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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 15 (2000), S. 127-135 
    ISSN: 1432-1262
    Keywords: Keywords Acute pancreatitis ; Animal models ; Therapy ; Study design
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Since randomized controlled studies of severe acute human pancreatitis can be performed only with restrictions, at least some aspects of innovative therapy concepts should first be clarified in animal experiments. In vitro trials are inadequate for this purpose since they cannot simulate the complex course of severe acute pancreatitis. Animal test results can be transferred to clinical practice if the results are based on trials with established models, standardized methods, and a study design imitating the clinical situation. This contribution discusses the demands on such an animal model of acute pancreatitis and a corresponding study protocol and presents models and protocols which meet these requirements. Concrete examples are presented to show that animal experiments are of great value under these conditions, especially in acute necrotizing pancreatitis. Further standardization of models, protocols, and monitoring should further improve future animal therapy studies at least to the extent that it is possible to select particularly promising substances, which should then be tested in randomized controlled trials.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: Key words MEN II A ; Prophylactic thyroidectomy ; Screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The fate of patients with multiple endocrine neoplasia of type II A (MEN II A) is determined by medullary thyroid carcinoma, which occurs in all cases. This has led to the therapeutic concept of prophylactic thyroidectomy in affected family members with the goal of removing the thyroid before the manifestation of carcinoma. We investigated a prophylactically thyroidectomized MEN II A population to determine whether the highly specific and sensitive tumor marker calcitonin correlates with tumor spread. Patients and methods: Fifteen patients with MEN II A (aged 4 – 24 years) who had undergone prophylactic thyroidectomy since 1990 were included in the study. Baseline and pentagastrin-stimulated calcitonin levels were preoperatively determined in all cases. The indication for surgery was established on the basis of pathologic calcitonin levels in the first seven patients and on the basis of detected RET proto-oncogene mutation in the other eight patients. Bilateral central lymphadenectomy was performed in all patients in addition to thyroidectomy. Results: Histology demonstrated C-cell hyperplasia in five patients (aged 4 – 13 years), unilateral medullary microcarcinoma in six (aged 9 – 17 years) and a bilateral medullary microcarcinoma in three cases (aged 17 – 24 years). One 9-year-old boy with bilateral microcarcinoma already had a lymph node metastasis. The mean baseline calcitonin level correlated with the histologic findings (r = 0.71, P = 0.003) but there was no correlation between pentagastrin-stimulated calcitonin levels and histology (r = 0.21, P = 0.47). Conclusion: In MEN II A patients undergoing prophylactic thyroidectomy, baseline but not stimulated calcitonin levels already correlate with the histologic tumor stage at the stage of clinically occult C-cell hyperplasia or medullary microcarcinoma. However, biochemical screening cannot reliably discriminate the transition from C-cell hyperplasia to invasive microcarcinoma. Individuals with MEN II A should therefore undergo early prophylactic thyroidectomy once the diagnosis is confirmed by molecular genetic testing.
    Type of Medium: Electronic Resource
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