Common feature of this patient group was marked inflammatory cell infiltration into fibrous septa, increase of copper concentration in liver parenchyma and distinct pathological changes of laboratory data. In the remaining 6 patients no pathological change of liver morphology was demonstrated by MRI corresponding to slight histopathological changes of parenchyma and normal laboratory data. As low-intensity nodules surrounded by high intensity septa can be demonstrated in patients with marked inflammatory infiltration of liver parenchyma MRI may help to define Wilson patients with poorer prognosis.
In patients with low-intensity nodules of the liver and unknown cause of liver cirrhosis laboratory data and histopathology should be checked when searching for disorders of copper metabolism. Experimental geothermal well at Bad Schinznach. First results; Geothermiebohrung Bad Schinznach.
The spa of Bad Schinznach Canton Argovia, Switzerland endeavours to cover its heating requirements with geothermal energy. A recently drilled well to a depth of meters encountered the regional acquifer of thermal water Oberer Muschelkalk, Triassic in three levels. Preliminary results indicate a productive aquifer in the uppermost level with a wellhead temperature of 42 C.
An additional exploitation of the bottomhole formation temperature of 63 C is envisaged. Eine neulich abgeteufte Bohrung bis auf Meter Tiefe hat die Formation auf drei Niveaus angetroffen. Erste Resultate deuten auf ein nutzbares Vorkommen im obersten Horizont mit einer Austrittstemperatur von 42 C. Eine zusaetzliche Nutzung der hohen Formationstemperatur von 63 C auf Endtiefe wird erwogen. Epithelioid sarcoma of the plantar fascia mimicking Morbus Ledderhose - A severe pitfall for clinical and histopathological misinterpretation.
Plantar fibromatosis, also known as Morbus Ledderhose, is a well known and frequently encountered disorder of the planta pedis. When conservative treatment fails, surgical therapy with complete resection is the therapeutical procedure of choice. Soft tissue sarcoma is a heterogeneous and rare malignant disease of the musculoskeletal system with over 50 histopathological subtypes which can potentially arise in any localization but is most commonly found at the extremities. Here, we report the case of an epithelioid sarcoma of the sole of the foot which was initially and repeatedly clinically and histopathologically misinterpreted as plantar fibromatosis, receiving insufficient resection and subsequently ending in amputation of the lower leg.
Published by Elsevier Ltd. Nuklearmedizinische Klinik] [Forschungszentrum Juelich Germany. Simple strategies like optimization of thyroid metabolism help to improve efficacy in radioiodine therapy thus lowering applied radioiodine doses, radiation exposure to the patient and to the environment and avoiding multiple vain therapeutic efforts. These strategies are likely to reduce costs at the same time.
Ziel ist es, mit einfachen Methoden wie der optimalen Einstellung der Stoffwechsellage die Effizienz der Radioiodtherapie zu optimieren im Hinblick auf eine Reduktion der einzusetzenden Aktivitaet, der Gesamtstrahlenexposition fuer Patient und Umwelt und durch Vermeidung mehrfacher, vergeblicher therapeutischer Ansaetze. Diese Optimierung traegt auch zur Reduktion der Gesamtkrankheitskosten bei. Efficacy and safety of collagenase Clostridium histolyticum injection for Dupuytren contracture: Dupuytren 's disease DD is a fibroproliferative pathology that affects the palmar aponeurosis causing the development of nodules and collagen cords and the progressive flexion of the fingers.
The standard procedure is surgical fasciectomy, followed by high recurrence rates. Collagenase Clostridium histolyticum CCH injection represents an innovative noninvasive approach to the treatment of DD. This prospective study was designed to examine the efficacy and safety of CCH injection performed in the outpatient, using local anesthesia.
The mean age was All joints were treated with a single vial of collagenase injection and manual breaking of the cord 24 h after. All adverse effects AEs were monitored. Patients were checked 7, 30, 90, and days after the injection. Secondary endpoints were the improvement of range of motion, the evaluation of AEs incidence, and cost-effectiveness of collagenase treatment.
At 6 months, a further 7. The mean contracture of treated joints was 5. Twenty-three patients had one or more mild-to-moderate side effects. The use of collagenase appears to be an effective and safe method for the treatment of Dupuytren 's contracture. Therapeutic success was achieved in a significant percentage of patients. The incidence of side effects was higher, but they were local reactions of short duration. The use of a single collagenase vial in patients treated in day surgery appears more cost-effective than surgery. Dupuytren 's disease is a fibroproliferative disorder of the palmar fascia.
The treatment used to date has mostly been surgery, but there is a high recurrence rate. The role of diabetes mellitus, liver disease, and epilepsy as risk factors for Dupuytren disease remains unclear. In this systematic review and meta-analysis, the strength and consistency of these associations were examined. The frequencies of Dupuytren disease and diabetes mellitus, liver disease, and epilepsy were extracted, as was information on potential confounders. Generalized linear mixed models were applied to estimate pooled odds ratios, adjusted for confounders. Heterogeneity between studies was quantified using an intraclass correlation coefficient and was accounted for by a random effect for study.
One thousand two hundred sixty unique studies were identified, of which 32 were used in the meta-analyses. An association between Dupuytren disease and diabetes mellitus was observed OR, 3. An association between Dupuytren disease and liver disease was observed OR, 2. Dupuytren disease and epilepsy were associated, yielding an OR of 2. Heterogeneity between studies was moderate to low. These findings demonstrate an association between Dupuytren disease and diabetes mellitus, liver disease, and epilepsy.
Prospective, longitudinal studies are needed to elucidate the pathways causing these associations. Hand function and quality of life before and after fasciectomy for Dupuytren contracture. To describe changes in joint motion, sensibility, and scar pliability and to investigate the patients' expectations, self-reported recovery, and satisfaction with hand function, disability, and quality of life after surgery and hand therapy for Dupuytren disease.
This prospective cohort study collected measurements before surgery and 3, 6, and 12 months after surgery and hand therapy. Outcomes measures were range of motion; sensibility; scar pliability; self-reported outcomes on expectations, recovery, and satisfaction with hand function; Disabilities of the Arm, Shoulder, and Hand scores; safety and social issues of hand function; physical activity habits; and quality of life with the Euroqol. The extension deficit decreased, and there was a transient decrease in active finger flexion during the first year after surgery.
Generally, patients with surgery on multiple fingers had worse scar pliability. Fear of hurting the hand and worry about not trusting the hand function were of greatest concern among safety and social issues. After surgery and hand therapy, disability decreased independent of single or multiple operated fingers. The total active finger extension improved enough for the patients to reach a functional range of motion despite an impairment of active finger flexion still present 12 months after treatment. Published by Elsevier Inc. Radiotherapy in early-stage Dupuytren 's contracture.
Long-term results after 13 years. In early-stage Dupuytren 's contracture, radiotherapy is applied to prevent disease progression. Long-term outcome and late toxicity of the treatment were evaluated in a retrospective analysis. The extent of disease was described according to a modified classification of Tubiana et al. Late treatment toxicity and objective reduction of symptoms as change in stage and numbers of nodules and cords were evaluated and used as evidence to assess treatment response.
There was no evidence for a second malignancy induced by radiotherapy. In case of disease progression after radiotherapy, a ''salvage'' operation is still feasible. Pulmonary radio-responses to surface field radiotherapy of Morbus Hodgkin using a 4 MeV linear accelerator. In patients suffering from Morbus Hodgkin who were treated between and , the pulmonary radio-response was retroperspectively investigated. Besides incidence and degree of severity, the course over the time of the individual stages of radio-response were also investigated. Each fibrosis had been preceded by the radiomorphologic sign of pneumonitis of always the same degree of severity.
The course over the time of the radiomorphologically subdivided stages determined that on the average the signs of a beginning pneumonitis occurred An active pneumonitis was detectable after The stage of stationary pulmonary fibrosis was reached Correlative relations to different individual disease-dependent and radiotherapeutic factors were detected, which are considered to be responsible for the intensity and character of the floride radio-response and the remaining pulmonary fibrosis.
Considered from the radiomorphologic course of pulmonary irradiation reaction and its intensity and character, no significant advantage of tumor-reducing chemotherapy compared to irradiation or of split-course-technique compared to continuous fractioning was found.
The introduction of individually adjustable shields helped to reduce the degree of severity of radio-response. Cost-effectiveness in the management of Dupuytren 's contracture. A Canadian cost-utility analysis of current and future management strategies. In Canada, Dupuytren 's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy PNA.
Injectable collagenase will soon be available. The optimal management of Dupuytren 's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren 's contracture it and the threshold at which collagenase is cost-effective.
We developed an expected-value decision analysis model for Dupuytren 's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger.
The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren 's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing. The nature of intrinsic muscle involvement in Dupuytren 's disease of the middle fingers long and ring remains poorly characterized.
Over the years, the authors have observed that both the spiral and lateral digital cords in the middle fingers receive contribution from intrinsic muscle-tendon units. This report describes the anatomical characteristics and frequency of intrinsic muscle-tendon unit involvement in Dupuytren 's disease of the middle fingers. Intrinsic muscle involvement in the middle digits was recorded in the operative reports of patients undergoing Dupuytren 's surgery between October of and February of The anatomical variations of diseased fascia were delineated and classified.
Of the digits with Dupuytren 's contracture operated on during this period, 52 involved the middle fingers 12 long and 40 ring fingers. Intrinsic muscles were found to be involved in the contracture of 14 of these digits. Two unique contracture patterns were identified: The frequency of type I and type II contractures was 6 percent and 12 percent, respectively. Intrinsic hand muscles may contribute to Dupuytren 's disease in the middle digits, and the authors suggest resecting cords as close as possible to their musculotendinous origin to improve postoperative outcomes.
In patients suffering from Morbus Hodgkin who were treated between and , the pulmonary radioresponse was retroperspectively investigated. Besides incidence and degree of severity also the course over the time of the individual stages of radio-response where investigated. Correlative relations to different individual diseasedependent and radiotherapeutic factors were detected, which are considered to be responsible for the intensity and character of the floride radio-response and the remaining pulmonary fibrosis.
Nuclear medicine offers a wide range of possibilities to investigate dementia. Different questions concerning evaluation of dementia are discussed taking Alzheimer's disease AD as an example. It is important to perform nuclear medicine investigations on high technical level, using standardized methods as statistical parametric mapping SPM for evaluation.
If neuroprotective therapies are available, an early diagnosis, the determination of risk factors and longitudinal investigations will be the focus of interest and the main goal of nuclear medicine. Apart from measuring cerebral perfusion and glucose metabolism the development of new ligands, concerning the cholinergic system and the visualization of amyloid plaques, is of great importance. Anhand des Morbus Alzheimer DAT werden in dem vorliegenden Artikel neben einer kurzen Schilderung der zur Verfuegung stehenden Methoden die verschiedenen nuklearmedizinisch relevante Fragestellungen angefuehrt, zu deren Beantwortung die funktionelle Bildgebung Informationen liefern kann.
Durch den Einsatz bestimmter, standardisierter Auswerteverfahren wie statistical parametric mapping SPM ist es moeglich, entscheidende Hinweise zur Diagnose und Differenzialdiagnose der DAT zu erlangen. In Zukunft werden, insbesondere bei einer Verfuegbarkeit neuroprotektiver Therapien, eine moeglichst fruehe Diagnosestellung und die Erfassung von Risikofaktoren sowie die Moeglichkeit einer Verlaufsbeobachtung in den Mittelpunkt des Interesses und in das Zentrum nuklearmedizinischer Untersuchungen ruecken. Vor allem fuer diese Anforderungen ist neben der qualitaetsvollen Untersuchung von zerebraler Perfusion und Glukosestoffwechsel eine Weiterentwicklung spezieller Liganden v.
Current surgical treatments for Dupuytren 's contracture DC include fasciectomy and fasciotomy. We assessed the clinical management of DC in England over a 5-year period; associated NHS costs were assessed for a 1-year period. Variables included demographics, OPCS, patient status and physician specialty. Over 5 years, 75, DC admissions were recorded; 64, were analyzed. Mean admissions per year were 12, and stable. The percent of patients having two or more admissions per year increased from 5.
In , classification was extended to identify Digital Fasciectomy, its Revision and Dermofasciectomy. In , admissions were: Between and , fasciectomy was the most common surgical procedure for DC in. Over time, it thickens into a cord-like band. Usually, there is no pain. There is usually little pain afterward. Late complications of clinical clostridium histolyticum collagenase use in Dupuytren 's disease.
While Dupuytren 's disease can cause disabling contractures requiring open surgery, a less-invasive option using Clostridium Histolyticum collagenase CHC via percutaneous injection was recently reported. A recent prospective, randomized trial demonstrated few complications during 90 days follow-up, however did not assess any longer term follow-up for these patients. Long-term outcomes in this setting have not been adequately reported, and the current manuscript aims to identify late complications from the clinical use of percutaneous CHC.
The current manuscript reports an extended month follow-up for a cohort of twelve of patients enrolled in the original prospective, randomized trial, treated at a single institution. An analysis of complications requiring surgical intervention was undertaken. Two of twelve patients reported debilitating pain and triggering requiring surgical intervention. Extensive deep-tissue scarring and adhesions were identified, providing the first visual and qualitative analysis of the pathologic effects of CHC.
Longer term follow-up of such patients is thus essential, and further investigation and characterization of the late effects of CHC use is warranted. Factors affecting functional recovery after surgery and hand therapy in patients with Dupuytren 's disease. The evidence of the relationship between functional recovery and impairment after surgery and hand therapy are inconsistent. To explore factors that were most related to functional recovery as measured by DASH in patients with Dupuytren 's disease. Eighty-one patients undergoing surgery and hand therapy were consecutively recruited.
The three variables "need to take special precautions", "avoid using the hand in social context", and health-related quality of life EQ-5D index explained Safety and social issues of hand function and quality of life had an evident association with functional recovery. Concurrent inhibition of TGF-beta and mitogen driven signaling cascades in Dupuytren 's disease - Non-surgical treatment strategies from a signaling point of view. Dupuytren 's disease DD is a benign progressive fibro-proliferative disorder of the fascia palmaris of the hand.
Currently, treatment consists of surgical excision with a relatively high recurrence rate and risk of complications. To improve long-term outcome of DD treatment, research focus has. Involvement of pro-inflammatory cytokines and growth factors in the pathogenesis of Dupuytren 's contracture: Dupuytren 's contracture DC is a benign fibro-proliferative disease of the hand causing fibrotic nodules and fascial cords which determine debilitating contracture and deformities of fingers and hands.
The present study was designed to characterize pro-inflammatory cytokines and growth factors involved in the pathogenesis, progression and recurrence of this disease, in order to find novel targets for alternative therapies and strategies in controlling DC. The expression of pro-inflammatory cytokines and of growth factors was detected by immunohistochemistry in fibrotic nodules and normal palmar fascia resected respectively from patients affected by DC and carpal tunnel syndrome CTS; as negative controls.
Histological analysis showed high cellularity and high proliferation rate in Dupuytren 's tissue, together with the presence of myofibroblastic isotypes; immunohistochemical staining for macrophages was completely negative. These results were confirmed by RT-PCR and by immunofluorescence in pathological and normal primary cell cultures. Collagenase clostridium histolyticum for the treatment of Dupuytren 's contracture: Dupuytren 's disease is a slowly progressive condition of the hand, characterised by the formation of nodules in the palm that gradually develop into fibrotic cords.
Contracture of the cords produces deformities of the fingers. Collagenase clostridium histolyticum CCH has been developed as a minimally invasive alternative to surgery for some patients. To assess the clinical effectiveness and cost-effectiveness of collagenase as an alternative to surgery for adults with Dupuytren 's contracture with a palpable cord. We searched all major electronic databases from to February Two reviewers independently extracted data and assessed risk of bias of included studies.
A de novo Markov model was developed to assess cost-effectiveness of collagenase, percutaneous needle fasciotomy PNF and limited fasciectomy LF. Results were reported as incremental cost per quality-adjusted life-year QALY gained. Deterministic and probabilistic sensitivity analyses were undertaken to investigate model and parameter uncertainty. Five RCTs comparing collagenase with placebo participants , three RCTs comparing surgical techniques participants , two non-randomised studies comparing collagenase and surgery participants , five non-randomised comparative studies assessing various surgical procedures participants and 15 collagenase case series participants were included.
Joints randomised to collagenase were more likely to achieve clinical success. Collagenase-treated participants experienced significant reduction in contracture and an increased range of motion compared with placebo-treated participants. Budget impact analysis in Spanish patients with Dupuytren 's contracture: The aim of this study was to estimate the budget impact of collagenase Clostridium histolyticum CCH vs. A cost minimization analysis was adopted effectiveness was assumed to be equivalent for both techniques. DD related costs were considered.
CCH costs including drug, administration and visits were obtained from clinical trials and a real-life study.
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FSC costs including type of admission, visits, operating room, re-admissions, tests, drugs and rehabilitation costs were collected through a retrospective, observational, local study. Results were presented from the NHS perspective for the next 3 years. All the data were validated through an expert panel. A sensitivity analysis was performed with the main variables. First robotized assembly line in for multivalve cylinder heads in Europe; Erste roborterautomatisierte Montagelinie fuer Mehrventilzylinderkoepfe in Europa.
From its earliest days the automotive industry has pioneered the automation of factory operations. This reputation is being added to by yet another new development in the assembly area. The trendsetter is ABB Flexible Automation GmbH, based in Butzbach, Germany, which has developed a future-oriented concept for vehicle engine assembly in which jointed-arm robots play a key role. Einmal mehr zeigt sich dies im Montagebereich.
Gelenkarmroboter spielen dabei eine entscheidende Rolle. What do we know about managing Dupuytren 's disease cost-effectively? Dupuytren 's disease DD is a common and progressive, fibroproliferative disorder of the palmar and digital fascia of the hand. Various treatments have been recommended for advanced disease or to retard progression of early disease and to prevent deterioration of the finger contracture and quality of life.
Recent studies have tried to evaluate the clinical and cost-effectiveness of therapies for DD, but there is currently no systematic assessment and appraisal of the economic evaluations. A systematic literature review was conducted, following PRISMA guidelines, to identify studies reporting economic evaluations of interventions for managing DD. Cost-effectiveness analyses of treating DD were identified and their quality was assessed using the CHEERS assessment tool for quality of reporting and Phillips checklist for model evaluation.
morbus dupuytren erste: Topics by theranchhands.com
A total of studies were screened, of which 4 met the study inclusion criteria. They all assessed the same interventions for advanced DD, namely collagenase Clostridium histolyticum injection, percutaneous needle fasciotomy and partial fasciectomy. All studies conducting a cost-utility analysis, two implemented a decision analytic model and two a Markov model approach. None of them were based on a single randomised controlled trial, but rather synthesised evidence from various sources.
Studies varied in their time horizon, sources of utility estimates and perspective of analysis. The quality of the model reporting in terms of model structure, data synthesis and model consistency varied across the included studies. MR evaluation of bone marrow features during treatment with enzyme replacement; Morbus Gaucher: Duesseldorf Germany ; Niederau, C.
Enzyme replacement therapy ERT arrests and reverses the hematological and visceral symptoms of adult Gaucher disease, the most frequent lysosomal storage disorder. There are only a few studies available evaluating bone disease during ERT. The aim of this study was to investigate the features of bone marrow bm by magnetic resonance imaging MRI in these patients during ERT. The morphological features of bm involvement, a homogeneous or non-homogeneous distribution of bm changes and focal bone lesions surrounded by a rim of reduced signal intensity SI , were analyzed.
Focal bone lesions, surrounded by a rim of reduced Sl, did not respond to ERT and correlated with a non-homogenous distribution of bone involvement and splenectomy. Einsatz und Wirksamkeit von Systemtherapien bei Erwachsenen mit schwerer Neurodermitis: Versorgungsregister dienen der Erfassung des Einsatzes und der Wirksamkeit von Therapien unter realen Versorgungsbedingungen und sind als Basis einer evidenzbasierten Gesundheitsversorgung unverzichtbar.
Die vorliegende Analyse beschreibt die Charakteristika, Therapiewahl und Wirksamkeit der eingesetzten antiinflammatorischen Systemtherapien der bis Oktober eingeschlossenen Patienten. Die vorliegende Registerauswertung gibt wichtige Hinweise zur derzeitigen Versorgung von Erwachsenen mit schwerer Neurodermitis in Deutschland, dokumentiert die hohe Erkrankungslast, den Nutzen vorhandener Therapien und den Bedarf an weiteren, effektiven und in der Langzeitanwendung sicheren Therapieoptionen. Full Text Available Abstract Background Splinting as part of the overall post-surgical management of patients after release of Dupuytren 's contracture has been widely reported, though there is variation in practice and criteria for using it.
The evidence on its effectiveness is sparse, of poor quality and contradictory with studies reporting negative and positive effects. Using a centrally administered computer randomization system consented patients will be allocated to one of two groups: Secondary outcomes are total active flexion and extension of fingers, patient satisfaction and recurrence of contracture. Outcome measures will be collected prior to surgery, 3 months, 6 months and 1 year after surgery.
An intention-to-treat analysis will be used. Discussion This pragmatic randomized controlled trial will provide much needed evidence on the clinical effectiveness of post-operative night splinting in patients who have undergone fasciectomy or dermofasciectomy for Dupuytren 's contracture of the hand. Positron-emission-tomography PET has enabled to study the metabolism and blood flow in specific brain areas.
Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease.
Bei Patienten mit Morbus Parkinson hat es diese Technik erstmals erlaubt, die Anzahl der dopaminergen Neurone zu quantifizieren, wodurch die Diagnose gesichert, die Progression der Erkrankung beurteilt und auch das Anwachsen von Implantaten beurteilt werden kann. PET activation in basal ganglia disorders: Morbus Parkinson und Dystonien. Muenchen Germany ; Boecker, H. Muenchen Germany ; Conrad, B. This article reviews PET activation studies with performance of different motor paradigms joy-stick movements, imagination of movement, writing in patients with movement disorders.
PET findings will be related to clinical and electrophysiological observations. The contribution of PET activation studies to the understanding of the pathophysiology of dystonia and PD is discussed. Die experimentellen Befunde werden mit der Klinik in Bezug gebracht. Neue Untersuchungen vor und nach therapeutischen Interventionen, wie die stereotaktische Pallidotomie bei Parkinson und die Botulinum-Toxin-Therapie bei Schreibkrampf, werden beschrieben.
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Block, W [Radiogische Klinik der Univ. In the hippocampal region metabolic maps of the local distribution of N-acetylaspartate NAA , choline Cho , creatine compounds P Cr and lactate were determined. The observed reduction of NAA is due to neuronal degeneration. Das Krankheitsbild des M. Koeln Germany ; Otte, R.
Koeln Germany ; Klink, J. Koeln Germany ; Schicha, H. But until now only little data has been presented due to the course of time and the extent of TVR. Since Dupuytren 's contracture is a common disorder, the costs for its surgical treatment impose a considerable burden on the healthcare system. For the first time in the German-speaking area, this study aimed to provide a comparative cost-effectiveness analysis for partial fasciectomy vs. A retrospective monocentric study of the period from to comprised 40 patients with previously untreated Dupuytren 's contracture of one finger.
The direct pre-interventional treatment and post-interventional costs were compared. The direct post-interventional and postoperative results were comparable. Group 1 CCH showed a mean reduction in contracture of There were fewer complications in Group 1 than in Group 2. Treatment with CCH is more cost effective than with partial fasciectomy.
This is due to greater costs for personnel, time and surgical material, as well as the treatment of the more frequent complications in Group 2. Despite the limited comparability, our findings are consistent with the present international literature. Full Text Available Objetivo: Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs; Radioiodtherapie des Morbus Basedow - dosimetrischer Vergleich verschiedener Therapieregime bezueglich der Thyreostatikabgabe.
Andererseits ist aus klinischen Gruenden und wegen des in der Hyperthyreose beschleunigten lodstoffwechsels vor RITh eine Kompensation der Stoffwechsellage anzustreben. We explored regional variations in the surgical management of patients with Dupuytren 's contracture DC in 12 European countries using a surgeon survey and patient chart review.
Descriptive statistics are reported. Most surgeons were satisfied with fasciectomy over other procedures. Recommended time away from work and duration of physical therapy increased with the invasiveness of the procedure. The intra-operative complication rate was 4. Important inter- and intraregional differences in these aspects of patient management are described. Understanding current regional treatment patterns and their relationships to country-specific health systems may facilitate earlier identification of, and intervention for, DD and help to optimise the overall treatment for patients with this chronic condition.
Full Text Available Abstract Background Dupuytren 's disease DD is a debilitating fibro-proliferative disorder of the hand characterized by the appearance of fibrotic lesions nodules and cords leading to flexion contractures of the fingers and loss of hand function. Results Contraction of the FPCLs occurred significantly faster and to a greater extent in disease cells compared to control cells.
Bioavailability of very finely distributed metallic platinum in the lungs and first orienting studies on effects. Part 2; Bioverfuegbarkeit von feinstverteiltem metallischem Platin in der Lunge und erste orientierende Wirkungsuntersuchungen VPT 09; 2. Platinum is emitted from automotive catalytic converters in particulate form. The first organ to be exposed to it after its uptake by the organism is the lung. Lung macrophages therefore constitute the first barrier of the immune system which can to react to platinum.
In this study the production of nitrogen oxides and cytokines was studied. These parameters play an important role in the initiation of inflammation and in the maintenance of chronic inflammatory processes that can lead to fibrosis of the lung. Das erste Zielorgan fuer eine Aufnahme im Organismus ist deshalb die Lunge. Die Lungenmakrophagen stellen also die erste Barriere des Immunsystems dar, das auf Platin reagieren kann. In vitro wurde die Produktion von Stickoxiden und Zytokinen untersucht.
Diese Parameter spielen eine Rolle bei der Initiation von Entzuendungen und auch bei der Aufrechterhaltung chronisch entzuendlicher Prozesse, die in der Lunge zu einer Fibrose fuehren koennen. Postural kyfose og morbus Scheuermann. Scheuermann's kyphosis is the most frequent structural kyphosis in adolescents.
There are gaps in the knowledge of epidemiology, aetiology and treatment. There are strong genetic and mechanical factors in the aetiology. Treatment options depend on the cobb's angle measured and the skeletal maturity Indications for surgery are subject of debate as complications are not uncommon Common peak clusters were then filtered using a bootstrap algorithm called SAM Significant Analysis of Microarrays for increased fidelity in our analysis. Several differentially expressed low molecular weight mass standard deviation for both methods of biomarker-rich low molecular weight region of the human proteome.
Dresden Germany ; Koch, R. A second generation assay using the human, recombinant TSH-receptor was developed during the last years. TRAb was measured in pts with various thyroid disorders and healthy controls using the new coated tube RRA Fa. A ROC-analysis was performed to find the optimal decision threshold level for positivity. Handling of the new assay is also improved.
First clinical experience with extended planning and navigation in an interventional MRI unit; Erste klinische Erfahrungen mit einer erweiterten Eingriffsplanung und Navigation am interventionellen MRT. Augustin Germany ; Trantakis, C. To present an advanced concept for patient-based navigation and to report on our first clinical experience with interventions in the cranium, of soft-tissue structures breast, liver and in the musculoskeletal system.
Intraoperatively acquired 3D data were used for interventional planning. The information content of these reference data was increased by integration of additional image modalities e. Within 18 months, the system was used in patients undergoing interventions in different anatomic regions brain: The mean duration of 64 brain interventions was compared that of 36 procedures using the scanner's standard navigation. In contrast with the continuous scanning mode of the MR system 0. With our system, patient movement and tissue shifts could be immediately detected intraoperatively, and, in contrast to the standard procedure, navigation safely resumed after updating the reference data.
The navigation system was characterized by good stability, efficient system integration and easy usability. Despite additional working steps still to be optimized, the duration of the image-guided brain tumor resections was not significantly longer. Vorstellung eines erweiterten Konzepts zur patientenbasierten Navigation sowie erste klinische Bewertung der durchgefuehrten Massnahmen im Kopf, Weichteil- und muskuloskeletalen Bereich.
Schilden umgeben, die sich auf Temperaturen von K und K befinden. Parallel zum Hauptbeschleuniger wird ein Injektor mit zwei Kryomodulen versorgt. Es wird ueber die Inbetriebnahme der Komponenten und erste Betriebserfahrungen berichtet. Behandling af Dupuytrens kontraktur. It may occur in the sole of the foot or in the penis.
The use of Collagenase Clostridium Histolyticum in the management of Dupuytren 's contracture-outcomes of a pilot study in a District General Hospital setting. The average metacarpophalangeal MCP joint and proximal interphalangeal joint PIP contractures pre-treatment were 52 0 range, 0 - 75 0 and 35 0 range, 0 - 84 0 respectively. The average DASH score pre-treatment was Patients were reviewed at lmonth, 3months and at an average of 23 months 17 to 27 months. MCP joint contractures significantly improved compared to pre-treatment and the improvement was maintained at latest follow up.
PIP joint contractures did significantly improve but to a lesser degree and there was no significant improvement compared to pre-treatment beyond 3months. A trend for MCP and PIP joint contracture recurrence was observed at latest follow up but did not reach statistical significance. DASH scores significantly improved from pre-treatment and the improvement was maintained at latest follow up. At 3months, the average patient satisfaction score was 9.
CCH is a useful option in the management of DC in appropriately selected patients. Cost-effectiveness in the treatment of DC should be carefully considered. Arthrodesis of the proximal interphalangeal joint of the 4th and 5th finger using an interlocking screw device to treat severe recurrence of Dupuytren 's disease. The angle of arthrodesis, fusion time and implant fixation were evaluated on x-rays.
The patients were monitored for complications during surgery and the follow-up period. The sample comprised 6 patients. Mean follow up was There were no complications and none of the implants had to be removed. The functional outcomes in these patients were poor. The system offers a reliable method for IPJ arthrodesis at a precise angle. It promotes stable fixation that does not require prolonged immobilisation.
It can be used together with other procedures on the hand with severe recurrence of DD. The functional outcomes for this group of patients using this device were poor. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?
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In addition, no influence of antithyroid medication on therapy success was found. Erlaubt die intratherapeutische Dosimetrie eine akkurate Dosiskalkulation? Zeigt eine thyreostatische Medikation einen messbaren Einfluss auf den Therapieerfolg? Die Behandlung wurde nach Monaten als erfolgreich betrachtet, wenn der Zustand eu- oder hypothyreot war. Thyreostatika, applizierte Aktivitaet, Dosis, spezifische Dosis pro Gewebe und HWZ wurden mittels der multiplen Regressionsanalyse bezueglich ihres Effekts auf den Therapieerfolg untersucht.
Die erzielte Dosis zeigte eine stark von der Organmasse abhaengige Streuung, die zu sehr unterschiedlichen spezifischen Dosen fuehrte. Die thyreostatische Medikation hatte keinen Einfluss. Durch individuelle praetherapeutische Dosimetrie mit kompletter Radioiodkinetik gegenueber einer einfachen individuellen. Long term results of surgery in Perthes disease: Vergleich der roentgenologischen und kernspintomographischen Untersuchung. In the clinical investigation eight patients complained of persistent stress-induced pain. In nine patients flexion, extension, ab- and adduction of the hip joint was limited.
In the MRI-Study of ten hip joints a reduction of fatty marrow was seen in the femoral head. In another five patients an additional dysplasia of the acetabulum was visualized. All these findings were diagnosed by X-ray studies as well. However, only by MRI were the extents of the postoperative defects of femoral spongiosa diagnosed in fifteen hip joints. Bei der klinischen Nachuntersuchung gaben 8 Patienten persistierende Beschwerden bei Belastung an. Bei der koerperlichen Untersuchung war die Flexion und Extension bei 9 sowie die Abduktion und Adduktion bei einem Patienten eingeschraenkt.
Bei der kernspintomographischen Untersuchung liessen sich bei 10 Hueftgelenken Residuen des M. Perthes im Fettmark des Femurkopfs nachweisen. Bei 5 Patienten wurde eine Pfannendysplasie gefunden. Diese Befunde waren auch roentgenologisch darzustellen. Als postoperative Defekte waren im Schaftmark des Femurs eine langstreckige Hoehlenbildung mit Zysten oder durch Fettmark aufgefuellte Spongiosadefekte bei 15 Hueftgelenken nur kernspintomographisch nachweisbar. A report of two cases. Full Text Available Backround. Clinical features of inherited glucocerebrosidase deficiency were first described by Phillippe Charles Ernest Gaucher, French physician Deficiency of glucocerebrosidase leads to the accumulation of the lipid glucocerebroside within the lysosomes of the monocyte macrophage system.
Lipid-laden cells, known as Gaucher cells, lead to hepatosplenomegaly, multiorgan dysfunction and sceletal deterioration. We reported a year-old male and a year-old female admitted for the clinical examination due to hepatosplenomegaly. The Clinical diagnosis was provided by a bone marrow examination and demonstration of the characteristic Gaucher cells.
Both of the patients had type I Gaucher's disease a mild form of the disease, which is distinguished by the lack of central nervous system involvement and striking phenotypic variation. Also, enzyme replacement therapy had not been available in our country. Althoungh rare, Gaucher's disease is also present in our country.
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Dupuytren 's contracture DC is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques. We planned a prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1: We will recruit participants from seven national centres in Finland.
Primary outcome is the rate of success in the treatment arm at 5 years after recruitment. Predictive factors for achieving the PASS will also be analysed. The study will be performed according to the principles of good clinical practice.
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- Basis-ops - Top 10 in Der Handchirurgie ISBN 3437229060 Isbn-13 9783437229060.
The results of the trial will be disseminated as. Thyroid size was measured by ultrasound and scintigraphy before and one year after therapy. Age and initial thyroid volume were major predictors of posttherapeutical thyroid function. With few exception, thyroid size markedly decreased after therapy. Initial thyroid size and age were also major predictors of posttherapeutical thyroid volume. Thyroid size normalized in all patients younger than 50 years of age, independent from initial thyroid size. Age and initial thyroid volume are important determinants of thyroid function and size after therapy and should be considered in dose calculation.
Das Schilddruesenvolumen wurde vor Therapie und ein Jahr nach Therapie sonographisch und szintigraphisch bestimmt. Lebensalter und Ausgangsvolumen der Schilddruese. Behandeling van contracturen van Dupuytren. This study investigated the short-term 6 weeks results of PNF carried out by a general practitioner. Paradigmenwechsel in der Anti-Aging-Medizin: The Orphans of Cholera Morbus in Yucatan, This essay discusses the phenomenon of orphanhood which affected a large number of children after the cholera epidemic that struck Yucatan in July Moreover, it inquires into the fate of children whose parents died of cholera, the role played by kinship networks to provide them with shelter, and the influence of the Church and the State on the situation.
Based on first hand sources, the author suggests that the orphanhood produced by cholera served as a pretext for economically and socia Full Text Available This essay discusses the phenomenon of orphanhood which affected a large number of children after the cholera epidemic that struck Yucatan in July Based on first hand sources, the author suggests that the orphanhood produced by cholera served as a pretext for economically and socially privileged groups to get hold of free labor force both for domestic service and hacienda work. Percutaneous transverse aponeurotomy of the cord by using a hypodermic needle as a scalpel blade in order to improve function of the hand.
Symptomatic flexion contracture with positive table top test caused by a single, palpable cord within the palm primarily Tubiana stages I and II. Multiple, infiltrating or broad-based cords within the palm; irritated skin conditions; exclusive digital cord localization; recurrence after aponeurectomy; previous surgical intervention at the site of interest, digital nerve lesions; lack of patient compliance.
Pinpoint surface anesthesia is obtained by injecting each portal area subdermally with 0. These applications start from distally to proximally within the palm while the most distal injection site is located proximal to the distal palm crease. Then the needle tip is introduced perpendicular to the cord.
Sawing movements through the cord are performed transversely. While passively extending the contracted finger, the cord is held under tension which guarantees safe cutting. Patients are encouraged to report immediate pain sensation or numbness in order to prevent injuries to neurovascular structures and active finger flexion excludes tendon lesions during the procedure. Introducing the needle tip may be performed at several sites along the cord, if necessary, from distal to proximal at least 5 mm apart with prior pinpoint surface anesthesia. Finally, cautious passive stretching may be done after each release.
Bandaging allowing immediate motion; application of a hand-based extension splint-glove during the night for months. Die historischen Romane von Jaan Kross: Rare localisations of osteochondrosis juvenilis. This is followed by discussion of etiology and differential diagnosis. A year-old man underwent uncomplicated dermofasciectomy of the right little finger. In the week after surgery, he presented with erythema, tenderness, reduced range of movement, and a chalklike discharge from the suture line.
Investigations revealed a raised serum urate level accompanied with a borderline rise in inflammatory markers.
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A diagnosis of acute gout was made. The patient was managed with nonsteroidal anti-inflammatory drugs. Clinicians should consider the diagnosis of gout when patients present after surgery with redness, pain, and swelling and also consider measuring urate levels before surgery and initiating colchicine prophylaxis when there is a known diagnosis of gout before surgery.
Accurate diagnosis may prevent unnecessary antibiotic use. Pediatric Dupuytren 's disease: The boy was subsequently taken to the operating room, where a Bruner incision was made on the palmar aspect of Gaucher disease GD is the most common lysosomal storage disease with a prevalence of 1: The disease is caused by a defiency of the lysosomal enzyme glucocerebrosidase which leads to an accumulation of the substrate glycosylceramide within macrophages.
GD presents with a wide spectrum Computed tomography of the temporal horns at Alzheimer's disease. Computertomographie der Temporalhoerner bei Morbus Alzheimer. In the literature there are different opinions referring to the involvement of the temporal lobes or horns at Alzheimer's disease. Conventionally computed tomogram of the head does not include the temporal horn in its full length.
A simple method to demonstrate the temporal horns after cranial computer tomography is described. It allows the evaluation of temporal lobe and temporal horn if questionable alterations at Alzheimer's disease are to be discussed. Cyclization by double reductive amination of d-xylo-hexosulose with methyl 6-aminohexanoate gave methoxycarbonyl pentyldeoxynojirimycin. Reaction of the terminal carboxylic acid with N-dansyl-1,6-diaminohexane provided the corresponding chain-extended fluorescent derivative.
By reaction with bis 6-dansylaminohexyl amine, the corresponding branched di-N-dansyl compound was obtained. Both compounds are strong inhibitors of d-glucosidases and could also be shown to distinctly improve, at sub-inhibitory concentrations, the activity of beta-glucocerebrosidase in a Gaucher fibroblast NS cell-line through chaperoning of the enzyme to the lysosome. Copyright Elsevier Ltd. Betydningen af kroppens stilling for det diuretiske respons ved behandling af dekompenseret cirrose og morbus cordis. The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure.
All patients received 1 mg bumethanide intravenously and were randomly assigned to either bed rest in the supine position or normal daily activity in the up Hereditary haemorrhagic telangiectasia HHT is an autosomal dominant disorder characterized by vascular dysplasia and haemorrhage. It is manifested by mucocutaneous telangiec-tases and arteriovenous malformations in organs such as lungs, liver and brain. We present a case of HHT. As there are no specific diagnostic laboratory tests or histopathologic findings which confirm the preliminary diagnosis, the final diagnosis should be based on clinical criteria.
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Frequently a definitive diagnosis is established within several years or months after the first manifestations appear. The increased number of cases, recently described worldwide also in the Polish population, indicates that the disease could spread out of endemic areas. The aim of this manuscript is to present the clinical picture, diagnosis criteria and therapeutic approaches of this "international disease" which currently is observed not only in emigrants from Asia but also in native Polish citizens.
The therapeutic effect of Ra-injection on Bechterew's disease is proved, but indication and eventual contra-indications should be observed with attention. Continue shopping Checkout Continue shopping. Basis-OPs — Top 10 in der Handchirurgie by. Zu jeder Erkrankung werden alle relevanten Aspekte systematisch dargestellt: Ratings and Reviews 0 0 star ratings 0 reviews. Overall rating No ratings yet 0. How to write a great review Do Say what you liked best and least Describe the author's style Explain the rating you gave Don't Use rude and profane language Include any personal information Mention spoilers or the book's price Recap the plot.
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