Lack of squamous cell lung carcinoma in vitro chemosensitivity to various drug regimens in the adenosine triphosphate cell viability chemosensitivity assay.

A pilot study on squamous cell lung carcinoma (LC) chemosensitivity in adenosine triphosphate cell viability chemosensitivity assay (ATP-CVA) was performed. Besides the histological investigation, a modified ATP-CVA was used for the analysis of cancer cell chemosensitivity to four drug regimens, including topotecan, a promising agent for non-small-cell lung cancer (NSCLC) chemotherapy. Results of in vitro chemosensitivity testing showed chemoresistance or only weak response in the predominant amount of tumors.

Analysis of long-term survival in patients with locally advanced non-small cell lung cancer.

Neoadjuvant combined radiochemotherapy followed by definitive tumor resection improved survival in patients with locally advanced non-small cell lung cancer (NSCLC). Fifty-four patients (NSCLC IIIa + IIIb) were treated with combined radiochemotherapy within a phase I/II study. Twenty-six patients had been resected after combined neoadjuvant treatment and this group was evaluated concerning long-term survival. The median survival for patients with stage IIIa tumor was calculated to be 26 months and 13 months for patients with IIIb status. Patients with no viable tumor cells in the mediastinal lymph nodes had a significantly better survival probability than patients with residual microscopic lymph node disease (p=0.038). Patients with no viable tumor cells had a 1-year (2-year) survival rate of 100% (60%) versus 58% (42%) for patients with residual microscopic tumor in the mediastinal nodes. No significant difference between the N1- and the N2-status was seen. Hence, response to neo-adjuvant radiochemotherapy seems to be an additional important prognostic factor in patients with advanced NSCLC.

[Basis for the use of peritoneal lavage dialysis in the therapy of acute pancreatitis]. / Begründung des Einsatzes der Peritoneal-Lavage-Dialyse in der Therapie der akuten Pankreatitis.

Today, as far as we know the multiple complications of different organs in connection with an acute pancreatitis are due to an enzyme intoxication and/or an endotoxinaemia. The paper reports about experimentally results which establish this view. In addition the favourable effects of the peritoneal dialysis on the course of the disease is emphasized by a prospective study. Important factors which must be considered in view of the effectiveness of the method are quoted.

[Analysis of patients with acute exogenous poisoning at an intensive care unit]. / Analyse der Kranken mit akuten exogenen Intoxikationen auf einer internistischen Intensivtherapieabteilung.

Over a period of 2 years patients with exogenic intoxications take 16% in the total number of patients of the department for internal intensive care. The cases in question were 43.3% males and 56.7% females. The average age of the patients with 31 years was low. The mortality was 2.4%. In the first place of the exogenic intoxications were intoxications with the groups of medicaments sedatives, hypnotics, tranquilizers, analgetics and antipyretics followed by intoxications with neuroleptics, beta-receptor blockers, antidepressives, antiepileptics and glycosides. The rate of complications was greatest in the mixed intoxications.

[Comparison of 2 methemalbumin measurements and of free hemoglobin in view of their value in the differential diagnosis of edematous and hemorrhagic pancreatitis]. / Vergleich zweier Methämalbuminbestimmungen und des freien Hämoglobins hinsichtlich ihrer Wertigkeit in der Differentialdiagnose der ödematösen und hämorrhagischen Pankreatitis.

Methemalbumin was estimated by means of electrophoresis and the method of Walberg, respectively in 59 patients (25 pat. with edematous, 34 patients with hemorrhagic pancreatitis) partially over three days. In addition the estimation of free hemoglobin in ascites has been carried out. By both approaches of methemalbumin estimation there was no differentiation of the two pancreatitis forms possible. Though the method of Walberg was much more sensitive especially in the serum its specificity was correspondingly lower. The tendency to a correlation of the methemalbumin-concentration to the severity of the course of the disease could be observed. Such a correlation has been proved statistically for the free hemoglobin.

[Rare malposition of a temporary pacemaker]. / Seltene Fehllage eines temporären Schrittmachers.

An unusual, pericardial malposition of an introducible electrode catheter in cardiopulmonary reanimation is described.

[Remission rate of mediastinal lymph nodes after multimodal therapy of lung cancer--is it a prognostic factor?]. / Remission mediastinaler Lymphknoten nach multimodaler Therapie des Bronchialkarzinoms--ein Prognosefaktor?

OBJECTIVE: General acceptance in the oncologic community has been gained for combined modality treatment of non-small cell lung (NSCLC) cancer in locally advanced stage IIIA and IIIB disease. However, no optimal regimen has been established. This study (chemotherapy and radiochemotherapy followed by operation) assesses feasibility, response, resectability, and survival in patients with stage IIIA and IIIB lung cancer. Currently, only little data is available about the prognostic significance of tumor clearance of mediastinal nodes. Thus, an important aim of our study was to evaluate the prognostic significance of the extent of tumor reduction in mediastinal nodes by a neoadjuvant multimodality protocol. PATIENTS: In a phase II protocol, 26 patients underwent neoadjuvant radiochemotherapy. Subsequently, a radical lymphadenectomy was performed during surgery. The extent of tumor regression was determined according to the methodology initially described by Salzer-Kuntschik for osteosarcoma: Grade I: no vital tumor cells, grade II: some tumor cells, grade III: less than 10 % vital tumor cells, grade IV: 10-50 % vital tumor cells, grade V: more than 50 % vital tumor cells, grade VI: no effect of chemotherapy. RESULTS: Complete pathologic response was seen in 30.7 % of primary tumors, in 38.5 % of mediastinal lymph nodes, and in 23 % of corresponding specimens simultaneously. Median survival was 34.7 months for those patients with grade I, 12.6 months with grade II, and 8.9 months for patients showing a grade III/IV regression in mediastinal nodes. Response rate to neoadjuvant chemotherapy in mediastinal nodes proved to be the only statistically significant parameter for long-term survival: In cases with no vital tumor cells in the operation specimen, median survival was 34.7 months in comparison to those with vital cells showing a median survival of only 11.4 months (P = 0.01). CONCLUSION: Patients with locally advanced NSCLCs can enjoy long-term survival after multimodal therapy. However, the complications related to therapy are considerably. Especially, clearance of tumor cells from mediastinal lymph nodes is an important independent prognostic factor.