[Polypoid dysplasia in inflammatory bowel disease: differential diagnosis and further diagnostic and therapeutic approaches]. / Polypoide Dysplasie bei chronisch-entzündlicher Darmerkrankung: Differenzialdiagnose und weiteres diagnostisch-therapeutisches Vorgehen.

Polypoid dysplasia in inflammatory bowel disease (IBD) is categorized as DALM (dysplasia associated lesion or mass) or ALM (adenoma-like mass). DALMs are etiologically related to the underlying inflammatory disease, have a high risk of cancer and remain an indication for colectomy. Sporadic adenomas occur coincidentally according to the adenoma-carcinoma sequence. They are adequately treated by polypectomy. More recently, a special group of lesions has been termed as "adenoma-like DALM" which shows a morphological overlap with sporadic adenomas in spite of arising against the background of chronic IBD. Adenoma-like DALMs may possess a lower risk of malignancy in contrast to non-adenoma-like DALMs. They may be treated adequately by polypectomy and continued monitoring if the lesion has been excised completely and there is no evidence of flat dysplasia elsewhere in the colon.

[Gastric leishmaniasis. A rare type of gastritis]. / Gastrale Leishmaniose. Ein seltener Gastritistyp.

Gastric leishmaniasis was diagnosed in a 43-year-old HIV infected patient by histopathology as an accidental diagnostic finding. Leishmania HIV co-infections have increasingly been reported recently as a result of intensive travelling and an increase in geographical extension. Nevertheless, Leishmania gastritis is a rare disease which can occur without clinical symptoms and in the absence of endoscopic abnormalities. In this case microscopic detection of the pathogen in macrophages of the gastric mucosa resulted in the correct diagnosis.

[Endoscopic-bioptic diagnostics, surveillance of and therapy for gastrointestinal diseases according to guidelines]. / Leitlinienorientierte endoskopisch-bioptische Diagnostik, Uberwachung und Therapie von Magen-Darm-Erkrankungen.

The present review summarises the detailed recommendations for an optimal endoscopic-bioptic diagnostic procedure, endoscopic surveillance of and therapy for gastrointestinal diseases. The recommendations are mainly based on the S 3-guidelines and have been developed by histopathologists and gastroenterologists in interdisciplinary work. The material has been arranged according to topographic regions of the gastrointestinal tract and clinical problems. The focus is placed on diagnostic and surveillance of Barrett's oesophagus, therapy and postoperative treatment for early gastrointestinal carcinoma, management of colon polyps and endoscopic surveillance of inflammatory bowel disease. Treatment recommendations for both ulcerative colitis and Crohn's disease as well as low-grade and high-grade intraepithelial neoplasia and polypoid neoplasia are currently being intensively discussed. Thus we examine this controversial discussion in detail. Furthermore, the recent guidelines for Helicobacter pylori (H. pylori) and gastric MALT-lymphoma diagnostics are included in this survey. To allow the gastroenterologist a time-sparing overview during practical work, most of the recommendations are presented in itemised form and summarised in tables and figures at the end of the discussion.

[Adherence of pacemaker electrodes to the endomyocardium--a postmortem study]. / Ausrissfestigkeit von Schrittmacherelektroden aus dem Endomyocard--Eine Post-mortem-Studie.

The weight of extraction of a pacemaker electrode from the endomyocardium was evaluated in 29 hearts (31 pacemakers). The maximum weight of extraction was 2375 g, the mean being 760 g. The weight of extraction depends on the duration of the implantation of the pacemaker, and on the thickness of the right ventricle, but there is no relationship to the shape of the pacemaker electrode, nor to the site of insertion in the right ventricular endomyocardium. In half the cases, pieces of endomyocardium adhered to the extracted electrode, the largest piece being 5 cm x 0.5 cm x 0.5 cm. The epicardium was not injured in any of these cases. It was often noticed that scarred adhesions existed between the cable of the pacemaker and the endocardium and/or the intima of the blood vessels. During traction in vivo, strangulation of the right heart and the blood vessels may occur.