BASAL CELL CARCINOMA OF THE FOOT - TWO CASE REPORTS AND LITERATURE REVIEW.

Basal cell carcinoma (BCC) is considered the most common skin cancer in men. BCC of the foot, however, is very rare, and may occur on dorsal surface of the foot, foot sole or nail apparatus. Diagnosis is often delayed due to the location at an unusual site. We report on two patients: a 61-year-old female with an ulcerated BCC of the sole and dorsum of the foot on a leg with Klippel-Trénaunay syndrome and a 61-year-old male with an ulcerated BCC of the foot sole. Histologic tumor types were either metatypic or mixed solid and morphea-like with partial glandular infiltration. Perineural invasion was evident in both patients indicating the aggressive tumor behavior in the particular region. Authors also provide a review of the literature with a focus on the years 2000 through 2017.

BASAL CELL CARCINOMA OF THE HEAD-AND-NECK REGION: A SINGLE CENTER ANALYSIS OF 1,750 TUMORS.

Basal cell carcinoma (BCC) is the most common malignancy in humans with a pre-dominance for the sun-exposed head-and-neck region. Its incidence is rising world-wide. Early detection and appropriate treatment ensures an excellent prognosis. We analyzed patients with BCC of the head-and-neck region treated at our Department from January 2008 to December 2012 with a follow-up between 2 to 6 years. Data were collected retrospectively. During a 4-year period, 1,750 BCC lesions of head-and-neck region were excised from 1,380 patients. Distribution of gender among the patients was nearly even. Mean age of patients was 74.3±11.4 years. Solid histological subtype dominated the series. Most tumors were removed surgically by delayed MOHS technique (77.0%). The recurrence rate of BCC was 1.6%. The highest recurrence rate of 15.5% was seen in cases of morphea-like BCC compared to 3.9% among solid BCC. The recurrence rate among R0 resected tumors was 0.24% compared to 19.8% among R1-resections (Pearson's Chi-square 56.000). The majority of recurrences occurred within the first 5 year-interval (64%). Multivariate analysis of risk factors for recurrences demonstrated an Odd's ratio for recurrences of 54.89 (95% confidence interval, 21.16, 142.37) in case of R1-resection status. Gender had a minor influence with a slight benefit toward males versus females (Odd's ratio 0.51; 95% confidence interval, 0.28, 0.92). The age of the patients had no impact on recurrence rate. Although there is relatively low mortality attributable to BCC, the morbidity and cost of treatment are significant. Surgical excision remains the mainstay of treatment. For head-and-neck BCC, delayed MOHS surgery offers significantly lower recurrence in both primary BCC and recurrent (secondary) BCC.

Foot ulcers in klippel-trenaunay syndrome: two case reports and one metatypical Basal cell carcinoma.

Klippel-Trenaunay syndrome (KTS) is a congenital malformation with vascular anomalies of capillaries, veins and lymphatics and hypertrophy of bones and soft tissues, associated with microdeletion of 2q37.3 and upregulation of angiogenic factor AGGF1. Although KTS predisposes to venous thromboembolic diseases and may be associate with potentially life-threatening vascular complications including bleeding, pulmonary embolism, and deep vein thrombosis, the development of leg or foot ulcers is uncommon. We present two adult patients with KTS and foot ulcers and advise doctors to keep in mind that chronic foot ulcers in KTS may have an underlying neoplasia.

[Patient representatives at the federal state level in Germany - results of a quantitative survey regarding the educational needs of patient representatives]. / Patientenvertretung auf der Ebene der Bundesländer - Ergebnisse einer quantitativen Befragung zu den Bildungsbedürfnissen von Patientenvertretern und Patientenvertreterinnen.

OBJECTIVES: During the last decades patient and public involvement has gained more and more political approval. An important milestone regarding collective patient interests was the Statutory Health Insurance Modernisation Act in 2004 (§ 140 f SGB V). No systematic research has been conducted regarding the situation of patient representatives at the federal state level as yet. The aim of the following study is to close this gap, focusing on educational needs of patient representatives. METHODS: After screening the literature we identified and discussed relevant aspects of patient participation in a focus group of 7 patient representatives. Based on these findings a standardised questionnaire was developed in cooperation with scientists and patient representatives. We sent the written questionnaire to 504 patient representatives at the federal state level. The survey was targeted at patient representatives who currently participate or have in the past participated in a committee at federal state level according to § 140 f SGB V. RESULTS: A total of 184 completed questionnaires was returned for an overall response rate of 36.5%. Most respondents felt poorly prepared for their role and regard a compulsory preparation course as necessary. Patient representatives want to be an active part in the decision-making process of the committee meetings. They report educational needs on different topics and they are willing to close these gaps. For the future, patient representatives expect increasing significance of collective participation. CONCLUSION: The results can be used to develop educational programmes for patient representatives in order to qualify them for the best possible performance of their tasks. Furthermore the results can provide a scientific basis for political discussions and for reasoning capacity building of patient representatives.

[The favorable effect of hydrolytic enzymes in the treatment of immunocytomas and plasmacytomas]. / Podporný úcinok hydrolytickych enzýmov pri liecbe imunocytómu a plazmocytómu.

At present attention is focused on research of biomodulating influences on tumorous processes, in particular inhibition of metastatic spread of tumors. In the aetiopathogenesis an important part is played by immune complexes, interaction of cytokines. The authors tested the supporting effect of hydrolytic enzymes in plasmocytoma and immunocytoma. The enzymes were administered along with cytostatic preparations according to the MOCCA pattern. They recorded a more rapid onset and longer persistence of remissions, a marked decline of total proteins, paraproteins, beta-2-microglobulin. Complications associated with paraprotein (hyperviscosity syndrome, nephrotic syndrome, peripheral angiopathy) improved. A combination of chemotherapy and enzymatic treatment proved effective and suitable, in particular for patients with interferon intolerance.

Biological activity in vivo of insulin analogues modified in the N-terminal region of the B-chain.

[AlaB5]Insulin as well as a hybrid analogue of insulin and "insulin-like growth factor" (IGF-I), in which the N-terminal amino-acid sequence H-Phe-Val-Asn-Gln- of the B-chain has been replaced by the tripeptide H-Gly-Pro-Glu-of IGF-I, have been prepared by the partial-synthetic route. Their biological activity in vivo has been compared with that of other analogues in rabbits, mice and rats as far as data are available. These rodents respond differently, rats being less sensitive to modifications than rabbits and mice. The results explain unexpected discrepancies discussed in previous papers.

[Synthesis of an insulin-like growth factor I hybrid insulin (author's transl)]. / Synthese eines "Insulin-Like Growth Factor I"-Hybrid-Insulins.

Stepwise Edman degradation of the insulin B chain is achieved after reversible protection of the amino groups in A1 and B29 with the acid-stable methylsulfonylethyloxycarbonyl residue. Condensation of the protected N-terminal tetrapeptide of insulin-like growth factor I with the degraded insulin yields an hybrid insulin whose synthesis and biological properties are discussed.

[Insulin analogues with substitution of A1-glycine by D-amino acids and omega-amino acids (author's transl)]. / Insulinanaloga durch Austausch von A1-Glycin gegen D-Aminosäuren und omega-Aminosäuren.

Substitution of A1-glycine of insulin by L-amino acids yields in analogues with low biological activity. With D-amino acids in A1 biological activity is essentially retained. The influence of aliphatic, aromatic, acidic and basic alpha-D-amino acids as well as omega-amino acids in A1 on the biological effects in different test systems is studied and discussed.

Digital deconvolution of a coded image obtained with a nonredundant pinhole array.

A coded image or pseudohologram, obtained optically with a nonredundant pinhole array imaging aperture, was digitized in a 512 x 512 format. Images were reconstructed digitally. The reconstruction scheme, a deconvolution in the Fourier domain, is presented. The applicability of this technique to a real-time imaging system is discussed.