and describes the appearance of primary and secondary cardiac masses as well as intracavitary thrombi.

[Eosinophilic oesophagitis. Significance of routine oesophageal biopsies for dysphagia of unknown aetiology]. / Eosinophile Ösophagitis. Signifikanz von Routinebiopsien des Ösophagus bei unklarer Dysphagie.

Eosinophilic oesophagitis (EO), primarily a gastro-enterological disease, should be known to the surgeon and endoscopist as a differential diagnosis of dysphagia. We present a chronic and recurrent case of EO. As frequently seen, macroscopic findings are indicative of the causal illness. The diagnosis is finally made by the histological findings of a macroscopically inconspicuous mucosa of the esophagus, which is found in 10% of cases with EO. Random biopsies are necessary for the diagnosis. A short overview of therapy and course and a review of the literature are given.