Aneurysmen der Arteria pancreatico-duodenalis als gastrointestinale Blutungsursache

Zusammenfassung Bei 2 erfolgreich operierten F?llen mit Aneurysmen der pancreatico-duodenalis, kompliziert durch schwerste gastrointestinale Blutungen, zeigt sich, da? unklare Symptomatik und hypovol?mischer Schock die Diagnose erschweren. Die Drosselung der A. hepatica und die Belassung des Aneurysmengrundes erleichtern das operative Vorgehen. Als ?tiologischer Faktor wird die Pankreatitis angedeutet.

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Summary 2 cases of aneurysm of the pancreatico-duodenal artery were successfully treated by operation. Hypovolemic shock due to gastrointestinal bleeding and atypical symptoms caused diagnostic difficulties. Constriction of the hepatic artery and leaving behind the ground of the aneurysm facilitated the intervention. It is assumed that the lesions were caused by pancreatitis.

     

Probleme der Lobektomie im Hinblick auf das funktionelle Spätresultat

Ohne Zusammenfassung     

Form- und Lageveränderung intra- und extrathorakal gelegener Organe nach Pneumonektonie und deren klinische Bedeutung

Ohne ZusammenfassungMit 9 Textabbildungen.     

Catechol-O-methyltransferase polymorphism and endometriosis

Purpose : Catechol-O-methyltransferase (COMT) inactivates the estradiol metabolites, 2-hydroxy and 4-hydroxy catechols, which have been implicated in the pathogenesis of endometriosis. A COMT valine to methionine polymorphism (G-to-A) in exon 4 of the COMT gene is polymorphic in the human population, with 25% of Caucasians being homozygous for the low-activity allele (COMT-L) of the enzyme. In a case-control study we investigated whether this COMT polymorphism is associated with endometriosis. Methods : Polymerase chain reaction was performed to analyze the COMT genotype among women with surgically and histologically confirmed endometriosis (study group; n = 91) and in women without evidence of endometriosis confirmed by laparoscopy or laparotomy (control group; n = 92). Results : Allele frequencies for the low-activity allele (COMT-L) among women with endometriosis and controls were 0.50 and 0.50, respectively (p = 0.999; odds ratio = 1.0, 95% CI: 0.66–1.51). Conclusions : Our results suggest that the valine to methionine polymorphism in exon 4 of the COMT gene is not associated with the risk of endometriosis compared to a surgical control population.     

Tumor necrosis factor-alpha promotor polymorphisms and endometriosis

To explore whether having the mutant tumor necrosis factor (TNF)2 (G-308*A) and TNFA-A (G-238*A) alleles in the TNF-alpha gene promotor region is higher in women with endometriosis, we determined the respective genotype and allele frequencies in a retrospective case-control study.Polymerase chain reaction was performed to identify the G-308A and G-238A promotor polymorphisms in 92 women with surgically and histologically confirmed endometriosis. A series of 69 healthy women without a history of endometriosis served as clinical controls.The allele frequencies of the TNF2 polymorphism were 0.13 and 0.16 in women with endometriosis and in the control group, respectively, and the frequencies of the TNFA-A polymorphisms in women with endometriosis and in the control group were 0.04 and 0.05, respectively, with no significant difference between the study and control groups. The TNF2 polymorphism was present in the homozygous form (TNF(2/2)) in 4.3% of women with endometriosis and in 2.9% of controls (P=.7). No TNFA-A homozygotes (TNFA(A/A)) were detected.We studied TNF-alpha promotor gene variants among women with endometriosis and found that having the G-308A TNF-alpha and the G-238A TNF-alpha polymorphism was not associated with endometriosis in a white population.     

Interleukin-1 receptor antagonist polymorphism in women with peritoneal adhesions

Interleukin (IL)-1 has been shown to induce peritoneal adhesions. We determined the IL-1 receptor antagonist (IL-1RN) genotype with respect to the two most common variant alleles IL-1RN*2 and IL-1RN*3 in Caucasian women with peritoneal adhesions. One hundred seven women with surgically verified peritoneal adhesions and 79 controls without peritoneal adhesions served as controls. Univariate analysis showed an increased risk for peritoneal adhesions for Caucasian women carrying the mutant IL-1RN*2 allele (OR: 2.1; 95% CI: 1.3–3.4;   P = 0.004  ). Multiple logistic regression analysis demonstrated an increased risk for peritoneal adhesions, which is independent of previous abdominal surgery and endometriosis. Our data suggest that IL-1RN*2 allele carriers have an increased risk for adhesion formation.