More than two decades have passed since the first gene therapy clinical trial was conducted.During this time,we have gained much knowledge regarding gene therapy in general,but also learned to understand the fear that...More than two decades have passed since the first gene therapy clinical trial was conducted.During this time,we have gained much knowledge regarding gene therapy in general,but also learned to understand the fear that persists in society.We have experienced drawbacks and successes.More than 1700 clinical trials have been conducted where gene therapy is used as a means for therapy.In the very first trial,patients with advanced melanoma were treated with tumor infiltrating lymphocytes genetically modified ex-vivo to express tumor necrosis factor.Around the same time the first gene therapy trial was conducted,the ethical aspects of performing gene therapy on humans was intensively discussed.What are the risks involved with gene therapy?Can we control the technology?What is ethically acceptable and what are the indications gene therapy can be used for?Initially,gene therapy was thought to be implemented mainly for the treatment of monogenetic diseases,such as adenosine deaminase deficiency.However,other therapeutic areas have become of interest and currently cancer is the most studied therapeutic area for gene therapy based medicines.In this review I will be giving a short introduction into gene therapy and will direct the discussion to where we should go from here.Furthermore,I will focus on the use of the Herpes simplex virus-thymidine kinase for gene therapy of malignant gliomas and highlight the efficacy of gene therapy for the treatment of malignant gliomas,but other strategies will also be mentioned.展开更多
Arthroscopic hip surgery has become an established diagnostic and therapeutic method for addressing different hip pathologies. This paper focuses on hip arthroscopy for treating hip disorders in children under the age...Arthroscopic hip surgery has become an established diagnostic and therapeutic method for addressing different hip pathologies. This paper focuses on hip arthroscopy for treating hip disorders in children under the age of 10. Arthroscopic hip surgery was performed 30 times on 24 children to address various hip pathologies. Indications were septic arthritis, benign soft tissue tumors, traumatic and congenital hip dislocation, juvenile idiopathic arthritis and osteochondroma of the acetabulum. Diagnostic arthroscopy was technically feasible in all cases. All cases of septic arthritis were successful treated using arthroscopic lavage and antibiotics. In the miscellaneous cases (benign fibrous tumor, juvenile idiopathic arthritis, osteochondroma congenital hip dislocations and traumatic hip dislocation) 4 hips had additional open surgery including surgical dislocation with synovectomy, open reduction and stabilization of the fractured posterior rim of the acetabulum, acetabulopasty and open resection of an osteochondroma with acetabuloplasty. In conclusion arthroscopic hip surgery is an additional diagnostic and therapeutic method that is suitable for treating different hip pathologies in children under the age of 10. Primary treatment of septic arthritis can be done easy by hip arthroscopy. Using cannulated mini arthroscopic hip instruments (2.7 mm), the range of application can be expanded to include treatment of very young infants. Hip arthroscopy can reduce the need of open surgery but cannot replace bony procedures in hip surgery.展开更多
文摘More than two decades have passed since the first gene therapy clinical trial was conducted.During this time,we have gained much knowledge regarding gene therapy in general,but also learned to understand the fear that persists in society.We have experienced drawbacks and successes.More than 1700 clinical trials have been conducted where gene therapy is used as a means for therapy.In the very first trial,patients with advanced melanoma were treated with tumor infiltrating lymphocytes genetically modified ex-vivo to express tumor necrosis factor.Around the same time the first gene therapy trial was conducted,the ethical aspects of performing gene therapy on humans was intensively discussed.What are the risks involved with gene therapy?Can we control the technology?What is ethically acceptable and what are the indications gene therapy can be used for?Initially,gene therapy was thought to be implemented mainly for the treatment of monogenetic diseases,such as adenosine deaminase deficiency.However,other therapeutic areas have become of interest and currently cancer is the most studied therapeutic area for gene therapy based medicines.In this review I will be giving a short introduction into gene therapy and will direct the discussion to where we should go from here.Furthermore,I will focus on the use of the Herpes simplex virus-thymidine kinase for gene therapy of malignant gliomas and highlight the efficacy of gene therapy for the treatment of malignant gliomas,but other strategies will also be mentioned.
文摘Arthroscopic hip surgery has become an established diagnostic and therapeutic method for addressing different hip pathologies. This paper focuses on hip arthroscopy for treating hip disorders in children under the age of 10. Arthroscopic hip surgery was performed 30 times on 24 children to address various hip pathologies. Indications were septic arthritis, benign soft tissue tumors, traumatic and congenital hip dislocation, juvenile idiopathic arthritis and osteochondroma of the acetabulum. Diagnostic arthroscopy was technically feasible in all cases. All cases of septic arthritis were successful treated using arthroscopic lavage and antibiotics. In the miscellaneous cases (benign fibrous tumor, juvenile idiopathic arthritis, osteochondroma congenital hip dislocations and traumatic hip dislocation) 4 hips had additional open surgery including surgical dislocation with synovectomy, open reduction and stabilization of the fractured posterior rim of the acetabulum, acetabulopasty and open resection of an osteochondroma with acetabuloplasty. In conclusion arthroscopic hip surgery is an additional diagnostic and therapeutic method that is suitable for treating different hip pathologies in children under the age of 10. Primary treatment of septic arthritis can be done easy by hip arthroscopy. Using cannulated mini arthroscopic hip instruments (2.7 mm), the range of application can be expanded to include treatment of very young infants. Hip arthroscopy can reduce the need of open surgery but cannot replace bony procedures in hip surgery.
