[The problems of rehabilitation abroad. APAE - an early recognition and treatment center for children in Joinville, Santa Catarina, Brazil].
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Biomedical subjects
Publications and source records attributed to M Fritsch.
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Electric Wheelchairs are driven on public roads. Neither an operating license, liability insurance nor special driving license is necessary according to Road Traffic and Road Licensing Regulations. Statutory regulations prescribe that these wheelchairs must be fitted with two independent brakes and adequate lighting equipment. Safety can be increased by: Totmann brake system - battery servicing - improved battery chargers and technical safety tests. Maintenance of the wheelchair prolongs its life. Social security agencies should allow a large number of the most severely handicapped people to benefit from medically prescribed wheelchairs.
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With continuing advances in microsurgery, the importance of free flap transfers in reconstruction has increased in every branch of surgery. Several free flaps (both simple and compound) will be described. The transfer of a bulk of tissue by microvascular tissue transfer is a reliable and proven method of reconstruction. The objective for microvascular surgery is to develop techniques of tissue transfer that restore function and improve appearance. There is no greater challenge than reconstructive surgery of the head and neck.
Three patients with dermal metastatic melanoma lesions responding to a synthetic peptide vaccine (g209-2M) derived from the sequence of gp100 melanoma-associated antigen, along with either IL-2 or granulocyte-monocyte colony-stimulating factor were studied to characterize the immunologic response occurring within and around the lesions during therapy. Standard immunocytochemical techniques were used to study the T-cell response (CD3, CD4, and CD8), the B-cell response (CD20), and the expression of class II major histocompatibility complex (HLA-DR) antigens. Between 40 and 65 days after the initiation of vaccine therapy (more than 3 weeks after the second dose of vaccine), the gross tumor size decreased and the tumors from all three patients showed substantial histologic regression associated with increased numbers of tumor-infiltrating lymphocytes and melanophages. The increased lesional tumor-infiltrating lymphocytes consisted of CD3+ T cells and very few CD20+ B cells. In two of the three patients, the T-cell infiltrate occurring during the initial tumor regression consisted predominantly of CD8+ cells. The number of perivascular T cells surrounding small vessels adjacent to melanoma lesions also increased during the time of peak histologic tumor regression. Also during the course of vaccine therapy, the expression of HLA-DR by vascular endothelial cells of the small vessels adjacent to lesions increased in all three patients, and elevated endothelial expression of HLA-DR was maintained in two of the three patients. These results show that patients with metastatic melanoma, who responded to melanoma vaccine therapy, had a predominantly CD8+ T-cell infiltrate associated with a loss of tumor cells. As the tumor cells diminished, they were replaced by heavily pigmented melanophages.