[The deceptiveness of the electrocardiographic image in patients with Wolff-Parkinson-White syndrome]

The urgent character of the clinical importance of the Wolff-Parkinson-White syndrome is among others also due to some treacherous characteristics of the electrocardiographic tracing. Three of them are mentioned in the submitted paper. The lability of the electrocardiographic tracing--spontaneous and induced--makes sometimes early detection difficult. The risk of confounding the ECG tracing of Wolff-Parkinson-White syndrome with myocardial infarction is considerable and sometimes underrated. Diagnosis of the ECG picture of myocardial infarction in a subject with Wolff-Parkinson-White syndrome may be associated with great difficulties. The electrocardiographic picture of the Wolff-Parkinson-White syndrome must be evaluated always with knowledge of the general clinical manifestations to prevent diagnostic, therapeutic and assessment errors.

Protein-protein interactions in concentrated electrolyte solutions

Protein-protein interactions were measured for ovalbumin and for lysozyme in aqueous salt solutions. Protein-protein interactions are correlated with a proposed potential of mean force equal to the free energy to desolvate the protein surface that is made inaccessible to the solvent due to the protein-protein interaction. This energy is calculated from the surface free energy of the protein that is determined from protein-salt preferential-interaction parameter measurements. In classical salting-out behavior, the protein-salt preferential interaction is unfavorable. Because addition of salt raises the surface free energy of the protein according to the surface-tension increment of the salt, protein-protein attraction increases, leading to a reduction in solubility. When the surface chemistry of proteins is altered by binding of a specific ion, salting-in is observed when the interactions between (kosmotrope) ion-protein complexes are more repulsive than those between the uncomplexed proteins. However, salting-out is observed when interactions between (chaotrope) ion-protein complexes are more attractive than those of the uncomplexed proteins.

Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study

BACKGROUND

Actinic keratoses (AKs) are the most common premalignant tumors. Without treatment, a significant number of patients with AK will experience squamous cell carcinoma. Photodynamic therapy (PDT) using the new highly selective photosensitizer methyl 5-aminolevulinate is a promising new treatment modality for AK.

OBJECTIVE

We investigated the complete response rates, cosmetic outcome, and patient satisfaction after photodynamic therapy (PDT) using methyl 5-aminolevulinate (Metvix) versus cryotherapy in the treatment of AKs.

METHODS

Patients were randomized to receive either cryotherapy with liquid nitrogen spray or PDT using methyl 5-aminolevulinate cream 160 mg/g, 3 hours application time, and red light (75 J/cm(2)).

RESULTS

Efficacy results from 193 patients with 699 lesions (92% face/scalp and 93% thin/moderately thick) were analyzed. Overall complete response rates after 3 months were 69% for PDT and 75% for cryotherapy. Both treatments gave higher response rates in thin lesions (PDT 75%, cryotherapy 80%). PDT gave better cosmetic results and higher patient satisfaction than cryotherapy.

CONCLUSION

PDT using methyl 5-aminolevulinate is an attractive treatment option for patients with AK, with a response rate similar to that of cryotherapy, but with superior cosmetic results and high patient satisfaction.

Intersubband transport in quantum wells in strong magnetic fields mediated by single- and two-electron scattering

We show theoretically that in quantum wells subjected to a strong magnetic field the intersubband current peaks at magnetic field values, which reveal the underlying specific intersubband scattering mechanism. We have designed and grown a superlattice structure in which such current oscillations are clearly visible, and in which the transition from the purely single-electron to the mixed single- and two-electron scattering regimes can be observed by tuning the applied voltage bias. The measurements were conducted in ultrahigh magnetic fields (up to 45 T) to obtain the full spectrum of the current oscillations.

[Disseminated actinic keratoses. Comparison of topical photodynamic therapy with 5-aminolevulinic acid and topical 5% imiquimod cream]

We report on a 75-year-old woman with skin type I suffering for 20 years from multiple actinic keratoses of areas exposed to the sun. The skin of her forearms was treated on one side with imiquimod 5% cream over 4 weeks and on the contralateral side with photodynamic therapy (PDT) using topical 5-aminolevulinic acid (ALA). Both sides showed good clinical response after 3-months follow-up, suggesting that these modalities can be effectively used for treating widespread multiple actinic keratoses.

Dacarbazine and interferon alpha with or without interleukin 2 in metastatic melanoma: a randomized phase III multicentre trial of the Dermatologic Cooperative Oncology Group (DeCOG)

In several phase II-trials encouraging tumour responses rates in advanced metastatic melanoma (stage IV; AJCC-classification) have been reported for the application of biochemotherapy containing interleukin 2. This study was designed to compare the efficacy of therapy with dacarbazine (DTIC) and interferon alpha (IFN-alpha) only to that of therapy with DTIC and IFN-alpha with the addition of interleukin 2 (IL-2) in terms of the overall survival time and rate of objective remissions and to provide an elaborated toxicity profile for both types of therapy. 290 patients were randomized to receive either DTIC (850 mg/m(2)every 28 days) plus IFN-alpha2a/b (3 MIU/m(2), twice on day 1, once daily from days 2 to 5; 5 MIU/m(2)3 times a week from week 2 to 4) with or without IL-2 (4.5 MIU/m(2)for 3 hours i.v. on day 3; 9.0 MIU/m(2) i.v. day 3/4; 4.5 MIU/m(2) s.c. days 4 to 7). The treatment plan required at least 2 treatment cycles (8 weeks of therapy) for every patient. Of 290 randomized patients 281 were eligible for an intention-to-treat analysis. There was no difference in terms of survival time from treatment onset between the two arms (median 11.0 months each). In 273 patients treated according to protocol tumour response was assessable. The response rates did not differ between both arms (P = 0.87) with 18.0% objective responses (9.7% PR; 8.3% CR) for DTIC plus IFN-alpha as compared to 16.1% (8.8% PR; 7.3% CR) for DTIC, IFN-alpha and IL-2. Treatment cessation due to adverse reactions was significantly more common in patients receiving IL-2 (13.9%) than in patients receiving DTIC/IFN-alpha only (5.6%). In conclusion, there was neither a difference in survival time nor in tumour response rates when IL-2, applied according to the combined intravenous and subcutaneous schedule used for this study, was added to DTIC and IFN-alpha. However, toxicity was increased in melanoma patients treated with IL-2. Further phase III trials with continuous infusion and higher dosages must be performed before any final conclusions can be drawn on the potential usefulness of IL-2 in biochemotherapy of advanced melanoma.

[Systematic sebaceous nevus with multiple secondary tumors as the chief symptom of Schimmelpenning-Feuerstein-Mims syndrome]

A women presented with a systematized sebaceous nevus of the head and neck. She had developed multiple basal cell carcinomas and sebaceomas in the nevus over the past 3 years after a period of about 55 years without any changes. Detailed medical history and physical examination revealed a constellation of findings suggesting a syndrome. Besides ptosis and a congenital, vascular corneal clouding at the right, there was hypoplasia of the right maxillary sinus, a right labyrinthine deafness and recurrent inguinal herniae on the right. The Schimmelpenning-Feuerstein-Mims-Syndrome was diagnosed.

[The return of Czech health professionals to Most in the spring of 1945]

During the chaotic days of May 1945 the hospital--a crucial point of the health services in Most--was taken over in an orderly manner by Czech authorities. This was followed by gradual organizational steps leading to supplementation of the medical and nursing staff by Czech employees. The arrival of medical personalities was very important.