Zur Bedeutung eines Kranken- und Berechtigungsscheines bei Leistungen zur künstlichen Befruchtung

Abstrakt 1. Das Vorliegen eines überweisungsscheins bei Inanspruchnahme vertrags?rztlicher Leistungen ist nicht Abrechnungsvoraussetzung. 2. Die Sterilit?t ist eine nachhaltig lebensver?ndernde Erkrankung, welche die Abrechnung der Nrn. 17/18 des EBM rechtfertigt. 3. Zur Auslegung des Umfangs einer Erm?chtigung kann auf die “Erm?chtigungsgeschichte” zurückgegriffen werden. (Leits?tze des Bearbeiters)     

Purification and characterization of a putative fimbrial protein/receptor of Porphyromonas gingivalis

Porphyromonas gingivalis has been implicated as a major aetiological agent in certain forms of periodontal disease. P. gingivalis is a Gram-negative, asaccharolytic bacterium that obtains energy from the fermentation of amino acids derived from the hydrolysis of host protein. Virulence factors of this bacterium include the capsule, fimbrial adhesins, cytotoxins and extracellular hydrolytic enzymes. A 43 kDa fimbrillin from P. gingivalis has been isolated and characterized. However, there is evidence that a second type of fimbria exists on the surface of P. gingivalis. A putative P. gingivalis fimbrial protein from a membrane preparation has been isolated and identified. This protein was shown to be reactive with sera from patients harbouring P. gingivalis. A 28 kDa protein fragment was purified by anion exchange, gel filtration and reversed-phase chromatography. N-terminal sequence analysis of the 28 kDa protein fragment revealed homology to the fimbrial precursor protein of Dichelobacter nodosus. A peptide corresponding to the N-terminal 26 amino acyl residues of the 28 kDa protein fragment was synthesized and used to raise antibodies to the protein. Western blot analysis after SDS-PAGE of a P. gingivalis membrane preparation using the antibodies raised to the synthetic peptide detected three proteins of 36, 41 and 67 kDa. When protease inhibitors were not included in the extraction procedure only the 36 and 41 kDa bands were detected. It would appear, therefore, that the intact protein has an M_r of 67 kDa and that the 28, 36 and 41 kDa bands represent protein fragments produced by endogenous proteolytic activity. Based on sequence homology, the 67 kDa protein is possibly a sub-unit of a second P. gingivalis fimbrial type or a surface receptor.     

Breast neoplasms: duplex sonographic imaging as an adjunct in diagnosis

Sonographic breast imaging has been useful in the differentiation of cystic from solid masses. It has also been helpful in the characterization of palpable breast masses in the absence of corresponding abnormalities. The authors undertook a prospective study that incorporated pulsed Doppler analysis into sonographic real-time imaging of solid breast masses. Thirty-eight patients were examined. In 12 of the patients there were positive Doppler signals, while in 26 patients there were no Doppler signals. The 12 patients showing positive Doppler signals proved to have infiltrating ductal carcinoma, while the 26 patients with negative Doppler signals proved to have benign breast disorders. Pulsed Doppler analysis as a supplement to sonographic real-time imaging shows promise for the identification of breast carcinoma.