Schadensersatzanspruch eines Kassenpatienten wegen Mehrkosten durch privatärztliche Behandlung nach Behandlungsfehler

Abstrakt Besteht zwischen Sch?diger und Gesch?digtem Streit über eine genau beschriebene, auch in der Zukunft m?glicherweise wiederkehrende einzelne Schadensposition, so besteht für die Feststellung der Einstandspflicht des Sch?digers hinsichtlich dieser konkret bezeichneten Position auch dann ein Feststellungsinteresse, wenn seine Einstandspflicht für zukünftige (materielle) Sch?den bereits zuvor allgemein rechtskr?ftig festgestellt wurde. Wird wegen der Folgen eines Behandlungsfehlers ein Patient nicht in eine private Krankenversicherung aufgenommen, so umfasst der vom Sch?diger zu leistende Schadensersatz auch die Verpflichtung, dem gesch?digten Patienten die Mehrkosten einer privat?rztlichen Behandlung zu ersetzen. Dabei sind die ersparten Versicherungsbeitr?ge abzuziehen. (Leits?tze des Bearbeiters)     

Diagnosis of pulmonary Kaposi's sarcoma with fiberoptic bronchoscopy and endobronchial biopsy. A report of five cases

Fiberoptic bronchoscopy is a major tool in the diagnostic evaluation of pulmonary disease in patients with the Acquired Immune Deficiency Syndrome. Multiple opportunistic infections and Kaposi's sarcoma affect the lung in this disorder. In contrast to opportunistic infections, Kaposi's sarcoma is rarely reported to be diagnosed by means of bronchoscopy. This report describes five of seven patients in whom endobronchial lesions consistent with submucosal involvement by the tumor were seen, and Kaposi's sarcoma was diagnosed without complication. Kaposi's sarcoma must be considered in the differential diagnosis of pulmonary disease in patients with a proven extrapulmonary tumor focus, and fiberoptic bronchoscopy is the initial diagnostic procedure of choice. Endobronchial Kaposi's sarcoma may be a marker for parenchymal involvement by the tumor. Diagnosis of endobronchial Kaposi's sarcoma can be an important factor in decisions regarding therapy.     

Clinical effectiveness of dermatomal evoked cerebrally recorded somatosensory responses

Among 129 patients with spine pain and radiculopathy in both the cervical and lumbar region, there were significant differences between the upper and lower extremity DSER groups, noting the higher number of normal studies by our criteria in the upper extremities as compared to the lower extremities. This difference may be due to the intertwining of the "nerve circuitry" of the input pathways. It appears that the dermatomal somatosensory evoked response is a study of low sensitivity and of high specificity.     

Cytologische Kriterien der Wirkung von Sanamycin

Zusammenfassung Die cytostatische Wirkung des Sanamycin auf Milz, Thymus und Nebennieren des Kaninchens wurde mit Hilfe einer vergleichenden cyto-histologischen Untersuchungtechnik geprüft, um einen näheren Einblick in die zellspezifischen Angriffspunkte des Medikamentes zu gewinnen. Der Effekt auf die normale Lymphopoese besteht in einer zeitlich begrenzten Abnahme der reifen Lymphocyten zugunsten einer Vermehrung der Lymphoblasten, wobei histologisch eine allgemeine Reduktion der lymphatischen Gewebsanteile in Erscheinung tritt. Das RHS bleibt in diesem Zusammenhang unberührt. Die Nebennieren zeigen nach hohen Sanamycindosen Veränderungen, die einer beträchtlichen Stresswirkung oder einer reversiblen toxischen Schäidgung entsprechen können. Das durch kurzfristige Sensibilisierung stimulierte Zellsubstrat der Antikörperbildung erfährt durch Sanamycingaben eine nachhaltige Depression, während dieser Effekt bei chronisch sensibilisierten Tieren wesentlich geringer ausgeprägt ist. Die tierexperimentell erhobenen Befunde werden im Hinblick auf die therapeutische Sanamycinwirkung bei lymphatischen Systemkrankheiten und die Möglichkeiteiner Beeinflussungakuter Antigen-Antikörperreaktionen diskutiert.Herrn Professor Dr.R. Schoen zum 65. Geburtstag.     

The prognostic value of serum troponin T in unstable angina.

BACKGROUND. Cardiac troponin T is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. We used a newly developed enzyme immunoassay for troponin T to determine whether its presence in the serum of patients with unstable angina was a prognostic indicator. METHODS. We screened 109 patients with unstable angina (25 with accelerated or subacute angina and 84 with acute angina at rest) for serum creatine kinase activity, creatine kinase isoenzyme MB activity, and troponin T every eight hours for two days after admission to the hospital. The outcomes of interest during the hospitalization were death and myocardial infarction. RESULTS. Troponin T was detected (range, 0.20 to 3.64 micrograms per liter; mean, 0.78; median, 0.50) in the serum of 33 of the 84 patients (39 percent) with acute angina at rest. Only three of these patients had elevated creatine kinase MB activity (two were positive for troponin T, and one was negative). Of the 33 patients who were positive for troponin T, 10 (30 percent) had myocardial infarction (3 after coronary-artery bypass surgery), and 5 of these died during hospitalization. In contrast, only 1 of the 51 patients with angina at rest who were negative for troponin T had an acute myocardial infarction (P less than 0.001), and this patient died (P = 0.03). Thus, 10 of the 11 patients with myocardial infarctions had detectable levels of troponin T; only 1 had elevated creatine kinase MB activity. Troponin T was not detected in any of the 25 patients with accelerated or subacute angina, and none of these patients died. CONCLUSIONS. Cardiac troponin T in serum appears to be a more sensitive indicator of myocardial-cell injury than serum creatine kinase MB activity, and its detection in the circulation may be a useful prognostic indicator in patients with unstable angina.     

Myocardial infarction in a large colony of nonhuman primates with coronary artery atherosclerosis.

Relatively few cases of myocardial infarction associated with coronary artery atherosclerosis have been described previously in macaques. In this study the authors report the prevalence and characteristics of coronary artery atherosclerosis and myocardial infarction in 10 rhesus (Macaca mulatta) and two cynomolgus (Macaca fascicularis) macaques that were fed atherogenic diets for 16 months or longer. Our findings show clearly that myocardial infarction occurs in macaques with diet-induced atherosclerosis. The frequency seems to be related to the species, composition of the atherogenic diet, and length of time fed the atherogenic diet. The myocardial lesions are remarkably similar to those described in human beings in terms of location and gross and microscopic characteristics. The characteristics of coronary artery atherosclerosis, including the occurrence of thrombosis, severe stenosis, mineralization, atheronecrosis, and sterol clefts, especially in animals fed the atherogenic diets for longer periods of time, also closely resemble those of the arterial lesions found in human beings. The greatest prevalence of myocardial infarcts was found in rhesus monkeys fed a cholesterol-containing diet with 40% of calories supplied by peanut oil and in cynomolgus macaques from Malaya that were fed the same amount of cholesterol with 40% of calories from lard. Electrocardiographic abnormalities as well as the occurrence of unexpected and relatively sudden death in several of these nonhuman primates are also consistent with signs frequently observed in human beings.     

The selective processing of briefly presented affective pictures: an ERP analysis

Recent event-related potential (ERP) studies revealed the selective processing of affective pictures. The present study explored whether the same phenomenon can be observed when pictures are presented only briefly. Toward this end, pleasant, neutral, and unpleasant pictures from the International Affective Pictures Series were presented for 120 ms while event related potentials were measured by dense sensor arrays. As observed for longer picture presentations, brief affective pictures were selectively processed. Specifically, pleasant and unpleasant pictures were associated with an early endogenous negative shift over temporo-occipital sensors compared to neutral images. In addition, affective pictures elicited enlarged late positive potentials over centro-parietal sensor sites relative to neutral images. These data suggest that a quick glimpse of emotionally relevant stimuli appears sufficient to tune the brain for selective perceptual processing.