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  • 1
    Electronic Resource
    Electronic Resource
    Rescue therapy with tacrolimus is effective in patients with severe and refractory inflammatory bowel disease (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 17 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Oral tacrolimus, approved for the prophylaxis of organ rejection in liver or kidney transplants, has been reported to be effective in anecdotal cases of refractory inflammatory bowel disease.Aim : To evaluate the usefulness of low-dose oral tacrolimus in refractory inflammatory bowel disease.Methods:  Thirty-one adult Caucasian patients with steroid-dependent (n = 15) or steroid-refractory (n = 16) inflammatory bowel disease (Crohn's disease, n = 6; ulcerative colitis, n = 23; pouchitis, n = 2) were enrolled. Tacrolimus (0.1 mg/kg body weight per day) was administered orally in 30 patients and initially intravenously in one patient (0.01 mg/kg body weight per day), aiming for serum trough levels of 4–6 ng/mL. The median treatment duration was 12 months (range, 1–137 months).Results : Twenty-eight patients (90.3%) experienced a clinical and laboratory response and 20 (64.5%) went into remission. One ulcerative colitis patient and two Crohn's disease patients did not improve. Three ulcerative colitis patients (9.7%) were colectomized at 1, 12 and 24 months after tacrolimus initiation. In 19 of 23 patients (82.6%) taking steroids, steroids were reduced or discontinued. Side-effects included a temporary rise of creatinine (n = 3, 9.7%), tremor or paraesthesias (n = 3, 9.7%), hyperkalaemia (n = 1, 3.2%), hypertension (n = 1, 3.2%) and an opportunistic infection (n = 1, 3.2%).Conclusion : Oral tacrolimus is safe and effective in refractory inflammatory bowel disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01534.x
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  • 2
    Electronic Resource
    Electronic Resource
    Diagnostik und Therapie gastroenteropankreatischer neuroendokriner Tumore aus internistischer Sicht (2000)
    Springer
    Der Onkologe 6 (2000), S. 624-633 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Neuroendokrine Tumoren (NET) sind seltene Neoplasien mit einer geschätzten Inzidenz von 0,1–1/100.000 [31], wobei etwa 75% der NET im gastroenteropankreatischen System lokalisiert sind [25]. Diese Tumoren zeigen einen deutlich protrahierten Erkrankungsverlauf im Vergleich zu anderen gastrointestinalen Neoplasien; so liegt die Fünfjahresüberlebenszeit in Abhängigkeit von Primärlokalisation und Metastasierung bei ca. 50% [25].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050036
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  • 3
    Electronic Resource
    Electronic Resource
    Pathologisch-diagnostische Aspekte neuroendokriner Tumoren des Gastrointestinaltrakts (2000)
    Springer
    Der Onkologe 6 (2000), S. 613-623 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Gastroenteropankreatische neuroendokrine Tumoren (NET) sind bezüglich ihres Differenzierungsgrads, der Lokalisation, Hormonproduktion und Prognose heterogen. Sie treten überwiegend sporadisch, aber auch familiär z. B. bei der multiplen endokrinen Neoplasie Typ 1 und dem von-Hippel-Lindau-Syndrom auf. Die komplexen Manifestationsformen spiegeln sich in den differenten bisher verwendeten Definitionen, Terminologien und Gradierungen von NET wider. Die allgemeinen Bezeichnungen “Karzinoid” bzw. “endokriner Pankreastumor” oder die funktions- bzw. funktionalitätsbezogenen Termini “Insulinom, Gastrinom, Somatostatinom” vermitteln nicht, ob die Neoplasien als benigne, potenziell maligne oder eindeutig maligne einzustufen sind. Neue molekular- und zellbiologische Entwicklungen auf dem Gebiet der Neurobiologie leisteten einen entscheidenden Beitrag zur Identifizierung und Charakterisierung von NET und bilden heute auch die Grundlage der aktuellen pathologisch-diagnostischen Beurteilung, auf deren Aspekte der folgende Beitrag eingeht.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050035
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  • 4
    Electronic Resource
    Electronic Resource
    Das Phäochromozytom (2000)
    Springer
    Der Onkologe 6 (2000), S. 642-650 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Phäochromozytome sind seltene Tumoren. Morphologisch zeichnen sie sich häufig durch Hämorrhagien sowie Nekrosen mit zystischer Degeneration aus. Histologisch zeigen sich alveoläre oder trabekulär angeordnete Zellen; auch gemischt alveolär-trabekuläre Bilder kommen vor. Häufigster Befund ist eine anfallsartige oder persistierende arterielle Hypertonie mit Tachykardie . Folgende Untersuchungn werden hauptsächlich zur Diagnose angewendet: Bestimmung der Katecholamine im Urin sowie der Plasmakatecholamine, Bestimmung der Plasmakonzentration von Chromogranin A, Clonidin-Test CT und MRT. Bei Diagnose eines Phäochromozytoms besteht die Indikation zur operativen Therapie. Eine Langzeitüberwachung aller Patienten ist dringend notwendig.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050038
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  • 5
    Electronic Resource
    Electronic Resource
    Vesicular monoamine transporter 2 as a marker of gastric enterochromaffin-like cell tumors (2000)
    Springer
    Virchows Archiv 436 (2000), S. 217-223 
    Details
    ISSN: 1432-2307
    Keywords: Key words VMAT2 ; Stomach ; ECL cell ; Tumors ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The vesicular monoamine transporter 2 (VMAT2) facilitates the ATP-dependent accumulation of biogenic amine inside the secretory granules of endocrine cells and neurons and was demonstrated in the histamine-producing enterochromaffin-like (ECL) cells of the stomach. In the present investigation, VMAT2 immunohistochemistry was tested in 85 endocrine tumors, of which 60 were well differentiated gastrointestinal and pancreatic growths, 5 poorly differentiated (neuro)endocrine carcinomas (PDEC) and 1 mixed PDEC/ECL cell carcinoma of the stomach, 12 pheochromocytomas/paragangliomas, 3 adrenocortical lesions, 2 parathyroid and 2 lung neuroendocrine tumors. Extensive and intense VMAT2 immunoreactivity was observed in 16 of 16 gastric ECL cell tumors, 6 of 6 adrenal pheochromocytomas, 2 of 2 chromaffin paragangliomas and in 3 of the 4 carotid body paragangliomas investigated. Rare VMAT2-positive cells were observed in 12 of 21 intestinal enterochromaffin (EC) cell tumors, in 9 of 11 pancreatic neuroendocrine tumors, and in the mixed PDEC/ ECL cell carcinoma of the stomach (differentiated cells only). No VMAT2 immunoreactivity was observed in five gastrin, four somatostatin and three enteroglucagon/peptideYY tumors of the gastrointestinal tract, in six gastric PDECs, in three adrenocortical growths, and two parathyroid and two lung neuroendocrine tumors. These data support VMAT2 immunohistochemistry as being a useful tool for the diagnosis of gastric ECL cell tumors, separating them from all other endocrine tumors arising in the gastroduodenal area i.e., gastrin, somatostatin, EC cell and PDEC tumors, all of which proved essentially negative.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050033
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  • 6
    Electronic Resource
    Electronic Resource
    Primary and secondary hepatic manifestation of neuroendocrine tumors (2000)
    Springer
    Langenbeck's archives of surgery 385 (2000), S. 265-270 
    Details
    ISSN: 1435-2451
    Keywords: Neuroendocrine tumors Liver metastasis Pancreatic endocrine tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: In comparison with most other malignancies, in the treatment of metastatic neuroendocrine tumors one also has to consider endocrine symptoms and natural progression of disease. Since hepatic metastasis predominates and endocrine symptoms correlate with functional tumor mass, hepatic resection may improve prognosis or even cure patients. Patients and methods: We reviewed 41 consecutive patients with metastatic neuroendocrine tumors and four patients with primary hepatic disease presenting between 1989 and 1999. The neuroendocrine tumors were classified according to their origin, pattern of metastasis, endocrine activity, and histology. Operative therapy including hepatic resections of different extent, liver transplantation, and removal of the primary tumor was analyzed. The median survival after initial diagnosis and after hepatic resection were major parameters of outcome. Results: There were 26 low-grade malignant, 12 high-grade malignant, 2 biphasically differentiated neuroendocrine carcinomas, and 5 pancreatic endocrine tumors. Hepatic resections were performed in 25 patients, resections of the primary tumor in 40 patients. The median survival after initial diagnosis was 49 months; 50.5 months in patients with hepatic resection versus 47 months in those with no liver surgery. Conclusion: Hepatic resection improved the outcome of patients with liver metastasis due to neuroendocrine tumors tendentiously but not significantly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004230000142
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