“Windhund”-Verfahren bei fehlender Auflage Im Öffnungsbeschluss des Landesausschusses (Anm.: R. Hildebrandt)

Ohne Zusammenfassung     

High dose cyclophosphamide, fractionated total body irradiation with involved field irradiation and autologous bone marrow transplantation in malignant lymphoma

The objective of this clinical trial was to determine if radiation to areas of recurrence or bulky disease prior to total body irradiation (TBI) and chemotherapy followed by autologous bone marrow transplantation (ABMT) altered the site of relapse andlor prolonged survival. Forty-eight patients with recurrent or refractory malignant lymphoma were treated with high-dose cyclophosphamide and fractionated TBI followed by ABMT. Thirty-four patients were eligible to receive involved field radiation therapy (IF-RT) to sites of recurrence or bulky disease. The overall response rate in 46 evaluable patients was 89% with 33 complete remissions (CR) and 8 partial remissions (PR). In a multivariant analysis increasing LDH, decreased serum albumin, older age, and lack of sensitivity to prior chemotherapy were associated with poorer survival. There were 10 deaths due to treatment related complications, 8 died of pulmonary complications of whom 6 were in CR. Of 11 who had received IF-RT and subsequently relapsed, 4 recurred in or adjacent to the involved field. We conclude that intensive chemo-radiotherapy proved to be an effective salvage therapy for patients with recurrent malignant lymphoma, resulting in a projected actuarial 33% DFS at 5 years, but was associated with a high transplant-related mortality.     

MVZ – Umfang der vertragsärztlichen Tätigkeit an einem weiteren Ort

Abstrakt  1. MVZ ist es grunds?tzlich gestattet, eine Zweig-/Filialpraxis (§1a Nr. 19 BMV-?) an einem weiteren Ort im Zulassungsbezirk des Vertragsarztsitzes zu betreiben. 2. In allen F?llen der Ausübung vertrags?rztlicher T?tigkeit an einem weiteren oder mehreren T?tigkeitsorten au?erhalb des Vertragsarztsitzes muss die pers?nliche, nicht delegierbare T?tigkeit am Vertragsarztsitz die Summe der T?tigkeitszeiten an den weiteren Orten überwiegen. 3. übernimmt ein MVZ eine Praxis im Wege der Praxisnachfolge, so besteht durch die Praxisnachfolge bereits von Gesetzes wegen ein Versorgungsbedarf am weiteren Ort im Umfang der bestehenden Praxis. 4. Das Auslagern eines vollst?ndigen Fachgebietes weg vom Hauptsitz in eine Zweigpraxis kommt dem Betreiben einer weiteren Praxis gleich und ist daher nicht genehmigungsf?hig. (Leits?tze des Bearbeiters)     

Organization and Running of the First Comprehensive Hereditary Cancer Clinic in India

Hereditary cancers are thought to account for around 5% of cancers, particularly breast/ovarian and colorectal cancers. In India there is a paucity of data on hereditary cancers and the mutations in some of the common genes linked to hereditary cancers, such as BRCA1, BRCA2, hMSH2 and hMLH1. The country's first comprehensive hereditary cancer clinic was established in February 2002. The article describes the organization and running of the Clinic. It also discusses some of the social issues relevant to the given population in running the Hereditary Cancer Clinic.     

Development of spatial resolution, contrast sensitivity and binocularity in normal and strabismic kittens

The purpose of the present experiment was to evaluate visual acuity, contrast sensitivity and binocularity in teno-tomized, strabismic kittens of various ages.     

Histomorphometric analysis of the effects of standard heparin on trabecular bone in vivo

Long-term heparin treatment causes osteoporosis through an as yet undefined mechanism. To investigate this phenomenon, we treated rats with once daily subcutaneous injections of heparin (in doses ranging from 0.25 to 1.0 U/g) or saline for 8 to 32 days and monitored the effects on bone both histomorphometrically and by serial measurements of urinary type 1 collagen cross linked-pyridinoline (PYD) and serum alkaline phosphatase, markers of bone resorption and formation, respectively. Histomorphometric analysis of the distal third of the right femur in the region proximal to the epiphyseal growth plate showed that heparin induces both a time- and dose-dependent decreased in trabecular bone volume, with the majority of trabecular bone loss occurring within the first 8 days of treatment. Thus, heparin doses of 1.0 U/g/d resulted in a 32% loss of trabecular bone. Heparin-treated rats also showed a 37% decrease in osteoblast surface as well as a 75% decrease in osteoid surface. In contrast, heparin treatment had the opposite effect on osteoclast surface, which was 43% higher in heparin- treated rats, as compared with that in control rats. Biochemical markers of bone turnover showed that heparin treatment produced a dose- dependent decrease in serum alkaline phosphatase and a transient increase in urinary PYD, thus confirming the histomorphometric data. Based on these observations, we conclude that heparin decreases trabecular bone volume both by decreasing the rate of bone formation and increasing the rate of bone resorption.