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  • 1
    Digitale Medien
    Digitale Medien
    Oxford, U.K. and Cambridge, USA : Blackwell Science Ltd
    Histopathology 32 (1998), S. 0 
    ISSN: 1365-2559
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Programmed cell death (apoptosis) has been described in different hepatobiliary diseases and in immune-mediated cytotoxicity. Apoptosis of hepatocytes and bile duct epithelial cells was detected in chronic liver allograft rejection. In severe acute rejection a DNA fragmentation in-situ assay showed positivity of apoptotic cells and centrilobular necrosis. Although apoptosis is triggered by ischaemia, the potential role of apoptosis in tissue damage caused by hepatic vascular occlusion after orthotopic liver transplantation has not yet been investigated.〈section xml:id="abs1-2"〉〈title type="main"〉Methods and resultsWe examined biopsies for apoptotic cell death in 50 liver allografts: 29 with acute liver rejection, six without rejection, five time-zero biopsies, and 10 cases with hepatic artery thrombosis. In addition to a semiquantitative assessment of apoptotic bodies in haematoxylin and eosin stains, an in-situ end nick-labelling technique (TUNEL) was used to detect DNA fragmentation. In all cases with hepatic artery thrombosis the incidence of apoptosis was found significantly increased in comparison to acute rejection.〈section xml:id="abs1-3"〉〈title type="main"〉ConclusionsAs apoptosis is a mechanism in the early stages of tissue damage prior to necrosis, increased apoptosis in liver allograft biopsies might be regarded as a signal of early ischaemia indicating initial vascular occlusion.
    Materialart: Digitale Medien
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  • 2
    ISSN: 1432-2277
    Schlagwort(e): Key words Apoptosis of hepatocytes ; Vascular occlusion ; Liver transplantation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Early vascular occlusion is liable to cause graft failure, and differential diagnosis between this condition and primary nonfunction (PNF) caused by preservation injury may be difficult. Apoptosis has been detected in immunomediated cytotoxicity and is known to be triggered by mild ischemia. In a retrospective analysis we investigated the role of apoptosis in vascular occlusion, PNF, and acute allograft rejection to improve the differential diagnosis of early graft failure. The liver graft histology of 75 patients (46 male, 29 female) a median 47 (1–64) years of age was screened semiquantitatively for the rate of apoptosis on the hematoxylin-eosin stain (HE) and by the in situ end nick labeling technique (TUNEL). This cohort included all patients who developed PNF (n = 9) or vascular occlusion (n = 11) after orthotopic liver transplantation (OLT) in the years 1992 to 1996. Within this period of time we performed 205 OLTs on 189 patients. We further included 22 patients with early acute rejection and 11 controls. The highest rates of apoptotic hepatocytes were seen in vascular occlusion (P 〈 0.001). Grafts with PNF were explanted 1–3 days after OLT and showed hepatocytes that were 100 % necrotic. Cases of acute early rejection showed a significantly higher apoptotic cell count than did normal controls (P 〈 0.003), increasing in direct proportion to the severity of rejection. Screening biopsies for the rate of apoptosis can improve the efficacy and accuracy of differential diagnosis of early graft failure.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    Knee surgery, sports traumatology, arthroscopy 7 (1999), S. 278-283 
    ISSN: 1433-7347
    Schlagwort(e): Key words Meniscal tears ; Diagnosis ; Magnetic resonance ; imaging ; Surgical decision making
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Sportwissenschaft
    Notizen: Abstract This clinical study evaluated factors affecting the decision for meniscal surgery in a patient population seen routinely at a trauma clinic. The study hypothesis was that patients who sustain a traumatic injury to the knee or have a long history of clinical symptoms are likelier to be operated on. We investigated 149 patients clinically and by magnetic resonance imaging (MRI). Group A (n = 62) underwent arthroscopic surgery and group B (n = 87) were treated conservatively. Multiple logistic regression analysis was used to examine correlations with regard to age, gender, injury pattern, period between the injury and first clinical examination, and MRI results. We found no significant difference between the two groups with regard to gender (P = 0.1), injury pattern (P = 0.44), or period between injury and first clinical examination (P = 0.5). Patients in group A were significantly older than those in group B (P = 0.044), and, as expected, MRI signal alterations were significantly higher in group A than in group B (P = 0.001). In acutely injured patients MRI helps to establish an accurate diagnosis, and in cases of positive MRI findings in a symptomatic patient, the surgeon should not wait 4–6 weeks but should immediately recommend surgery.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1573-7217
    Schlagwort(e): breast conserving surgery ; elderly breast cancer ; local recurrence ; treatment without adjuvant radiotherapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The purpose of this study was the evaluation of the necessity of routinely applied postoperative radiotherapy in a highly selected patient-group after breast conserving surgery. Between 1983 and May 1994, 356 women over 60 years of age with Stage I or II breast cancer were treated by quadrantectomy and axillary dissection followed by either adjuvant irradiation or no radiotherapy. We have analysed our data retrospectively to investigate whether irradiation has any benefit in elderly patients with respect to locoregional recurrence rates. After a median follow-up of 60 months the multivariate model revealed lymph node status (p=0.002) as highly significant with regard to local recurrence free survival. We were not able to identify a positive effect of adjuvant irradiation in patients with negative lymph nodes and positive receptor status: both patient groups with or without irradiation had similar locoregional recurrence rates of 3%. In a subgroup of patients who were lymph node negative, receptor positive, and received adjuvant tamoxifen therapy, the local recurrence rates were as low as 2% in both groups. Concerning these results it may be possible to avoid the morbidity and potential psychological side effects of radiotherapy in breast cancer patients over 60 years of age treated by breast conserving surgery (T1, N0, positive hormone receptor, adjuvant tamoxifen) without increasing risk of locoregional recurrence. These data have to be confirmed in a prospectively randomized fashion.
    Materialart: Digitale Medien
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  • 5
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; prognosis ; growth fraction ; Ki-67 ; TLI
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary In situ determination of proliferative activity was performed on 184 consecutive primary invasive breast cancers. Methods used were monoclonal antibody Ki-67 in immunohistochemistry and thymidine labeling index. Tumor proliferation correlated between both methods (p = 0.0001). For thymidine labeling index and Ki-67, respectively, significant correlations existed with histologic tumour grade and steroid hormone receptors (Tumor grade: TLIp = 0.0001; Ki-67 p = 0.0001. ER-ICA: TLI = 0.0001; Ki-67 p = 0.014. PgR-ICA: TLIp = 0.0001; Ki-67 p = 0.0008). For thymidine labeling index a significant correlation was demonstrated for overall survival (p = 0.001) and recurrence free survival (p = 0.01). No statistical significance was observed for clinical outcome and Ki-67 (overall survival p = 0.18; recurrence free survival p = 0.1). None of the factors, TLI or Ki-67, was an independent prognostic factor as demonstrated by multivariate analysis.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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