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  • Digitale Medien  (219)
  • 1995-1999  (139)
  • 1985-1989  (56)
  • 1965-1969  (24)
  • 1955-1959
  • Obesity
  • Pancreas
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  • Digitale Medien  (219)
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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Annals of surgical oncology 6 (1999), S. 682-690 
    ISSN: 1534-4681
    Schlagwort(e): Adenocarcinoma ; Cystadenocarcinoma ; Cystadenoma ; Dermoid cyst ; Hamoudi tumor ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Cystic pancreatic neoplasms may be benign, premalignant, or malignant. These lesions may remain asymptomatic for long periods and can be quite large at the time of presentation. Methods: A retrospective analysis was used to determine whether preoperative evaluation can predict pathology and determine resectability and outcome. Results: Over 12 years, 145 cystic pancreatic neoplasms, of which 24 (17%) were larger than 10 cm, were managed at the Johns Hopkins Hospital. Those 24 large tumors included 9 of 73 cystadenomas (12%), 7 of 27 cystadenocarcinomas (26%), 2 of 35 adenocarcinomas producing mucin or associated with a cyst (6%), 5 of 9 Hamoudi tumors (55%), and 1 dermoid cyst. Clinical symptoms, liver function tests, and computed tomographic scans did not distinguish benign from malignant pathology. On 18 angiograms, 2 malignant and 4 benign neoplasms demonstrated encasement or occlusion; however, 3 of these 6 tumors were resectable. Twenty of 22 patients (91%) who were explored underwent resection with no hospital mortality. For the entire series, 5-year survival for those with cystadenomas, cystadenocarcinomas, and cystic adenocarcinomas was 97%, 38%, and 9%, respectively. Three-year survival for those 7 with cystadenocarcinomas larger than 10 cm was 54%, compared with 51% for those 20 with smaller cystadenocarcinomas. Conclusions: Preoperative evaluation usually does not predict pathology, resectability, or outcome. Moreover, resectability is high and morbidity is low, irrespective of size. Large cystic pancreatic tumors should be explored to determine pathology, attempt resection, and provide an opportunity for long-term survival.
    Materialart: Digitale Medien
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Annals of surgical oncology 6 (1999), S. 117-122 
    ISSN: 1534-4681
    Schlagwort(e): Chemotherapy ; Radiotherapy ; Pancreas ; Malignant neoplasm
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In western countries, carcinoma of the pancreas remains the most lethal of the common malignancies. Even the favorable “organ-confined” tumors present a considerable challenge. The lack of anatomic barriers to local infiltration and the biological propensity for early lymphatic, perineural, and vascular invasion are nearly insurmountable obstacles to complete surgical eradication of this malignancy. Various combinations of chemotherapy and radiotherapy (RT) have been used with marginal but measurable success. Earlier trials conducted by the Gastrointestinal Tumor Study Group established roles for 5-fluorouracil chemotherapy and RT in the treatment of patients with resectable or locally advanced pancreatic cancer. More recently, computed tomography-guided conformal RT and a variety of intraoperative RT techniques have enabled more reliable sterilization of the local surgical field and escalation of doses to potentially curative levels (7000 cGy) for unresectable lesions. Chemotherapy dose intensification through the use of portable programmable pumps for protracted venous infusions and the development of active systemic agents in addition to 5-fluorouracil suggest that an effective combination chemotherapeutic regimen might soon be developed. This report reviews the current standards of practice and integrates recent developments to construct a modern algorithm for the use of chemoradiotherapy in the management of localized (nonmetastatic) pancreatic cancer. The likely directions of future investigations are also discussed.
    Materialart: Digitale Medien
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  • 3
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Blood supply ; Dorsal pancreatic artery
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The present article is the fifth part of a comprehensive review on the arterial blood supply of the pancreas and deals with the dorsal pancreatic artery. The aim of this review is to summarise the anatomic studies, starting from Haller’s reports, and to supply, as far as possible with original material, angiographic evidence for the classic anatomic notions. For this purpose, the overall research was carried out by studying 1015 selective angiographies (celiac trunk and its branches, superior mesenteric artery) taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. Angiographically, the authors could demonstrate the dorsal pancreatic artery, present in most instances, as arising from the splenic artery, common hepatic artery, superior mesenteric artery or celiac trunk and accessory right hepatic artery as coming from the superior mesenteric artery. Variations in the course and length of the dorsal pancreatic artery were demonstrated as well as some collateral branches. The authors underline the discordant opinions still existing regarding the incidence of the different ways the dorsal pancreatic artery arises, and discuss its uncertain embryologic development and surgical relevance.
    Materialart: Digitale Medien
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    Emergency radiology 6 (1999), S. 113-120 
    ISSN: 1438-1435
    Schlagwort(e): Key words Computed tomography (CT) ; helical ; Pancreatitis ; Pancreas ; CT
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Acute pancreatitis represents one of the more commonly encountered etiologies of acute abdominal pain. Many complications can present emergently, including pancreatic abscess, necrosis, and hemorrhage. The purpose of this pictorial essay is to educate the reader about the spectrum of CT findings in patients with complications from pancreatitis. Emphasis is placed on evaluation with helical CT, stressing optimal technique and the imaging parameters essential for accurate diagnosis.
    Materialart: Digitale Medien
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  • 5
    ISSN: 1432-1440
    Schlagwort(e): Key words Collagen ; Pancreas ; Porcine ; Islet transplantation ; Islets of Langerhans
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract One of the difficulties of porcine islet isolation is their fragility during collagenase digestion. The object of this study was to determine the distribution of 4 different collagen types within adult and juvenile porcine pancreata. Five different areas from each pancreas were analysed by light microscopy. The distribution of collagen types I, IV, V and VI were measured within the interlobar, intralobular (acinar), peri-insular and intra-islet regions. Their was an abundance of collagen type VI compared to I, IV and V in both the interlobar and intralobular septa in both juveniles (P〈0.001) and adults (P〈0.001). The peri-insular collagen content also showed diversity. This was mainly attributable to the distribution of collagen type I (weak) and type VI (intense) in both adults and juveniles. In general, the peri-insular capsule was fragmentary and contained less than 50% of the total islet circumference. The latter finding taken together with the distributions of different collagen types can partly explain some of the variability of porcine islet isolation.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 15 (1999), S. 579-581 
    ISSN: 1437-9813
    Schlagwort(e): Key words Hydatid disease ; Pancreas ; Children ; Echinococcosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Primary hydatid disease of the pancreas is rare. The authors report a 3-year-old girl who had a cystic mass in the head of the pancreas with no other viscera involved. At laparatomy the entire endocyst was totally extracted from the surrounding pancreatic parenchyma. The postoperative course was uneventful. She is currently disease-free with a follow-up of 5 years. Only four other pediatric cases have been reported in the English literature.
    Materialart: Digitale Medien
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  • 7
    ISSN: 1432-2307
    Schlagwort(e): Key words Mixed ductal-endocrine carcinoma ; Pancreas ; Gastrinoma ; Immunohistochemistry ; Zollinger-Ellison syndrome
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  We report an autopsy case of mixed ductal-endocrine carcinoma of the pancreas presenting as gastrinoma with Zollinger-Ellison syndrome. A 38-year-old Japanese male was found to have Zollinger-Ellison syndrome and pancreatic gastrinoma, and gastrectomy and resection of the pancreatic tumor were performed. However, hypergastrinemia persisted, and the patient died of disseminated carcinomatosis at 62 years of age, 24 years after the onset of Zollinger-Ellison syndrome. At autopsy, the main tumor was present in the residual pancreas, and metastases were noted in many organs. In the pancreas and other organs, ductal and endocrine carcinoma areas were mixed and there was a gradual transition between the two. No acinar differentiation was noted. The ductal elements were positive for mucins and carcinoembryonic antigen but negative for neuroendocrine markers, while endocrine elements were positive for chromogranin A and synaptophysin and to a lesser extent for gastrin, but negative for mucins and carcinoembryonic antigen. The ductal elements comprised about 30% of the tumor cells, and endocrine elements 70%. According to the revised World Health Organization classification, our case was diagnosed as mixed ductal-endocrine carcinoma. Our case is rare because the tumor manifested as gastrinoma with Zollinger-Ellison syndrome and the patient survived for 24 years. To the best of our knowledge, no such case has been reported. Our case suggests that pancreatic endocrine tumors may evolve into mixed ductal-endocrine carcinomas.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1432-2307
    Schlagwort(e): Key words Autopsy ; Factor V gene ; Obesity ; Pulmonary embolism ; Sudden death
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Several clinical and environmental conditions are causally related to sudden death from acute pulmonary thromboembolism (APT). Morbid obesity, despite its frequency and association with adverse health effects, is usually considered at most only an additive risk factor for APT. We reviewed protocols and histories from 7227 consecutive autopsies performed between 1985 and 1996 at the Mayo Clinic, including all deaths from APT where no clinical or environmental risk factor could be identified in the study. Body mass indices (BMI) were calculated and compared with those of age- and sex-matched controls who had died suddenly and naturally without evidence of APT. Resistance to activated protein C is the most common molecular clotting defect predisposing to APT, and it is caused by a point mutation in the factor V gene (R506Q). Genomic DNA was extracted from archival tissues of all cases and controls, and the R506Q status was determined by polymerase chain reaction amplification, restriction endonuclease digestion, and direct sequencing. APT was found as the immediate cause of death in 433 patients, with 36 (8%) having no previously established risk factors. Twenty-four of these persons (67%) were morbidly obese (BMI 〉30 kg/m2), compared with only five controls (14%, P〈0.0001). Four patients in both groups, each with a BMI 〈30 kg/m2, had at least one allele positive for R506Q. Morbid obesity is an independent risk factor in cases of sudden death from APT after the exclusion of previously established clinical, environmental, and molecular risk factors.
    Materialart: Digitale Medien
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  • 9
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 568-577 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Leber ; Pankreas ; Hepatozelluläres Karzinom ; Metastase ; Pankreaskarzinom ; Sonographie ; Computertomographie ; Magnetresonanztomographie ; Key words Liver ; Pancreas ; Contrast-enhanced CT ; Contrast-enhanced MRI ; Staging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Modern therapeutic strategies can improve survival of patients with pancreatic or liver malignancies. A prerequisite is thorough radiologic assessment of these patients. A variety of radiologic techniques are available, such as ultrasound, contrast-enhanced CT, CTAP, contrast-enhanced MRI, and endoscopic ultrasound. In this review the advantages and weaknesses of the different techniques are presented in the staging of patients with HCC, cholangiocarcinoma, suspected liver metastases, and pancreatic carcinoma. In an era of economic restraints, funds are not flowing freely anymore for radiologic studies. We have to consider not doing so many different examinations for each patient. We have to decide in the future which diagnostic test we want to perform for detection and staging of a particular disease. For liver and pancreatic malignancies it is likely to be MRI that will take this role.
    Notizen: Zusammenfassung Moderne Therapieverfahren können die Überlebenschance von Patienten mit malignen Tumoren von Leber oder Pankreas deutlich verbessern. Um das Potential dieser Techniken ausnutzen zu können, ist eine genaue prätherapeutische Abklärung nötig. Dafür steht eine Reihe von bildgebenden Verfahren für das Staging von Leber- oder Pankreasmalignomen zur Verfügung, die entsprechend einem diagnostischen Algorithmus eingesetzt werden sollten. Die Vorzüge und Nachteile der jeweiligen bildgebenden Verfahren, wie transabdominelle Sonographie, kontrastverstärkte CT, CTAP, MRT mit organspezifischen Kontrastmitteln und Endosonographie, werden dargestellt und ihre diagnostische Wertigkeit im klinischen Kontext erläutert. In Zeiten zunehmender ökonomischer Restriktionen in der Gesundheitspolitik wird es notwendig, die Zahl der präoperativen Untersuchungen beim Tumorstaging zu limitieren, ohne an diagnostischer Genauigkeit einzubüßen. Der Trend geht deshalb immer mehr zum radiologischen „one stop-shopping”, d.h. der vollständigen diagnostischen Abklärung eines Patienten mit nur einer bildgebenden Methode. Diese Rolle wird in Zukunft die Magnetresonanztomographie mit organspezifischen Kontrastmitteln übernehmen, die eine hohe diagnostische Aussagekraft bei der Detektion und beim Staging von Leber- und Pankreasmalignomen besitzt.
    Materialart: Digitale Medien
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  • 10
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 9 (1999), S. 1142-1144 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Intestines ; Duodenum ; Stenosis or obstruction ; Stents and prostheses ; Pancreas ; Neoplasms ; Gastrointestinal tract ; Interventional procedures
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. This is the first report of palliative percutaneous treatment of a malignant duodenal stenosis due to cancer of the pancreatic head with Palmaz stents. A 65-year-old male with a malignant tumour of the pancreatic head developed an abscess with fistular communication to the cutis. In the subsequent course of the disease, tumour growth led to a severe duodenal stenosis. To dilate the tumorous stenosis, three Palmaz stents were introduced coaxially into the duodenum percutaneously, via the preexisting fistula. A technique to pass an almost 90 ° kink is described. Symptomatic malignant duodenal stenosis was treated by insertion of three Palmaz stents. Due to their accurately controlled passive expansion at the level of the stenosis, and the resulting good adaptation to the individual anatomical situation, they were suitable for application in the duodenum.
    Materialart: Digitale Medien
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  • 11
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 9 (1999), S. 1513-1522 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Bile ducts ; Biliary stones ; Biliary strictures ; Bile ducts ; Neoplasms ; Obstruction ; Pancreatic duct ; Pancreas ; Chronic pancreatitis ; MR imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Magnetic resonance Cholangiopancreatography (MRCP) is a non-invasive imaging technique able to provide projectional images of the bile ducts. Different sequences, using both breath-hold and non-breath-hold acquisition techniques, have been employed in order to obtain MRCP images. The authors discuss technical aspects, considering both three-dimensional non-breath-hold techniques and two-dimensional breath-hold, multi-slice and thick slab sequences. Clinical applications of MRCP are evaluated, presenting data from both the literature and personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy 85–100 %) and, subsequently, its level (accuracy 91–100 %) and its cause. The utility of associating conventional MR images to MRCP in malignant strictures, in order to characterize and stage the malignant lesion, is also discussed. Finally, data are presented regarding the indications and the utility of MR-pancreatography in the evaluation of patients with pancreatic duct anomalies and chronic pancreatitis.
    Materialart: Digitale Medien
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  • 12
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 9 (1999), S. 1496-1512 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Liver neoplasms ; Diagnosis ; MR ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Following the introduction of rapid, high-quality scan techniques and the development of new, tissue-specific contrast agents, the applications of MRI for abdominal imaging are experiencing unprecedented growth. This article examines the current status of liver and pancreatic MRI, highlighting technical and methodological approach, use of contrast agents, and main clinical applications. The MRI technique appears to be the ideal diagnostic tool for detection and characterization of benign and malignant liver neoplasms, and for evaluating tumor response after nonsurgical treatments. Dynamic imaging after bolus injection of a gadolinium chelate is currently a fundamental component of an MRI examination of the liver in many instances. Optimal dynamic scanning depends on the use of a multisection spoiled gradient-echo technique that allows one to image the entire region of interest during a single suspended respiration. Images are obtained during four phases relative to the injection of the contrast agent: precontrast, arterial (pre-sinusoidal), portal (sinusoidal), and delayed (extracellular) phase. Liver-specific contrast agents, including hepatobiliary agents and reticuloendothelial system-targeted iron oxide particles, however, may offer advantages over gadolinium chelates in some clinical settings. Computed tomography is still preferred to MRI for imaging the pancreas. However, state-of-the-art MRI may currently be at least as accurate as spiral CT for depiction of inflammatory and neoplastic pancreatic diseases. Moreover, MRI has the advantage of allowing simultaneous investigation of the biliary tree, owing to cholangiopancreatography techniques. Hence, a comprehensive assessment of most pancreatic diseases can be achieved with a single examination.
    Materialart: Digitale Medien
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  • 13
    ISSN: 1432-1076
    Schlagwort(e): Key words Tuberous sclerosis complex ; TSC2 gene ; Loss of heterozygosity ; Pancreas ; Islet cell tumour
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 12-year-old boy with tuberous sclerosis complex (TSC) presented with a large retroperitoneal tumour. Exploratory surgery revealed an infiltrative tumour originating from the pancreas, with local metastases to the lymph nodes. The histologal diagnosis was a malignant islet cell tumour. Retrospectively measured pancreatic hormone levels, however, were normal. A connection between the malignancy and TSC was demonstrated by loss of heterozygosity of the TSC2 gene in the tumour. The primary mutation Q478X in this patient was identified in exon 13 of the TSC2 gene on chromosome 16. Conclusion Pancreatic islet cell tumours have been mainly associated with multiple endocrine neoplasia syndrome type 1. In our case we demonstrate a direct relationship of this tumour to tuberous sclerosis complex, in the absence of further signs of multiple endocrine neoplasia syndrome type 1.
    Materialart: Digitale Medien
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  • 14
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 28 (1999), S. 354-358 
    ISSN: 1432-2161
    Schlagwort(e): Key words Extraskeletal myxoid chondrosarcoma ; Metastasis ; Kidney ; Pancreas ; Chemotherapy ; Knee
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Extraskeletal myxoid chondrosarcoma is an uncommon neoplasm, accounting for less than 2% of all soft tissue sarcomas. It affects adult males with a median age in the fifth decade at the time of diagnosis. The tumor usually arises in the deep soft tissues, especially in the lower extremities. Patients present with a gradually enlarging mass that may or may not be associated with pain. This report describes a 25-year-old man who initially presented with a 4- to 5-year history of right knee pain and an enlarging mass in the right knee. Evaluation revealed a cartilaginous neoplasm with no evidence of metastatic disease. The tumor was widely excised and an allograft reconstruction was performed. The patient was closely followed with an eventual above the knee amputation for recurrent myxoid chondrosarcoma. At 34 months, retroperitoneal metastases were noted on abdominal CT. The patient underwent a left radical nephrectomy, renal vein thrombectomy and enucleation of the mass in the right kidney, distal pancreatectomy, and splenectomy. The patient received postoperative chemotherapy. Forty-eight months after initial diagnosis, the patient was found to have recurrent abdominal and retroperitoneal lesions. At 64 months, the patient died from complications of extraskeletal myxoid chondrosarcoma.
    Materialart: Digitale Medien
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  • 15
    ISSN: 1432-1459
    Schlagwort(e): Key words Intracranial pressure ; Cerebral venous thrombosis ; Coagulation ; Thrombophilia ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Evidence suggests that isolated intracranial hypertension (iIH) is often associated with cerebral venous thrombosis (CVT). In eight patients referred to our Institution for iIH who were later shown to harbor CVT we have performed a comprehensive coagulation work-up, including genetic tests for inherited predisposition to thrombophilia, to clarify the etiology of sinus venous thrombosis. All subjects were women. All but one were overweight. There were high plasma concentrations of D dimer, thrombin-antithrombin complexes or prothrombin fragments 1 and 2, further supporting the neuroimaging diagnosis of CVT. Importantly, seven of eight cases had a raised level of plasminogen activator inhibitor 1, a well known inhibitor of fibrinolysis related to obesity. Tissue plasminogen activator levels were elevated accordingly. Factor V gene mutation was present in one subject, and the 20210 prothrombin gene mutation was found in another individual. Three patients had elevated plasmatic levels of homocysteine. In conclusion, the present study provides solid evidence that impaired fibrinolysis probably related to overweight, acting in concert with other prothrombotic abnormalities, is involved in the pathogenesis of CVT presenting as iIH.
    Materialart: Digitale Medien
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  • 16
    ISSN: 1432-2307
    Schlagwort(e): Key words Soft tissue tumours ; Pancreas ; Solitary fibrous tumour
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Solitary fibrous tumours usually occur in the pleura, but occasionally they appear in extraserosal soft tissues or parenchymatous organs, where their diagnosis often causes problems. This report describes a solitary fibrous tumour (SFT) of the pancreas in a 50-year-old woman treated by left-side pancreatectomy. The tumour showed immunocytochemical reactivity for CD34, CD99 and bcl-2. Because of its favourable prognosis, SFT must be clearly distinguished from leiomyosarcoma, the most frequent nonepithelial tumour of the pancreas. Other mesenchymal tumours that may occur in the pancreas include tumours of the peripheral nerve sheath, fibrous histiocytic tumours and rare vascular tumours.
    Materialart: Digitale Medien
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  • 17
    Digitale Medien
    Digitale Medien
    Springer
    European journal of applied physiology 80 (1999), S. 233-239 
    ISSN: 1439-6327
    Schlagwort(e): Key words Energy expenditure ; Obesity ; Carbohydrate and fat oxidation ; Blood lactate
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In this study we compared substrate use at submaximal intensities of a maximal graded exercise test (GXT) with that derived from equivalent intensities during continuous submaximal steady-state exercise in obese and normal-weight women. Sedentary obese (n = 20, body fat 〉30%) and normal-weight (n = 15, body fat ≤30%) women performed three treadmill tests with concurrent metabolic measurements. Maximal oxygen consumption (V˙O2max) was determined using the Bruce protocol, followed by two, randomly assigned, continuous 15-min, steady-state exercise bouts, on different days; one bout at 50% and one bout at 75% V˙O2max. Analysis of variance revealed no significant differences between groups for blood lactate or respiratory exchange ratio (R) values at any point during exercise. Therefore, obese and normal-weight group data were combined for subsequent analyses. The R at 50% V˙O2max from the GXT [0.83 (0.01)] was significantly (P 〈 0.05) lower than at 8 min [0.90 (0.01)] and 15 min [0.89 (0.01)] of steady-state exercise, whereas at 75% V˙O2max, the GXT R [0.96 (0.01)] was similar to that seen at 8 min [0.96 (0.01)] and at 15 min of steady-state exercise [0.93 (0.01)]. Blood lactate values at 50% V˙O2max were similar between the GXT [1.66 (0.10) mM] and steady-state exercise [1.65 (0.09) mM], but at 75% V˙O2max the GXT blood lactate values [2.58 (0.21) mM] were lower than after 15 min of steady-state exercise [4.65 (0.46) mM]. Total exercise fat oxidation was greater at 50% compared to 75% V˙O2max. There was no difference in substrate use between sedentary obese and normal-weight women either at rest or during steady-state exercise at the same relative intensity. Total fat oxidation was greater during low- (50% V˙O2max) compared to high-intensity (75% V˙O2max) exercise. Data from a GXT cannot be used to predict R or substrate utilization values for the purpose of exercise prescription.
    Materialart: Digitale Medien
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  • 18
    Digitale Medien
    Digitale Medien
    Springer
    European journal of epidemiology 15 (1999), S. 41-49 
    ISSN: 1573-7284
    Schlagwort(e): Child ; Kuwait ; Matched case–control study ; Obesity ; Risk factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The prevalence of adult obesity in Kuwait is among the highest in the Arab peninsula, and cardiovascular disease, for which obesity is a risk factor, is the leading cause of death. This study reports familial and environmental factors associated with childhood obesity; in addition to adverse effects of obesity on children's serum lipids, lipoproteins, apolipoproteins, insulin, and blood pressure profiles. The authors carried out a pair-matched case–control study including 460 obese (body mass index 〉90th percentile of the age/sex specific reference value of the National Center for Health Statistics), school children 6 to 13 years old matched by age and gender to 460 normal weight controls. We ascertained obese children in a cross-sectional survey of a representative sample of 2400 school children selected from 20 schools by multistage stratified random sampling. Biochemical variables and blood pressure were adversely affected in obese children. The conditional logistic regression analysis showed that family history of obesity, and diabetes mellitus, respiratory and bone diseases in child were significant associated factors with obesity after adjusting for social and behavioural factors. Physical activity and parental social class were not significant. We recommend early preventive measures with emphasis on families in which one or both parents are overweight.
    Materialart: Digitale Medien
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  • 19
    Digitale Medien
    Digitale Medien
    Springer
    European journal of epidemiology 15 (1999), S. 649-654 
    ISSN: 1573-7284
    Schlagwort(e): Italy ; Obesity ; School
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Childhood and adolescent obesity prevalence rates have steadily increased in industrialised countries in the last 20 years. Current rates of obesity range between 6 and 30%. Several studies showed that risk factors for weight gain in school age are strongly linked to low physical activity and family environmental factors (parents' education and job, number of family members, number of hours spent on watching television, etc.). In order to plan a nutritional and health educational programme, a study was conducted on the nutritional status of the school age population of the Province of Frosinone, Central Italy, and family factors that can influence it. Three percentage of the school age population of the Province of Frosinone (2053 students) and their families were randomly sampled from the Province school district database. In each of the 12 recruited schools, a meeting with teachers and students was arranged to discuss aims and methods of research and to collect informed consent by students. Each student was interviewed about physical activity, and underwent the following measurements: height, weight, bicipital, tricipital, sub-scapular and over-iliacal skinfolds, sexual development. Students' parents were asked to answer a questionnaire about family structure, parents' educational level and job, parents' height and weight, presence in the family of pathologies as hypertension or diabetes. One thousand three hundred fifty-seven students (66% of the target population) and 1802 parents (66.5% of the responders' population) agreed to enter the study. Students' age range was 8 years (11–19 years; mean age was 14.9, SD, 2.55). Among them 8.4% were considered obese, with a higher prevalence in male population (9.8%) as compared to female population (6.5%). Of these responders, 21.4 % were considered at risk of overweight with no statistical difference due to gender. Statistically significant correlations of teenagers' risk of overweight and obesity with nutritional conditions of parents, mother's educational level and amount of weekly physical activity were observed. Number of children in the family, parents' age and job do not appear to be correlated to obesity or risk of overweight. Our results show that, although the prevalence of obesity in the students population in the Province of Frosinone is comparable to other Italian Provinces and lower than other industrialised countries such as USA, the percentage of students at risk of overweight is particularly high. Main risk factors for developing obesity seem to be linked to parents' nutritional conditions, mother's educational level and children's physical inactivity and this should lead to intensify efforts for preventive interventions both at family level (focused on parents) and at school.
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  • 20
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; eating ; common environment ; unique environment ; heritability ; twins ; gene–environment interaction ; behavior
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract Human obesity is associated with greater-than-average energy intake, although relatively few studies have tested the heritability of food intake. The present study examined the genetic architecture of measured caloric intake during laboratory test meals in 36 monozygotic and 18 dizygotic twin pairs. A series of analyses tested the hypotheses that (1) there would be a genetic influence on total caloric intake, (2) there would be genes influencing total caloric intake above and beyond those influencing body composition, (3) there would be a phenotypic association between total caloric intake and fat mass above and beyond any genetic influences, and (4) there would be genetic influences on macronutrient intake (i.e., fat, carbohydrate, and protein intake) above and beyond total caloric intake. Results suggested genetic influences on age- and sex-adjusted total caloric intake (24–33% of the variance), although 95% confidence intervals were wide and suggested that “true” heritability estimates might be considerably lower or higher. Caloric intake was influenced by both common and unique environmental factors. Greater-than-average caloric intake was associated with increased adiposity, despite probable genetic influences on both phenotypes. Finally, there was evidence for macronutrient-specific familial influences, although the extent to which they were genetic or environmental in origin could not be teased apart. Results suggest that human obesity may be influenced by behaviors that are themselves genetically regulated. However, further studies are needed to obtain more precise heritability estimates and a better understanding of the conditions under which genetic influences on energy intake emerge.
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  • 21
    ISSN: 1573-7284
    Schlagwort(e): Cigarette smoking ; Menstruation ; Nutrition ; Obesity ; Race ; Reproductive history ; Sex hormones
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract While irregular menstruations have been associated with lower cumulative exposure to the ovarian steroids, shorter regular cycles have been postulated to increase the cumulative exposure. Epidemiological correlates with menstrual patterns were analyzed among 4900 premenopausal women aged 45 or younger from the New York University Women's Health Study. The length of regular menstrual cycles increased with increasing age at menarche, body mass index and parity, but decreased with age, nonwhite racial background and current smoking. The likelihood of irregular cycles increased with increasing age, body mass index and number of cigarettes smoked per day. With adjustment for age, body mass index and number of cigarettes smoked per day, the risk of irregular cycles was marginally positively associated with total fat intake.
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  • 22
    ISSN: 1573-2649
    Schlagwort(e): Health-Related Quality of Life ; Obesity ; Weight loss
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract To examine the effect of treatment-induced weight loss on Health-Related Quality of Life (HRQL), 38 mildly-to-moderately overweight persons recruited to participate in a study to examine the efficacy of a lifestyle modification treatment program completed a sociodemographic questionnaire, the Beck Depression Inventory (BDI), the Medical Outcomes Study Short-Form Health Survey (SF-36, as an assessment of HRQL), and underwent a series of clinical evaluations prior to treatment. After baseline evaluations, participants were randomly assigned to either a program of lifestyle physical activity or a program of traditional aerobic activity. Participants again completed the SF-36 and BDI after the 13-week treatment program had ended. Weight loss averaged 8.6 ± 2.8 kg over the 13-week study. We found that weight loss was associated with significantly higher scores (enhanced HRQL), relative to baseline, on the physical functioning, role-physical, general health, vitality and mental health domains of the SF-36. The largest improvements were with respect to the vitality, general health perception and role-physical domains. There were no significant differences between the lifestyle and aerobic activity groups on any of the study measures. These data indicate that, at least in the short-term, weight loss appears to profoundly enhance HRQL.
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  • 23
    Digitale Medien
    Digitale Medien
    Springer
    Journal of hepato-biliary-pancreatic surgery 6 (1999), S. 86-89 
    ISSN: 1436-0691
    Schlagwort(e): Key words: Electrocautery ; Electric coagulation ; Pancreas ; Pancreatoduodenectomy ; Pancreatojejunostomy ; Leakage
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: To assess whether electrocautery is appropriate for cutting the pancreas in pancreatoduodenectomy, we compared leakage of the pancreatojejunostomy (PJ-stomy) in patients who underwent pancreatic division by electrocautery and with a conventional scalpel, in a retrospective study. Eighty-four patients with invaginating end-to-end PJ-stomies (performed in the period 1986–1996) were enrolled in this study; 34 patients underwent pancreatic division with a conventional scalpel (group A) and 50 by electrocautery (group B). Of the 84 patients, 12 (14%) had leakage from the PJ-stomies. In relation to consistency of the pancreatic parenchyma, the incidence of leakage in patients with hard pancreas (1/28; 3.6%) was significantly lower than that in patients with soft or moderate pancreas consistency (11/56; 20%) (P 〈 0.05). Nine patients (27%) in group A and 3 (6%) in group B presented with leakage. The incidence of leakage was significantly lower in group B than in group A (P 〈 0.05). Even when patients with hard pancreas were excluded, the incidence of leakage was significantly lower in group B (3/34; 9%) than in group A (8/22; 36%) (P 〈 0.05). These results suggest that pancreatic division by electrocautery can reduce the incidence of leakage from the pancreatojejunostomy and make pancreatoduodenectomy a safer procedure.
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  • 24
    ISSN: 1530-0358
    Schlagwort(e): Peutz-Jeghers syndrome ; Appendix ; Hamartoma ; Pancreas ; Duodenum ; Cancer ; Intussusception
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The unusual occurrence of an “inside-out” appendix reported here is a case of complete intussusception of the appendix of a 45-year-old woman with Peutz-Jeghers syndrome in whom the diagnosis of intussusception was made preoperatively. At laparotomy, the lead point of intussusceptum was revealed to be a Peutz-Jeghers syndrome polyp of the appendix. There was also a cystic lesion in the pancreas, and subsequent distal pancreatectomy revealed a cystadenocarcinoma of the pancreas. Two jejunal Peutz-Jeghers syndrome polyps and two duodenal Peutz-Jeghers syndrome polyps were foundvia intraoperative endoscopies. The duodenal polyps were endoscopically removed, whereas a jejunal wedge resection was performed for the adjoining jejunal polyps. One of the two duodenal polyps possessed an adenocarcinoma focus. To our knowledge, this is the first report of complete intussusception of the appendix caused by a Peutz-Jeghers syndrome polyp.
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  • 25
    Digitale Medien
    Digitale Medien
    Springer
    Der Chirurg 69 (1998), S. 301-305 
    ISSN: 1433-0385
    Schlagwort(e): Key words: Non-Hodgkin lymphoma ; Pancreas ; Pancreatic tumors ; Differential diagnosis ; Case report. ; Schlüsselwörter: Non-Hodgkin-Lymphom ; Pankreas ; Pankreastumoren ; Differentialdiagnose ; Kasuistik.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Bei einem 71 jährigen Patienten mit einem seit 8 Wochen bestehenden schmerzlosen Verschlußikterus war sonographisch und computertomographisch eine 7 × 6 cm große Raumforderung im Bereich des Pankreaskopfes nachweisbar, die in Zusammenhang mit einem CA 19–9 von 329 U/l hochgradig verdächtig auf ein Pankreascarcinom war. Nach endoskopischer Einlage einer Pigtail-Drainage in den mit 2,7 cm deutlich dilatierten Ductus hepatocholedochus (DHC) machte eine anhaltende kreislaufwirksame Blutung aus dem DHC eine notfallmäßige partielle Duodenopankreatektomie nach Whipple erforderlich. Die histopathologische Untersuchung ergab ein sklerosierendes folliculäres centroblastisch-centrocytisches Lymphom i. S. eines niedrig malignen Non-Hodgkin-Lymphoms (NHL) des B-Zell-Systems. Eine sichere Abgrenzung des primären NHL des Pankreas zum Pankreascarcinom ist weder klinisch noch durch laborchemische oder bildgebende Verfahren sicher möglich. Die Impression des Ductus pancreaticus ohne Infiltration bei relativ großen Tumorprozessen sollte an eine extranodale Manifestation eines NHL denken lassen und eine histologische Abklärung herbeiführen.
    Notizen: Summary. A 71-year-old patient had been suffering from pain-free obstructive jaundice for 8 weeks. Ultrasonography and computed tomography revealed an inhomogeneous mass (diameter 7 × 6 cm) in the head of the pancreas. In combination with a CA 19–9 of 329 U/l, the findings were highly suggestive of a pancreatic carcinoma. Endoscopic implantation of a pigtail drain into the dilated choledochal duct was performed. A partial duodenopancreatectomy (Whipple's procedure) became necessary because of continuous bleeding with hemodynamic disorders after endoscopic papillotomy. In the histopathological examination a low-grade malignant non-Hodgkin lymphoma of the pancreas (follicular centroblastic-centrocytic) was diagnosed. The differential diagnosis of primary pancreatic lymphoma from pancreatic carcinoma is usually impossible. Neither clinical nor laboratory nor imaging methods indicate to the correct diagnosis. In cases of relatively large pancreatic tumor masses and impression of the pancreatic duct without infiltration, a primary pancreatic lymphoma should be considered and a histological diagnosis by biopsy should be performed.
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  • 26
    Digitale Medien
    Digitale Medien
    Springer
    International urogynecology journal 9 (1998), S. 140-144 
    ISSN: 1433-3023
    Schlagwort(e): Constitution ; Physical work ; Obesity ; Urinary incontinence ; Women
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Urinary incontinence in women is a common and complex problem which can be defined and classified as stress, urge and mixed incontinence. Three of the eight most common risk factors are obesity, constitution and physical work, in addition to age, length of menstrual cycle, number of pregnancies, education and level of health awareness. Women with the diagnosis of urinary incontinence were invited to respond to questionnaires on a voluntary basis. The three factors found to be associated with urinary incontinence are increased body weight, strong osteomuscular structure and hard physical work. These indicate that the work of a health team must take a holistic approach to women even before the phenomenon of urinary incontinence occurs.
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  • 27
    Digitale Medien
    Digitale Medien
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 409-411 
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Splenic artery ; Pancreatic ducts ; Developmental anatomy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In a 47-year-old male cadaver the splenic artery traveled partially through the substance of the pancreas. Additionally, the pancreas was apparently large and had an unusual shape; the neck of the organ could not be differentiated; the uncinate processus was absent; two pancreatic ducts were present. The probable reason for this combined anomaly was abnormal fusion of the ventral and dorsal pancreatic buds due to different levels of origin.
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  • 28
    Digitale Medien
    Digitale Medien
    Springer
    Hernia 2 (1998), S. 175-177 
    ISSN: 1248-9204
    Schlagwort(e): Incisional hernia ; Obesity ; Postoperative complications ; Suture technique ; Wound healing
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The aim of this study was to report the incidence of incisional hernias following midline laparotomy incisions after 12 months and after 8 years. 374 patients who underwent midline laparotomy between August 1989 and December 1990 were included. The wounds were closed with a continuous suture and the technique was monitored by the suture length to wound length ratio. The incidence of incisional hernia, defined as a palpable defect in the fascia or a protrusion beyond this level, was monitored at 12 months and after 8 years. Early wound dehiscence occurred in 3 patients (1%) and wound infection in 32 (9%). At the 12-month examination 58 (20%) incisional hernias were detected in 292 patients. After 8 years 142 patients were examined and 5 (3%) hernias were found. All hernias that caused inconvenience or required surgical repair were detected at 12 months follow-up. Most hernias appearing later have probably been overlooked at the first examination.
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  • 29
    ISSN: 1432-1440
    Schlagwort(e): Key words Oncostatin ; Transgenic ; Pancreas ; Fibrosis ; Neuropeptide ; SPARC
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Oncostatin M (OM), a member of the IL-6 gene family, stimulates a variety of functions implicated in wound repair. Transgenic mice that express this cytokine in islet β-cells develop a connective tissue disorder that typifies excessive healing with severe fibrosis and lymphocytic infiltration. To compare this phenotype with the normal progression of connective tissue disease, we measured the expression patterns of genes encoding proinflammatory cytokines, fibrogenic cytokines, and ECM components by in situ hybridization. To test whether the OM effect was caused by its ability to regulate IL-6, we crossed the OM transgene into IL-6-deficient mice. Our data suggest that the fibrosis in these animals is not a secondary consequence of inflammation, or IL-6 expression, but is a direct effect by OM on extracellular matrix production. In a separate experiment, we observed that OM could regulate vasoactive intestinal peptide gene expression in the neurons that innervate the transgenic pancreas. This nerve healing response, in combination with its fibrogenic activity, suggests that OM functions downstream of inflammation in the wound repair cascade. These transgenic mice represent a useful model in which the fibroproliferative phase of connective tissue disease is uncoupled from inflammation.
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  • 30
    Digitale Medien
    Digitale Medien
    Springer
    Der Chirurg 69 (1998), S. 366-370 
    ISSN: 1433-0385
    Schlagwort(e): Key words: Adenocarcinoma ; Chemotherapy ; Pancreas ; Radiotherapy ; Surgery. ; Schlüsselwörter: Adenocarcinom ; Chemotherapie ; Pankreas ; Radiotherapie ; Chirurgie.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Bei dem größten Teil aller Patienten liegt zum Zeitpunkt der Diagnose „Pankreascarcinom“ bereits eine systemische Tumorerkrankung vor und nahezu alle Patienten entwickeln nach radikaler Resektion im weiteren Verlauf ein Rezidiv. Somit ist die alleinige chirurgische Behandlung insuffizient. Diese Arbeit focussiert auf die adjuvante multimodale Behandlung und gibt einen Überblick über den aktuellen Status der prä- und postoperativen Radiochemotherapie, intraoperativen Radiotherapie (IORT), adjuvanten Chemotherapie und regionalen Infusionstherapie. Die verfügbaren Studien sind häufig durch fehlende Randomisierung und eine zu geringe Patientenzahl gekennzeichnet. Aktuell ist keine adjuvante, multimodale Behandlung verfügbar, welche für den Routinegebrauch empfohlen werden kann. Es ist zu hoffen, daß 2 laufende prospektiv randomisierte Studien (ESPAC-1 und eine EORTC-Studie) genug statistische Aussagekraft haben werden, um verwertbare Informationen zu diesem Thema zu erhalten. Diese und andere Studien könnten die Basis für weitere klinische Untersuchungen zur multimodalen Behandlung des Pankreascarcinoms geben mit dem langfristigen Ziel, die extrem schlechte Überlebensrate dieser Patienten zu verbessern.
    Notizen: Summary. The majority of patients with pancreatic cancer have systemic disease already at diagnosis, and nearly all patients will develop recurrence following radical resection. Thus, surgical treatment alone is insufficient. The paper focuses on adjuvant multimodal treatment and reviews the current status of pre- and postoperative chemoradiation, intraoperative radiotherapy (IORT), adjuvant chemotherapy, and regional infusion therapy. Studies in this area are hampered by often being non-randomized and with too few patients included. Overall there presently is no adjuvant multimodal treatment which can be suggested for routine use. However, two ongoing prospective randomized studies (ESPAC-1 and an EORTC study) will have enough statistical power to give reliable information on the topic. It is hoped that these and other studies will form the basis for further proper clinical trials on multimodal treatment in pancreatic cancer with the aim at long last to improve the extremely poor survival in these patients.
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  • 31
    ISSN: 1433-0385
    Schlagwort(e): Key words: Haemosuccus pancreaticus ; Bleeding ; Pancreas ; Chronic pancreatitis. ; Schlüsselwörter: Haemosuccus pancreaticus ; Blutung ; Pankreas ; chronische Pankreatitis.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Haemosuccus pancreaticus ist eine seltene Ursache einer oberen gastrointestinalen Blutung. Die chronische Pankreatitis mit ihren Komplikationen der Pseudocysten- oder Pseudoaneurysmenbildung stellt die häufigste Ursache einer spontanen Blutung aus dem Pankreasgang dar. Wir berichten über 2 Fälle einer intestinalen Blutung als Erstmanifestation einer chronischen Pankreatitis, bei denen die Diagnose einer chronischen Pankreatitis zum Zeitpunkt der Blutung nicht bekannt war und sich in der Anamnese kein Hinweis auf eine chronische Pankreatitis fand.
    Notizen: Summary. Haemosuccus pancreaticus is an unfrequent but known cause of an upper gastrointestinal bleeding. Pathogenesis of spontaneous severe hemorrhage of the pancreatic duct includes chronic pancreatitis generated pseudocysts or aneurysms of the visceral arteries. We present two cases of severe spontaneous gastrointestinal bleeding as a first manifestation of chronic pancreatitis, in which the diagnosis chronic pancreatitis was not known and the patients denied any gastrointestinal symptoms in their medical history at the time of hemorrhage.
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  • 32
    Digitale Medien
    Digitale Medien
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 1192-1196 
    ISSN: 1433-0474
    Schlagwort(e): Schlüsselwörter Body-mass-Index ; Übergewicht ; Adipositas ; Key words Body Mass Index ; Overweight ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Objective: To examine changes in Body Mass Index (BMI) in children in the last twenty years and to determine the prevalence of overweight and obesity. Design and Subjects: Body height and body weight were measured in Jena school children 7 to 14 years of age in cross-sectional anthropological investigations in 1975, 1985 and 1995 and from these measurements the Body Mass Index (BMI) was calculated. The investigated children were classified as overweight or obese by the age- and sex-specific 90th or 97th percentile values of BMI from Rolland-Cachera et al. [31] recommended by the European Childhood Obesity Group. Results: Between 1975 and 1995 the BMI of Jena children increased. The prevalence of overweight and obesity among the children increased also. These changes were striking between 1985 and 1995. Conclusions: Changing living conditions, e. g. changes in the leisure-time lifestyle, in dietary practices and in the families, related to the unification of Germany in 1989, may be caused this trend.
    Notizen: Zusammenfassung Fragestellung/Hintergrund: Es wurden Veränderungen des Body-mass-Index (BMI) bei Kindern in den letzten 20 Jahren untersucht und die Prävalenz von Übergewicht und Adipositas bestimmt. Methode und Probanden: Körperhöhe und Körpergewicht wurden im Rahmen anthropologischer Querschnittsuntersuchungen in den Jahren 1975, 1985 und 1995 bei 7- bis 14jährigen Jenaer Kindern erfaßt und daraus der Body-mass-Index berechnet. Die Einstufung der untersuchten Kinder als übergewichtig und adipös erfolgte anhand der von der European Childhood Obesity Group empfohlenen alters- und geschlechtsspezifischen 90. oder 97. Perzentile für den BMI von Rolland-Cachera et al. [31]. Ergebnisse: Zwischen 1975 und 1995 stieg der BMI der Jenaer Kinder an. Der prozentuale Anteil von Kindern, die als übergewichtig oder adipös einzustufen sind, nahm ebenfalls zu. Diese Veränderungen fielen zwischen 1985 und 1995 besonders deutlich aus. Schlußfolgerungen: Veränderte Lebensbedingungen, wie z. B. Änderungen beim Freizeitverhalten, beim Ernährungsverhalten oder in der Familienstruktur, die im Zusammenhang mit der politischen Wende im Jahr 1989 auftraten, werden als Ursache für diesen Trend angesehen.
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  • 33
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 13 (1998), S. 428-430 
    ISSN: 1437-9813
    Schlagwort(e): Key words Cyst ; Heterotopic ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The case of a large cyst arising from heterotopically-situated pancreatic tissue in an 11-month-old girl is reported. This is the first published report of childhood pancreatic cyst that developed in heterotopic pancreatic tissue. There is strong evidence to suggest that the cyst became symptomatic as a result of secondary infection, an additional unreported phenomenon. This case serves to underscore the fact that pancreatic cysts should be considered in the differential diagnosis of intestinal duplication cysts of childhood.
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  • 34
    Digitale Medien
    Digitale Medien
    Springer
    Virchows Archiv 432 (1998), S. 191-194 
    ISSN: 1432-2307
    Schlagwort(e): Key words Hamartoma ; Adenomyoma ; Pancreas ; Choristoma ; Small intestine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  A rare case of myoepithelial hamartoma of the duodenal wall is presented, and previous case reports found in the literature are reviewed. Myoepithelial hamartomas are thought to arise from displaced pancreatic anlage present along the gastrointestinal tract during embryogenesis, which can differentiate into various pancreatic elements; the most highly differentiated form is heterotopic pancreas. An alternative theory is pancreatic metaplasia of endodermal tissues. We describe a 41-year-old man who presented with abdominal pain and vomiting. CT scanning revealed a mass at the head of the pancreas. A pancreaticoduodenectomy was performed for presumed cystadenoma. Histology of the mass revealed a disorderly arrangement of smooth muscle, dilated and nondilated ducts, pancreatic acinar tissue and mucus glands. The relationship of myoepithelial hamartomas involving the small bowel to similar lesions in the stomach, bile ducts and gallbladder is discussed.
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  • 35
    Digitale Medien
    Digitale Medien
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 445-452 
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Blood supply ; Dorsal pancreatic artery
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Résumé Cet article sur l'artère pancréatique dorsale représente le cinquième d'une étude d'ensemble sur la vascularisation artérielle du pancréas. Le but de cette étude est de résumer les recherches scientifiques depuis les rapports de Hallers, et de fournir avec un support original si possible, des preuves angiographiques des notions anatomiques classiques. Pour atteindre cet objectif, l'ensemble de la recherche a été réalisée en sélectionnant et en étudiant 1 015 angiographies (tronc coeliaque et ses branches, artère mésentérique supérieure) puisées dans les archives angiographiques de l'Institut de Radiologie de Sienne, de l'Université Catholique de Rome et Perugia. Angiographiquement, les auteurs pourraient démontrer que l'artère pancréatique dorsale, présente dans la plupart des cas, comme issue de l'artère splénique, de l'artère hépatique commune, de l'artère mésentérique supérieure, du tronc coeliaque et accessoirement de l'artère hépatique droite issue de l'artère mésentérique supérieure. Des variations dans la position et la longueur de l'artère pancréatique dorsale sont démontrées, tout comme quelques branches collatérales. Les auteurs soulignent les opinions discordantes qui demeurent concernant l'incidence des différentes directions dans lesquelles l'artère pancréatique dorsale se dirige et discutent son développement embryologique incertain et son intérêt chirurgical.
    Notizen: Summary The present article is the fifth part of a comprehensive review on the arterial blood supply of the pancreas and deals with the dorsal pancreatic artery. The aim of this review is to summarise the anatomic studies, starting from Haller's reports, and to supply, as far as possible with original material, angiographic evidence for the classic anatomic notions. For this purpose, the overall research was carried out by studying 1015 selective angiographies (celiac trunk and its branches, superior mesenteric artery) taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. Angiographically, the authors could demonstrate the dorsal pancreatic artery, present in most instances, as arising from the splenic artery, common hepatic artery, superior mesenteric artery or celiac trunk and accessory right hepatic artery as coming from the superior mesenteric artery. Variations in the course and length of the dorsal pancreatic artery were demonstrated as well as some collateral branches. The authors underline the discordant opinions still existing regarding the incidence of the different ways the dorsal pancreatic artery arises, and discuss its uncertain embryologic development and surgical relevance.
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  • 36
    ISSN: 1432-1084
    Schlagwort(e): Key words: CT ; Gastrointestinal tract ; Pancreas ; Adrenal glands ; Kidneys ; Trauma State-of-the-art reviews
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Computed tomography plays an important role in the detection and management of blunt visceral injuries in adults. Current standard examination techniques enable detection of the majority of perforating or devascularizing bowel injuries, although diagnostic findings are often subtle and meticulous inspection is required. Computed tomography may demonstrate pancreatic contusions and lacerations and help in distinguishing minor traumatic lesions without involvement of the pancreatic duct (organ injury scale, grades I and II) from deep lacerations with ductal involvement (grades III and V). Computed tomography enables distinguishing renal contusions and minor cortical lacerations that can usually be managed conservatively (injuries of grades I–III) from corticomedullary lacerations and injuries of the major renal vessels (grades IV and V) that have a less favorable prognosis and more commonly require surgical repair. In addition, CT is well suited for the detection of active renal hemorrhage and guidance of transcatheter embolization treatment and delineation of preexisting benign or malignant pathologies that may predispose to posttraumatic hemorrhage. The radiologist's awareness of the diagnostic CT findings of abdominal visceral injuries as well as their clinical and surgical implications are important prerequisites for optimal patient management.
    Materialart: Digitale Medien
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  • 37
    ISSN: 1432-1084
    Schlagwort(e): Key words: MR imaging ; MR cholangiopancreatography ; Pancreas ; Endoscopic retrograde cholangiopancreatography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The aim of this study was to investigate whether IV secretin administration is useful to enhance the delineation of the main pancreatic duct (MPD) and its side branches, and if it provides additional information concerning signal voids and strictures. Twenty-seven patients referred for abdominal pain or laboratory abnormalities (group 1, n = 13) or for the follow-up of chronic pancreatitis (CP; group 2, n = 14) were studied. Magnetic resonance cholangiopancreatography was acquired at 1.5 T before and after IV secretin by a coronal 3D TSE T2-weighted sequence with maximum intensity projection postprocessing. In group 1 secretin provided a better visualization of MPD in 9 patients. In a patient with pancreas divisum, it allowed suggestion of stenosis of the accessory papilla, confirmed at endoscopic retrograde cholangiopancreatography (ERCP). In group 2 secretin provided a better visualization of MPD only in the 3 patients with mild disease. A mild dilation upstream a stricture occurred in 2 cases and a marked dilation appeared upstream a wallstent which was non-patent at ERCP. Few changes were noticed concerning side branches. These preliminary results indicate that in patients without CP, secretin improves MPD delineation avoiding invasive diagnostic ERCP. In patients with mild CP secretin does not improve the characterization of signal voids, but it may be useful to appreciate their significance and to follow-up stenosis.
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  • 38
    ISSN: 1432-198X
    Schlagwort(e): Key words: Kidney length ; Body weight ; Body mass index ; Systolic blood pressure ; Obesity ; Hypertension
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Somatometric parameters, renal size, and systolic blood pressure (SBP) were studied in 406 patients referred to pediatric nephrology and urology clinics. These patients included 269 females (66%), 67 African Americans (17%), and 87 patients with essential hypertension (21%). Z scores for the study population were comparable to published standards for height, kidney length, and SBP. Weight and body mass index scores were significantly greater than predicted from the standards, especially in the subset of patients with essential hypertension. Age, height, weight, body mass index, kidney length, and SBP all correlated with one another; however, on multiple regression analysis of SBP with the other five independent variables, only weight proved to have a significant correlation. Furthermore, the relationship of kidney length with SBP was positive and hypertensive patients had greater kidney size than published standards. These data do not support reduced kidney size in the population with essential hypertension, nor is there support for a convincing correlation between kidney length and SBP in the general pediatric population. Body weight correlates best with blood pressure. These findings warrant further study in a less-select population. Prevention and treatment of obesity may thus be of prime importance in addressing hypertension in children.
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  • 39
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 901-910 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Bile ducts ; Biliary stones ; Biliary strictures ; Neoplasms ; Obstruction ; Pancreatic duct ; Pancreas ; Chronic pancreatitis ; MR imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Magnetic resonance cholangiography (MRCP) is a new non-invasive imaging technique for the evaluation of bilio-pancreatic disorders. Different sequences, using both breathhold and non-breathhold techniques, have been employed in order to obtain MRCP images. The authors discuss the technical aspects, particularly focusing their attention on a non-breathhold, three-dimensional, fat-suppressed turbo-spin-echo sequence, optimized on a 0.5-T magnet with 15 mT/m gradients. Clinical applications of MRCP are evaluated, presenting data from both the literature and personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy 85–100 %) and, subsequently, its level (accuracy 91–100 %) and its cause. The utility of associating conventional MR images to MRCP in malignant strictures in order to characterize and stage the malignant lesions is also discussed. Finally, data are presented regarding the indications and utility of MR pancreatography in the evaluation of patients with chronic pancreatitis.
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  • 40
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 1236-1244 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Pancreas ; anatomy ; Pancreas ; congenital abnormalities ; Pancreatitis ; Pancreas ; neoplasms ; Children
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Pancreatic disorders are not rare in children. Modern imaging equipment allows recognition of many pancreatic diseases that were difficult to identify in the past and therefore were considered to be unusual. Within the scope of this article we include information on imaging modalities for studying the pancreas and a description of the radiologic manifestations of the most common congenital, inflammatory, tumoral, traumatic and systemic disorders.
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  • 41
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 1425-1428 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Choriocarcinoma ; Stomach ; Pancreas ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. In this report we present the CT findings of two non-gestational,extragonadal choriocarcinomas, one arising within the stomach and one in the pancreas. These are rare tumours and a pancreatic primary site has not been previously described.
    Materialart: Digitale Medien
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  • 42
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 1627-1629 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Simple cyst ; Pancreas ; CT ; MRI
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. We report a case of a woman diagnosed with a solitary true cyst of the pancreas. CT and especially MRI guided us in the diagnosis of this benign lesion. The cyst has been surgically removed because of secondary bile-duct obstruction causing painless jaundice. Clinical history, laboratory, imaging, and histological findings are reported.
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  • 43
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 54 (1998), S. 621-625 
    ISSN: 1432-1041
    Schlagwort(e): Key words Vancomycin ; Obesity ; Pharmacokinetic variability
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract Objectives and methods: Vancomycin hydrochloride dosing requirements in morbidly obese patients with normal renal function were computed to determine the dose of vancomycin necessary to achieve target steady-state peak and trough concentrations and compared with a normal weight population. Results: Morbidly obese patients [total body weight (TBW) 165 kg, ideal body weight (IBW) 63 kg] required 31.2 mg · kg−1 · d−1 TBW or 81.9 mg · kg−1 · d−1 IBW to achieve the target concentrations. Normal weight patients (TBW 68.6 kg) required 27.8 mg · kg−1 · d−1 to achieve the same concentrations. Because of altered kinetic parameters in the morbidly obese patients (obese: t1/2=3.3 h, V=52 l, CL =197 ml · min−1; normal: t1/2=7.2 h, V=46 l, CL=77 ml · min−1, 20 of 24 patients required q8h dosing (1938 mg q8h) compared with q12h dosing (954 mg q12h) in all normal weight patients in order to avoid trough concentrations that were too low for prolonged periods. There was a good correlation between TBW and CL, but only fair correlation between TBW and V. Conclusion: Doses required to achieve desired vancomycin concentrations are similar in morbidly obese and normal weight patients when TBW is used as a dosing weight for the obese (approximately 30 mg · kg−1 · d−1). Shorter dosage intervals may be needed when dosing morbidly obese patients so that steady-state trough concentrations remain above 5 μg · ml−1 in this population. Because of the large amount of variation in required doses, vancomycin serum concentrations should be obtained in morbidly obese patients to ensure that adequate doses are being administered. Dosage requirements for morbidly obese patients with renal dysfunction require further study.
    Materialart: Digitale Medien
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  • 44
    ISSN: 1432-2013
    Schlagwort(e): Key words Exercise ; Fatigue ; Obese women ; Obesity ; Lactate threshold ; Lactate
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  A series of untrained, healthy, obese women (body mass index 32.5 ± 0.9 kg·m–2) were subjected to a protocol of intense exercise on a cycloergometer and compared with lean controls (body mass index 20.9 ± 0.5 kg·m–2). Physiological parameters, blood lactate, bicarbonate, plasma metabolites, oxygen consumption and CO2 production were measured. Impedance-derived extracellular water and plasma changes in lactate and bicarbonate were used to determine changes in bicarbonate pools and lactate-displaced CO2. From these and respiratory gases, the respiratory quotient was calculated and thence overall fuel consumption. Anaerobic energy during exercise accounted for about 1.8% of all energy consumed in the lean but only 0.7% in the obese. Obese women fatigued at lower workloads and energy expenditure levels than did the lean, and their lactate buildup was similar when compared on the basis of fat-free mass. The data support the postulation of fatigue being triggered by a combination of factors: stretched cardiovascular work would be the main factor for obese women, in part limiting lactate production. For lean women, the triggering factor for fatigue could be the loss of buffering capacity; but it is the combination of stretching cardiovascular capacity, exhaustion of glycogen and available glucose and increase in lactate/loss of bicarbonate buffer that determines the onset of fatigue.
    Materialart: Digitale Medien
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  • 45
    Digitale Medien
    Digitale Medien
    Springer
    Acta diabetologica 35 (1998), S. 117-129 
    ISSN: 1432-5233
    Schlagwort(e): Key words Incretin ; Gastric inhibitory polypeptide ; Glucagon-like peptide 1 ; Gut hormones ; Type 2 diabetes ; Type 1 diabetes ; Obesity ; New treatment modalities
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Glucagon-like peptide 1 (GLP-1) is a physiological incretin hormone from the lower gastrointestinal tract, partially explaining the augmented insulin response after oral compared to intravenous glucose administration in normal humans. In addition, GLP-1 also lowers glucagon concentrations, slows gastric emptying, stimulates (pro)insulin biosynthesis, and reduces food intake upon intracerebroventricular administration in animals. Therefore, GLP-1 offers some interesting perspective for the treatment of type 2, and perhaps also for type 1 diabetic patients. The other incretin hormone, gastric inhibitory polypeptide (GIP), has lost almost all its activity in type-2 diabetic patients. In contrast, GLP-1 glucose-dependently stimulates insulin secretion in type-2 diabetic patients and exogenous administration of GLP-1 ([7–37] or [7–36 amide]) in doses elevating plasma concentrations to approximately three to four times physiological postprandial levels fully normalizes fasting hyperglycaemia and reduces postprandial glycaemic increments. Due to rapid proteolytic cleavage, which results in an inactive or even antagonistic fragment, GLP-1 [9–36 amide], and to rapid elimination, the half-life of GLP-1 is too short to maintain therapeutic plasma levels for sufficient periods by subcutaneous injections of the natural peptide hormone. Current research aims to characterize GLP-1 analogues with more suitable pharmacokinetic properties than the original peptide. Given the large amount of GLP-1 present in L cells, it also appears worthwhile to search for more agents that could `mobilize' this endogenous pool of GLP-1.
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  • 46
    ISSN: 1432-5233
    Schlagwort(e): Key words Bioelectric impedance ; Body water ; Obesity ; Non-insulin-dependent diabetes ; Insulin-dependent diabetes
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Since bioelectrical characteristics correspond well to body water compartments, this study investigated bioelectrical differences between type 1 and type 2 diabetic subjects that could reflect differences in body water compartments. We investigated cross-sectionally 612 adult subjects, classified into 10 groups according to sex and disease (control, obese normal glucose tolerant, non-obese type 2 diabetes, obese type 2 diabetes, type 1 diabetes). Resistance (R), reactance (Xc) and phase angle (PA) were measured (800 μA – 50 kHz alternating current). The bioelectrical vector was obtained by plotting R and Xc normalized for height (ht), it is easily identified on the basis of the length (inversely related to the total body water, likewise R) and direction, given by the PA (inversely related to the extra-/intra-cellular water – ECW/ICW –). Results show that disease and sex had a significant (ANOVA: P〈0.0001 for both F disease and F sex) and independent effect on both R/ht and Xc/ht; no difference was found between type 2 and type 1 diabetic groups. A bioelectrical vector with a lower PA characterized both type 2 and type 1 diabetic groups. An independent positive correlation between fasting plasma glucose and R/ht and a negative correlation between fasting plasma glucose and PA were observed. These findings suggest a non-different body water content and distribution between type 2 and type 1 diabetic subjects; the bioelectrical vector indicates a higher ECW/ICW in type 2 and type 1 diabetic compared to non-diabetic subjects.
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  • 47
    ISSN: 1432-0878
    Schlagwort(e): Key words Adrenomedullin ; Pancreas ; Development ; Immunocytochemistry ; Colocalizations ; Rat (Sprague Dawley)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract  Adrenomedullin is an α-amidated 52-amino acid peptide involved in many physiological actions, among others the regulation of insulin secretion. Using immunohistochemical methods, we found that adrenomedullin immunoreactivity first appears at day 11.5 of embryonic development in the rat, coinciding with the appearance of pancreatic glucagon. The early appearance of adrenomedullin in the developing pancreas may indicate an active involvement in either the morphogenesis of the organ or its endocrine/paracrine/autocrine hormone regulation during intrauterine life. We also investigated the pattern of colocalizations of adrenomedullin with the other pancreatic hormones. At some point during development all the cell types express adrenomedullin, progressively evolving towards the adult pattern where only the pancreatic polypeptide cells contain a strong immunoreactivity for adrenomedullin. At this point the remaining cells of the islet are, in general, weakly stained. This sequential and time-dependent expression of adrenomedullin suggests a tight regulation similar to that observed for other modulatory substances responsible for embryonic morphogenesis.
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  • 48
    Digitale Medien
    Digitale Medien
    Springer
    Cell & tissue research 291 (1998), S. 277-283 
    ISSN: 1432-0878
    Schlagwort(e): Key words Diurnal pattern ; Pancreas ; Acinar cell replication ; Cholecystokinin (CCK) ; Proliferating cell nuclear antigen (PCNA) ; 5-Bromodeoxyuridine (BrdU) ; Rat (Wistar)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract  Fully differentiated pancreatic acinar cells can enter the cell cycle under appropriate conditions in the rat. The aim of this study was to analyse the diurnal pattern of acinar cell proliferation as a function of food intake and the release of cholecystokinin (CCK), because the peptide hormone CCK is a major physiological regulator of rat pancreatic acinar cell replication. Pancreatic acinar cell replication was quantitated using an antibody against the S-phase marker proliferating cell nuclear antigen (PCNA). In addition, acinar cells in S-phase were detected after injecting bromodeoxyuridine (BrdU) and subsequent immunohistochemical staining of BrdU-positive nuclei. Rat pancreata were analysed during the day under standard diet conditions, as well as after various schedules of fasting and refeeding and after the application of the CCK receptor antagonist L-364,718. Between 6 a.m. and 6 p.m., the PCNA labeling index was 4.4±0.9%, while between 9 p.m. and 3 a.m. the PCNA labeling index was elevated and reached peak values of 11.4% (mean value: 7.8±2.5%) around midnight. BrdU-positive cells also doubled around midnight, compared to the 9:00 a.m. value. In fasted rats, acinar cell proliferation was completely suppressed and this suppression could be overcome by injection of the CCK analog cerulein. In addition, the CCK antagonist L-364,718 led to the same results as fasting. Here we show for the first time that there is a diurnal pattern of pancreatic acinar cell proliferation in rats, which is dependent on food intake and is mediated by CCK.
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  • 49
    Digitale Medien
    Digitale Medien
    Springer
    Cell & tissue research 294 (1998), S. 227-231 
    ISSN: 1432-0878
    Schlagwort(e): Key words ChAT ; DβH ; NADPH-d ; Colocalization ; Pancreas ; Innervation ; Guinea pig
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract Choline acetyltransferase (ChAT) as a rate-limiting enzyme in the biosynthetic pathway of acetylcholine is thought to be present in all cholinergic neurons. However, its immunoreactivity has not been successfully applied to the study of cholinergic neurons in the pancreas. In a previous study in the pancreas of newborn guinea pig we reported the colocalization of nicotinamide adenine dinucleotide hydrogen phosphate-diaphorase (NADPH-d), a marker for nitric oxide synthase (NOS) with various neuropeptides as well as dopamine-β-hydroxylase (DβH), the enzyme responsible for converting dopamine to noradrenaline. Whether NADPH-d is colocalized with ChAT in the pancreatic neurons is not known. Also it would be interesting to find out whether noradrenaline and acetylcholine could be colocalized in the same pancreatic neurons. In the present study, a method for triple labelling of ChAT, DβH and NADPH-d was used to answer the above questions. Colocalization of ChAT, DβH and NADPH-d was constantly demonstrated in the same neurons in the same sections. It is concluded that some of the pancreatic neurons may utilize more than one neurotransmitter such as nitric oxide (NO), acetylcholine and noradrenaline to achieve their function. The possible cotransmission of acetylcholine and noradrenaline was extremely intriguing, and its mechanism and significance needs to be further investigated.
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  • 50
    Digitale Medien
    Digitale Medien
    Springer
    European journal of nuclear medicine 25 (1998), S. 259-264 
    ISSN: 1619-7089
    Schlagwort(e): Key words: 2-Deoxy-2-[fluorine-18]fluoro-d-glucose ; Pancreas ; Pancreatitis ; InflammationIntroduction
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Focal 2-deoxy-2-[fluorine-18]fluoro-d-glucose (FDG) uptake on positron emission tomography (PET) in a pancreatic mass has been reported as a specific finding for pancreatic carcinoma. Inflammatory conditions of the pancreas and associated clinical circumstances yielding similar findings have not yet been fully defined. Among 42 patients studied by attenuation-corrected FDG PET for pancreatic disease, 12 with focal FDG uptake in the pancreas were identified as having no underlying neoplasm based on surgical findings, biopsy results, and long term clinical and imaging follow up. Focal FDG accumulation in the pancreas with standardized uptake values ranging from 3.4 to 11.2 on FDG PET was ultimately found to be related to inflammation rather than neoplasm. This occurred in pancreatic masses in which clinical and laboratory evidence of acute pancreatitis was equivocal or entirely lacking, as well as in the setting of acute pancreatitis and after recovery from acute pancreatitis. Inflammation can give rise to focal FDG uptake in the same intensity range as pancreatic neoplasm, even when clinical, laboratory and computed tomographic findings suggestive of an inflammatory etiology are equivocal or absent.
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  • 51
    Digitale Medien
    Digitale Medien
    Springer
    International journal of anthropology 13 (1998), S. 117-128 
    ISSN: 1824-3096
    Schlagwort(e): Obesity ; systolic blood pressure ; diastolic blood pressure ; body composition ; anthropometry ; impedance
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie
    Notizen: Abstract Estimates of relationships between blood pressures and anthropometric structure or body composition were made on a total sample of 414 children, taking age and sex into account. A subsample of 250 children was formed from obese (or slightly obese) subjects. A different pattern in anthropometric structure and body composition resulted in relation to a different degree of obesity. A canonical correlation analysis was carried out for each sex, in which a multivariate measure of the linear association between heart-circulatory functionality parameters, on the one hand, and all the anthropometric traits and body composition parameters, on the other, was computed. This association resulted statistically significant in both sexes, also if a difference was observed as concerns the traits that most heavily contributed to the relation-ships between sets of variables, with an evident sexual dimorphism also in infancy. The necessity of preventive measures and sanitary screening also during infancy was pointed out.
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  • 52
    ISSN: 1439-6327
    Schlagwort(e): Key words Exercise ; Obesity ; Lipoproteins ; Glucose tolerance
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We characterized the effect of ten days of training on lipid metabolism in 6 [age 37.2 (2.3) years] sedentary, obese [BMI 34.4 (3.0) kg · m−2] males with normal glucose tolerance. An oral glucose tolerance test was performed prior to and at the end of the 10 d of training period. The duration of each daily exercise session was 40 min at an intensity equivalent to ˜75% of the age predicted maximum heart rate. Blood measurements were performed after an overnight fast, before and at the end of the 10 d period. Plasma triacylglycerol was significantly (p 〈 0.05) reduced following exercise training (2.15 ± 0.29 vs. 1.55 ± 0.28 mmol · l−1). Very low density lipoprotein-triacylglycerol was also significantly (p 〈 0.05) reduced (1.82 ± 0.3 vs. 1.29 ± 0.29 mmol · l−1). No significant changes in high density lipoprotein-cholesterol were observed as a result of training. Following training fasting plasma glucose and fasting plasma insulin were significantly reduced [Glucose: 5.9 (0.2) mmol · l−1 vs. 5.3 (0.22) mmol · l−1 (p 〈 0.05); Insulin 264.3 (53.8) ρ · mol · l−1 vs. 200.9 (30.1) ρ · mol · l−1, p = 0.05]. The total area under the glucose curve during the OGTT decreased significantly (p 〈 0.05). These preliminary data suggest that short-term exercise, without concomitant loss of body mass, induces favorable changes in plasma triacylglycerol, and very low density lipoprotein-triacylglycerol and glucose tolerance but has no effect on high density lipoproteincholesterol.
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  • 53
    ISSN: 1573-7284
    Schlagwort(e): High lipids ; Hypertension ; Obesity ; Prevalence ; Region
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: the study was set up to explore regional disparities in France in the annual prevalence of cardiovascular risk factors (hypertension, high lipids, obesity, diabetes and tobacco consumption) and protective factors (alcohol intake) in members of the GAZEL Cohort and to determine which, if any, risk factors followed the same north-south gradient as the one known for cardiovascular mortality. Methods: the population studied comprised 18,070 subjects aged from 35 to 50 years, employed by the French national gas and electricity company. Every year from 1989 to 1993 they received a self-administered questionnaire by mail. From the replies, differences in risk factor prevalence were evaluated by an odds ratio adjusted for sex and age, using a marginal model. Results: a regional effect was found (p 〈 0.001) for arterial hypertension, with high odds ratios in northern France and low ratios in the south east, for high lipids, with high odds ratios in Champagne, the Loire region and Upper Normandy and low ratios in the south east and the Paris area, and for obesity, with high odds ratios in the north and north east and low ratios in the south, south east and west. Conclusion: these results show a gradient between the north and south east for hypertension, obesity, and to a lesser degree high lipids. This gradient corresponds to the known regional disparities for cardiovascular mortality.
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  • 54
    ISSN: 1573-7284
    Schlagwort(e): Alcohol ; Cholesterol ; High density lipoprotein ; Obesity ; Occupational health ; Physical activity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We studied some life-style characteristics that may predict changes in total serum cholesterol and cholesterol bound to high density lipoproteins (HDL-cholesterol) in a sample of 980 healthy Spanish employees of both sexes who were followed for three years. All workers participated in a multifactorial program aimed at preventing cardiovascular disease. Linear regression models were fitted with changes in total and HDL-cholesterol as the dependent variables, after eliminating variability due to the influence of basal values. The association between lifestyle factors and lipid changes was controlled for dietary modifications. In the multivariate analysis, decreases in body mass index, and in alcohol consumption were associated with significant reductions in total serum cholesterol. Maintaining sports at post-test or starting to practice them in the interim was also significantly and independently associated with favourable changes in serum cholesterol. Leisure-time exercise (p=0.002) and giving up smoking (p = 0.06) were each associated with increased HDL-cholesterol.
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  • 55
    Digitale Medien
    Digitale Medien
    Springer
    Plant foods for human nutrition 53 (1998), S. 15-28 
    ISSN: 1573-9104
    Schlagwort(e): Cholesterol ; Diabetes ; Glucose ; Guar gum ; Low-density-lipoprotein ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Land- und Forstwirtschaft, Gartenbau, Fischereiwirtschaft, Hauswirtschaft
    Notizen: Abstract The effects of guar gum derived from the endosperm of Cyamopsis tetragonoloba (75% soluble fiber, 7.6% insoluble fiber, 2.16% crude protein, 0.78% total lipids, 0.54% ash and 9.55% moisture) on food intake, levels of blood serum cholesterol, triacylglycerols, glucose and LDL and HDL-cholesterol were studied. The effects of guar gum on indices of protein absorption and utilization were also investigated. Diets containing 0%, 10% and 20% (w/w) guar gum or 10% and 20% cellulose powder (reference) were fed to normal rats for 60 days. The rats fed the guar gum diets showed significantly (p ≤ 0.05) lower levels of blood serum cholesterol, triacylglycerols, reduced food intake and body weight gain. Furthermore, a concomitant increase in HDL-cholesterol with a substantial elevation of the HDL/LDL cholesterol ratio were noted. Guar gum decreased blood serum glucose only during the first month of the experiment, and no changes in the indices of protein absorption and utilization were found. The guar gum caused a 10% increase in the small intestine length and a 25% retardation in the intestinal transit. The results of this research suggested that guar gum could potentially be effective in the treatment of hypercholesterolemia and obesity in humans.
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  • 56
    ISSN: 1573-7284
    Schlagwort(e): BMI ; Height ; Increase ; Obesity ; Prevalence ; Secular trends ; Weight
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: To examine the secular trend of weight, height and obesity among young Portuguese males at the time of military inspection for national conscription purposes in the region of Lisbon, during the last thirty years. Design: Cross-sectional study, based on the review of military census files. Setting: Military selection centre of Lisbon. Subjects and methods: In Portugal, military service is obligatory and medical inspections are carried out every year on males at the age of twenty. For study purposes, representative samples were taken from the young male population undergoing inspection for the Armed Forces on a five year basis, between 1960 and 1990 in the region of Lisbon. Weight and height were evaluated by a trained team, using standard measurement instruments and procedures. Results: A progressive and significant increase in weight, height and BMI of the young male population was found between 1960 and 1990. For certain variables the increase was also statistically significant within a five-year period, as it was the case for height between 1965–1980 and for weight between 1985–1990. The increase in BMI experienced some minor fluctuation along the reference period, however, it was statistically significant between 1985–1990. The increase in weight and in BMI was greater in the highest percentiles and particularly noticeable between 1985 and 1990. The percentage of young males with BMI over 25 kg/m2 was of 8.1% in 1960 and of 18.0% in 1990, while those having a BMI over 27 kg/m2 varied between 3.6% and 6.4% in the same period, respectively. The percentage of young adult males with BMI higher than 25 kg/m2 doubled between 1960 and 1990.
    Materialart: Digitale Medien
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  • 57
    ISSN: 1435-2451
    Schlagwort(e): Key words Cystic tumours ; Pancreas ; Treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Cystic neoplasms of the pancreas account for only 1% of primary pancreatic lesions. However, patients with these tumors are diagnosed more frequently. Up to now, nonsurgical management is still the established form of treatment of benign cystic tumours of the pancreas. Methods: Between 1987 and 1996 we treated 51 patients with serous and mucinous cystadenoma and their malignant counterparts, serous and mucinous cystadenocarcinoma. Results: Eighty-five percent of the patients presented symptoms. Computed tomography and endoscopic cholangiopancreatography (ERCP) were the most sensitive diagnostic techniques; however, in three patients with serous cystadenoma and in one patient with serous cystadenocarcinoma, ERCP findings were completely normal. The tumour was resected in all but one patient. There was no perioperative mortality. After dismissal from the hospital, all patients in whom benign tumours had been resected are still alive; however, the late mortality of mucinous cystadenocarcinoma was 36% after a median follow-up of 6 years. Conclusion: Surgical resection is recommended in all cystic tumours, even in serous cystic tumours, because symptoms may develop and malignant transformation to serous cystadenocarcinoma is possible.
    Materialart: Digitale Medien
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  • 58
    ISSN: 1435-2451
    Schlagwort(e): Key words Nitric oxide synthase ; Endothelium ; Tumor biology ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Cellular nitric oxide (NO) synthesis determines whether NO has cytoprotective or cytotoxic effects at anatomic sites; thus it is important to identify potential NO synthase isoforms in tumor tissue and tumor cell lines which might be involved in tumor development or destruction. Incubation of human pancreatic adenocarcinoma cell lines (AsPc-1, BxPc-3, CaPan-2) with cytokines resulted in increased NO formation, indicating the existence of the NOS2 isoform. This was confirmed by reverse transcriptase–polymerase chain reaction (RT-PCR) and western blot analysis. Furthermore, we identified the presence of the endothelium-derived NOS isoform 3 by RT-PCR analysis and immunohistochemistry in normal and pancreatic tumor biopsies. NOS3 was markedly overexpressed in the vasculature of the tumor tissue. RT-PCR analysis of tumor biopsies identified NOS isoform 2 mRNA in 60% of cases, but western blot analysis or immunohistochemistry scored negative for this isoform. It is noteworthy that the NOS enzyme activity in pancreatic tumor cell lines and tumor biopsies was inhibited by EGTA by approximately 30% and 65%, respectively. Our results suggest that increased endothelium-derived NOS isoform 3 expression in pancreatic adenocarcinomas regulates blood flow and is therefore involved in the vascularization and neovascularization of human pancreatic tumors.
    Materialart: Digitale Medien
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  • 59
    Digitale Medien
    Digitale Medien
    Springer
    Journal of human genetics 43 (1998), S. 278-279 
    ISSN: 1435-232X
    Schlagwort(e): Key words Tumor necrosis factor ; Dinucleotide repeat rheumatoid arthritis ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract Tumor necrosis factor alpha (TNFα) in activated monocytes exerts cytotoxic activity and has a variety of other biological effects. We isolated a polymorphic dinucleotide (CA) repeat sequence from a genomic clone containing the gene located at 6p21.3. High heterozygosity (0.80) makes this polymorphism a useful marker in the genetic study of disorders affecting immunological response and cell differentiation.
    Materialart: Digitale Medien
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  • 60
    ISSN: 1860-1499
    Schlagwort(e): Pancreas ; Peripheral nerve ; Cancer ; Ultrastructure
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Nerve invasion is one of the biological features of pancreatic cancer, and its mechanism remains to be determined. In this paper, we report on 37 pancreatic cancer specimens observed by immunohistochemical and electron microscopical techniques. The results showed that pancreatic cancer directly invaded and destroyed the perineurium. At the early stage of disease, the peripheral nerve and synaptic membrane were easily destroyed by cancer cells, and invasion and metastasis continuously advanced along the perineural space and central side of nerves. These results suggest that the soft tissue and nerve plexus on the dorsal region of the pancreas may contribute to the recurrence of pancreatic cancer after duodenopancreatectomy.
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  • 61
    ISSN: 1534-4681
    Schlagwort(e): Adenocarcinoma ; Pancreas ; Resection ; CA 19-9 ; Prognosis ; Recurrence
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: CA 19-9 levels are useful for the diagnosis of patients with pancreatic adenocarcinoma. However, interest has recently turned toward its use as a prognostic indicator. The purpose of this study is to determine whether postoperative CA 19-9 levels predict disease-free survival (DFS) and median survival (MS) in patients after resection. Methods: Between 1988 and 1996, 40 patients underwent resection for pancreatic adenocarcinoma and were evaluated with postoperative CA 19-9 assays. Eight patients had low preoperative levels of CA 19-9 (〈2) and were excluded. Results: CA 19-9 levels are good predictors of DFS and MS. Patients whose postoperative CA 19-9 values normalized by 3 to 6 months (〈37 U/ml) had longer DFS (24 vs. 10 months,p〈0.04) and MS (34 vs. 13 months,p〈0.04). Patients with postoperative CA 19-9 values less than 180 U/ml at 1 to 3 months had a similar DFS (19 vs. 5 months,p〈0.0009) and MS (34 vs. 13 months,p〈0.0001) compared to patients with normal values at 3 to 6 months. Conclusions: Postoperative measurements of CA 19-9 were the best predictors of DFS and MS. Values〈180 U/ml at 3 months were as predictive as normal values by 3 to 6 months postoperatively. Consequently, CA 19-9 levels should be obtained for use as a stratification parameter in phase III trials.
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  • 62
    Digitale Medien
    Digitale Medien
    Springer
    Surgical and radiologic anatomy 19 (1997), S. 409-411 
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Splenic artery ; Pancreatic ducts ; Developmental anatomy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Résumé Sur le cadavre d'un homme de 47 ans, l'artère splénique présentait un trajet partiel à travers le pancréas. De plus, le pancréas paraissait volumineux et avait une forme inhabituelle, il n'était pas possible de différencier le col du pancréas, le processus uncinatus était absent, il y avait deux conduits pancréatiques. La raison probable de ces variations multiples se trouverait dans la fusion anormale des bourgeons pancréatiques dorsal et ventral en raison de leurs niveaux d'origine différents.
    Notizen: Summary In a 47-year-old male cadaver the splenic artery traveled partially through the substance of the pancreas. Additionally, the pancreas was apparently large and had an unusual shape; the neck of the organ could not be differentiated; the uncinate processus was absent; two pancreatic ducts were present. The probable reason for this combined anomaly was abnormal fusion of the ventral and dorsal pancreatic buds due to different levels of origin.
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  • 63
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Arteries ; Blood supply ; Angiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Résumé Le présent article est la quatrième partie d'un étude d'ensemble de la circulation artérielle du pancréas et complète l'étude d'ensemble de la vascularisation artérielle de la tête du pancréas par celle des aa. pancréatico-duodénales antérieure et inférieure, et postérieure et inférieure, et avec quelques sources vasculaires plus mineures n'appartenant pas au classique système des arcades pancréatico-duodénales. L'objet de cette étude d'ensemble est de résumer les études anatomiques depuis les publications de Haller et de complèter autant que possible avec un matériel original angiographique les notions anatomiques classiques. Dans ce but, ce travail repose sur l'étude de 1015 angiographies sélectives (tronc cœliaque et ses branches, a. mésentérique supérieure) prisent dans les archives angiographiques des instituts de radiographiques de Sienne, Rome (université catholique) et Pérouse. Sur le plan angiographique, les auteurs ont pu démontrer que l'a. pancréatico-duodénale antérieure et inférieure, présente dans la plupart des cas, naissait de l'a. pancréatico-duodédale inférieure, d'un tronc commun avec l'a. pancréatico-duodénale postérieure et inférieure et la première a. jéjunale, de la première a. jéjunale, ou de l'a. mésentérique supérieure. D'autre part, l'a. pancréatico-duodénale inférieure et postérieure était plus variable et naissait de l'a. pancréatico-duodénale inférieure, d'un tronc commun avec l'a. pancréticoduodénale antérieure et inférieure et la première a. jéjunale, de l'a. mésentérique supérieure, de l'a. pancréatique dorsale, ou de l'a. hépatique accessoire droite d'origine mésentérique supérieure. En outre, des branches pancréatiques mineures pour la tête du pancréas naissent de l'a. gastro-duodénale, de l'a. pancréatique dorsale, de l'a. hépatique commune, et de l'a. phrénique inférieure droite. Les autres origines de l'a. pancrético-duodénale inférieure, précédemment rapportées, mais non détectables angiographiquement, de même que des sources vasculaires mineures pour la tête du pancréas ont été répertoriées. Les auteurs soulignent et discutent des opinions divergentes sur l'incidence des différentes voies de l'a. pancréaticoduodénale inférieure et tentent d'expliquer la variabilité de l'anatomie vasculaire de la tête du pancréas sur la base d'hypothèses embryologiques.
    Notizen: Summary The present article is the fourth part of a comprehensive review of the arterial blood supply of the pancreas and completes the study of the arterial vascularization of the pancreatic head dealing with the anterior inferior and posterior inferior pancreaticoduodenal aa. and with some minor sources of blood supply not involving the classical system of the pancreaticoduodenal arches. The aim of this review is to summarise the anatomical studies, starting from Haller's reports, and to supply, as far as possible with original material, angiographic evidence for the classic anatomical concepts. For this purpose, 1015 selective angiographs (celiac trunk and its branches, superior mesenteric a.) were taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. These demonstrated the anterior inferior pancreaticoduodenal a., present in most instances, as arising from the inferior pancreaticoduodenal a., from a common trunk with the posterior inferior pancreaticoduodenal a. and the 1st jejunal a., from the 1st jejunal a. or from the superior mesenteric a.; on the other hand, the posterior inferior pancreaticoduodenal a. was more variable, originating from the inferior pancreaticoduodenal a., from a common trunk with the anterior inferior pancreaticoduodenal a. and the 1st jejunal a., from the superior mesenteric a., from the dorsal pancreatic a., or from a right accessory hepatic a. coming from the superior mesenteric a. In addition, minor branches to the head of the pancreas arose from the gastroduodenal a., the dorsal pancreatic a., the common hepatic a. and the inferior right phrenic a. Other origins of the inferior pancreaticoduodenal aa. previously reported, but not angiographically detectable with certainty, as well as further minor sources of blood supply to the head of the pancreas, have been listed. The differing opinions regarding the incidence of the various ways the inferior pancreaticoduodenal aa. arise are discussed and an attempt is made to explain the variability of the vascular anatomy of the pancreatic head on embryologic grounds.
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  • 64
    Digitale Medien
    Digitale Medien
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 355 (1997), S. 631-637 
    ISSN: 1432-1912
    Schlagwort(e): Key words Acinar cell ; Amylase ; Calcium ; Carbamyl choline ; Cholecystokinin ; Cholecystokinin-JMV-180 ; Pancreas ; Pilocarpine ; Receptor
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The release of amylase and the elevation of cytoplasmic Ca2+ concentration ([Ca2+]i) in response to cholecystokinin-octapeptide (CCK-8), the cholecystokinin analogue JMV-180, the stable choline ester carbamylcholine (carbachol) and the muscarinic agonist pilocarpine were studied in guinea-pig pancreatic acinar cells. The maximal amylase and [Ca2+]i responses to JMV-180 and pilocarpine were 12-15% of the corresponding responses to CCK-8 and carbachol. The amylase and [Ca2+]i responses to maximal concentrations of CCK-8 and carbachol were inhibited in concentration-dependent manners by JMV-180 and pilocarpine, respectively. In individual acinar cells, JMV-180 and pilocarpine like low concentrations of CCK-8 and carbachol caused oscillations of [Ca2+]i. The sustained [Ca2+]i responses to maximal concentrations of CCK-8 and carbachol were transformed into oscillatory responses during simultaneous exposure to JMV-180 and pilocarpine, respectively. Maximal concentrations of JMV-180 and pilocarpine did not cause homologous or heterologous desensitization of the [Ca2+]i responses but inhibited desensitization evoked by maximal concentrations of CCK-8 or carbachol. JMV-180 and pilocarpine acted as weak, partial agonists exhibiting effective inhibition of the acinar cell responses to full agonists. The effects appeared to be best explained by interactions with two forms of the respective receptor with JMV-180 and pilocarpine acting as partial agonists for one state of the receptor and as antagonist for the second state.
    Materialart: Digitale Medien
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  • 65
    ISSN: 1433-2965
    Schlagwort(e): Dieting ; Obesity ; Osteoporosis ; Weight reduction
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The hypothesis that a history of one or more weight reductions and regains (weight cycling) is associated with lower site-specific bone mineral density (BMD) was examined in 169 premenopausal women, aged 29–46 years. Data on the previous 10-years' weight cycling history, present weight-bearing physical exercise, number of deliveries, present use of contraceptive pills or hormone-releasing coils, age at menarche and present menstrual status were collected by a self-administered questionnaire. Dietary intake was calculated from food records. The areal BMD (g/cm2) was measured with dual-energy X-ray absorptiometry (norland XR-26). The lumbar spine (L2–4) BMD, adjusted to weight and age at menarche (ANCOVA), was 0.062 g/cm2 (95% confidence interval: 0.015 to 0.011 g/cm2;p=0.01) higher in the non-cyclers (n=68) than in subjects with reported weight-cycling history (n=101). The corresponding difference for femoral neck BMD was 0.019 g/cm2 (−0.018 to 0.056;p=0.30), for trochanter BMD 0.013 g/cm2 (−0.025 to 0.05 g/cm2;p=0.50) and for distal radius BMD 0.022 g/cm2 (0.006 to 0.397 g/cm2;p=0.008). A pairwise comparison of 34 weight-matched subjects (non-cycler vs cycler) gave similar BMD differences as found in the above (ANCOVA) analyses. The results suggest that weight cycling might be associated with lower spine and distal radius BMD.
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  • 66
    Digitale Medien
    Digitale Medien
    Springer
    Der Chirurg 68 (1997), S. 325-333 
    ISSN: 1433-0385
    Schlagwort(e): Key words: Imaging modalities ; Pancreas ; Carcinoma of the pancreas ; Neuroendocrine tumor ; Surgical significance. ; Schlüsselwörter: Bildgebende Diagnostik ; Pankreas ; Pankreascarcinom ; neuroendokriner Pankreastumor ; chirurgische Relevanz.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Bildgebende Verfahren beeinflussen die chirurgischen Entscheidungswege bei Patienten mit einem Tumor im Bereich des Pankreas auf verschiedenen Ebenen. Im Vordergrund steht dabei zunächst die Frage nach der Existenz und Lokalisation eines Tumors ganz generell. Bei gesichertem Tumor müssen anschließend mittels eines exakten Staging die Möglichkeiten eines operativen Eingriffs abgeklärt werden. Bildgebende Verfahren sind auch für die im Einzelfall notwendige, diagnostische Punktion notwendig, falls für die chirurgische Entscheidungsfindung eine histologische Diagnose des Befundes erforderlich erscheint. Schließlich werden bildgebende Verfahren auch bei der interventionellen palliativen Therapie eines durch einen Pankreastumor hervorgerufenen, obstruktiven Ikterus eingesetzt. Eine sinnvolle und effiziente Auswahl aus den vielen, derzeit zur Verfügung stehenden, bildgebenden Verfahren kann nur erfolgen, wenn die chirurgische Fragestellung zuvor klar definiert ist. Dabei muß immer berücksichtigt werden, ob es sich um einen Tumor des exokrinen oder einen des endokrinen Pankreas handelt.
    Notizen: Summary. Imaging of tumors of the pancreas may have a series of significant implications for surgical decision making. First of all verification and localization of a suspected tumor is crucial. Later on, accurate staging of local tumor extent and of distant metastases is necessary for evaluating the indications for surgical intervention. If histologic proof of malignancy of a pancreatic lesion is needed, different imaging techniques can be used for percutaneous biopsy of the tumor. Finally imaging is required in patients with a pancreatic tumor if an obstruction of the common bile duct is treated with palliative intent by endoscopy or transhepatic intervention. A rational and efficient selection from all the imaging techniques currently available requires a clear-cut definition of what is needed for surgical decision making in each individual case. Thereby one has to take into account whether the tumor arises from the exocrine or from the endocrine tissue of the pancreas.
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  • 67
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 13 (1997), S. 52-54 
    ISSN: 1437-9813
    Schlagwort(e): Key words Inflammatory pseudotumour ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We describe a rare case of pancreatic inflammatory pseudotumour that clinically presented as a malignant tumour in an 11-year-old boy. We also review all six previously described cases, including three that occurred in children. Complete surgical removal is regarded as the best choice of therapy, and follow-up in our case showed no evidence of disease after 3 years. It is important to be aware of this lesion, since it can be confused with a malignant tumour both radiologically and clinically.
    Materialart: Digitale Medien
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  • 68
    ISSN: 1279-8517
    Schlagwort(e): Pancreas ; Arteries ; Blood supply ; Angiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The present article is the fourth part of a comprehensive review of the arterial blood supply of the pancreas and completes the study of the arterial vascularization of the pancreatic head dealing with the anterior inferior and posterior inferior pancreaticoduodenal aa. and with some minor sources of blood supply not involving the classical system of the pancreaticoduodenal arches. The aim of this review is to summarise the anatomical studies, starting from Haller’s reports, and to supply, as far as possible with original material, angiographic evidence for the classic anatomical concepts. For this purpose, 1015 selective angiographs (celiac trunk and its branches, superior mesenteric a.) were taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. These demonstrated the anterior inferior pancreaticoduodenal a., present in most instances, as arising from the inferior pancreaticoduodenal a., from a common trunk with the posterior inferior pancreaticoduodenal a. and the 1st jejunal a., from the 1st jejunal a. or from the superior mesenteric a.; on the other hand, the posterior inferior pancreaticoduodenal a. was more variable, originating from the inferior pancreaticoduodenal a., from a common trunk with the anterior inferior pancreaticoduodenal a. and the 1st jejunal a., from the superior mesenteric a., from the dorsal pancreatic a., or from a right accessory hepatic a. coming from the superior mesenteric a. In addition, minor branches to the head of the pancreas arose from the gastroduodenal a., the dorsal pancreatic a., the common hepatic a. and the inferior right phrenic a. Other origins of the inferior pancreaticoduodenal aa. previously reported, but not angiographically detectable with certainty, as well as further minor sources of blood supply to the head of the pancreas, have been listed. The differing opinions regarding the incidence of the various ways the inferior pancreaticoduodenal aa. arise are discussed and an attempt is made to explain the variability of the vascular anatomy of the pancreatic head on embryologic grounds.
    Materialart: Digitale Medien
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  • 69
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 7 (1997), S. 241-245 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Pancreas ; Neoplasms ; Pancreas ; Computed Tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. We report the CT appearance of pancreatic metastases and describe their features in relation to the originating primary tumor. We also discuss some limitations in their differential diagnosis and report some theories explaining the pathogenesis of their occurrence. A total of 20 cases (9 males and 11 females) of pancreatic metastases were diagnosed at staging or follow-up of oncologic patients. All patients were evaluated with CT before and after contrast medium administration and had subsequent pathologic confirmation. In 1 case metastases were located solely in the pancreas; in 6 there was only another metastatic location, and in the remaining 13 there was diffuse spread throughout the body. Two of our patients exhibited a multinodular metastatic involvement of the pancreas, 11 had a solitary nodule or mass, and the remaining 7 had a diffusely enlarged pancreas, without any signs of focal disease. All but one of the solitary lesions measured more than 4 cm. In 2 cases a metachronous malignancy was detected at follow-up. Primary malignancies were located: 6 in the lungs, 2 on the skin (melanomas), 3 in breasts, 2 in the ovaries, 3 in the colon, 1 in the stomach, 2 in the kidney, and 1 the thyroid. Our findings confirm the existence of three patterns of metastatization to the pancreas: large solitary masses, multinodular lesions, and diffuse enlargement of the pancreas without focal signs at CT. In contrast to other studies, the large solitary lesion was our most frequent encounter, therefore making differential diagnosis vs primary cancer difficult. Metastases tended to repeat the imaging pattern of the primary. Nevertheless, we wrongly diagnosed pancreatitis due to a small nondetected metastasis, pseudo-cystic mass as a mucinous cystadenocarcinoma, conglomerate of peripancreatic lymph nodes, and a solitary pancreatic mass diagnosed as primary pancreatic cancer. Thus, when faced with a solitary pancreatic lesion at follow-up, histologic diagnosis is strongly recommended. In 2 cases changes in aspect and size were related to therapy.
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  • 70
    ISSN: 1432-1084
    Schlagwort(e): Key words: Iopentol ; Diatrizoate ; Contrast media ; ERCP ; Adverse events ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary. The efficacy and safety of the non-ionic contrast medium iopentol, 250 mg I/ml (Imagopaque®, Nycomed Imaging AS, Oslo, Norway) were evaluated and compared to those of the ionic contrast medium diatrizoate 219 mg I/ml (Urografin®, Schering AG, Berlin, Germany). The trial was carried out as a randomized, double-blind comparative two-group study. One hundred and sixteen patients completed the study: 59 received iopentol and 57 received diatrizoate, the contrast medium used according to routine hospital procedure for ERCP. Demographic data and details of the ERCP procedure were comparable for the two contrast medium groups. Safety was assessed by monitoring serum pancreatic iso-amylase and by recording adverse events. Efficacy was evaluated through assessment of the diagnostic information and the quality of radiographs. Twenty-one of the patients receiving iopentol and 27 of the patients receiving diatrizoate reported adverse events during the ERCP procedure. Pain was the kind of procedure-related event most frequently reported. Three patients experienced serious adverse events with a fatal outcome 2, 10 and 12 days after the ERCP procedure, respectively. The principal investigator concluded for all three serious adverse events that any causal relationship with the contrast medium injected was unlikely. A mean change in serum pancreatic iso-amylase after contrast medium injection was noted in both contrast medium groups. However, statistical analysis did not show any significant difference between mean changes for the two groups. The efficacy results, both in terms of diagnostic information and quality of radiographic visualisation, were comparable for the two contrast media. In conclusion, the study did not show any statistically significant differences between the two contrast media as regards safety or efficacy in ERCP.
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  • 71
    ISSN: 1432-1939
    Schlagwort(e): Key words Procellariiformes ; Nutrition ; Obesity ; Chick growth ; Life history
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie
    Notizen: Abstract Procellariiform seabirds such as short-tailed shearwaters Puffinus tenuirostris accumulate large quantities of lipid during the nestling period. The functional significance of this pattern of development remains unclear, but has been related both to temporal variation in feeding conditions around the colony and to stochastic variation in the foraging success of individual parents. This paper examines temporal and age-specific variation in the pattern of food delivery to nestling short-tailed shearwaters, which have one of the lowest provisioning rates of any procellariiforms and are known to experience occasional long intervals between feeds. We assess whether variation in the provisioning rates of chicks was associated primarily with temporal variation in food delivery at the level of the colony or with stochastic variation in food delivery at the level of the individual. We then discuss this variability in the context of nestling obesity. For all but the youngest chick age-classes, individual meals delivered by adults averaged 141 g, which was 25% of adult body mass. The proportion of chicks fed each night was low (49%) and highly variable (coefficient of variation = 82%), which means that occasional long intervals between feeds would be expected to arise simply by chance. In keeping with this, intervals between feeding events for individual chicks followed a negative exponential distribution with a mean of 2 nights and a maximum interval of 13 nights. There was significant temporal variation in food delivery, but deviations from expected values for both feeding frequency and meal size were restricted to a small number of nights, included values both higher and lower than expected and did not persist for more than 2 nights in succession. These data suggest that even among those species with very low feeding frequencies and occasional long intervals between feeds, nestling obesity in Procellariiformes should be regarded as a response to chronic stochastic variability in food delivery at the level of the individual chick rather than as insurance against sporadic temporal variation at the level of the colony.
    Materialart: Digitale Medien
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  • 72
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter MR ; Gadolinium-DTPA ; Niere ; Pankreas ; Angiographie ; Transplantation ; MR-Angiographie ; Key words MR angiography ; Transplant ; Kidney ; Pancreas ; Gadolinium-DTPA enhancement
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Purpose: The assessment of vascular complications by DSA in patients who have undergone kidney and pancreas transplantation is an invasive investigation and has the risk of nephrotoxicity caused by the iodinated contrast agent. The aim of this study was to compare the diagnostic value of noninvasive gadolinium – enhanced MRA with intraoperative and DSA results. Patients and Methods: Eleven MRA investigations were performed in eight patients after kidney and pancreas transplantation. A fast T1-weighted 3D-gradientecho sequence with short TR and TE was used in a dynamic technique including three consecutive data acquisitions after a Gd-DTPA (Magnevist) injection. MRA was compared with intraoperative findings in all patients and with DSA in three patients. Results: In the distal abdominal aorta, the internal and external iliac arteries, the main transplanted arterial vessels, and the arteries after first branching, high signal intensity was found. Assessment of renal and pancreatic parenchyma perfusion was possible in all patients. Venous transplant vessels could be depicted in four patients. Conclusion: Our initial experience with the MRA sequence used shows that this technique may be promising in the assessment of larger arterial transplanted vessels and kidney/pancreas parenchyma perfusion. Improvement of the MRA technique is necessary for transplanted venous vessels.
    Notizen: Zusammenfassung Zielsetzung: Die Abklärung vaskulärer Komplikationen durch die DSA bei Nieren- und Pankreastransplantationen erfordert einen invasiven Eingriff in meist diabetisch vorgeschädigte Gefäße, und die Verwendung jodhaltiger Kontrastmittel kann nephrotoxische Wirkungen zeigen. Es wurde die Wertigkeit der kontrastverstärkten MR-Angiographie in dieser Patientengruppe überprüft. Patienten und Methodik: Es wurden 11 Untersuchungen bei 8 Patienten nach Nieren- und Pankreastransplantation mit einer kontrastverstärkten T1-gewichteten 3D-Gradientenechosequenz mit ultrakurzen Echozeiten durchgeführt. Es wurde eine dynamische Untersuchung mit 3 aufeinanderfolgenden Messungen nach Gd-DTPA (Magnevist®)-Injektion durchgeführt. Die Ergebnisse wurden bei allen Patienten mit dem intraoperativen Befund und bei 3 Patienten mit der DSA verglichen. Ergebnisse: Die distale Aorta abdominalis, die Aa. iliacae sowie die Hauptstämme der transplantierten Gefäße und ihre Äste nach der ersten Aufzweigung konnten kontrastreich dargestellt werden. Die Parenchymperfusion konnte bei allen transplantierten Organen gut beurteilt werden. Die Ergebnisse der MRA korrelierten gut mit dem intraoperativen Befund und mit der DSA. Eine Darstellung der großen venösen transplantierten Gefäße gelang bei 4 Patienten. Schlußfolgerungen: Die ersten Erfahrungen mit der verwendeten MRA-Sequenz zeigen, daß diese Technik ein nichtinvasives Verfahren zur Beurteilung der großen arteriellen Transplantatgefäße und zur Beurteilung der Perfusion von Pankreas- und Nierenparenchym sein kann. Verbesserungen der MRA-Technik sind zur zuverlässigen Darstellung der venösen Gefäße der transplantierten Organe notwendig. Zur Überprüfung der Wertigkeit der MRA bezüglich Stenosen der Transplantatgefäße sind größere Vergleichsstudien notwendig.
    Materialart: Digitale Medien
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  • 73
    ISSN: 1432-1084
    Schlagwort(e): Key words: Acute pancreatitis ; Dynamic magnetic resonance imaging ; Gadolinium ; Pancreas ; MR studies
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Eleven piglets with haemorrhagic necrotizing pancreatitis and nine piglets with oedematous pancreatitis were imaged using a multi-breath-hold TurboFLASH (TR 6.5 ms, TE 3 ms, TI 300 ms, flip angle 8 °, three slices) pre-excited T1-weighted sequence with an IV bolus injection of gadopentetate dimeglumine (Gd-DTPA, 0.3 mmol/kg) as a contrast agent to show dynamic contrast enhancement of the pancreas by MRI. All piglets were imaged according to the same protocol before inducing the disease. Following the IV Gd-DTPA bolus, time-enhancement curve of the pancreas during haemorrhagic necrotizing pancreatitis was significantly lower than during oedematous pancreatitis. The enhancement curves for the healthy piglets and piglets with oedematous pancreatitis did not differ significantly. Each piglet served as its own control. Because the results of this initial study are similar to those obtained with contrast-enhanced CT, we conclude that our results may encourage further clinical trials, and contrast-enhanced dynamic MRI may be an alternative to the established method of CT for diagnosing acute haemorrhagic necrotizing pancreatitis.
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  • 74
    ISSN: 1432-2013
    Schlagwort(e): Key words Acetylcholine ; Acinar cell ; Bombesin ; Calcium ; Cholecystokinin ; JMV-180 ; Pancreas ; Substance P
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Cytoplasmic Ca2+ levels ([Ca2+]i) in guinea-pig pancreatic acinar cells stimulated with acetylcholine (ACh) as well as cholecystokinin octapeptide (CCK-8), its analogue CCK-JMV-180, bombesin and substance P (SP) have been compared by confocal Ca2+ imaging. We found that at intermediate and high concentrations all agonists evoked [Ca2+]i waves emanating from the secretory pole of the cell. The [Ca2+]i gradients evoked by ACh and SP were often unidirectional whereas CCK-8- and bombesin-elicited [Ca2+]i responses consisting of [Ca2+]i waves were normally followed by a secondary phase with reversed [Ca2+]i gradients. At low agonist concentrations the [Ca2+]i responses appeared diffuse or localized to the granular part of the cells. The lag times to the [Ca2+]i rises were shorter in response to ACh and SP than for other peptides. Thus, we found that agonists induced different spatio-temporal patterns of Ca2+ waves in pancreatic acinar cells of the guinea-pig. The reactions evoked by SP and bombesin resembled those evoked by ACh and CCK-8, respectively.
    Materialart: Digitale Medien
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  • 75
    Digitale Medien
    Digitale Medien
    Springer
    Pflügers Archiv 434 (1997), S. 422-428 
    ISSN: 1432-2013
    Schlagwort(e): Key words White fat ; Adipocyte ; Extracellular ATP ; Ion channel ; Exocytosis ; Purinergic receptors ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  We used whole-cell and perforated-patch voltage-clamp methods to study the membrane electrical properties of isolated rat epididymal and inguinal white adipocytes. We examined cells from both Sprague-Dawley and Zucker lean and Zucker obese (fa/fa) rats. A delayed-rectifier potassium current was present and similar in unstimulated white fat cells from all these sources. The potassium current activated rapidly with depolarization positive to about –30 mV and showed slow inactivation. Stimulation with extracellular ATP activated both hyperpolarizing and depolarizing conductances. ATP exposure also increased cell membrane capacitance by an average of 16%, suggesting that ATP activates exocytosis. Exposure to norepinephrine had little electrophysiological effect. We conclude that white adipocytes are very similar to brown adipocytes in their resting electrophysiological profile and in their responses to extracellular ATP.
    Materialart: Digitale Medien
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  • 76
    ISSN: 1432-2013
    Schlagwort(e): Key words Nitric oxide ; cGMP ; Ca2+ entry ; Pancreas
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Nitric oxide (NO) production reportedly regulates guanosine 3′,5′-cyclic monophosphate (cGMP) formation and Ca2+ influx in pancreatic acini. We have investigated the functional roles of the NO/cGMP messenger system in rat pancreatic acini. In dispersed acini, the levels of amylase secretion, cytosolic [Ca2+]([Ca2+]i), NO synthase, and cGMP were measured. The NO synthase inhibitor N G-nitro-L-arginine methyl ester (L-NAME, 0.01–100 μM) had no effect on amylase secretion induced by various concentrations of carbachol, cholecystokinin octapeptide (CCK-8) or the high affinity CCK agonist, JMV-180. Similarly, L-NAME up to 100 μM did not affect the changes in Ca2+ spiking evoked by these secretagogues; nor was Ca2+ entry, refilling or oscillation altered by L-NAME. Sub- and supramaximal concentrations of these secretagogues did not change NO synthase activities compared with basal levels. While sodium nitroprusside (SNP), a NO donor, caused a 9.4-fold increase in cGMP levels compared with basal levels, carbachol, CCK-8 and JMV-180 had no effect. In addition, the guanylate cyclase inhibitor LY 83583 (10 nM to 10 μM) altered neither amylase secretion nor Ca2+ signaling induced by these secretagogues. These findings indicate that the stimulatory action of carbachol or CCK-8 is not mediated by NO or cGMP. To investigate whether cGMP stimulates pancreatic secretion we showed that both SNP and a cell-permeant cGMP analog at 0.1–1 mM stimulated amylase secretion and Ca2+ transients to a level equal to 10–15% and 13–24%, respectively, of those observed with maximal concentrations of secretagogues. The guanylate cyclase activator guanylin (1–10 μM), which increased cGMP levels 2.4-fold compared with basal levels, elicited a small amount of amylase secretion and a small Ca2+ transient. In conclusion, exogenous NO is capable of increasing endogenous cGMP, which results in a modest increase in the [Ca2+]i transient and pancreatic amylase secretion. However, the NO/cGMP system does not appear to be involved significantly in the mediation of Ca2+ signaling and amylase secretion stimulated by carbachol and CCK-8.
    Materialart: Digitale Medien
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  • 77
    Digitale Medien
    Digitale Medien
    Springer
    Psychopharmacology 133 (1997), S. 309-312 
    ISSN: 1432-2072
    Schlagwort(e): Key words mCPP ; 5-HT receptor ; Body weight ; Obesity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We studied the effect of 2 weeks administration of the 5-HT2C receptor agonist, m-chlorophenylpiperazine (mCPP), on appetite and body weight in 18 moderately obese subjects in a double-blind, placebo-controlled trial. mCPP caused a small but significant (0.75 kg) reduction in body weight and in subjective ratings of hunger. Plasma prolactin was significantly elevated by the final dose of mCPP. Our data suggest that during 2 weeks treatment in humans, mCPP may continue to activate brain 5-HT2C receptors, and that this effect is associated with decreases in appetite and body weight.
    Materialart: Digitale Medien
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  • 78
    ISSN: 1432-5233
    Schlagwort(e): Key words Glucagon-like peptide 1 ; Leptin ; Obesity ; C-peptide
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Glucagon-like peptide 1 [7–36 amide] (GLP-1) and the obese gene product (leptin) are thought to be involved in the central regulation of feeding. Both may act from the peripheral circulation to influence brain function. To study potential interactions, GLP-1 ([7–36 amide]: 0.4, 0.8 pmol kg–1 min–1 or placebo on separate occasions) was infused intravenously (from –30 to 240 min) into nine healthy volunteers [age 26±3 years, body mass index: 22.9±1.6 kg/m2, glycated haemoglobin HbA1c: 5.0%± 0.2% (normal: 4.0%–6.2%), creatinine: 1.1±0.1 mg/dl], and (at 0 min) a liquid test meal (50 g sucrose in 400 ml 8% amino acid, total amino acids 80 g/l) was administered via a nasogastric tube. Plasma leptin (radioimmunoassay, RIA), glucose, insulin (microparticle enzyme immunoassay), C-peptide (enzyme-linked immunosorbent assay) and GLP-1 (RIA) were measured, and statistical analysis was done with repeated-measures ANOVA and Student's t-test. Plasma leptin concentrations were 31±6 pmol/l in the basal state. They did not change within 240 min after meal ingestion nor in response to the infusion of exogenous GLP-1 [7–36 amide] (P=0.99 for the interaction of experiment and time) leading to GLP-1 mean plasma levels of 25±2 and 36±3 (basal 6±1) pmol/l. On the other hand, glucose (from basal 4.7±0.1 to 6.0±0.2 mmol/l at 15 min, P〈0.05) and insulin (from basal 28±2 to 325±78 pmol/l at 45 min, P〈0.05) increased clearly after the meal with placebo. In conclusion, (1) plasma leptin levels in normal human subjects show no short-term changes after feeding a liquid mixed meal and (2) do not appear to be directly influenced by physiological and pharmacological elevations in plasma GLP-1 [7–36 amide] concentrations. This does not exclude interactions at the cerebral (hypothalamic) level or on more long-term temporal scales.
    Materialart: Digitale Medien
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  • 79
    ISSN: 1432-5233
    Schlagwort(e): Key words Exercise ; Obesity ; Counterregulatory hormones ; Insulin resistance ; Energy expenditure
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A reduction of postprandial thermogenesis has been described in obesity; insulin resistance and/or decreased sympathetic nervous system activity seem to play the major role in its pathogenesis. On the other hand, a normal energy expenditure during exercise has been reported. At present, the response and the role of catecholamines in energy metabolism during exercise in obesity have not been well clarified yet. The aim of this work was to study the metabolic and hormonal changes caused by intense exercise in obesity. Nine obese subjects and ten normal weight controls were submitted to exhaustive exercise on a cycloergometer. Blood glucose, free fatty acids (FFA), glycerol, lactate, β-OH-butyrate, insulin, glucagon, plasma growth hormone (HGH), catecholamine plasma levels were assayed before and at the end of exercise, and after a recovery period. The energy cost of exercise was evaluated by indirect calorimetry. In our experiment muscular exercise did not provoke any change in blood glucose and FFA plasma levels in either of our groups. In the obese subjects the insulin plasma levels were higher than in the controls. Glucagon plasma levels did not change. The exercise responses of norepinephrine (NE) (4.28±0.74 vs 8.81±1.35 nmol/l; P〈0.01), epinephrine (E) (234.21±64.18 vs 560.51±83.38 pmol/l; P〈0.01) and plasma growth hormone (HGH) (134.84±58.97 vs 825.92±195.25 pmol/l; P〈0.01) were significantly lower in obese subjects. At the end of exercise, the thermic effect of exercise did not differ between obese and control subjects (0.335±0.038 vs 0.425±0.040 kJ/min×kg fat-free mass. Our findings indicate that an impaired counterregulatory hormone response to exercise exists in obese subjects. The thermic effect of exercise does not seem to be affected by either the reduced catecholamine response nor insulin resistance.
    Materialart: Digitale Medien
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  • 80
    ISSN: 1432-2307
    Schlagwort(e): Key words Osteoclast-like giant cell tumour ; Pancreas ; Cystic lesion ; Immunohistochemistry
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  A 57-year-old male patient presented with a cystic lesion in the tail of the pancreas, which was considered to be a pseudocyst. He was treated by cystojejunostomy but one year later a tumour was found to have invaded the stomach and jejunum. This was an osteoclast-like giant cell tumour containing a small area of typical ductal adenocarcinoma. Immunohistochemical staining revealed that the pleomorphic tumour cells were positive for cytokeratin, epithelial membrane antigen, vimentin and the proliferation marker MIB-1. The osteoclast-like giant cells and some small histiocytic cells stained for leukocyte common antigen and histiocytic markers and were negative for MIB-1. At autopsy, tumour rests were found in the pancreas but there were no metastases. Osteoclast-like giant cell tumours of the pancreas may present as cystic lesions and should be included in the differential diagnosis of pseudocysts.
    Materialart: Digitale Medien
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  • 81
    Digitale Medien
    Digitale Medien
    Springer
    Transplant international 10 (1997), S. 284-288 
    ISSN: 1432-2277
    Schlagwort(e): Key words Kidney transplantation ; Obesity ; Risk factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract At our center, since 1982, a body mass index (BMI) of less than 30 has been a prerequisite for placing a patient on the waiting list for renal transplantation. This decision was made because obese transplant recipients seemed to have a less than favorable post-transplant outcome. The aim of this study was to evaluate whether this requirement is still justified. Forty-six patients with a BMI above 30 underwent primary cadaveric renal transplantation between 1972 and 1993. For each of these obese patients, five consecutive non-obese (BMI 20–25) control patients were selected. Patient and graft survival, causes of graft loss, and acute rejection rate were evaluated for the two patient groups before and after the year 1982. Within the first 30 post-transplant days, one patient (2 %) and 11 grafts (24 %) were lost in the group of obese patients whereas seven patients (3 %) and 36 grafts (16 %) were lost in the control group. Among the obese patients, renal circulatory complications were a major cause of graft loss. In the period 1973–1981, the 1-year patient survival rate was 65 % among obese patients versus 75 % among controls from 1982 to 1993, this was 90 % versus 93 %. From 1973 to 1981, the 1-year graft survival rate was 25 % among obese patients versus 53 % among controls (P 〈 0.05); from 1982 to 1993, it was 68 % versus 84 % (P = NS). Multivariate analysis showed that the immunosuppressive regimen, age of the patient, BMI, and cold ischemia time of the graft had a significant influence on graft survival. The acute rejection rate within the first 30 days was 28 % among obese patients and 35 % among controls (P = NS). We conclude that a BMI below or equal to 30 is still justified as a prerequisite for placement on the waiting list for renal transplantation, for despite an overall improvement, the outcome of renal transplantation in obese patients remains worse than that in non-obese patients.
    Materialart: Digitale Medien
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  • 82
    ISSN: 1432-0878
    Schlagwort(e): Key words: Hepatopancreas ; Hepatocytes ; Pancreas ; exocrine ; Biliary system ; Cell culture ; Cyprinus carpio (Teleostei)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract. When cultured together in a primary serum-free hormone-free system, hepatocytes and exocrine pancreas cells from the carp, Cyprinus carpio, spontaneously establish unique morphological structures that do not occur in vivo. These structures include intercellular bile canaliculi between neighbouring hepatocytes and hybrid canaliculi between hepatocytes and pancreas cells. In vivo, carp hepatocytes form only unicellular bile canaliculi; hybrid canaliculi between hepatocytes and exocrine pancreas cells do not exist at all in nature. This study shows that, in an artificial environment, cells are able spontaneously to establish novel morphological structures that are absent in the animal from which the cells have been obtained.
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  • 83
    ISSN: 1432-0878
    Schlagwort(e): Key words: Acinus ; Guanine nucleotide release factor ; Pancreas ; exocrine ; ras ; Rat (Wistar)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract. The polymerase chain reaction was used to amplify a cDNA encoding the catalytic region of ras-guanine nucleotide release factor (ras-GRF1) from mouse embryonic stem cell mRNA. Antibodies directed against this protein were prepared and affinity purified. Western immunoblotting of rat tissue lysates revealed a 140-kDa protein in brain as expected but, in addition, a strongly immunoreactive 54-kDa protein, p54, was identified in pancreas. Expression of ras-GRF1 in pancreas was confirmed at the RNA level by reverse-transcriptase-coupled polymerase chain reaction analysis; p54 may therefore correspond to a form of ras-GRF1 or a closely related protein. The cellular and subcellular localization of p54 was investigated by enzyme-linked immunocytochemistry and immunogold electron microscopy. In the pancreas, p54 was expressed primarily in acinar cells, where it was localized along the basolateral and apicolateral plasma membranes. Indirect immunofluorescence microscopy of cultured acini further indicated that the plasma membrane localization of p54 was dependent on the maintenance of the acinar histotype and organized acinar structure. When primary acinar cells were permitted to dissipate into monolayer cultures devoid of zymogen granules, ras-GRF1 staining became cytosolic. Our results suggest that ras-GRF1 is involved in the structure and function of the pancreas.
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  • 84
    Digitale Medien
    Digitale Medien
    Springer
    European journal of epidemiology 13 (1997), S. 919-924 
    ISSN: 1573-7284
    Schlagwort(e): Body morphology ; Bone mineral density ; Obesity ; Premenopausal women
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract To investigate whether body morphology, obesity and its long time evolution were associated with lumbar and femoral bone mineral density (BMD) in premenopausal women of the same age. Design: Cross-sectional study. Subjects: 72 healthy premenopausal women born in 1950 (42 years) with a regular physical activity. Measurements: BMD measured by dual-X-ray absorptiometry (DEXA) at lumbar spine and proximal femur; body weight, body mass index (BMI), BMI at 20 years (BMI-20), increase in BMI since age of 20 (BMI-〉20), body circumferences (breast, waist, hip) and their ratios (WHR, BHR, WBR), smoking and alcohol intake. Results: Lumbar spine BMD did not correlate with any anthropometric measurement. Femoral BMDs correlated positively with weight, BMI, BMI-20, breast, waist, WHR and BHR. The BMI-20 explained the 5% and the current BMI the 13% of variance of total femur BMD. After adjustment for weight or BMI, breast circumference and BHR remained significantly correlated with all femoral BMDs sites except neck. Weight was the best predictor for neck BMD (R2 = 0.08; p 〈 0.02), and BHR for Ward's triangle (R2 = 0.12; p 〈 0.01) and trochanter (R2 = 0.10; p 〈 0.001). Alcohol intake, cigarette smoking, and age of menarche were not related to BMDs. Conclusion: In premenopausal women of the same age, lumbar spine BMD was not associated with any anthropometric measurement. Greater BHR and its long time of evolution may be determinants of greater femoral BMD (trabecular), whereas body weight may be determinant of femoral neck BMD (cortical). Further studies are needed to determine whether large breast to hip ratio may be considered as a protective factor for femoral osteoporosis.
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  • 85
    Digitale Medien
    Digitale Medien
    Springer
    Behavior genetics 27 (1997), S. 353-358 
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; body mass index ; genetics ; environment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract Genetic studies have shown that both childhood and adult body mass index are substantially heritable. The evidence for shared family environmental influences is largely absent, even though there are clear indications that secular changes in energy expenditure have brought about a significant increase in the prevalence of obesity. This apparent inconsistency may be explained by the dual phenomena of the near-universality of access to environments that facilitate reductions in energy expenditure (e.g., TV as a recreational pastime), together with heritable individual differences in the response to or utilization of these environments. The impact of changes in nonshared environments on body weight can be estimated from biometrical genetical studies and is found to be both small and relatively short-lived. Genetic and environmental results from longitudinal studies are consistent with what is known about the changing distribution of adiposity during adulthood and clinical experience of the difficulty of maintaining behavioral-induced weight loss.
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  • 86
    Digitale Medien
    Digitale Medien
    Springer
    Behavior genetics 27 (1997), S. 389-399 
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; energy expenditure ; metabolic rate ; physical activity ; fat oxidation ; respiratory quotient
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract Understanding the genetic factors of obesity requires consideration of the genetic basis of the underlying etiological factors including energy expenditure and substrate utilization. Genetic susceptibility studies suggest that altered energy expenditure and/or preferential substrate utilization are likely to be involved in the etiology of obesity. Twin and family studies suggest that there is a strongly heritable component to resting energy expenditure, substrate utilization, and the thermic response to feeding. Physical activity energy expenditure has been less well studied; new data are presented in young sib pairs that suggest moderate heritability of nonresting energy expenditure. Only a few candidate gene studies have been performed to examine the role of basic proteins involved in energy expenditure (the sodium–potassium ATPase and the uncoupling protein) or substrate utilization (fatty acid binding protein). The lack of information in this area warrants further investigation into genetic aspects of energy and substrate metabolism.
    Materialart: Digitale Medien
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  • 87
    Digitale Medien
    Digitale Medien
    Springer
    Langenbeck's archives of surgery 382 (1997), S. 307-310 
    ISSN: 1435-2451
    Schlagwort(e): Key words Annular pancreas ; Pancreas ; Congenital anomaly ; Duodenal obstruction ; Case report ; Schlüsselwörter Pancreas anulare ; Pankreas ; Kongenitale Anomalie ; Duodenalstenose ; Kasuistik
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Das Pancreas anulare ist eine seltene kongenitale Anomalie des Pankreas, welche in der Hälfte der Fälle erst im Erwachsenenalter symptomtisch wird. Wir berichten über einen 52jährigen Patienten mit einer subtotalen Duodenal- und Pylorusstenose, bei dem eine partielle Duodenopankreatektomie nach Whipple durchgeführt wurde. Die Histologie ergab ein Pancreas anulare, wobei die entzündlichen Komplikationen dieser Fehlbildung mit tryptischer Sialadenitis des Caput pancreatis zu einer zusätzlichen Stenose geführt haben. Bei der Duodenalstenose des Erwachsenen sollte das Pancreas anulare in die Differentialdiagnose einbezogen werden. Obwohl die endoskopisch retrograde Cholangiopankreatikographie (ERCP) das diagnostische Mittel der Wahl darstellt und in Kombination mit der Computertomographie (CT) die Diagnose präoperativ in vielen Fällen möglich ist, kann ein Pancreas anulare derzeit teilweise erst intraoperativ diagnostiziert werden, insbesondere wenn entzündliche Pseudotumoren vorliegen oder eine subtotale Stenosierung die ERCP unmöglich macht.
    Notizen: Abstract Annular pancreas is a rare congenital malformation of the pancreas. In about 50% of the cases the malformation is asymptomatic until the third to fifth decade. We report on a 52-year-old male patient who presented with subtotal duodenal and gastric outlet stenosis. Duodenohemipancreatectomy (Whipple's procedure) was performed. The histological examination showed an annular pancreas with complicating inflammatory reactions (tryptic sialadenitis) of the pancreatic head causing additional obstruction. Annular pancreas should be taken into account as a possible cause of adult duodenal obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) is the diagnostic modality of choice, and in combination with computed tomography the diagnosis can be obtained preoperatively in many patients. However, there are still patients in whom the diagnosis can finally be obtained only intraoperatively especially in cases where inflammatory pseudotumors or subtotal duodenal stenosis make ERCP impossible.
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  • 88
    Digitale Medien
    Digitale Medien
    Springer
    Langenbeck's archives of surgery 382 (1997), S. 307-310 
    ISSN: 1435-2451
    Schlagwort(e): Annular pancreas ; Pancreas ; Congenital anomaly ; Duodenal obstruction ; Case report ; Pancreas anulare ; Pankreas ; Kongenitale Anomalie ; Duodenalstenose ; Kasuistik
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Das Pancreas anulare ist eine seltene kongenitale Anomalie des Pankreas, welche in der Hälfte der Fälle erst im Erwachsenenalter symptomtisch wird. Wir berichten über einen 52jährigen Patienten mit einer subtotalen Duodenal- und Pylorusstenose, bei dem eine partielle Duodenopankreatektomie nach Whipple durchgeführt wurde. Die Histologie ergab ein Pancreas anulare, wobei die entzündlichen Komplikationen dieser Fehlbildung mit tryptischer Sialadenitis des Caput pancreatis zu einer zusätzlichen Stenose geführt haben. Bei der Duodenalstenose des Erwachsenen sollte das Pancreas anulare in die Differentialdiagnose einbezogen werden. Obwohl die endoskopisch retrograde Cholangiopankreatikographie (ERCP) das diagnostische Mittel der Wahl darstellt und in Kombination mit der Computertomographie (CT) die Diagnose präoperativ in vielen Fällen möglich ist, kann ein Pancreas anulare derzeit teilweise erst intraoperativ diagnostiziert werden, insbesondere wenn entzündliche Pseudotumoren vorliegen oder eine subtotale Stenosierung die ERCP unmöglich macht.
    Notizen: Abstract Annular pancreas is a rare congenital malformation of the pancreas. In about 50% of the cases the malformation is asymptomatic until the third to fifth decade. We report on a 52-year-old male patient who presented with subtotal duodenal and gastric outlet stenosis. Duodenohemipancreatectomy (Whipple's procedure) was performed. The histological examination showed an annular pancreas with complicating inflammatory reactions (tryptic sialadenitis) of the pancreatic head causing additional obstruction. Annular pancreas should be taken into account as a possible cause of adult duodenal obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) is the diagnostic modality of choice, and in combination with computed tomography the diagnosis can be obtained preoperatively in many patients. However, there are still patients in whom the diagnosis can finally be obtained only intraoperatively especially in cases where inflammatory pseudotumors or subtotal duodenal stenosis make ERCP impossible.
    Materialart: Digitale Medien
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  • 89
    ISSN: 1432-136X
    Schlagwort(e): Key words Starvation ; Obesity ; Corticosterone Thyroid hormones ; Body protein ; Body fat
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract The effect of fasting on hormonal and metabolic variables was evaluated in normal rats and in rats with obesity induced by neonatal treatment with monosodium glutamate (MSG). The hyperinsulinemia of the fed obese rats was reversed by fasting. Plasma corticosterone was also high in the fed obese and decreased to levels similar to fed controls, while it increased in the latter group during fasting. In contrast, thyroid hormone levels decreased in controls but increased in the obese rats in response to fasting. The fed obese group had lower carcass protein and higher carcass lipid contents than controls. In response to fasting, the decrements of the initial amount of both protein and fat were lower in MSG than in controls. Fasting induced a sustained increase in plasma free fatty acids only in the obese rats, although a single 100 μmol · l−1 dose of norepinephrine stimulated in vitro glycerol release more pronouncedly in epididymal adipocytes from control than obese rats. The results indicate that MSG-obese rats were able to mobilize fat stores during prolonged fasting. The high availability of lipid fuels and the sharp and sustained decrease in circulating corticosterone in the MSG group were probably important in diminishing body protein consumption during fasting.
    Materialart: Digitale Medien
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  • 90
    ISSN: 1860-1499
    Schlagwort(e): Osteoclast-like giant cell tumor ; Pancreas ; Immunohistochemistry ; Electron microscopy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a rare case of osteoclast-like giant cell tumor of the pancreas in a 70-year-old Japanese woman. The tumor was composed of a proliferation of ovoid to spindle-shaped mononuclear cells admixed with osteoclast-like giant cells. The tumor cells were immunore-active for vimentin, ±1-antitrypsin, and CD68. In ultrastructural examination, the giant cells resembled osteoclasts, and the mononuclear stromal cells had fibroblastic and histiocytic features. No elements of epithelial differentiation were found in this tumor. These findings suggest that this tumor had a derivation similar to giant cell tumor of bone.
    Materialart: Digitale Medien
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  • 91
    Digitale Medien
    Digitale Medien
    Springer
    Behavior genetics 27 (1997), S. 307-324 
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; mental retardation ; Prader–Willi syndrome ; Bardet–Biedl syndrome ; Cohen syndrome ; Albright hereditary osteodystrophy ; genetic imprinting
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract Constitutional obesity and mental retardation cooccur in several multiple congenital anomaly syndromes, including Prader–Willi syndrome, Bardet–Biedl syndrome, Cohen syndrome, Albright hereditary osteodystrophy, and Borjeson–Forssman–Lehmann syndrome as well as some rarer disorders. Although hypothalamic–pituitary axis abnormalities are thought to be a possible causative mechanism in some of these disorders, current knowledge is insufficient to explain the pathophysiologic mechanism of obesity in most multiple congenital anomaly/mental retardation syndromes. The chromosomal location of many of these syndromes is known, and studies are ongoing to identify the causative genes. Further delineation of the functions of the underlying genes will likely be instructive regarding mechanisms of appetite, satiety, and obesity in the general population. This review details current knowledge of the clinical and molecular genetic findings of multiple congenital anomaly/mental retardation syndromes associated with intrinsic obesity in an effort to delineate causative mechanisms and genetic abnormalities contributing to obesity.
    Materialart: Digitale Medien
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  • 92
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; food preferences ; dietary fat intake ; saccharin ; sweet ; taste
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract What an animal chooses to eat can either induce or retard the development of obesity; this review summarizes what is known about the genetic determinants of nutrient selection and its impact on obesity in humans and rodents. The selection of macronutrients in the diet appears to be, in part, heritable. Genes that mediate the consumption of sweet-tasting carbohydrate sources have been mapped and are being isolated and characterized. Excessive dietary fat intake is strongly tied to obesity, and several studies suggest that a preference for fat and the resulting obesity are partially genetically determined. Identifying genes involved in the excess consumption of dietary fat will be an important key to our understanding of the genetic disposition toward common dietary obesity.
    Materialart: Digitale Medien
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  • 93
    Digitale Medien
    Digitale Medien
    Springer
    Behavior genetics 27 (1997), S. 277-284 
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; monogenic models
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract The study of rodent monogenic models of obesity has yielded significant insights into the pathogenesis of obesity. Multiple independent mutations in several genes can produce obesity. As these genes act in different regulatory pathways, it is clear that multiple mechanisms can produce obesity. Furthermore, a single gene defect can produce regulatory deficits in multiple modes of energy expenditure. The most severe forms of genetic obesity involve multiple pathogenic processes. It is significant that regulatory defects in any single component of caloric intake or energy expenditure appear to be sufficient to produce obesity. Finally, the systems regulating energy balance are loosely coupled; positive and negative influences are not completely balanced, both in strength as well as temporally.
    Materialart: Digitale Medien
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  • 94
    Digitale Medien
    Digitale Medien
    Springer
    Behavior genetics 27 (1997), S. 285-306 
    ISSN: 1573-3297
    Schlagwort(e): Obesity ; body weight ; polygenic ; quantitative trait loci (QTL) ; mice ; pigs
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Psychologie
    Notizen: Abstract In contrast to diseases caused by single-gene defects, many of the most common human maladies such as obesity, atherosclerosis, diabetes, and hypertension exhibit continuous phenotypic variation and a predominantly multifactorial and polygenic basis. Genes with roles in energy balance, nutrient partitioning, lipid and insulin metabolism, and a variety of behavioral traits are likely interacting with environmental stimuli to regulate obesity phenotypes. With the current proliferation of highly polymorphic genetic markers and the refinement of experimental approaches, it is now possible to screen thoroughly the genomes of model organisms for the individual genes or quantitative trait loci (QTL) that control measurable polygenic traits such as obesity. With the growing wealth of comparative mapping, it will be possible to predict the location of a homologous locus in the human after first mapping it in the mouse. Many experiments have been conducted in mice, rats, and pigs to estimate the number, location, and effect of QTL controlling obesity and related traits. This review describes the design and strategies of such studies and summarizes the results and their implications toward understanding the complex nature of obesity in humans.
    Materialart: Digitale Medien
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  • 95
    Digitale Medien
    Digitale Medien
    Springer
    Diseases of the colon & rectum 39 (1996), S. 1164-1170 
    ISSN: 1530-0358
    Schlagwort(e): Sphincter repair ; Sphincter injury ; Incontinence ; Postobstetric damage ; Prognostic factors ; Obesity ; Age greater than 50 years ; Perineal descent
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract PURPOSE: This study was designed to critically analyze the outcome of sphincter repair and, if possible, to identify high-risk factors. METHODS: Clinical and physiologic assessment was made of all sphincter repairs (42 patients) performed in one unit by two surgeons during five years. RESULTS: Forty-two patients (10 men, 32 women) underwent sphincter repair. Only three of five men with anterior defects of the anorectum from perineal trauma were rendered continent. Only three of five men with defects from fistula operations became continent, but one improved by later graciloplasty. All six women with fistula-related injuries eventually achieved continence, but two required repeat sphincter repairs because of early breakdown from sepsis. The worst results were in 26 women with third-degree obstetric injuries, of whom 11 remain incontinent; poor results in this group were associated with gross perineal descent, obesity, and age older than 50 years; two or more of these factors indicated a poor outcome. Preoperative anorectal physiology did not identify a poor-risk group. CONCLUSIONS: Poor results were identified in women with anterior defects from obstetric trauma, especially if they were obese, older than 50 years of age, and had perineal descent.
    Materialart: Digitale Medien
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  • 96
    ISSN: 1435-604X
    Schlagwort(e): Photodynamic therapy ; 5-Aminolaevulinic acid ; Pancreas ; Bile duct ; Duodenum ; Fluorescence microscopy ; Light dosimetry
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Physik , Technik allgemein
    Notizen: Abstract Photodynamic therapy (PDT) using 5-aminolaevulinic-acid-(ALA)-induced protoporphyrin IX (PPIX) increases survival in hamsters with pancreatic cancer. However, experiments with other photosensitizers on this model show a high risk of duodenal perforation. In this paper, the pharmacokinetics and PDT effects of ALA on normal tissues in the pancreatobiliary region are presented. Using quantitative fluorescence microscopy, maximum PPIX fluorescence was seen in the bile ducts, less in the duodenal mucosa and least in the muscularis propria and pancreas. For PDT, light was delivered either using a bare fibre touching the tissue (single-point illumination), or irradiating a 1.5 cm diameter circular area. Single-point PDT (50 J) produced only localized reversible damage without perforation. Surface irradiation of the whole periampullary region (50 J cm−2) caused extensive damage, sometimes with perforation. Before PDT can be used safely to treat tumours of the pancreas and bile duct, further studies are necessary to understand its effect on larger areas of normal tissue.
    Materialart: Digitale Medien
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  • 97
    Digitale Medien
    Digitale Medien
    Springer
    Der Chirurg 67 (1996), S. 1012-1015 
    ISSN: 1433-0385
    Schlagwort(e): Key words: Papillary cystic tumor ; Pancreas ; Pancreatic neoplasms.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Wir berichten über unsere Erfahrungen an 3 Patientinnen mit einem solid-pseudopapillären Tumor des Pankreas. Charakteristisch für diesen semimalignen Tumor sind das Vorkommen bei jungen Frauen, die auffallende Größe (bis 10 cm) und das seltene Auftreten von Metastasen. Trotz erheblicher Größe der Tumoren war in allen Fällen eine kurative Resektion möglich. Präoperatives Hauptunterscheidungsmerkmal zum duktalen Adenocarcinom war in allen Fällen die normale Weite des Pankreasgangs ohne Gangabbruch. Im Gegensatz zu den meisten anderen Tumoren des Pankreas hat dieser Tumor eine gute Prognose. Alle unsere Patientinnen sind z. Z. (bis zu 8 Jahren nach der Operation) rezidivfrei.
    Kurzfassung: Schlüsselwörter: Solid-pseudopapillärer Tumor – Pankreas – papillär-cystischer Tumor
    Notizen: Summary. We report on three female patients with solid pseudopapillary tumors of the pancreas. The histogenetic origin of this entity is still unclear. The tumor, usually occurring in young women, forms large masses (up to 10 cm in diameter) before becoming symptomatic. Metastases have very rarely been reported. In contrast to other pancreatic tumors, the main pancreatic duct was displaced, but of normal caliber without stenosis, in all our patients. Despite the large size of the tumors, they were curatively resected in all three cases. Two of the tumors infiltrated the parenchyma or adipose tissue of the pancreas but did not spread into the lymph nodes or other organs. All of the patients are alive and without signs of tumor recurrence up to 8 years after surgical resection.
    Materialart: Digitale Medien
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  • 98
    Digitale Medien
    Digitale Medien
    Springer
    Journal of molecular medicine 74 (1996), S. 313-320 
    ISSN: 1432-1440
    Schlagwort(e): Pancreas ; Cancer ; Genes ; Growth factors ; Tumor markers
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Cancer of the pancreas still has a very poor prognosis despite improved diagnostic methods and therapeutic regimens. The reasons for the aggressiveness of this cancer are not known, and the molecular mechanisms that govern the growth of pancreatic cancer cells are still not clearly defined. During the past two decades the development of new molecular biological techniques has offered new perspectives for a better understanding of pancreatic cancer. Tumor markers such as CA19-9 and CEA are used for diagnosis and for following the postoperative course of cancer patients. Characterization of pancreatic cancer cells using several molecular biological techniques has revealed overexpression or altered expression of growth factors and adhesion molecules, implying altered cell-cell and growth-regulatory interactions. In pancreatic cancer mutations in oncogenes and tumor suppressor genes are frequently detected in p53 and K-ras. This article reviews the possible molecular approaches for diagnosis, prognosis, or even therapy of pancreatic cancer.
    Materialart: Digitale Medien
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  • 99
    Digitale Medien
    Digitale Medien
    Springer
    Der Chirurg 67 (1996), S. 900-906 
    ISSN: 1433-0385
    Schlagwort(e): Key words: Gallbladder ; Bile ducts ; Pancreas ; Malignancy ; Surgery ; Lymphadenectomy.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung. Malignome von Gallenblase, Gallenwegen und Pankreas zeichnen sich unter den gastrointestinalen Malignomen durch ihre schlechte Prognose aus. Zahlreiche Analysen identifizierten den Lymphknotenstatus als wichtigen prognostischen Faktor. Dieser Tatsache versucht von chirurgischer Seite eine möglichst umfassende Resektionsstrategie unter Einschluß einer erweiterten Lymphadenektomie Rechnung zu tragen. Die hierzu mitgeteilten Therapieerfolge variieren allerdings in weiten Grenzen und die resultierende Morbidität liegt zumeist deutlich über den heute zu fordernden Standards. Bis zum Nachweis des Nutzens einer Lymphadenektomie, die das Ausmaß derjenigen im Rahmen üblicher Resektionen überschreitet, in Form von kontrollierten Studien kann dieses Vorgehen nicht allgemein empfohlen werden.
    Kurzfassung: Schlüsselwörter: Gallenblase – Gallenwege – Pankreas – Malignom – Chirurgie – Lymphadenektomie.
    Notizen: Summary. Malignancies of the gallbladder, bile ducts and pancreas have a very bad prognosis compared with other gastrointestinal malignomas. Lymph node metastasis has frequently been identified as an important prognostic factor. This leads some surgeons to embark on an extremely aggressive resectional strategy, including wide lymphadenectomy. So far, reported results of these procedures have varied considerably and concomitant morbidity has often exceeded that of standard resections. Until there is unequivocal proof of the benefit of an extended lymphadenectomy in controlled studies this strategy cannot be recommended generally.
    Materialart: Digitale Medien
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  • 100
    Digitale Medien
    Digitale Medien
    Springer
    Virchows Archiv 427 (1996), S. 553-560 
    ISSN: 1432-2307
    Schlagwort(e): Beta cell ; Duct cell ; Pancreas ; Islets of Langerhans ; Diabetes
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The beta cell population of the endocrine pancreas may expand by either of two processes, neogenesis or replication. While replication requires the existence of an already differentiatied beta cell, neogenesis depends on the presence of active stem cells. Since the replicative activity of highly specialized cells such as beta cells seems to be limited, it is interesting to study the potential of the endocrine pancreas for beta cell neogenesis. In this article we review both the current state of knowledge of beta cell neogenesis under natural conditions and in response to stimulation, and the significance of neogenesis for beta cell growth in health and disease.
    Materialart: Digitale Medien
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