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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.; 20050504-20050508; Erfurt; DOC05hno220 /20050922/
    Publication Date: 2005-09-23
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  121. Kongress der Deutschen Gesellschaft für Chirurgie; 20040427-20040430; Berlin; DOC04dgch0474 /20041007/
    Publication Date: 2004-10-07
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Medizinische Informatik, Biometrie und Epidemiologie; VOL: 1; DOC02 /20050407/
    Publication Date: 2005-04-08
    Description: Before general application of a primary prevention program its efficacy has to be demonstrated. For this purpose a randomized controlled trial with active or passive follow-up may be conducted. In the last 5 years, the ratio of controlled trials with passive versus those with active follow-up was 1:13. However, under certain circumstances a passive follow-up may be more appropriate and useful to overcome the drawbacks of an active follow-up, as e.g. high costs and many drop-outs. In a randomized controlled trial, a passive follow-up is based on the reporting of cases by physicians or hospitals instead of actively following up all study participants individually. The statistical evaluation can be carried out using a one-sample chi2-test. Advantages and limitations are discussed. A passive follow-up may be advantageous in situations with low incidence, large number of participants, complete ascertainment of conditions with obligatory notification or effective disease registries and should be preferred in such a context.
    Description: Vor dem Einsatz primärer Präventionsprogramme auf Bevölkerungsebene ist deren Wirksamkeit zu prüfen. Standardmäßig werden dazu randomisierte kontrollierte Studien mit aktivem oder passivem Follow-up durchgeführt. In den letzten 5 Jahren kamen auf 1 Studie mit passivem Follow-up 13 Studien mit aktivem Follow-up. Unter bestimmten Voraussetzungen kann ein passives Follow-up jedoch geeigneter und sinnvoll sein und dazu dienen die Nachteile eines aktiven Follow-ups, wie z.B. hohe Kosten und viele Drop-outs, zu vermeiden. In einer randomisierten kontrollierten Studie mit passivem Follow-up werden alle Patienten mit der interessierenden Erkrankung von den behandelnden Ärzten oder den Krankenhäusern der Region direkt an das Studiensekretariat gemeldet. Die statistische Auswertung kann mit einem 1-Stichproben-Chi2-Test erfolgen. Die Vor- und Nachteile dieses Vorgehens werden diskutiert. Ein passives Follow-up kann in Situationen mit niedriger Inzidenz, großer Anzahl von Studienteilnehmern, Gewährleistung einer vollständigen Erhebung der Krankheitsfälle durch Betrachtung einer meldepflichtigen Erkrankung und gut geführte Krankheitsregister vorteilhaft sein und sollte dann durchaus bevorzugt werden.
    Keywords: active follow-up ; passive follow-up ; study design ; randomized controlled trial ; primary prevention program ; aktives Follow-up ; passives Follow-up ; Studiendesign ; randomiserte kontrollierte Studie ; primäres Präventionsprogramm ; ddc: 610
    Language: English
    Type: article
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  • 4
    ISSN: 1434-4726
    Keywords: Squamous cell carcinoma ; Selective neck dissection ; Upper digestive tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Selective neck dissection has been used clinically in elective treatment of carcinoma, although many surgeons continue to advocate modified radical or radical neck dissection for therapeutic management of the neck. In a retrospective study 167 previously untreated patients were reviewed following curative laser microsurgical resections of oral or pharyngeal primary tumors and a unior bilateral selective neck dissection. In all, 221 (54 bilateral) neck dissections were performed. In patients with oral primary disease lymph nodes of levels I–III were removed, while nodes in levels II and III were removed in patients with pharyngeal tumors. Level IV was dissected when several metastases were suspected during operation. The posterior triangle was not dissected. Lymph nodes were histopathologically negative in 73 patients and positive in 94 patients. Twenty-five of these latter cases had pN1 disease, 55 had pN2b disease and 10 had bilateral lymph node metastases. Twenty patients in the pN0 group and 63 patients in the pN+ group received postoperative radiotherapy (to 56.7 Gy to the primary site and 52.5 Gy to the neck). With a median follow-up interval of 34 months, recurrence in the dissected neck occurred in 3 of 73 patients (4.1%) with pN0 disease and 6 of 90 patients (6.6%) with pN+ necks. Four patients with pN+ necks had simultaneous recurrences at the primary site. The addition of adjuvant radiotherapy seemed to improve disease control in the neck and improve overall survival in patients with an unfavorable prognosis due to multiple metastases or metastases with extracapsular spread.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1335
    Keywords: Oncogene ; Receptor ; c-erbB-2 ; Membrane protein ; Ovarian cancer ; Pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Amplification of the proto-oncogene c-erbB-2 (HER-2/neu) has been shown to be a prognostic marker in ovarian cancer. In order to obtain further information on the biological role of the c-erbB-2 gene product p185 it is necessary to quantify expression levels. In this study we evaluated an enzyme-linked immunosorbant assay (ELISA) for the extracellular domain of p185 to determine whether a soluble oncoprotein fragment can be detected in the serum of ovarian cancer patients and in the serum of pregnant women. Sera from 199 women (57 previously untreated ovarian cancer patients, 62 pregnant women and 80 healthy controls) were assaved in a sandwich ELISA utilizing two mouse monoclonal antibodies. To study c-erbB-2 overexpression in ovarian cancer tissue samples we have used an immunohistochemical technique involving a monoclonal antibody specifically reactive with the external domain of the protein p185. The mean serum value for the normal controls was 1203 HNU/ml with a standard deviation (SD) or 279 HNU/ml and a range of 595–1947 HNU/ml. We chose a level of 1761 HNU/ml (2 SD above the mean) as a cut-off to distinguish individuals with elevated levels. The ovarian cancer patients' serum values ranged from 526 to 16 332 HNU/ml. Immunohistochemically detectable p185 was noted in 8 of 57 ovarian cancer patients. The oncoprotein fragment levels in the sera from these 8 patients ranged from 878 to 16 332 HNU/ml. Of 8 patients with p185 overexpression in their tumors, 4 had elevated serum levels. In the sera from the 49 cancer patients without overexpression the values were distributed in the range 526–2892 HNU/ml. There was no association between serum oncoprotein fragment levels and tumor stage, histological type or grading. Serum concentrations of the p185 fragment in pregnancy ranged from 612 to 3265 HNU/ml. The highest levels were found in the third trimester. The results of the present study raise the possibility that the soluble c-erbB-2 protein level in serum is an indicator for cell proliferation and therefore deserves further evaluation as a diagnostic tool in ovarian cancer patients and pregnancy.
    Type of Medium: Electronic Resource
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