Walter Josef Fassbender

Genotoxicity and Cytotoxicity of Cisplatin Treatment Combined with Anaesthetics on EAT Cells In Vivo

In this study, DNA damage in tumour cells, as well as irreversible cell damage leading to apoptosis induced in vivo by the combined application of cisplatin and inhalation anaesthetics, was investigated. The genotoxicity of anaesthetics on Ehrlich ascites tumour (EAT) cells of mice, alone or in combined application with cisplatin, was estimated by using the alkaline comet assay. The percentage of EAT cell apoptosis was quantified by flow cytometry. Groups of EAT-bearing mice were (i) treated intraperitoneally with cisplatin, (ii) exposed to repeated anaesthesia with inhalation anaesthetic, and (iii) subjected to combined treatment of exposure to anaesthetics after cisplatin for 3 days. Sevoflurane, halothane and isoflurane caused strong genotoxic effects on tumour cells in vivo. The tested anaesthetics alone showed no direct effect on programmed cell death although sevoflurane and especially halothane decreased the number of living EAT cells in peritoneal cavity lavage. Repeated anaesthesia with isoflurane had stimulatory effects on EAT cell proliferation and inhibited tumour cell apoptosis (6.11%), compared to the control group (10.26%). Cisplatin caused massive apoptosis of EAT cells (41.14%) and decreased the number of living EAT cells in the peritoneal cavity. Combined cisplatin and isoflurane treatment additionally increased EAT cell apoptosis to 51.32%. Combined treatment of mice with cisplatin and all anaesthetics increased the number of living tumour cells in the peritoneal cavity compared to cisplatin treatment of mice alone. These results suggest that the inhalation of anaesthetics may protect tumour cells from the cisplatin-induced genotoxic and cytotoxic effects.

Penile injury and effect on male sexual function

Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4‐year period. According to the American Association for the Surgery of Trauma five‐grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patients received conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5‐item International Index of Erectile Function (IIEF‐5) test at 3 and 12 months of injury. At 3‐month follow up, moderate, mild and no erectile dysfunction was recorded in 5, 6 and 11 patients respectively (mean IIEF‐5: 19.62). At 12‐month follow up, mild erectile dysfunction was found in only one patient (IIEF‐5: 20), whereas all other patients were free from erectile dysfunction (mean IIEF‐5: 23.75). The 12‐month follow up yielded a higher statistical difference (P < 0.001) when compared with 3‐month follow up. Study results indicated that appropriate treatment of penile injuries resulted in complete recovery of sexual function within 12 months.

Diagnosis and therapy of gestational breast cancer: a review.

PURPOSE In spite of the general consensus on the issue, to point to major dilemmas which appear in this matter of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. RESULTS Recent literature data show that the rate of gestational breast cancer, according to most protocols, range from 0.2% to 3.8%. By definition, the clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year after delivery. The mode of treatment and prognosis is identical to those of women with breast carcinoma beyond pregnancy, except for radiotherapy that is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exceptions to this practice are women with any advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that the therapy for breast cancer has no adversarial effect on the prognosis of subsequent pregnancy. CONCLUSION The evaluation and management of women with gestational breast cancer requires a multidisciplinary approach. A chemotherapeutic regimen should be individualised to a maximum reduction of risk, if applied in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.

Influence of stress related to war on biological and morphological characteristics of breast cancer in a defined population.

PURPOSE To assess differences between patients with breast cancer before, during and after the 1991-1995 war in Croatia. MATERIAL AND METHODS We analyzed 660 patients of Pozesko-Slavonska County, during the three periods. Relative predictive values of patients characteristics and stage of tumor were assessed using the X2-test, and survival with Kaplan-Meier analysis. RESULTS Tumors were significantly more often of higher stages (IIA and IIB) and with axillary lymph node metastases (N1) during the war, than in pre-war and post-war period.Breast cancer was significantly more frequent in patients who previously experienced death in the family (35,3%). The Kaplan-Meier analysis showed correlation between survival, T and N stages of tumor and clinical stage of tumor. CONCLUSION The war aggression towards Croatia with its impact on our patients, contributed to modification of characteristics of breast cancer in the analyzed period.

The successful development of bisphosphonates in the therapy of osteoporosis

ZusammenfassungBisphosphonate sind eine Gruppe osteotroper Substanzen, die in den letzten 30 Jahren erfolgreich bei verschiedenen Knochenerkrankungen eingesetzt werden. Seit über einer Dekade sind Bisphosphonate in oraler Form als etablierte Therapieoption der Osteoporose verfügbar und zugelassen. Die Entwicklung neuer, potenter oraler und parenteraler Bisphosphonate ermöglichte den breiten Einsatz dieser Substanzen in der Onkologie, Hämatologie und Osteologie. Sowohl im Hinblick auf die hochwirksame Therapie der Osteoporose als auch in adjuvanten Therapieansätzen oder zur Schmerztherapie sind die Bisphosphonate innovativ und stellen einen Durchbruch vor allem in der Behandlung der Osteoporose und metabolischer Osteopathien dar.AbstractIn the last 30 years bisphosphonates have been used in the treatment of different bone diseases. Bisphosphonates in their oral pharmaceutical form are an established and approved medication in osteoporosis treatment for years. Latest research developed more potent bisphosphonates in different application forms: oral and parenteral. Therefore, their prospects for medical treatment could be enlarged to the fields of oncology, hematology, and osteology. Bisphosphonates are innovative in case of adjuvant therapy as well as in adequate pain therapy. In the medical treatment of osteoporosis and metabolic osteopathies bisphosphonates could be rightly denoted as groundbreaking.

Die Entwicklung der Bisphosphonate—ein Meilenstein in der Osteoporosetherapie

ZusammenfassungBisphosphonate sind eine Gruppe osteotroper Substanzen, die in den letzten 30 Jahren erfolgreich bei verschiedenen Knochenerkrankungen eingesetzt werden. Seit über einer Dekade sind Bisphosphonate in oraler Form als etablierte Therapieoption der Osteoporose verfügbar und zugelassen. Die Entwicklung neuer, potenter oraler und parenteraler Bisphosphonate ermöglichte den breiten Einsatz dieser Substanzen in der Onkologie, Hämatologie und Osteologie. Sowohl im Hinblick auf die hochwirksame Therapie der Osteoporose als auch in adjuvanten Therapieansätzen oder zur Schmerztherapie sind die Bisphosphonate innovativ und stellen einen Durchbruch vor allem in der Behandlung der Osteoporose und metabolischer Osteopathien dar.AbstractIn the last 30 years bisphosphonates have been used in the treatment of different bone diseases. Bisphosphonates in their oral pharmaceutical form are an established and approved medication in osteoporosis treatment for years. Latest research developed more potent bisphosphonates in different application forms: oral and parenteral. Therefore, their prospects for medical treatment could be enlarged to the fields of oncology, hematology, and osteology. Bisphosphonates are innovative in case of adjuvant therapy as well as in adequate pain therapy. In the medical treatment of osteoporosis and metabolic osteopathies bisphosphonates could be rightly denoted as groundbreaking.