[Self-competence as a condition for self-determination in disabled women and girls for rehabilitation legal relations]. / Selbstkompetenz als Voraussetzung für Selbstbestimmung behinderter Frauen und Mädchen im Rehabilitationsrechtsverhältnis.

Self-competence is a keyword of modern reform legislation in public health and social policy in general and in disability law more specifically. The article defines self-competence from the perspective of constitutional law and describes the new provisions of Book 9 of the Social Code, SGB IX with relation to disabled women and girls. These new provisions are a response to new scientific analyses of the status of disabled women and girls. Their status is determined by multiple discrimination and by threat of sexual violence. Within this context self-competence means capacity for self-determination. Such an interpretation is in line with reforms in disability law, i. e. the adoption of anti-discrimination law. With this reform legislators pursue a shift in paradigm from the medical to the social model of disability. Such a paradigm shift demands new paths to be treaded in rehabilitation. Rehabilitation agencies have corresponding duties to protect and to promote.

Differential expression of HLA-DR, HLA-DP, HLA-DQ and associated invariant chain (Ii) in normal colorectal mucosa, adenoma and carcinoma.

The expression of MHC class II antigens (HLA-DR, HLA-DP and HLA-DQ) and the associated invariant chain (Ii) was studied in epithelial cells of normal colorectal mucosae, colorectal adenomas and carcinomas, using a sensitive immunoperoxidase technique with monoclonal antibodies on frozen sections. In contrast to class II antigens, Ii was detected in some normal mucosae distant from the tumour. In residual non-neoplastic mucosa adjacent to carcinomas, Ii and class II antigens were induced in the order Ii greater than or equal to HLA-DR greater than or equal to HLA-DP greater than or equal to HLA-DQ, the reactions being most pronounced in cases with inflammatory alteration of the crypts. In 22/37 adenomas and 77/123 carcinomas, Ii expression clearly exceeded class II antigen expression. Class II antigens were found in 20/37 adenomas and 62/123 carcinomas, mostly in a non-coordinate manner, following the above order. A detailed analysis of the expression patterns in normal and neoplastic colon epithelial cells revealed a closer association of HLA-DP with HLA-DQ than of HLA-DR with HLA-DP, or HLA-DQ.

Loss of HLA-A,B,C and de novo expression of HLA-D in colorectal cancer.

One hundred primary colorectal carcinomas and 19 metastases were studied for the expression of HLA-A,B,C and HLA-D antigens using monoclonal antibodies (MAbs) against framework determinants and a sensitive immunoperoxidase technique on frozen sections. With MAb W6/32, 65 tumors were intensely stained for HLA-A,B,C; 22 showed a reduced staining intensity, in 5 carcinomas a minor or major subset of the tumor cells lacked HLA-A,B,C, and in 8 cases all tumor cells were unreactive. The loss of HLA-A,B,C was inversely correlated with the degree of differentiation. No relation was found to type, stage and site of the tumor, or to age and sex of the patients. With MAb 2.06, 58 tumors were HLA-D negative, 20 exhibited small positive foci, 19 showed a patchy staining pattern, and 3 were homogeneously HLA-D positive. There was no apparent correlation between HLA-D expression and any of the clinico-pathological features mentioned, nor was it related to the loss of HLA-A,B,C. About half of the metastases displayed the same staining pattern for HLA-A,B,C and -D as the respective primary tumors. The remainder differed from the primary carcinoma by gain or loss of HLA antigens.