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1.
Dtsch Med Wochenschr ; 138(43): 2195-8, 2013 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-24132532

RESUMO

HISTORY AND ADMISSION FINDINGS: A 67-year-old female patient got ill during holidays in USA with acute abdominal pain. She was discharged after symptomatic treatment and presented afterwards in Germany for further clarification and treatment. INVESTIGATIONS, TREATMENT AND COURSE: Following abdominal sonography, gastroscopy and CT scan with contrast medium, a gastrointestinal stromal tumor (GIST) was assumed. Thereupon a tumor extirpation with cholecystectomy and liver resection was performed. After laparotomy a solid fibrous abdominal tumor could be diagnosed histologically. There was no indication for an adjuvant treatment. CONCLUSION: In the international literature reports about these tumors are rare. A complete resection is essential; there is no data for an adjuvant treatment.


Assuntos
Abdome Agudo/etiologia , Neoplasias Abdominais/diagnóstico , Tumores Fibrosos Solitários/diagnóstico , Antígeno 12E7 , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Idoso , Antígenos CD/análise , Biomarcadores Tumorais/análise , Moléculas de Adesão Celular/análise , Colecistectomia , Diagnóstico Diferencial , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Hepatectomia , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Tumores Fibrosos Solitários/patologia , Tumores Fibrosos Solitários/cirurgia , Tomografia Computadorizada por Raios X , Ultrassonografia
2.
Neuroscience ; 218: 78-88, 2012 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-22609930

RESUMO

Synaptotagmin (syt) I is a Ca(2+) sensor that has been thought to trigger all vesicle secretion with similar mechanisms. However, given the calcium and stimulation requirements of small clear, and large dense core vesicles, we hypothesized that syt I expression differentially regulates vesicle release. Therefore, in this study, we generated multiple stable cell lines of PC12 cells that each had a different and stable level of syt I expression. We determined the functional effects of titrated syt I expression on transmitter release from the two vesicle types, and showed that the transmitters, norepinephrine (NE) and neuropeptide Y (NPY), each have a threshold level of syt I expression required for their release that is different for the two transmitter types. We used carbon fiber amperometry to measure release of NE from single vesicles, and found that release ranged from 50% to 100% in the syt I-targeted cells compared to release from control cells. We used an immunoassay to measure NPY release and found that NPY release was abolished in cells that had abolished syt I expression, but cell lines that expressed 50-60% of control levels of syt I exhibited NPY release levels comparable to release of NPY from control cells. Furthermore, the vesicle fusion pore exhibited a reduced open duration when syt I was abolished, but a longer open duration time for 50% syt I expression than control cells. Therefore, vesicles have a threshold for syt I that is required to control opening of the fusion pore, expansion, and full fusion to release large dense core proteins, but not for full fusion of the small molecules like NE.


Assuntos
Neurônios/metabolismo , Neuropeptídeo Y/metabolismo , Norepinefrina/metabolismo , Vesículas Secretórias/metabolismo , Sinaptotagmina I/metabolismo , Animais , Exocitose/fisiologia , Immunoblotting , Células PC12 , Ratos , Transfecção
3.
Dtsch Med Wochenschr ; 132(49): 2620-3, 2007 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-18050025

RESUMO

BACKGROUND AND OBJECTIVES: Levels of experience and competence in palliative medicine vary considerably among physicians. The aim of the study was to collect information from specially interested general practitioners on education, pivotal lectures and experience regarding the delivery of palliative care. SUBJECT AND METHODS: 92 general practitioners (41 women and 22 men) attending a basic course in palliative medicine were asked to fill in a standardized questionnaire relating to their knowledge and experience of palliative medicine. 63 responded (68%), 54 in general private practice, nine worked in a hospital. The same number worked in urban and in rural health care facilities. RESULTS: The majority of those questioned (53%) gained their first experience in palliative medicine as junior hospital doctors about a quarter (26%) only after starting in private practice. Many of the doctors (31%) admitted to taking more interest in palliative medicine only after having made mistakes, a significant percentage (20%) after the death of a relative. 28% expressed the view that practical courses were an important part in learning about palliative medicine. CONCLUSIONS: The implementation of practice-based c tuition of medical students and of continuing education of established general practitioners and hospital physicians in palliative medicine is indispensable.


Assuntos
Competência Clínica , Educação Médica Continuada/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Cuidados Paliativos/normas , Médicos de Família/educação , Médicos de Família/psicologia , Feminino , Alemanha , Humanos , Masculino , Cuidados Paliativos/psicologia , Relações Médico-Paciente
4.
Oncology ; 68(1): 71-8, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15809523

RESUMO

BACKGROUND: Docetaxel is one of the most effective antitumor agents currently available for the treatment of metastatic breast cancer (MBC). This phase II multicenter study prospectively analyzed the efficacy and toxicity of docetaxel given on a weekly schedule as first-line treatment of metastatic breast cancer. PATIENTS AND METHODS: All patients received docetaxel, 35 mg/m(2) weekly for 6 weeks, followed by 2 weeks of rest. Subsequent cycles (3 weeks of treatment, 2 weeks of rest) were given until a maximum of 5 cycles or disease progression. Premedication consisted of 8 mg dexamethasone intravenously 30 min prior to the infusion of docetaxel. RESULTS: Fifty-four patients at a median age of 58 years with previously untreated MBC were included in the study. A median of 10 doses (median cumulative dose 339 mg/m(2)) was administered (range: 2-18). The overall response rate was 48.1% (95% CI: 34-61%, intent-to-treat). Median survival was 15.8 months and median time to progression was 5.9 months (intent-to-treat). Hematological toxicity was mild with absence of neutropenia-related complications. Grade 3 neutropenia was observed in 3.7% of patients and grade 3 and 4 anemia was observed in 5.6 and 1.9% of patients, respectively. CONCLUSION: The weekly administration of docetaxel is highly efficient and safe as first-line treatment for MBC and may serve as an important treatment option specifically in elderly patients and patients with a reduced performance status.


Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Taxoides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/induzido quimicamente , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/efeitos adversos , Docetaxel , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Estudos Prospectivos , Índice de Gravidade de Doença , Análise de Sobrevida , Taxoides/administração & dosagem , Taxoides/efeitos adversos , Trombocitopenia/induzido quimicamente , Resultado do Tratamento
6.
Med Klin (Munich) ; 93(10): 619-23, 1998 Oct 15.
Artigo em Alemão | MEDLINE | ID: mdl-9849053

RESUMO

BACKGROUND: The diagnostic classification of a malabsorption is often made more difficult, particularly in oligosymptomatic forms. CASE REPORT: A female patient is presented, where the diagnosis of malabsorption syndrome was concluded because of recurring tetanias. This could be traced back to an oligosymptomatic celiac disease. Diagnostic course of action, differential diagnosis as well as further observation during therapy are discussed. CONCLUSION: Oligosymptomatic developments of celiac disease are common amongst adults and present a diagnostic challenge. The existence of a malabsorption should be considered, even if the momentary individual symptoms are unclarified.


Assuntos
Doença Celíaca/diagnóstico , Tetania/etiologia , Adulto , Biópsia , Doença Celíaca/complicações , Doença Celíaca/patologia , Diagnóstico Diferencial , Feminino , Humanos , Mucosa Intestinal/patologia , Pessoa de Meia-Idade , Tetania/patologia
7.
Z Gesamte Inn Med ; 45(20): 616-20, 1990 Oct 15.
Artigo em Alemão | MEDLINE | ID: mdl-2099580

RESUMO

In the paper a survey on new results in the pharmacokinetics of ethanol is given. Resorption follows the rules of diffusion and is influenced by a lot of factors, this results in a high interindividual variation. Distribution is influenced by a first-pass-effect and the tissue contents of water. Metabolism is performed by alcohol dehydrogenase and microsomal ethanol oxidizing system. The kinetics of ADH is undependent on concentration, the MEOS is inducible. Results of acute and chronic ethanol treatment are discussed, clinical consequences are reviewed.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Intoxicação Alcoólica/enzimologia , Alcoolismo/enzimologia , Etanol/farmacocinética , Álcool Desidrogenase/fisiologia , Oxirredutases do Álcool/fisiologia , Sistema Enzimático do Citocromo P-450/fisiologia , Humanos , Taxa de Depuração Metabólica/fisiologia , Microssomos Hepáticos/enzimologia
8.
Z Gesamte Inn Med ; 45(8): 214-8, 1990 Apr 15.
Artigo em Alemão | MEDLINE | ID: mdl-2378133

RESUMO

From 1978 to 1988 in 77 patients of a district hospital, 58 females and 19 males, with malignant tumours or haemoblastoses a therapy with cytostatic agents was finished. A retrospective study analyses characteristics of haematotoxic side effects of cytostatic agents, which despite usual dosage according to the valid guide-lines have appeared in this patient population. According to this the granulocytopoiesis is injured most frequently and most severely. In one third of all patients under influence of cytostatic agents the number of the segment-nuclear granulocytes in the peripheral blood decreased deeper than 0.5 Gpt/l (severe neutropenia). In toxic influences on the thrombopoiesis slight and medium degrees of severity are dominating. Lesions of the erythropoiesis are apparently more infrequent, though they are more difficult to be proved. Further characteristics in the occurrence of severe neutropenias (date, dependence on age, pharmacological aspects) are demonstrated and discussed.


Assuntos
Agranulocitose/induzido quimicamente , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias/tratamento farmacológico , Neutropenia/induzido quimicamente , Trombocitopenia/induzido quimicamente , Idoso , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Leucemia/tratamento farmacológico , Linfoma/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Plasmocitoma/tratamento farmacológico , Estudos Retrospectivos , Fatores de Risco , Neoplasias Testiculares/tratamento farmacológico
9.
Z Gesamte Inn Med ; 45(8): 219-22, 1990 Apr 15.
Artigo em Alemão | MEDLINE | ID: mdl-2378134

RESUMO

The clinical courses of 26 patients with severe neutropenia after application of cytostatic agents are demonstrated. The symptomatology reaches from complete freedom of complaints to severe and most severe clinical appearances. In all 7 asymptomatic patients a complete remission of the changes of the blood picture occurred. Patients with lacking or partial remission of the blood picture after severe neutropenia induced by cytostatic agents have in general a bad prognosis quoad vitam. Infections are the most important complication of a severe neutropenia. Conclusions for the clinical practice concerning the prophylaxis and the early recognition of severe neutropenias as well as of neutropenic complications are derived. Irreversible lesions of the bone marrow by cytostatic agents are notifiable unwished effects of drugs.


Assuntos
Agranulocitose/induzido quimicamente , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias/tratamento farmacológico , Neutropenia/induzido quimicamente , Adulto , Idoso , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/induzido quimicamente , Estudos Retrospectivos , Fatores de Risco
10.
Z Gesamte Inn Med ; 45(6): 172-4, 1990 Mar 15.
Artigo em Alemão | MEDLINE | ID: mdl-2197830

RESUMO

It is reported on the unusually rare case of a primary malignant teratoma of the spleen. Course of diagnosis and therapy are discussed.


Assuntos
Neoplasias Esplênicas/patologia , Teratoma/patologia , Terapia Combinada , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Baço/patologia , Esplenectomia , Neoplasias Esplênicas/cirurgia , Teratoma/cirurgia , Ultrassonografia
11.
Z Gesamte Inn Med ; 45(1): 22-3, 1990 Jan 01.
Artigo em Alemão | MEDLINE | ID: mdl-2330733

RESUMO

The frequency of hypertension in a group of alcoholics and the incidence of alcohol abuse in a group of patients with hypertension was compared with a collective with type-II-diabetes. There is a high relationship between alcoholics and hypertension, a lower one between alcohol abuse in the hypertension group. Chronic alcohol abuse seems to be a more important risk factor for the development of hypertension than diabetes. Genesis and therapeutic consequences of alcohol-induced hypertension are discussed.


Assuntos
Alcoolismo/complicações , Hipertensão/etiologia , Adulto , Complicações do Diabetes , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Obesidade , Estudos Retrospectivos , Fatores de Risco
12.
Z Gesamte Inn Med ; 44(24): 731-3, 1989 Dec 15.
Artigo em Alemão | MEDLINE | ID: mdl-2629368

RESUMO

Cimetidine inhibits hepatic drug metabolism, but its effect on ethanol elimination is less well established. The influence of cimetidine on the kinetics of ethanol is studied with three standardized drinking experiments. Cimetidine had no influence on the absorption or elimination of ethanol. There were significant differences in distribution of ethanol in consequence of inhibition of vascular histamine receptors after cimetidine application.


Assuntos
Cimetidina/farmacologia , Etanol/farmacocinética , Adolescente , Adulto , Relação Dose-Resposta a Droga , Feminino , Humanos , Absorção Intestinal/efeitos dos fármacos , Masculino , Taxa de Depuração Metabólica
13.
Z Gesamte Inn Med ; 44(6): 192-3, 1989 Mar 15.
Artigo em Alemão | MEDLINE | ID: mdl-2728563

RESUMO

Because of increasing alcoholism the importance of alcoholic organ lesions is also increasing. The alcoholic cardiomyopathy, which is the result of toxicity of alcohol, but also of alcohol-induced hypertension, coronary sclerosis and toxic destroyed nervous system, is demonstrated with a the keep of case. Stages, diagnosis, therapy and prognosis are described. The most important consequence is abstinence.


Assuntos
Alcoolismo/complicações , Cardiomiopatia Alcoólica/etiologia , Adulto , Morte Súbita/etiologia , Humanos , Hepatopatias Alcoólicas/etiologia , Testes de Função Hepática , Masculino
14.
Z Gesamte Inn Med ; 43(20): 577-80, 1988 Oct 15.
Artigo em Alemão | MEDLINE | ID: mdl-3213117

RESUMO

The authors take position to distribution of age, sex and stadium, risk factors and therapeutic possibilities in 85 patients with cerebrovascular disease under 65 years. 80 percent have had hypertension, 34 percent diabetes and 15 percent had overweight. Ischemic forms of CVI prevailed with 62 percent. Within the stadia the age distribution is equal. In Stadium II and III mortality is small independent of age. The therapeutic success seems to be independent of therapeutic program. In stadium IV an oncoosmotic and brain metabolism promoting program seems to be superior to an only oncoosmotic acting. An ordered therapy-program after CVI-stadia is proposed.


Assuntos
Transtornos Cerebrovasculares/reabilitação , Reabilitação Vocacional/métodos , Adulto , Isquemia Encefálica/reabilitação , Transtornos Cerebrovasculares/classificação , Transtornos Cerebrovasculares/mortalidade , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Gegenbaurs Morphol Jahrb ; 130(1): 1-47, 1984.
Artigo em Alemão | MEDLINE | ID: mdl-6714613

RESUMO

The development and size of the maxillary sinus, its septums and its cstium are measured. The nasolacrimal canal and duct and the foramina alveolaria superior are included. The thickness of the orbit floor (roof of maxillary sinus) is estimated. The angles of the inferior, medial, lateral rectus muscles, and the inferior oblique muscle with the median plane are determined. The results are discussed with those of earlier researchers. The clinical importance of the results are discussed.


Assuntos
Órbita/anatomia & histologia , Adulto , Idoso , Feminino , Feto , Humanos , Masculino , Seio Maxilar/anatomia & histologia , Pessoa de Meia-Idade
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