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Recent data suggest that recombinant human erythropoietin (rhEPO) modulates tumour growth and therapy response. The purpose of the present study was to examine the modulation of radiotherapy (RT) effects on tumour microvessels by rhEPO in a rat colorectal cancer model. Before and after 5 x 5 Gy of RT, dynamic contrast-enhanced -magnetic resonance imaging was performed and endothelial permeability surface product (PS), plasma flow (F), and blood volume (V) were modelled. Imaging was combined with pO(2) measurements, analysis of microvessel density, microvessel diameter, microvessel fractal dimension, and expression of vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1 alpha (HIF-1alpha), Bax, and Bcl-2. We found that RT significantly reduced PS and V in control rats, but not in rhEPO-treated rats, whereas F was unaffected by RT. Oxygenation was significantly better in rhEPO-treated animals, and RT induced a heterogeneous reoxygenation in both groups. Microvessel diameter was significantly larger in rhEPO animals, whereas VEGF expression was significantly lower in the rhEPO group. No differences were observed in HIF-1alpha, Bax, or Bcl-2 expression. We conclude that rhEPO results in spatially heterogeneous modulation of RT effects on tumour microvessels. Direct effects of rhEPO on neoplastic endothelium are likely to explain these findings in addition to indirect effects induced by increased oxygenation., Journal Article, Research Support, Non-U.S. Gov't, info:eu-repo/semantics/published

The diagnosis and treatment of facial pain remains a great challenge for oral and maxillofacial surgeons. By taking an exact anamnesis--especially a pain anamnesis--and by starting specific examinations the patient can quickly be recommended to a qualified therapist. The pain syndromes are classified according to the IASP (International Association for the Study of Pain). The pain syndromes the maxillofacial surgeon is most frequently confronted with--idiopathic trigeminal neuralgia, atypical facial pain and the temporomandibular joint--are described. The necessity of a multidisciplinary examination is emphasized and the different diagnostic investigations are illustrated, particularly in the case of myo-arthropathy. Beside the analysis of temporomandibular joint dysfunction, a radiologic examination is performed. In some cases the advise of a neurologist, ophthalmologist or otolaryngologist may be indicated.

The primary or secondary reconstruction of the facial access after Caldwell-Luc and the more selective resection of sinusal mucous membranes can be important in the therapy and prevention of postoperative complications such as neuralgic facial pain, formation of cysts and chronic sinusitis. The different osteoplastic sinus operations are described and the use of a pedicled bonelid is illustrated. The most common accepted ethiology of post-operative pain is based on the formation of scar-tissue. Postoperative pain is first being treated conservatively, while in case of persisting pain an exploration with dissection of the infra-orbital nerve and reconstruction of the facial defect can be indicated. In a retrospective study of 36 patients the results of our surgical therapy are illustrated.

Complications of fronto-basal trauma can, as a function of their severity, be divided into three classes: life-threatening situations, functional complications and cosmetic defects or facial deformities. They find their origin in the type of trauma, the extent of the lesions of bone and soft tissues, as well as in their timely management and quality of treatment. The etiology of the most common complications and their significance are covered with accent on inadequate primary treatment, insufficient repair of dural lesions, inadequate drainage, unstable osteosynthesis, insufficient treatment of scalp- and frontal defects, and finally the lack of antibiotic prophylaxis. The major complications of frontobasal trauma such as chronic cerebral spinal fluid fistulae and pneumocephalus are reviewed. Attention is also given to the importance of adequate drainage in cases of chronic ethmoidofrontal sinusitis, and on the treatment of osteomyelitis and sinus cysts. The therapeutic possibilities in patients with tissue deficits, i.e. reconstruction of frontal skull defects using autologous hip and rib material, as well as split calvarial bone grafts is discussed.

This study analyses the possibilities of somato-sensory evoked potentials following trigeminal stimulation in order to classify pain sensations provoked by the trigeminal nerve. 43 patients suffering from trigeminal neuralgia, atypical facial pain and from pain due to carcinoma were investigated. Pain sensations correlated with the responses of the evoked potentials--usually with increased latencies. However, it was not possible to point out specific correlative pathological peaks for individual diseases. Therefore, the judgement of TSEP alterations requires knowledge of each patient's clinical symptoms.

After a survey of the literature about etiological and physiopathological data or hypothesis, the different therapeutic possibilities are quoted. According to our experience we describe the occurrence of the Auriculotemporal Syndrome in a total of 157 parotidectomies performed in our clinic during the past seven years. One single post-traumatic case is commented. About 30% of our post-parotidectomic patients were incommodated by the syndrome, more specifically as an aggravating transpiration in the temporal region during meals. The greater number of patients experienced a distinct improvement applying a simple Scopolamin-salve; as a result we prefer this conservative therapy to a more aggressive treatment. However, whether we could prevent the appearance of the syndrome by using a more subtle surgical technique particularly in the region of the preauricular blood vessels, remains an open question.

The characteristics of the basal cell naevus syndrome are multiple basal cell naevi and basal cell carcinomas, cysts of the jaws, anomalies of ribs and vertebra, intracranial calcification and striking deformities of the skull, usually with a positive family anamnesis. We will discuss symptomatology, histopathology and therapy. A flemish family, where the syndrome occurs with the mother and her four children, three of whom are admitted in hospital nearly simultaneously with sinusitis maxillaris, are discussed in extenso. Also, the occurrence of the syndrome's stigmata in other members of the family is noted.