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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  124. Kongress der Deutschen Gesellschaft für Chirurgie; 20070501-20070504; München; DOC07dgch7601 /20071001/
    Publication Date: 2007-10-02
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  123. Kongress der Deutschen Gesellschaft für Chirurgie; 20060502-20060505; Berlin; DOC06dgch4613 /20060502/
    Publication Date: 2006-05-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Journal for Medical Education; VOL: 34; DOC5 /20170215/
    Publication Date: 2017-02-15
    Description: Objectives: A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians' choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students' attitudes towards risk; whether they waited for their place of study (Wartesemester ); whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector.Methods: We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender), their parents' occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (Abiturnote ), and First National Boards Examination grade (Physikum ). In 2014, we additionally asked for waiting periods (Wartesemester ) as well as for prior professional experience in the health-care sector.Results: We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: having a medical doctor among the parents, having worse grades in the high-school grade point average, and being more risk averse. Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school.Discussion: Our results suggest that a change in the selection process for medical school may increase the supply of country doctors. Instead of focusing on the high-school grade point average, universities could even more intensely screen for study motivation through interviews or by taking into account students' background, extracurricular activities, or waiting periods.
    Description: Forschungsziele: Die Veränderung der Zugangsregelungen zum Medizinstudium stellt eine Möglichkeit dar, um die Knappheit von Landärzten zu verringern. Wir analysieren daher den Zusammenhang zwischen dem Abiturnotendurchschnitt und der Entscheidung zukünftiger Ärzte, in ländlichen Regionen zu arbeiten. Zur Anregung der Debatte über die Zulassungsregelungen beschäftigen wir uns zudem mit den Effekten anderer Einflussvariablen wie der Risikobereitschaft der Studierenden, der Anzahl der Wartesemester, der Zugehörigkeit der Eltern zum ärztlichen Berufsfeld sowie der praktischen Erfahrung der Studienbewerber im Gesundheitssektor.Methoden: In den Jahren 2012 und 2014 führten wir zwei Internetbefragungen durch. Die erste Befragung umfasste 701 Studierende, die zweite 474 Studierende. In beiden Erhebungen wurden die Studierenden nach ihren regionalen Präferenzen für ihre künftige Berufsausübung gefragt; in der Befragung des Jahres 2014 ermittelten wir zudem die ersten, zweiten und dritten Präferenzen bezüglich der Facharztwahl. In beiden Befragungen wurden demographische Merkmale (Alter und Geschlecht), die Berufe der Eltern, subjektive Einkommenserwartungen, die Risikobereitschaft sowie die Notendurchschnitte in Abitur und Physikum erhoben. 2014 fragten wir darüber hinaus nach der Anzahl der Wartesemester und vorherigen praktischen Erfahrungen im Gesundheitssektor. Ergebnisse: Drei Faktoren erhöhen ceteris paribus die Wahrscheinlichkeit einer Präferenz für eine Beschäftigung in ländlichen Gebieten signifikant: ein Elternteil ist Arzt, relativ schlechtere Abiturnoten und geringere Risikobereitschaft. Des Weiteren zeigt sich, dass Studierende, die eine Tätigkeit auf dem Land anstreben, vor der Zulassung zum Medizinstudium signifikant häufiger eigene praktische Arbeitserfahrungen im Gesundheitssektor haben. Diskussion: Unsere Ergebnisse legen nahe, dass eine Veränderung des Auswahlprozesses für das Medizinstudium das Angebot an Landärzten erhöhen könnte. Statt sich nur auf die Abiturnote zu konzentrieren, sollten die Universitäten die Motivation für das Studium in größerem Maße berücksichtigen, sei es mit Hilfe von Auswahlgesprächen oder durch die Berücksichtigung von Herkunft, außerschulischen Aktivitäten oder Wartesemestern.
    Keywords: admission to medical school ; specialization choice ; physician shortages ; rural work ; Zulassung zum Medizinstudium ; Facharztwahl ; Hausärztemangel ; Niedergelassene Ärzte in ländlichen Regionen ; ddc: 610
    Language: English
    Type: article
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  126. Kongress der Deutschen Gesellschaft für Chirurgie; 20090428-20090501; München; DOC09dgch10787 /20090423/
    Publication Date: 2009-05-06
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 5
    Keywords: Germany ; THERAPY ; CLASSIFICATION ; RISK ; PATIENT ; treatment ; LESIONS ; EXPERIENCE ; REPAIR ; HIGH-RISK ; SELECTION ; RECONSTRUCTION ; MANAGEMENT ; SURGICAL-TREATMENT ; ABDOMINAL AORTIC-ANEURYSM ; aneurysm ; ARTERY ANEURYSMS ; endograft ; endovascular ; ENDOVASCULAR TREATMENT ; GRAFTS ; iliac artery ; MIDTERM EXPERIENCE
    Abstract: Isolated iliac aneurysms (IIA) are uncommon lesions that require surgical repair to prevent rupture. The aim of this article is to give an update on the current surgical management of IIA. This report also evaluates the application of endovascular repair in IIA, based on a recent Pubmed search and on our own experience in the interventional field: Open reconstruction achieves good longterm results and still represents the golden standard in surgical treatment of IIA. Transluminally placed endovascular stent grafts can be successfully used to exclude isolated iliac aneurysms in selected high risk patients with suitable anatomy. A classification based on aneurysm morphology is useful for patient selection. The value of endovascular therapy has yet to be determined
    Type of Publication: Journal article published
    PubMed ID: 16485205
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  • 6
    Keywords: Germany ; THERAPY ; FOLLOW-UP ; SYSTEM ; SYSTEMS ; MORTALITY ; RISK ; computed tomography ; SURGERY ; PATIENT ; treatment ; DESIGN ; AGE ; REPAIR ; RATES ; tomography ; COMPUTED-TOMOGRAPHY ; COMPLICATIONS ; DISSECTION ; STROKE ; THORACIC AORTA ; THROMBOSIS ; methods ; Male ; VARIABLES ; endovascular ; GRAFTS ; ANEURYSM REPAIR ; DISSECTIONS ; PHANTOMS ; PULSATILE FLOW ; SINGLE-CENTER ; STENT-GRAFT PLACEMENT ; TRUE-LUMEN COLLAPSE
    Abstract: Objective: To outline the complications after endovascular repair in patients with acute symptomatic and chronic expanding Stanford type B aortic dissections. Methods: Between 1997 and 2004, of 125 patients with acute and chronic aortic type B dissections, 88 were treated conservatively. Thirty-seven patients ( 29 male, mean age 58 years, range 30-82 years) underwent endovascular repair (30%) using 44 stent grafts of 3 different designs: Excluder ( W. L. Gore & Associates, Inc, Flagstaff, Ariz), Talent ( Medtronic Vascular, Santa Rosa, Calif), and Endofit (Endomed, Inc, Phoenix, Ariz). Indications for treatment were acute symptomatic type B dissection in 15 patients, chronic expanding aortic dissection greater than 55 mm in 14, rupture in 3, and simultaneous type A repair in 5 patients. Twenty-two operations were performed on an emergency basis. Patient characteristics, procedural variables, outcome, and complications were prospectively recorded. All patients underwent follow-up by computed tomography before discharge, at 6 and 12 months, and annually thereafter ( mean follow-up: 24 months). Results: Correct deployment was achieved in 97% of cases. There were no instances of primary conversion, paraplegia, or stroke. Complete false lumen thrombosis was observed in 11 patients (44%). Perioperative complication rate was 22%. Thirty-day mortality rate in acute and chronic dissections was 19% and 0%, respectively. Freedom from aortic reintervention was 81%, 73%, and 68%, freedom from late rupture was 97%, 90%, and 80%, and overall success rate was 76%, 65%, and 57% at 1, 2, and 5 years, respectively. Results for patients with chronic dissections are significantly ( P =.038) better than results in those with acute dissections. Conclusions: Despite the minimally invasive approach, the complication and mortality rates for endovascular therapy of aortic dissections are still high. Frank reporting of these sequelae is if great importance to clarify the recent limitations of the method
    Type of Publication: Journal article published
    PubMed ID: 16872963
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  • 7
    Keywords: Aorta, aortal thrombus, DISEASE, DISORDERS, embolisation, EMBOLISM, Germany, HIGH-RISK, PATIENT, pro
    Abstract: Intraluminal mobile thrombus of the descending aorta are rare disorders. They are at high risk for peripheral embolism and therefore indication for treatment is mandatory. We report on a 54-year-old patient with peripheral arterial embolization who was treated by surgical thrombus removement by thoracotomy and staged peripheral bypass grafting. New diagnostic tools are presented, therapy and prognosis are discussed
    Type of Publication: Journal article published
    PubMed ID: 17708104
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  • 8
    Keywords: abdominal aortic aneurysm, ABDOMINAL AORTIC-ANEURYSMS, aneurysm, ANEURYSM REPAIR, CLASSIFICATION, co
    Abstract: Purpose: To present a technique to treat endotension and avoid surgical conversion after endovascular aneurysm repair (EVAR). Technique: The surgical procedure is based on decompression, downsizing, and fenestration of the aneurysm sac combined with proximal aortic neck banding and transmural endograft fixation with sutures. Among 193 patients who underwent infrarenal EVAR between October 2001 and October 2007, 3 (1.5%) patients developed endotension without evidence of endoleak (increasing aneurysm diameter in 2 and a pulsating aneurysm with unchanged diameter in the third). This technique was applied successfully in uneventful procedures. Considerable shrinkage of the aneurysm sac has been observed over a 13- to 31-month follow-up. Conclusion: This open surgical procedure is a safe and effective treatment for endotension and can avoid conversion. More experience is needed for definitive evaluation. J Endovasc Ther 2008;15:449-452
    Type of Publication: Journal article published
    PubMed ID: 18729551
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  • 9
    Keywords: adhering junctions, ADULT, ARCHITECTURE, ARRAY, ARRAYS, ASSEMBLIES, assembly, BIOLOGY, CARDIOMYOPATH
    Abstract: In the adult mammalian heart, the cardiornyocytes are connected by large polar arrays of closely spaced or even fused composite, plaque-bearing adhering junctions,(areae contpositae, ACs), in a region usually termed "intercalated disk," (ID). We have recently reported that during late embryogenesis and postnatally these polar assemblies of ACjunction structures are gradually formed as replacements of distinct embryonal junctions representing desmosomes and Jasciae adhaerentes which then may amalgamate to the fused AC structures, in some regions occupying more than 90% of the total ID area. Previous gene knockout results as well as mutation analyses of specific human cardi'omyopathies have suggested that among the various AC constituents, the desmosomal plaque protein, plakophilin-2, plays a particularly important role in the formation, architectural organization and stability of these junctions interconnecting mature cardiomyocytes. To examine this hypothesis, we have decided to study losses of - or molecular alterations in such AC proteins with respect to their effects on myocardiac organization and functions. Here we report that plakophilin-2 is indeed of obvious importance for myocardial architecture and cell-cell coupling of rat cardiornyocytes growing in culture. We show that siRNA-mediated reduction of the cardiomyocyte content of plakophilin-2 but not of some other major plaque components such as desmoplakin results in progressive disintegration - and losses - of AC junction structures and that numerous variously sized vesicles appear, which are plaque protein-associated as demonstrable by immunofluorescence and immunoelectron microscopy. The importance of plakophilin-2 as a kind of "organizer" protein in the formation, stabilization and functions of the AC structure and the ID architecture is discussed in relation to other junction proteins and to causes of certain cardiornyopathies. (c) 2007 Elsevier GmbH. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 18261826
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  • 10
    Keywords: EXPRESSION ; TUMOR-CELLS ; INTERMEDIATE-FILAMENTS ; vimentin ; cholesterol ; ELECTRON-MICROSCOPY ; DIFFERENTIATION-RELATED PROTEIN ; PAT-FAMILY ; ADIPOSE CONVERSION ; ADRENAL-CELLS
    Abstract: Lipid droplets (LDs) are spherical accumulations of apolar lipids and other hydrophobic substances and are generally surrounded by a thin cortical layer of specific amphiphilic proteins (APs). These APs segregate the LDs from the mostly polar components of the cytoplasm. We have studied LDs in epithelium-derived cell cultures and in particular characterized proteins from the perilipin (PLIN) gene family - in mammals consisting of the proteins Perilipin, Adipophilin, TIP47, S3-12 and MLDP/OXPAT (PLIN 1-5). Using a large number of newly generated and highly specific mono- and polyclonal antibodies specific for individual APs, and using improved LD isolation methods, we have enriched and characterized APs in greater detail and purity. The majority of lipid-AP complexes could be obtained in the top layer fractions of density gradient centrifugation separations of cultured cells, but APs could also be detected in other fractions within such separations. The differently sized LD complexes were analyzed using various biochemical methods and mass spectrometry as well as immunofluorescence and electron- in particular immunoelectron-microscopy. Moreover, by immunoprecipitation, protein-protein binding assays and by immunoelectron microscopy we identified a direct linkage between LD-binding proteins and the intermediate-sized filaments (IF) cytokeratins 8 and 18 (also designated as keratins K8 and K18). Specifically, in gradient fractions of higher density supposedly containing small LDs, we received as co-precipitations cytidylyl-, palmitoyl- and cholesterol transferases and other specific enzymes involved in lipid metabolism. So far, common proteomic studies have used LDs from top layer fractions only and did not report on these transferases and other enzymes. In addition to findings of short alternating hydrophobic/hydrophilic segments within the PLIN protein family, we propose and discuss a model for the interaction of LD-coating APs with IF proteins.
    Type of Publication: Journal article published
    PubMed ID: 23704888
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