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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  77. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.; 20060524-20060528; Mannheim; DOC06hnod325 /20060424/
    Publication Date: 2006-04-25
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  84. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie; 20130508-20130512; Nürnberg; DOC13hnod133 /20130415/
    Publication Date: 2013-04-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.; 20070516-20070520; München; DOC07hnod213 /20070424/
    Publication Date: 2007-04-24
    Keywords: ddc: 610
    Language: German
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  • 4
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery; VOL: 1; DOC072 /20051206/
    Publication Date: 2005-12-07
    Description: Chronisch-rezidivierende infektiöse Parotitiden im Kindesalter sind allseits bekannt. Als Ursache wird eine Störung der Sekretbildung , aber auch angeborenen Strikturen des Gangsystems dikutiert. Zunehmend häufig sind atypische Mycobakterien - Infektionen. Fremdkörper als Ursache einer Parotitis wurden in der Literatur nur in Einzefällen beschrieben.Wir berichten über ein einjährigen Kind mit undulierendem Fieber seit mehreren Wochen, einer Schwellung links präaurikulär sowie eitriger Otorrhoe links. Weiterhin bestanden Meningismuszeichen und Lymphknotenschwellungen links cervical.Nach Ausschluß einer Mastoiditis, lokaler Behandlung des linken Ohres mit chinolonhaltigen Ohrentropfen, sowie zusätzlich intravenöser Antibiose kam es nach drei Tagen zu einer Entfieberung des Kindes, wobei eine umschriebene pustulöse Effloreszenz links präauriculär bestehen blieb. Aufgrund der Sekretion aus dem linken Gehörgang bei blandem Trommelfell mußte an eine kongenitale Fehlbildung des 1. Kiemenbogenganges Typ II nach Work gedacht werden. Differentialdiagnostisch mußte auch eine eitrige einschmelzende Lymphadenitis und eine atypische Mykobakteriose diskutiert werden. Wir entschlossen uns zu einer operativen Exploration zur Histologiegewinnung und eventuel Resektion der vermeintlichen Gehörgangsduplikatur. Dabei fanden wir eine über den Boden des Gehörganges vollständig in die Glandula parotis eingedrungene Daunenfeder als Ursache der Entzündung.Nach erfolgter Entfernung kam es zu einer problemlosen Abheilung, so daß wir das Kind zeitnah entlassen konnten.
    Keywords: ddc: 610
    Language: German
    Type: article
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  • 5
    ISSN: 1432-2277
    Keywords: Key words Hepatocellular carcinoma ; Liver transplantation ; Recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recurrence-free survival (RFS) in patients with small hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT) was analyzed. From 1988 until 1996, 725 OLTs were performed in 669 patients. In 52 adults, HCC was confirmed histologically. OLT was limited to patients with small (〈 5 cm) HCC with a maximum number of three nodules. Actuarial survival for these 52 patients at 1 and 5 years is 88 % and 71 %. RFS was defined as time until death without recurrence, time until follow up with a diagnosis of recurrence, or, in patients without recurrence, time of last follow up. Overall, the 5-year RFS was 60 %. Five-year RFS was less for bilobar compared to unilobar tumors (36 % vs 70 %), less for stage IVa tumors (UICC) compared to stage I–III tumors (17 % vs 71 %), and less for multiple compared to solitary tumors (54 % vs 67 %). In conclusion, potential cure may be achieved in more than 50 % of all transplanted patients.
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  • 6
    ISSN: 1432-2277
    Keywords: Key words Liver transplantation ; Hepatitis C
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The optimal immunosuppressive regimen in patients transplanted for hepatitis C (HCV) is still under discussion. High immunosuppression may promote viral replication and recurrent graft hepatitis. But acute and chronic rejection frequently seen in conjunction with HCV recurrence may require some rescue therapy. One hundred and thirty-seven patients transplanted for HCV cirrhosis, who were HCV-RNA positive prior to transplantation, were analyzed. Seventy-nine patients received CSA-based immunosuppression and 58 patients FK506-based immunosuppression. One-month patient survival was 100 % in both groups. Three month and 1-year survival rates and the cumulative 1–5-year patient survival was similar in CsA-treated [67/79 (84.8 %)] and FK506-treated patients [50/58 (86.2 %)]. Retransplantations for HCV recurrence were performed in 5.1 % of CsA-treated patients and 6.9 % of FK506-treated patients; it was successful in 50 % and 75 % of patients, respectively. Conversion from CsA to FK506 and vice versa was high with 25 out of 79 patients (31.6 %) converting in the CsA group and 8 out of 58 patients (13.8 %) converting in the FK506 group. Conversion to FK506 was performed due to acute and chronic rejection and to CsA because of toxicity and HCV recurrence. In both groups, 25 % of converted patients died. Five patients of the CsA group and 9 of the FK506 group received OKT3; more than one-third of each group died. Five patients in the CsA group and 6 in the FK506 group received mycophenolate mofetil (MMF) for HCV recurrence or acute and chronic rejection in conjunction with HCV recurrence. All patients of this critical group are alive with good graft function. In conclusion, survival rates of HCV patients were similar to those seen for other indications. Conversion from CsA to FK506 and vice versa was high and reflects a critical group concerning patient survival. OKT3 treatment should be avoided. A promising therapeutic option for critical patients experiencing acute or chronic rejection in conjunction with HCV recurrence may be treatment with MMF.
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  • 7
    ISSN: 1433-0385
    Keywords: Key words: Schwannoma ; Soft tissue tumors ; Surgical therapy ; Diagnosis. ; Schlüsselwörter: Schwannom ; Weichteiltumoren ; chirurgische Therapie ; Diagnostik.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Wir berichten exemplarisch über drei Patienten, die im Zeitraum von Februar 1991 bis Oktober 1994 in unserer Klinik wegen intraabdomineller Schwannome operiert wurden. Im Fall 1 wurde ein benignes Schwannom des Magens durch Billroth-II-Resektion behandelt, Leitsymptom war eine gastrointestinale Blutung. In Fall 2 wurde ein malignes Schwannom des Duodenums mit Lebermetastase durch weite En-bloc-Tumorresektion mit retroperitonealer Lymphadenektomie und anatomischer Rechtsresektion der Leber behandelt. Eine nach 7 Monaten aufgetretene metachrone Lebermetastase wurde durch intraparenchymatöse Lasercoagulation kontrolliert, ein nach 19 Monaten aufgetretenes Lokalrezidiv erforderte eine weitere Tumorresektion. Primäres Leitsymptom war eine palpable Tumormasse. In Fall 3 wurde ein malignes Schwannom der Bauchwand auswärts in Fragmenten reseziert. Trotz postoperativer Radiatio kam es nach 6 Monaten zum Lokalrezidiv mit Leberinfiltration, welches en bloc reseziert wurde. Zu diesem Zeitpunkt bestand bereits eine beginnende Peritonealsarkomatose. Unter postoperativer Chemotherapie kam es zum raschen Tumorprogreß. Der Patient verstarb 18 Monate nach Erstoperation. Anhand der dargestellten Fälle werden Symptomatik, differentialdiagnostische Probleme und operatives Vorgehen bei benignen und malignen Schwannomen des Bauchraums erörtert.
    Notes: Summary. We report three patients who were operated on because of an intraabdominal schwannoma between February 1991 and October 1994 in our department. In the first case, a benign gastric schwannoma was treated by a distal gastric resection (Billroth II); the main symptom was gastric bleeding. In the second case, a malignant duodenal schwannoma with liver metastasis was treated by wide en-bloc resection of the tumor including retroperitoneal lymphadenectomy and an anatomical resection of the right lobe of the liver. A metachronous metastasis of the liver, appearing 7 months postoperatively, was treated by intraparenchymatous laser coagulation; a local recurrence, appearing 19 months postoperatively, led to another tumor resection. The main symptom was a palpable intraabdominal mass in this case. In the third case, a malignant schwannoma of the abdominal wall was resected in fragments in another clinic. Six months later a local recurrence with infiltration of the liver appeared in spite of postoperative radiation and was resected en bloc. Early peritoneal sarcomatosis was apparent at that time. Postoperative chemotherapy did not prevent quick progression of the tumor. The patient died 18 months after the first operation. The clinical presentation, differential diagnosis and operative strategy for benign and malignant intraabdominal schwannomas are discussed.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 900-901 
    ISSN: 1433-0474
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-2277
    Keywords: Key words Extracellular matrix ; Liver transplantation ; Acute rejection ; Early chronic rejection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have previously observed changes at the extracellular matrix (ECM) which significantly correlated with the extent of preservation and reperfusion injury. In the present study, we attempted to investigate whether the ECM may be also involved in the pathophysiological sequelae of acute and chronic rejection. Of 81 patients monitored for the ECM parameters laminin, hyaluronic acid, fibronectin receptor, and transforming growth factor (TGF)-β , 28 patients developed acute rejection (〈 1 month), in 14 patients (17.4 %) acute rejection was steroid resistant, 4 patients (4.5 %) developed early chronic rejection following acute steroid-resistant rejection. Acute and chronic rejection were confirmed by established clinical and histological criteria. Laminin levels were significantly increased in patients experiencing acute steroid-resistant rejection (4204 ± 133 ng/ml; P K 0.01) compared with patients with steroid-sensitive rejection (1059 ± 27.3 ng/ml) and with an uneventful postoperative course (1214 ± 17.4 ng/ml). No increase in laminin was observed in those four patients who developed early chronic rejection (1099 ± 58.7 ng/ml). Hyaluronic acid, fibronectin receptor, and TGF-β levels also increased in patients with acute steroid-resistant rejection; hyaluronic acid: 290 ± 10.8 μg/l vs 154 ± 13.6 μg/l and 131 ± 11.7 μg/l in patients with steroid-sensitive and no rejection, respectively; fibronectin receptor: 1003 ± 23.5 ng/ml vs 573 ± 24.8 ng/ml and 428 ± 13.6 ng/ml in patients with steroid-sensitive and no rejection, respectively; and TGF-β : 393 ± 14.9 pg/ml versus 315 ± 10.7 pg/ml and 233 ± 8.9 pg/ml in patients with steroid-sensitive and no rejection, respectively. A further increase in hyaluronic acid levels was observed in patients who developed early chronic rejection, while fibronectin receptor and TGF-β levels remained low, similarly to laminin levels. The increase in laminin, hyaluronic acid, fibronectin receptor, and TGF-β during acute steroid-resistant rejection may be stimulated by the rejection-related release of cytokines and adhesion molecules which paralleled the increase in ECM parameters. The lack of increase in laminin and fibronectin receptor levels in those patients who developed early chronic rejection may reflect an inability to recover from acute rejection.
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  • 10
    ISSN: 1432-2277
    Keywords: Liver transplantation, Budd-Chiari syndrome ; Hemoglobinuria, liver transplantation ; Budd-Chiari syndrome, liver transplantation ; PNH, Budd-Chiari syndrome, liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 54-year-old male patient with end-stage liver failure from Budd-Chiari syndrome due to paroxysmal nocturnal hemoglobinuria (PNH) underwent liver transplantation (OLT) in 1989. Retransplantation became necessary 1 year later when thrombotic occlusion of the portal vein and common hepatic artery led to graft loss after withdrawal of anticoagulation therapy because of several gastrointestinal bleeding episodes. The patient is now alive 3 years after the first OLT. To the best of our knowledge and according to the literature, this is, to date, the longest that any PNH patient has survived after liver transplantation. Although the course of this patient was complicated in a way similar to that reported for other cases in the literature, patients with PNH should not, in principle, be excluded from liver transplantation. Lifelong anticoagulation with coumarin and the use of steroids together with cyclosporin reduce the risk of recurrent thrombosis and PNH crises.
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