Zur Indikation der Cholecystektomie bei steinfreien Gallenblasen

Zusammenfassung Bei der Cholecystektomie der steinfreien Gallenblasen ist zwischen derrelativen und derabsoluten Indikation zur Operation zu unterscheiden. W?hrend man bei der relativen Indikation (Deformit?ten, Funktionsst?rungen, Syphopathien und dergleichen) zurückhaltend ist, sollte die absolute Indikation gro?zügig gestellt werden. Es handelt sich hierbei in erster Linie um chronische Cholecystitiden mit Wandfibrose, um benigne und maligne Tumoren, um die Cysticusstenose mit Ver?nderungen an der Gallenblase und um die Cholesterose (Stippchengallenblase). Nachuntersuchungen von Patienten, bei denen wegen steinfreier Cholesterose eine Cholecystektomie durchgeführt worden war, lie?en ein günstiges Ergebnis erkennen.

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Summary In patients undergoing cholecystectomy for gall-bladders without stones one must differentiate between therelative and theabsolute indication for surgery. Whereas one uses reservation as far as the relative indications are concerned (deformities, functional disorders, syphopathies etc.), the absolute indications should be stated more liberally. These are mainly chronic cholecystitis with fibrosis of the wall, benign and malignant tumors, duct stenosis with changes of the gallbladder and cholesterosis (strawberry gall-bladder). Follow-up examinations of patients who underwent cholecystectomy for cholesterosis without stones showed a favourable result.

     

Decreased CK1δ expression predicts prolonged survival in colorectal cancer patients

Tumor Biology - Cancers arising from the large intestine or rectum are called colorectal cancer (CRC) and represent the fourth leading cause of cancer-related death worldwide. Since casein kinase 1...     

Hypersensitivity pneumonitis: evaluation with CT

Thirteen chest radiographs and computed tomographic (CT) scans obtained from 11 patients with hypersensitivity pneumonitis were reviewed. The CT findings were correlated with open lung biopsy findings in seven patients. The two patients with acute hypersensitivity pneumonitis showed air-space opacification on CT scans. An open lung biopsy, done in one of these patients, demonstrated noncaseating granulomas and filling of the air spaces with macrophages. The nine patients with subacute hypersensitivity pneumonitis showed small, rounded opacities and patchy air-space opacification on CT scans. These findings reflected the histologic findings, which consisted of interstitial pneumonitis, cellular bronchiolitis, and small, noncaseating granulomas. The six patients with symptoms for 12 months or longer also showed irregular linear opacities on CT scans, corresponding to areas of fibrosis. CT scans were superior to radiographs in helping to assess the type and extent of abnormalities, and high-resolution CT scans were superior to conventional CT scans.     

DNA microarray technology for neonatal screening

Modern molecular biology, owing much to the Human Genome Initiative, has elucidated many of the genetic mechanisms underlying heritable metabolic disease. While the use of molecular methods has flourished in research laboratories, complexity and cost have limited their utility in newborn screening. Newborn blood cards provide high quality DNA samples able to provide reliable support to highly multiplexed polymerase chain reactions (PCR). New manufacturing processes have reduced the cost of DNA microarray technology to the point where it is a practical tool for population screening. In a single assay, a DNA microarray facilitates the co-detection of amplification products diagnostic for several genetic diseases. High throughput is achieved with automation at every step, from DNA extraction to detection of hybrids. We suggest that it is both feasible and practical to develop a first-tier newborn screening protocol based upon multiplex PCR and analysis of amplification products using DNA microarrays. Initial data utilizing the model systems of sickle cell disease, α-1-antitrypsin deficiency and Factor V Leiden will be reported.     

Signaling events following the interaction of the neuronal adhesion molecule F3 with the N-terminal domain of tenascin-R

Interaction between the extracellular matrix protein tenascin-R and the neuronal adhesion molecule F3 might be involved in the formation of neuronal networks. In this study, the fragment of tenascin-R comprising epithelial growth factor (EGF)-like repeats and the cysteine-rich NH2 terminal stretch (EGF-L), known to be inhibitory for growing neurites and repellent for growth cones, was used to investigate the signaling events following the F3/EGF-L interaction. We addressed this question using an in vitro test with F3-transfected Chinese hamster ovary (CHO) cells that allowed us to measure the kinetics, magnitude and specificity of the repellent effect resulting from the specific F3/EGF-L interaction. We showed that the repellent effect was counteracted by addition of the serine/threonine kinase and -phosphatase modulators (staurosporine, okadaic acid and H7) but not by modulators of tyrosine kinase or -phosphatases. This result indicates that the intracellular signals activated by the repellent effect involve a serine/threonine kinase pathway. Furthermore, the repellent effect of the EGF-L fragment for growth cones of cultured cerebellar neurons was also abolished by the identical modulators of serine/threonine kinase and -phosphatases. The inhibition of neurite outgrowth from hippocampal neurons by EGF-L was abolished in the presence of the serine threonine-kinase inhibitor H7. These results strongly suggest that the F3/tenascin-R interaction through EGF-L involves an intracellular activation of serine/threonine kinase(s) in all F3-expressing cells tested. J. Neurosci. Res. 49:698–709, 1997. © 1997 Wiley-Liss, Inc.