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  • 1
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zur Beantwortung der Frage, ob es im Knorpelüberzug eines Gelenkkörpers Prädilektionsstellen der Arthrose gibt, wurden biometrische Untersuchungen an Talusrollen eines Unfallkollektivs (316 Fälle) und eines Sektionskollektivs (306 Fälle) durchgeführt. Gemessen wurde einerseits das frontale und sagittale Profil der Talusrolle und andererseits der prozentuale Arthroseanteil an der Gelenkoberfläche. Dabei wurden folgende Befunde erhoben: 1. Die Talusrolle wird sowohl in frontaler als auch in sagittaler Ebene mit zunehmendem Alter flacher. Eine Zuordnung zu potentiellen arthrosefördernden Faktoren ist nicht möglich. Eine Ausnahme bilden die Diabetiker mit wesentlich konkaverem Talusprofil (ein Pendant zum Fischwirbel?). 2. Die arthrotischen Knorpelusuren im Bereich des oberen Sprunggelenkes sind mehrheitlich spiegelbildsymmetrisch und vorwiegend im Bereich der Rollkanten lokalisiert. Die prozentuale Arthrosefläche an der Gelenkknorpeloberfläche nimmt mit zunehmendem Alter zu. Eine Zuordnung zu potentiellen arthrosefördernden Faktoren ist auch hier nicht möglich.
    Notes: Summary The age dependent profile changes and the predilection areas of arthrosis in ankle joints were investigated using a series of patients with foregoing accidental trauma (316 cases) and from 306 consecutive autopsy cases. Biometrical analysis was carried out by measuring the profile of talar trochlea in sagittal and frontal plane as well as the relative area showing arthrosis compared to total cartilage area. The following results were obtained: The talar trochlea profile flattens in frontal as well as sagittal plane with age. A correlation between the age dependent profile changes and the possible arthrosis promoting factors could not be established. Diabetics show more concave profils than others. Arthrotic areas are usually symmetrical in the ankle joint and more pronounced in lateral and medial part of the articular surface. The arthrotic area increases with age, without correlation between the degree of arthrosis and the possible arthrosis promoting factors.
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  • 2
    ISSN: 1434-0879
    Keywords: Renal cell carcinoma ; Prognosis ; p53 ; mdm-2 ; Survival ; Proliferation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical course of renal cell carcinoma (RCC) is highly variable. Overexpression of the p53 protein has been suggested as a possible prognostic parameter in RCC. Overexpression of the mdm-2 oncogene product has been shown to interact with the p53 function. To investigate the immunohistochemical overexpression of mdm-2 protein in comparison with that of p53 protein in RCC, 50 nonpapillary pT3 RCCs were immunostained for p53 protein (DO-7) and mdm-2 (1172). Tumor growth fraction (Ki-67 labeling index; MIB-1) was determined by immunohistochemistry. p53 positivity was detected in 16% of tumors. mdm-2 overexpression was seen in 30% of RCCs. There was a significant association between p53 and mdm-2 immunostaining (P=0.0006), suggesting that mdm-2 protein may contribute to p53 protein stabilization in RCC. p53 overexpression was associated with a high Ki-67 LI (P=0.0002), suggesting that p53 overexpression is involved in growth control in RCC. Survival analysis showed that Ki-67 LI (P=0.04) and p53 overexpression were associated with poor prognosis (P=0.0021), whereas mdm-2 overexpression was not related to patient outcome (P=0.73). A Cox regression analysis revealed tumor stage (P〈0.001) and p53 overexpression (P〈0.05) to be independent prognostic parameters. It is concluded that p53 but not mdm-2 may be of practical relevance in predicting patient prognosis in RCC.
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  • 3
    ISSN: 1434-0879
    Keywords: Bladder neoplasms ; Flow cytometry ; Fluorescence in situ hybridization ; Chromosome Y ; Chromosome X ; Chromosome 1 ; Chromosome 7 ; Chromosome 9 ; Chromosome 17 ; Aneuploidy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Detection of molecular alterations is of potential significance for diagnosis and prognosis in bladder cancer. Fluorescence in situ hybridization (FISH) allows visualization and quantitation of genes and chromosomes on a cell by cell level and can easily be applied to urinary cells. To evaluate the sensitivity of FISH for detection of DNA aberrations in bladder cancer, formalin-fixed tissues of 293 tumors were examined by FISH and flow cytometry (FCM). Centromere probes for the chromosomes X, Y, 1, 7, 9, and 17 were used for FISH analysis. FISH was more sensitive for detection of quantitative DNA aberrations than FCM. An aberration of at least one chromosome was found in 107 of 108 tumors (99%), which were tetraploid, aneuploid, or multiploid, and in 29 of 49 tumors (59%), which were diploid, by FCM. The frequency of FISH aberrations showed greater differences between pTa (47%) and pT1 tumors (85%;P〈0.0001) than between stages pT1 and pT2-4 (98%). The marked genetic difference between pTa and pT1 tumors argues against the concept of grouping pTa and pT1 tumors together as “superficial bladder cancer.” The frequency of tumors with chromosomal aberrations detected by FISH increased with the number of chromosomes examined. Aneusomy was seen in 68% of grade 1 tumors examined for ≥4 chromosomes, suggesting that the cytological diagnosis of bladder cancer recurrences could be substantially improved by FISH.
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  • 4
    ISSN: 1434-0879
    Keywords: Urinary bladder carcinoma ; Peritumoural inflammation ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Peritumoural inflammation consisting of lymphocytes, plasma cells and lymph follicles is present in two thirds of invasive urothelial bladder carcinomas. This type of inflammation is significantly rarer in advanced tumour stages (P3, P4) and its presence is a favourable prognostic factor. The mean survival time in patients with this type of inflammation is 26.1 months compared to only 14.8 months in patients without. All other forms of inflammation e. g. eosinophilic or polymorphonuclear leukocytes have no relation with prognosis. The significant prognostic value of lympho-plasmocytic inflammation may be considered as local expression of immunological host resistance.
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  • 5
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Thyreoparathyreoprive Ratten, die einem Vitamin D-Mangel unterzogen werden, weisen in den Epiphysenfugen ein gestauchtes Zerrbild einer floriden Rachitis auf. Der ganze Wachstumsknorpel ist verglichen mit einer reinen Vitamin D-Mangelrachitis verschmälert und wird als Folge der Thyreoparathyreoidektomie in Form einer einheitlichen Vascularisationsfront von der Metaphyse abgesetzt. Dies bedeutet, daß die in einer rachitischen Epiphysenfuge wegen des sekundären Hyperparathyreoidismus stellenweise entgleiste Knorpelresorption zum Stillstand gekommen ist. Als Zeichen der weiterhin bestehenden Vitamin D-Mangelrachitis sind die plumpen Spongiosaelemente von breiten unverkalkten Osteoidsäumen überzogen. Auch das chondrocytäre Cytoplasma wird durch die Thyreoparathyreoidektomie in Mitleidenschaft gezogen. Die Vacuolisierung des Ergastoplasmas und des Golgi-Apparates weist auf eine gehemmte Ausschleusung der chondrocytären Syntheseprodukte hin. Im selben Sinne sind auch die nativen Kollagenfibrillen in der Matrix der Epiphysenfuge zu werten. Bei einem Mangel an metabolisch wirksamen Vitamin D darf deshalb der sekundäre Hyperparathyreoidismus nicht vernachlässigt werden.
    Notes: Summary Thyreo-parathyreoprival rats who have been exposed to a vitamine D deficiency show a compressed, distorted picture of florid rickets in the epiphyseal plate. The entire growth cartilage, compared to a pure vitamine D deficiency rickets, is narrowed and, due to thyreo-parathyreoidectomy, is demarcated from the methaphysis by a compact vascular wall. This means that resorption of cartilage which, in a rachitic epiphyseal plate has been partially impeded due to secondary hyperparathyreoidism, has come to a stillstand. Plump, spongiosal elements, which are covered by wide uncalcified osteoid fringes, are evidence of continuing vitamine D deficiency rickets. Chondrocytic cytoplasma is also implicated by thyreo-parathyrectomy. Vacuolisation of the ergastoplasma and Golgi apparatus indicate an inhibited delivery of the products required for chondrocytic synthesis. Native collagenous fibrills in the epiphyseal plate matrix are to be interpreted similarly. Therefore, secondary hyperparathyreoidism is not to be neglected in the presence of a deficiency of metabolic effective vitamine D.
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  • 6
    ISSN: 1432-1963
    Keywords: Schlüsselwörter: Karyomegalie – Niere – Chronische interstitielle Nephritis ; Key words: Karyomegaly – Kidney – Interstitial nephritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Systemic karyomegaly associated with interstitial nephritis was first described in 1978 by Mihatsch. Seven cases have been reported to date. We give an account of an autopsy case of systemic karyomegaly in a 30-year-old Italian man. Bizarre enlargement of nuclei was found in renal tubular epithelial cells, Schwann cells and in smooth muscle cells of vessels and bowel and, less obviously, in endothelial and adventitial cells of vessels, in alveolar epithelial cells and in astrocytes of the brain. These findings were associated with chronic interstitial nephritis, nonspecific hepatopathy, adenocarcinoma of the rectum and multiple slerosis. The clinical course was marked by chronic renal failure, chronic haemodialysis and renal transplantation. The patient died 8 years after diagnosis in septic-toxic shock. The aetiology and pathogenesis of the disease are discussed.
    Notes: Zusammenfassung. Die Karyomegalie der Niere ist ein seltenes Krankheitsbild, von dem bislang nur 7 Fälle beschrieben wurden. Anhand der Autopsie eines 30 Jahre alten Italieners berichten wir über Morphologie und mögliche Ursachen dieser Krankheit. Typische bizarre Vergrößerungen von Zellkernen kommen in Tubulusepithelien der Niere, in Schwannzellen, in glatten Muskelzellen von Gefäßen und Darm und in geringerem Ausmaß in Endothelzellen und Adventitiazellen der Blutgefäße, in Alveolarepithelzellen und in Astrozyten des Gehirns vor. Diese Befunde waren assoziiert mit einer chronischen interstitiellen Nephritis, einer unspezifischen Hepatopathie, einem Adenokarzinom des Rektums und einer multiplen Sklerose. Der klinische Verlauf war charakterisiert durch ein chronisches Nierenversagen, gefolgt von Hämodialyse und konsekutiver Nierentransplantation. Der Patient starb 8 Jahre nach der Diagnose des Krankheitsbildes in einem septisch-toxischen Schock.
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  • 7
    ISSN: 1432-1440
    Keywords: Whipple's disease ; Chronic interstitial nephritis ; Granulomas ; Boeck's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Report is given on a 68-year-old man who suffered primarily from progressive weight loss and repeated episodes of fever and arthralgia. Later, liver dysfunction and renal insufficiency developed. Liver and kidney biopsics disclosed granulomatous hepatitis and nephritis. Because of the morphologic and clinical findings, the diagnosis of Boeck's disease was made. Shortly before death, diarrhea developed. Autopsy revealed a massive systemic involvement in Whipple's disease proven by light and electron microscopy and immunofluorescence. Tuberculoid and epitheloid cell granulomas and isolated giant cells were found in addition to the biopsy findings in skeleton muscles, the small intestine, lymphnodes and bronchi. At autopsy, the kidney showed chronic interstitial nephritis. The literature of kidney involvement in Whipple's disease is reviewed. This is the first case with granulomatous interstitial nephritis and chronic renal insufficiency in an inadequately treated Whipple's disease.
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  • 8
    ISSN: 1432-1440
    Keywords: Cyclosporin ; Nephropathy ; Side effects ; Autoimmune disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal biopsy specimens were evaluated from patients with different autoimmune diseases treated with cyclosporin (CyA). Ten biopsies were done before CyA, 10 biopsies after low-dose (〈7.5 mg/kg/day, initial dose or mean daily dose within the first month, respectively), and 9 after high-dose (〉7.5 mg/kg/day) treatment. Definite chronic CyA nephrotoxicity (cyclosporin-associated arteriolopathy and/or interstitial fibrosis striped form with tubular atrophy) was only present in the initial high-dose group. In this group a significant serum creatinine increase was noted and 8 of the 9 patients were hypertensive. No significant correlation was found between the severity of morphologic lesions and the mean daily dose during total treatment, cumulative dose, and duration of therapy. The morphologic changes in the low-dose group did not differ from the control biopsy specimens before CyA treatment. Based on these results, it can be concluded that major nephrotoxicity can be avoided by initial low CyA doses.
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  • 9
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Normales Hirngewicht ; Erwachsene ; Alter ; Geschlecht ; Körpergröße ; Gewicht ; Key words Normal brain weight ; Adults ; Age ; Sex ; Height ; Weight
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Based on more than 8000 autopsies of male and female patients without brain diseases the normal brain weight of adult males and females in relation to sex, age, body-weight, and body-height as well as Body Mass Index were calculated. The average brain weight of the adult male was 1336 gr; for the adult female 1198 gr. With increasing age, brain weight decreases by 2.7 gr in males, and by 2.2 gr in females per year. Per centimeter body height brain weight increases independent of sex by an average of about 3.7 gr. Body Mass Index is of minor importance and only relevant in males. Based on these data the independent variables, age and height, were for the first time combined in a nomogram for the calculation of brain weight. The mathematical functions were integrated in a computer program which facilitates the calculation of normal brain weights in individual cases.
    Notes: Zusammenfassung Anhand von über 8000 Autopsien von Patienten ohne Hirnkrankheiten wurden die Normgewichte der Gehirne für Männer und Frauen in Abhängigkeit von Alter, Körpergröße, Gewicht und Body Mass Index berechnet. Das Hirngewicht des erwachsenen Mannes beträgt im Durchschnitt 1336 g, das der erwachsenen Frau 1198 g. Pro Altersjahr nimmt das Hirngewicht beim Mann um ca. 2,7 g, bei der Frau um ca. 2,2 g ab. Pro cm Körpergröße nimmt das Hirngewicht bei beiden Geschlechtern um ca. 3,7 g zu. Den geringsten Einfluß auf das Hirngewicht hat der Body Mass Index, der praktisch nur bei Männern bedeutsam ist. Aus den unabhängigen Variablen, Alter und Körpergröße, wurde erstmals ein Nomogramm für das zu erwartende Hirngewicht konstruiert. Gleichzeitig wurden die Funktionen unter Berücksichtigung der wichtigsten Einflußgrößen in ein Computerprogramm integriert, das die Normgewichte errechnet und quantitative Aussagen über die Abweichung des Hirngewichts von der Norm im Einzelfall erlaubt.
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  • 10
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Prostatakarzinom ; Zytogenetik ; Gen-Amplifikation ; Polysomie ; Key words Prostate cancer ; Cytogenetics ; Gene amplification ; Polysomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Development and progression of tumors is driven by a malfunction of specific genes. Although prostate cancer is one of the most frequent tumors, little is known about the genes involved. Cytogenetic and molecular examinations have shown that chromosomal deletions most frequently involve 7q, 8p, 10q, 13q, 16q, 17p and the Y chromosome. These loci may carry tumor suppressor genes with relevance for prostate cancer. DNA sequence copy number gains were most frequently observed at chromosomes 7, 8q, and 11q. These regions may carry currently un-known oncogenes. There is increasing evidence for a clinical relevance of genetic alterations. Polysomies of several chromosomes were shown to be associated with poor prog-nosis of prostate cancer patients. Androgen receptor amplification can be found in hormone-refractory carcinomas which may re-spond to total androgen blockage. For the future it is hoped that the identification of the genes involved in prostate cancer and the determination of their function could allow for significant improvements of treatment strategies for prostate cancer patients.
    Notes: Zusammenfassung Entstehung und Progression von Tumoren werden durch Funktionsstörungen von spezifischen Genen gesteuert. Obwohl das Prostatakarzinom zu den häufigsten Tumoren gehört, ist über die bei diesem Tumor involvierten Gene wenig bekannt. Zytogenetische und molekulare Untersuchungen haben gezeigt, daß chromosomale Deletionen besonders häufig das Y-Chromosom, 7q, 8p, 10q, 13q, 16q und 17p betreffen. Diese Loci dürften für das Prostatakarzinom relevante Tumorsuppressorgene enthalten. Häufige DNS-Sequenzvermehrungen von Chromosom 7, 8q und 11q deuten auf die Lokalisation von möglichen Onkogenen hin. Bereits heute bestehen Anhaltspunkte für eine Prognoserelevanz genetischer Veränderungen. Der Nachweis von Polysomien in Primärtumoren deuten auf eine ungünstige Prognose hin. Eine Amplifikation des Androgenrezeptors spricht für einen Hormontherapie-resistenten Tumor, welcher möglicherweise besonders gut auf eine totale Androgenblockade ansprechen wird. Die Identifikation der alterierten Gene und die Entschlüsselung ihrer Funktion könnte in Zukunft zu deutlich verbesserten Behandlungsstretegien für Patienten mit Prostatakarzinom führten.
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