Teilausschreibung eines Vertragsarztsitzes

Abstrakt 1. Der Sinn und Zweck des § 103 Abs. 4 SGB V besteht im Erhalt der wirtschaftlichen Verwertungsf?higkeit einer Praxis. 2. Auch im Falle der Beschr?nkung des Versorgungsauftrags auf einhalb besteht ein Recht des Arztes, einen Teil seines Vertragsarztsitzes wirtschaftlich zu verwerten.     

Mycosis fungoides presenting with extensive pyoderma gangrenosum-like ulcers

Mycosis fungoides (MF) may present with atypical clinical manifestations. Usually it mimics various chronic dermatoses, with the appearance of ulcers during the tumour stage. Infrequently, cutaneous ulcers are the main or initial sign of lymphoma. We report the case of a man who presented multiple skin lesions that clinically appeared to be pyoderma gangrenosum (PG). However, histological and immunohistochemical examination revealed MF. This case illustrates that PG-like ulcers maybe atypical cutaneous manifestations of MF and exceptionally the presenting sign of this disease.     

Konsiliararzt und „unechter“ („schwarzer“) Belegarzt

Abstrakt 1. Eine mit der Ausübung vertrags?rztlicher T?tigkeit unvereinbare Interessen- und Pflichtenkollision liegt vor bei einer faktischen Wahrnehmung der T?tigkeit eines Krankenhausarztes durch einen zugelassenen Arzt. 2. Ein Konsiliararzt ist ein Arzt mit einer anderen Fachgebietsbezeichnung, der in einem konkreten Behandlungsfall w?hrend eines station?ren Aufenthalts auf seinem Fachgebiet untersucht und Behandlungsvorschl?ge macht, weil die entsprechende Fachkompetenz in dem Krankenhaus nicht vorhanden ist. (Leits?tze des Bearbeiters)     

Vergütung psychotherapeutischer Leistungen; Korrekturbeschluss des Bewertungsausschusses vom 16.2.2000

Ohne Zusammenfassung     

Interleukin-1 alpha upregulates tumor necrosis factor receptors expressed by a human bone marrow stromal cell strain: implications for cytokine redundancy and synergy

To explore the biochemical and physiologic basis of the overlapping effects of interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor alpha (TNF-alpha) on myeloid cytokine production, we have studied the dynamics of granulocyte colony-stimulating factor (G-CSF) and granulocyte-monocyte colony-stimulating factor (GM-CSF) production as well as IL-1 receptor and TNF receptor expression in a clonally derived bone marrow stromal cell strain (CDCL). IL-1 alpha and TNF alpha act in a synergistic manner to stimulate G-CSF and GM-CSF production by CDCL, resulting in an increase in CSF secretion that is 250-fold greater than that observed with either cytokine alone. This synergism in protein secretion is paralleled by synergistic increases the steady-state level of GM- and G-CSF mRNA, with supra-additive levels achieved by 24 hours. Coincident with this synergistic induction of myeloid CSFs, treatment of CDCL cells with IL-1 alpha induces a 300% increase in the expression of TNF receptors. IL-1 alpha induction of TNF receptors reaches a peak after 6 hours and gradually returns to baseline level by 24 hours. IL-1 alpha does not affect TNF receptor ligand binding affinity. A kinetic study comparing IL-1/TNF synergistic induction of growth factor secretion with IL-1 alpha induction of TNF receptors shows that these events occur in parallel. In contrast with the induction of TNF receptors by IL-1 alpha, treatment with TNF alpha has no effect on either the number of IL-1 receptors expressed by CDCL cells or IL-1 receptor ligand binding affinity. Brief treatment of IL-1 alpha/TNF alpha-stimulated CDCL cells with cycloheximide before receptor induction reduces the synergistic increase in growth factor mRNA by 40% to 60% compared with cells not treated with CHX. Taken together, these results raise the possibility that IL-1 alpha cross-induction of TNF receptors may contribute to the biochemical mechanisms underlying the synergistic stimulation of G-CSF and GM-CSF production by IL-1 alpha and TNF alpha.     

Anthropometry profiles of elite rugby players: quantifying changes in lean mass

Objective

To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes.

Methods

Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfolds^x, for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes.

Results

The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits ±0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits ±2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits ±3.1%) during the club season. A small decrease in LMI (∼1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits ±2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons.

Conclusions

Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes.