Selbstständige Berufsausübung durch Physiotherapeuten

Zusammenfassung  Für eine selbstst?ndige, eigenverantwortliche Behandlung des Physiotherapeuten auf dem von ihm erlernten Gebiet ist keine Kenntnisüberprüfung nach dem Heilpraktikergesetz erforderlich; der Nachweis der abgeschlossenen Ausbildung reicht für die Erteilung der Heilpraktikererlaubnis aus. Diese kann und muss entsprechend beschr?nkt werden. (Leitsatz des Bearbeiters)     

Genetic characterization of T‐PLL reveals two major biologic subgroups and JAK3 mutations as prognostic marker

T‐cell prolymphocytic leukemia (T‐PLL) is a rare post‐thymic T‐cell neoplasm with aggressive clinical course and short overall survival. So far, due to the rareness of this disease, genetic data are available only from individual cases or small cohorts. In our study, we aimed at performing a comprehensive cytogenetic and molecular genetic characterization of T‐PLL comprising the largest cohort of patients with T‐PLL analyzed so far, including correlations between the respective markers and their impact on prognosis. Genetic abnormalities were found in all 51 cases with T‐PLL, most frequently involving the TCRA/D locus (86%). Deletions were detected for ATM (69%) and TP53 (31%), whereas i(8)(q10) was observed in 61% of cases. Mutations in ATM, TP53, JAK1, and JAK3 were detected in 73, 14, 6, and 21% of patients, respectively. Additionally, BCOR mutations were observed for the first time in a lymphoid malignancy (8%). Two distinct genetic subgroups of T‐PLL were identified: A large subset (86% of patients) showed abnormalities involving the TCRA/D locus activating the proto‐oncogenes TCL1 or MTCP1, while the second group was characterized by a high frequency of TP53 mutations (4/7 cases). Further, analyses of overall survival identified JAK3 mutations as important prognostic marker, showing a significant negative impact. © 2015 Wiley Periodicals, Inc.     

Zulassung eines Universitätsklinikums als Transplantationszentrum nach dem Transplantationsgesetz

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Radiation sensitivity of resting and activated nonspecific cytotoxic cells of T lineage and NK lineage

Natural killer (NK) cell-mediated killing of tumor cells is a radiation- sensitive function that in most subjects is completely abrogated by treatment of the effector cells with 3,000 cGy. The radiation sensitivity of LAK (lymphokine-activated killer) cells and their precursors, the bulk of which are NK cells, is undetermined. In this study, functional cytotoxicity assays and electron microscopy were used to determine the effect of radiation on the cytotoxic function of NK cells, LAK cells (generated by three-day culture of peripheral blood lymphocytes with IL-2), and LAK cell precursors (lymphocytes irradiated prior to culture with IL-2). For comparison, we analyzed the radiation sensitivity of lectin-dependent cell-mediated cytotoxicity (LDCC), which is primarily a function of CD3+ CD8+ granular lymphocytes. We also analyzed the radiation sensitivity of nonspecific cytotoxicity mediated by mitogen-activated T cells (AK activity). Following 3,000 cGy irradiation, NK cells retained their ability to bind to tumor cell targets but, as shown by both morphologic and functional analyses, they did not undergo activation after conjugate formation, and were unable to release the content of their granules. In order to evaluate LDCC, lymphocytes were depleted of CD16+ cells and tested in a cytotoxicity assay in the presence of Con A. The radiation sensitivity curve was comparable to that of NK cell-mediated cytotoxicity. IL-2-treated lymphocytes (LAK cells) were relatively radioresistant as compared with untreated NK cells, and their cytotoxic function was not abrogated until treatment with greater than 10,000 cGy. Cells receiving such radiation doses displayed cytoplasmic blebbing and damage of their cytoskeletal structures, with disruption of centrioles and microtubules, and disarray of the intermediate filaments. As was shown with NK cells, irradiated LAK cells formed conjugates with tumor targets but failed to degranulate. The radiation sensitivity of nonspecific cytotoxicity mediated by mitogen-activated T cells was identical to that of LAK effector cells. Doses up to 2,000 cGy did not prevent generation of LAK cells from blood lymphocytes, but 3,000 cGy did so. Blast transformation similar to that observed in IL-2- stimulated controls occurred when lymphocytes irradiated with 3,000 cGy were cultured with IL-2. These transformed cells were not cytotoxic and displayed a normal cytoskeletal apparatus but did not bear electron- dense granules.(ABSTRACT TRUNCATED AT 400 WORDS)     

Führen einer im Ausland verliehenen Bezeichung

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Antigenic Expression of B-Cell Chronic Lymphocytic Leukemic Cell Lines

A flow cytometric analysis of five B cell chronic lymphocytic leukemic (B-CLL) cell lines was undertaken using 129 unknown reagents from the blind panel (BP) and 72 reagents from the known CD panel obtained from the Fourth International Leucocyte Differentiation Conference and Workshop, B cell section (Vienna, 1989). The five cell lines examined were: SeD (PNAS 75, 5706, 1978), B-CLL-LCL (BLOOD 71, 9, 1988), JVM-HH and JVM-2(INT J CAN 38, 531, 1986), and WR # 1 (TH and BD). The reagents were #1-129 (blinded panel) and reagents 1-44 and 53-84 (CD panel with CD23 reagents missing). Positivity was defined as greater than 30% of the cells having a three fold increase or more in mean channel fluorescence. Fourty-three reagents of the blinded panel were negative by these criteria while all remaining reagents were positive on all five lines. SeD showed the lowest reactivity; B-CLL-LCL and JVM-2 showed the most reactivity; JVM-HH and WR #1 were intermediate. The known CD panel confirmed the reactivity of the blinded panel. An average immunophenotype was constructed and compared to published normal EBV lymphoblastoid cell lines and several differences were noted. There was an absence or significant decrease in the expression of CD19, CD21, CD22 and CD37 while there was an increased expression of CD38, CD54, CD74 and CD76. The heterogeneity observed between the B-CLL lines may in part be due to polymorphisms but is more likely to represent the underlying heterogeneity seen in common and familial B-CLL. In addition the variation in CD expression may be related to the effects of EBV transformation.     

Errors in the diagnosis and treatment of pancreatic cysts

Errors in the diagnosis and treatment of pancreatic cysts have been studied at various stages of rendering medical aid. In a polyclinic the diagnostic errors are due to inadequate skill of physicians, insufficient study of medical records, inadequate examination and ungrounded refusal to consult a surgeon. The most informative methods of examination are X-ray of the stomach, duodenography in the state of hypotonia, pneumoperitoneography in combination with retropneumoperitoneography and ultrasound examination. It is emphasized that the most common complication of cysts of the pancreas are suppuration of its contents and malignant transformation of its walls. The operation of choice in this condition is pancreatico-jejunostomy with an isolated jejunum according to the Roux-en-Y technique. External drainage of the cyst is indicated only in suppuration. Pancreatogastrostomy is considered an emergency operation.