Chirurgie der Hyperthyreose

Pathophysiologie, Diagnostik, Operationsindikation und Vorbehandlung, chirurgisches Krankengut, Operationsverfahren und Nachbehandlung mit funktionellen Spätergebnissen wurden gezeigt. Der ätiologisch bedingte Unterschied in Therapie und Prognose der Hyperthyreose vom Typ des M. Basedow gegenüber den anderen Hyperthyreoseformen war dargestellt. Von 1891 schilddrüsenoperierten Patienten in den letzten 10 Jahren waren fast (n = 625) hyperthyreot; 22,7% der Hyperthyreosen waren vom Typ des M. Basedow, 26,5 % multinoduläre Strumen, der Rest autonome AdenomePathophysiology, diagnosis, indication for operation and pretreatment, data of operated patients, surgical treatment, and postoperative care with late results are demonstrated. The differences between Graves' disease and other kinds of hyperthyroidism are pointed out. About (n = 625) of all patients operated upon for goiter (n= 1891) within the last ten years had hyperthyroidism. Exophthalmia was present in 22.7 %, toxic multinodular goiter in 26.5 %; the rest of the patients had autonomous adenoma. The importance of radioimmunoassays to determine preoperative treatment and postoperative hormone levels for long-term results is stressed

NY-ESO-1 tumour associated antigen is a cytoplasmic protein detectable by specific monoclonal antibodies in cell lines and clinical specimens

NY-ESO-1 gene encodes a novel member of the cancer/testis (CT) family of human tumour-associated antigens (TAA). Specific monoclonal antibodies (mAb) have identified the corresponding gene product in lysates of tumour cell lines as a 22 kDa protein but no data are available concerning its intracellular location or distribution within neoplastic tissues. We have generated NY-ESO-1 specific mAbs recognizing the target molecule in cytospin preparations and in sections from clinical tumour specimens. These reagents identify NY-ESO-1 TAA in melanoma cell lines expressing the specific gene as a cytoplasmic protein, sharing the intracellular location of most MAGE TAA. In a series of 12 melanoma specimens, specific staining, limited to neoplastic cells, was detectable in the five cases where NY-ESO-1 gene expression was observed. In two of them over 90% of tumour cells showed evidence of positive staining. Lower percentages of positive neoplastic cells ranging between single cells and 50% were observed in the remaining tumours. These data suggest that active specific immunotherapies targeting NY-ESO-1, alone or in combination with other TAA could be of high clinical relevance in sizeable subgroups of melanoma patients. © 2000 Cancer Research Campaig

Journal of Geophysical Research: Earth Surface / The topography of a continental indenter : the interplay between crustal deformation, erosion, and base level changes in the eastern Southern Alps

The topography of the eastern Southern Alps (ESA) reflects indenter tectonics causing crustal shortening, surface uplift, and erosional response. Fluvial drainages were perturbed by Pleistocene glaciations that locally excavated alpine valleys. The Late Miocene desiccation of the Mediterranean Sea and the uplift of the northern Molasse Basin led to significant base level changes in the far field of the ESA and the Eastern Alps (EA), respectively. Among this multitude of mechanisms, the processes that dominate the current topographic evolution of the ESA and the ESA-EA drainage divide have not been identified. We demonstrate the expected topographic effects of each mechanism in a one-dimensional model and compare them with observed channel metrics. We find that the normalized steepness index increases with uplift rate and declines from the indenter tip in the northwest to the foreland basin in the southeast. The number and amplitude of knickpoints and the distortion in longitudinal channel profiles similarly decrease toward the east. Changes in slope of -transformed channel profiles coincide spatially with the Valsugana-Fella fault linking crustal stacking and uplift induced by indenter tectonics with topographic evolution. Gradients in across the ESA-EA drainage divide imply an ongoing, north directed shift of the Danube-ESA watershed that is most likely driven by a base level rise in the northern Molasse basin. We conclude that the regional uplift pattern controls the geometry of ESA-EA channels, while base level changes in the far field control the overall architecture of the orogen by drainage divide migration.(VLID)222030

Book reviews

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41286/1/268_2005_Article_BF01664894.pd

Uptake, Translocation, and Accumulation of Pharmaceutical and Hormone Contaminants in Vegetables

A team led by Wei Zheng, senior research scientist at ISTC, investigated whether our food is at risk of accumulating PPCPs when irrigated with wastewater from concentrated animal feedlot operations (CAFOs) and wastewater treatment plants (WWTPs). The results appeared in Zheng, Wei et al (2014). "Uptake, Translocation, and Accumulation of Pharmaceutical and Hormone Contaminants in Vegetables." in Kyung Myung, Norbert M. Satchivi, and Colleen K. Kingston, eds. Retention, Uptake, and Translocation of Agrochemicals in Plants. Washington, DC : American Chemical Society, 167-181. DOI: 10.1021/bk-2014-1171.ch009.Ope

Boerhaave syndrome as a complication of colonoscopy preparation: a case report

<p>Abstract</p> <p>Introduction</p> <p>Colonoscopy is one of the most frequently performed elective and invasive diagnostic interventions. For every colonoscopy, complete colon preparation is mandatory to provide the best possible endoluminal visibility; for example, the patient has to drink a great volume of a non-resorbable solution to flush out all feces. Despite the known possible nauseating side effects of colonoscopy preparation and despite the knowledge that excessive vomiting can cause rupture of the distal esophagus (Boerhaave syndrome), which is a rare but severe complication with high morbidity and mortality, it is not yet a standard procedure to provide a patient with an anti-emetic medication during a colon preparation process. This is the first report of Boerhaave syndrome induced by colonoscopy preparation, and this case strongly suggests that the prospect of being at risk of a severe complication connected with an elective colonoscopy justifies a non-invasive, inexpensive yet effective precaution such as an anti-emetic co-medication during the colonoscopy preparation process.</p> <p>Case presentation</p> <p>A 73-year-old Caucasian woman was scheduled to undergo elective colonoscopy. For the colonoscopy preparation at home she received commercially available bags containing soluble polyethylene glycol powder. No anti-emetic medication was prescribed. After drinking the prepared solution she had to vomit excessively and experienced a sudden and intense pain in her back. An immediate computed tomography (CT) scan revealed a rupture of the distal esophagus (Boerhaave syndrome). After initial conservative treatment by endoluminal sponge vacuum therapy, she was taken to the operating theatre and the longitudinal esophageal rupture was closed by direct suture and gastric fundoplication (Nissen procedure). She recovered completely and was discharged three weeks after the initial event.</p> <p>Conclusions</p> <p>To the best of our knowledge, this is the first report of a case of Boerhaave syndrome as a complication of excessive vomiting caused by colonoscopy preparation. The case suggests that patients who are prepared for a colonoscopy by drinking large volumes of fluid should routinely receive an anti-emetic medication during the preparation process, especially when they have a tendency to nausea and vomiting.</p

VEGF dose regulates vascular stabilization through Semaphorin3A and the Neuropilin-1+ monocyte/TGF-β1 paracrine axis

VEGF is widely investigated for therapeutic angiogenesis, but while short-term delivery is desirable for safety, it is insufficient for new vessel persistence, jeopardizing efficacy. Here, we investigated whether and how VEGF dose regulates nascent vessel stabilization, to identify novel therapeutic targets. Monoclonal populations of transduced myoblasts were used to homogeneously express specific VEGF doses in SCID mouse muscles. VEGF was abrogated after 10 and 17 days by Aflibercept treatment. Vascular stabilization was fastest with low VEGF, but delayed or prevented by higher doses, without affecting pericyte coverage. Rather, VEGF dose-dependently inhibited endothelial Semaphorin3A expression, thereby impairing recruitment of Neuropilin-1-expressing monocytes (NEM), TGF-β1 production and endothelial SMAD2/3 activation. TGF-β1 further initiated a feedback loop stimulating endothelial Semaphorin3A expression, thereby amplifying the stabilizing signals. Blocking experiments showed that NEM recruitment required endogenous Semaphorin3A and that TGF-β1 was necessary to start the Semaphorin3A/NEM axis. Conversely, Semaphorin3A treatment promoted NEM recruitment and vessel stabilization despite high VEGF doses or transient adenoviral delivery. Therefore, VEGF inhibits the endothelial Semaphorin3A/NEM/TGF-β1 paracrine axis and Semaphorin3A treatment accelerates stabilization of VEGF-induced angiogenesis