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  • 1
    Electronic Resource
    Electronic Resource
    T lymphocytes and altered keratinocytes express interferon-γ and interleukin 6 in lichen planus (1999)
    Springer
    Archives of dermatological research 291 (1999), S. 485-490 
    Details
    ISSN: 1432-069X
    Keywords: Key words Lichen planus ; Interferon-γ ; Interleukin 6 ; T cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lichen planus is asumed to represent a delayed hypersensitivity reaction, in the course of which cytokines control the proliferation and differentiation of cytotoxic T lymphocytes which attack the epidermis and cause apoptosis of undifferentiated keratinocytes. Since interferon-γ and interleukin 6 are known to be markedly generated in lichen planus, we investigated the cellular localization of these cytokines in affected skin/oral mucosa biopsy specimens using in situ hybridization for interferon-γ and in situ reverse transcription-polymerase chain reaction for interleukin 6 mRNA. In the upper subepithelial connective tissue interferon-γ mRNA was noted within proliferating CD3+ T lymphocytes. In this tissue compartment interleukin 6 mRNA was detected in infiltrating CD4+ and CD8+ T lymphocytes. In the epithelium, expression of interferon-γ mRNA and interleukin 6 mRNA was observed in the basal and suprabasal keratinocytes of altered skin/oral mucosa. In contrast, normal skin did not reveal any interferon-γ or interleukin 6 expression, although a few CD4+ and CD8+ T lymphocytes were noted in the dermis as well as the epidermis. These findings indicate that in lichen planus the proinflammatory cytokines interferon-γ and interleukin 6 are produced not only by activated T lymphocytes but also by altered keratinocytes, and suggest that stimulated keratinocytes may amplify the course of lichen planus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004030050442
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Mechanical ventilation with PEEP – a unique therapy for failing hearts (1999)
    Springer
    Intensive care medicine 25 (1999), S. 778-780 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050952
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Endoscopic grading of the gastroesophageal valve in patients with symptoms of gastroesophageal reflux disease (GERD) (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 1184-1188 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopy — Gastroesophageal valve — Gastroesophageal reflux disease — GERD — Esophagus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: It has been suggested that endoscopic grading of the gastroesophageal flap valve is a good predictor of the reflux status. Methods: To test this hypothesis, 268 symptomatic patients underwent endoscopic grading of the gastroesophageal valve using Hill's classification, with grades I through IV. Esophageal acid exposure, lower esophageal sphincter characteristics, and the degree of esophageal mucosal injury were compared among the groups. Results: The prevalence of a mechanically defective sphincter, abnormal esophageal acid exposure, erosive esophagitis, and Barrett's esophagus increased with increasing alteration of the gastroesophageal valve. The presence of a grade IV valve indicated increased esophageal acid exposure in 75% of patients. As a predictor, this is similar to lower esophageal sphincter pressure but not as good as the presence of esophageal mucosal injury. Conclusions: Endoscopic grading of the gastroesophageal valve provides useful information about the reflux status but is less useful as an indicator of gastroesophageal reflux disease (GERD) than the presence of esophageal mucosal injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00009617
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Die pathophysiologische Basis des Zenker-Divertikels (1999)
    Springer
    Der Chirurg 70 (1999), S. 741-746 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Cricopharyngeal diverticulum ; Zenker's ; Upper esophageal sphincter ; Swallowing ; Dysphagia. ; Schlüsselwörter: Cricopharyngeales Divertikel ; Zenker-Divertikel ; oberer Oesophagussphincter ; Schlucken ; Dysphagie.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Störungen der pharyngooesophagealen Phase des Schluckens, inkl. Zenker-Divertikel, resultieren aus Änderungen der neuromuskulären Vorgänge, die beim Kauen, zu Beginn des Schluckens und bei der Beförderung der Speise vom Oropharynx in den cervicalen Oesophagus beteiligt sind. Obwohl eine Reihe von Mechanismen zur Erklärung der Entstehung des Zenker-Divertikels vorgeschlagen wurde – inkl. Störung der Sphincterkoordination, Schlucken gegen einen geschlossenen oberen Oesophagussphincter (OÖS), versagende OÖS-Relaxation, hypertensiver „spastischer“ OÖS –, weisen neuere Untersuchungen darauf hin, daß eine veränderte Compliance des cricopharyngealen Segments an der Pathophysiologie des Zenker-Divertikels beteiligt ist. Manometrisch kann eine Relaxation auch dann vorkommen, wenn anatomisch keine Öffnung erfolgt ist. Eine fehlende Koordination ist ungewöhnlich. Complianceänderungen sind mit einer speziellen cricopharyngealen Manometrie nachweisbar als Verminderung der Sphincteröffnung oder als Erhöhung des Boluspassagedrucks. Diese Störungen normalisieren sich nach Diverticulektomie und cricopharyngealer Mytomie.
    Notes: Summary. Disorders of the pharyngoesophageal phase of swallowing, including Zenker's diverticulum, result from alterations of the neuromuscular events involved in chewing, initiation of swallowing, and propulsion of the material from the oropharynx into the cervical esophagus. Although a number of mechanisms have been postulated to explain the genesis of Zenker's divertcula, including sphincter incoordination, swallowing against a closed UES, failed UES relaxation, and a hypertensive spastic upper sphincter, recent evidence suggests that the pathophysiology of Zenker's diverticula involves altered compliance of the cricopharyngeal segment. Manometric relaxation may occur in the absence of anatomic opening. Incoordination is uncommon. Altered compliance is detectable with specialized cricopharyngeal manometric recording as impaired sphincter opening or a raised intrabolus pressure. Both return to normal following diverticulectomy and cricopharyngeal myotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050714
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    Paper (German National Licenses)
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