In der Studie wurden 20 Patienten mit AV-Reentry Tachykardie unter Einbezug einer mittelseptalen gelegenen atrioventricul ren akzessorischen Leitungsbahn(MS) eingeschlossen, die seit 4 Jahren in unserem Elektrophysio...In der Studie wurden 20 Patienten mit AV-Reentry Tachykardie unter Einbezug einer mittelseptalen gelegenen atrioventricul ren akzessorischen Leitungsbahn(MS) eingeschlossen, die seit 4 Jahren in unserem Elektrophysiologischen Untersuchungslabor mittels Katheters erfolgreich abladiert wurden. Die 20 Patienten hatten 26 akzessorische Leitungsbahnen. Daunter waren 21 MS (rechtsmittelseptal (RMS) zu linksmittelseptal(LMS)=17:4). 18 akzessorische Leitungsbahnen waren offen. Die Lokalisation der akzessorischen Leitungsbahnen wurde aufgrund der Stelle erfolgreich abladiert bestimmt. Die Ergebnisse zeigten, da die RMS und LMS den gleichen Charakter in den meisten Ableitungen des EKGs hatten, und jedoch der wenige Unterschied bei diesen beiden akzessorischen Lritungsbahnen besteht. Wenn die positive Polaritat der Delta Welle in der Ableitung V 1 bei der Patienten mit MS auftritt, mu sich berlegen, ob die M glichkeit der Lokalisation der akzessorischen Leitungsbahn im Linksmittelseptum besteht.展开更多
Aims: The FREEZE-cohort study (NCT 01360008) is a prospective observational, multicenter and multinational study to evaluate safety and effectiveness of cryoballoon ablation for pulmonary vein isolation as compared to...Aims: The FREEZE-cohort study (NCT 01360008) is a prospective observational, multicenter and multinational study to evaluate safety and effectiveness of cryoballoon ablation for pulmonary vein isolation as compared to radiofrequency ablation in patients with paroxysmal or persistent atrial fibrillation (lasting < one year) under the conditions of clinical routine. Methods and Results: The study started in 2011 and anticipates inclusion up to 2000 patients in each of the two treatment groups. A total of 37 centers from 8 countries worldwide, all experienced in at least one of the two ablation techniques, participate in the study. The primary outcome parameter of the study is defined as atrial fibrillation recurrence rate during twelve months of follow-up. Secondary outcome parameters include primary success rates, complication rates in general, specific complications with respect to phrenic nerve palsy and pulmonary vein stenosis, radiation exposure, clinical course including death and repeat ablation. Finally specific procedural aspects will be evaluated in a descriptive manner. Preliminary data of the first 1882 patients show that in clinical practice cryoablation is preferentially performed in patients with paroxysmal atrial fibrillation, whereas application of radiofrequency ablation is equally distributed between patients with persistent and paroxysmal atrial fibrillation. Conclusion: Based on multi-center and multi-national data the FREEZE-cohort study will provide important information on long-term efficacy, clinical effectiveness, complication rates and procedural differences between atrial fibrillation patients treated with either cryoablation or radiofrequency ablation.展开更多
Circumscribed palmar or plantar hypokeratosis is a new entity recently described by Perez et al in 2002. It seems to be underdiagnosed or clinically it is often misdiagnosed as Bowen’ s disease or porokeratosis. Obvi...Circumscribed palmar or plantar hypokeratosis is a new entity recently described by Perez et al in 2002. It seems to be underdiagnosed or clinically it is often misdiagnosed as Bowen’ s disease or porokeratosis. Obviously the number of case reports of circumscribed palmar or plantar hypokeratosis has increased since the first publication by Perez et al. The histopathological hallmarks of this condition are a stair- like configuration with an abrupt thinning of the stratum corneum from uninvolved to involved skin with a central hypokeratotic area. There are no atypical keratinocytes or cornoid lamellation. We describe two new patients with circumscribed palmar hypokeratosis. In one case there were additional histopathological features including the loss of granular cell layer in the center of the lesion and an overlying compact thin parakeratotic layer.展开更多
Background/Aims: The natural course of the hepatitis C virus genotype 1b (HCV-1b) infection is still unclear but important for therapeutic decisions. There are few unbiased long-term follow-up studies with known dates...Background/Aims: The natural course of the hepatitis C virus genotype 1b (HCV-1b) infection is still unclear but important for therapeutic decisions. There are few unbiased long-term follow-up studies with known dates of infection. Methods: Between August 1978 and March 1979, 14 HCV-1b contaminated batches of anti-D immunoglobulin had been administered to 2867 women for prophylaxis of rhesus isoimmunization throughout East Germany. We reexamined 1980 women, representing 70% of the total cohort of 15 centers. Results: After application of the contaminated anti-D, 93% of the recipients developed an acute hepatitis C. After 25 years, 86% of the 1833 affected women still tested positive for hepatitis C virus antibodies and 46% for HCV RNA. Only nine (0.5% ) had overt liver cirrhosis, 30 women (1.5% ) developed precirrhotic stages and one HCC was diagnosed. Ten (0.5% ) died of HCV related complications, half of these related to additional comorbidity. In the last 5 years, a continuous, but low increase of fibrotic scores was observed. Conclusions: Young women without comorbidity may clear HCV (1b) infection in more than half of the cases, or develop mild chronic hepatitis C. We confirmed the low risk of progression to cirrhosis in this cohort within 25 years.展开更多
Background. Despite widespread use of anti-inflammatory drugs the morbidity of asthma in the paediatric age group is still increasing. Los acceptance of therapy may be a reason for this. Methods. A validated questionn...Background. Despite widespread use of anti-inflammatory drugs the morbidity of asthma in the paediatric age group is still increasing. Los acceptance of therapy may be a reason for this. Methods. A validated questionnaire was administered into 101 children and 109 of their parents in personal interviews and to 102 paediatriicians in telephone interviews. Results.The majority of the children and their parents expressed dissatisfaction with the current asthma management. Children and their parents expressed very similar judgments, but the answers given by the paediatricians differed notably from those of both other groups. The physicians underestimated the time taken up by the therapy, and overestimated the patients’ anxiety about asthma drugs. New types of inhalers (dry powder inhalers; DPIs) were not rated at all highly, “classic”MDIs(metered dose inhalers) being preferred by children and their parents, followed by tablets or capsules. Physicians imagined patients would prefer DPIs,as they themselves thought these were superior for inhalation therapy. In addition, children and their parents reported more frequently than the paediatricians imagined that they would like more information on the disease and the medication available, Especially if this were presented in a group situation or through the new media. Conclusion. It will not be possible to improve compliance in asthma management unless the frequency of drug administration is reduced and better communication between doctor and patient is achieved.展开更多
Objectives: Patients with hyperhidrosis suffer from an extreme perspiration that cannot be aligned with natural or situational standards. Endoscopic sympathectomy is a meaningful option for palmar and axillary hyperhi...Objectives: Patients with hyperhidrosis suffer from an extreme perspiration that cannot be aligned with natural or situational standards. Endoscopic sympathectomy is a meaningful option for palmar and axillary hyperhidrosis. A standardized method of monitoring the immediate intraoperative success has not been established yet. The presented investigation shows one proposed sollution by monitoring skin surface temperature. The main aspect is to demonstrate a significant rise in temperature with utility for monitoring the immediate success of surgery. Methods: Twenty patients with primary hyperhidrosis were observed and treated in a standardized setting against a control group (n = 10). We obtained diverse data that permit determination of a point of time of measurement of surface temperature and definition of a degree of temperature variance. Results: After 5 minutes a significant change of 0.5? Celcius was noted on the palms;after 10 minutes on average 1.2? Celcius. Axillary temperature had significantly changed after 10 minutes with a mean temperature variation of 0.8? Celcius on the right side and 0.6? Celcius on the left side. Conclusions: Under consideration of appropriate time intervals of measurement and determined changes in surface temperature an early control of correct clip application in ETS is possible. In the palmar aspect an increase of 0.5? Celcius at an 5 minutes interval, and more than 1? Celcius at 10 minutes after placement of the clip as compared to basic values before application of the clip can be proposed.展开更多
We report the case of a 68- year- old female with reactive angioendotheliomatosis (RAE). This case highlights the benign course of this condition and suggests that this entity might be an intravascular histiocytosis.
《2015年St.Gallen早期乳腺癌国际专家共识》在外科手术领域做出了若干更新,指出最小可接受保乳切缘为"无浸润性肿瘤或导管原位癌(ductual carcinoma in situ,DCIS)印染";只要切缘达到"无浸润性肿瘤或DCIS印染"标...《2015年St.Gallen早期乳腺癌国际专家共识》在外科手术领域做出了若干更新,指出最小可接受保乳切缘为"无浸润性肿瘤或导管原位癌(ductual carcinoma in situ,DCIS)印染";只要切缘达到"无浸润性肿瘤或DCIS印染"标准以及有计划行术后放疗,小叶组织来源、广泛导管内成分、年轻病人、多灶或多中心和不良生物学亚型的早期乳腺癌同样可行保乳手术;ACOSOG Z0011的结果在临床实践中推广是可行的。展开更多
文摘In der Studie wurden 20 Patienten mit AV-Reentry Tachykardie unter Einbezug einer mittelseptalen gelegenen atrioventricul ren akzessorischen Leitungsbahn(MS) eingeschlossen, die seit 4 Jahren in unserem Elektrophysiologischen Untersuchungslabor mittels Katheters erfolgreich abladiert wurden. Die 20 Patienten hatten 26 akzessorische Leitungsbahnen. Daunter waren 21 MS (rechtsmittelseptal (RMS) zu linksmittelseptal(LMS)=17:4). 18 akzessorische Leitungsbahnen waren offen. Die Lokalisation der akzessorischen Leitungsbahnen wurde aufgrund der Stelle erfolgreich abladiert bestimmt. Die Ergebnisse zeigten, da die RMS und LMS den gleichen Charakter in den meisten Ableitungen des EKGs hatten, und jedoch der wenige Unterschied bei diesen beiden akzessorischen Lritungsbahnen besteht. Wenn die positive Polaritat der Delta Welle in der Ableitung V 1 bei der Patienten mit MS auftritt, mu sich berlegen, ob die M glichkeit der Lokalisation der akzessorischen Leitungsbahn im Linksmittelseptum besteht.
文摘Aims: The FREEZE-cohort study (NCT 01360008) is a prospective observational, multicenter and multinational study to evaluate safety and effectiveness of cryoballoon ablation for pulmonary vein isolation as compared to radiofrequency ablation in patients with paroxysmal or persistent atrial fibrillation (lasting < one year) under the conditions of clinical routine. Methods and Results: The study started in 2011 and anticipates inclusion up to 2000 patients in each of the two treatment groups. A total of 37 centers from 8 countries worldwide, all experienced in at least one of the two ablation techniques, participate in the study. The primary outcome parameter of the study is defined as atrial fibrillation recurrence rate during twelve months of follow-up. Secondary outcome parameters include primary success rates, complication rates in general, specific complications with respect to phrenic nerve palsy and pulmonary vein stenosis, radiation exposure, clinical course including death and repeat ablation. Finally specific procedural aspects will be evaluated in a descriptive manner. Preliminary data of the first 1882 patients show that in clinical practice cryoablation is preferentially performed in patients with paroxysmal atrial fibrillation, whereas application of radiofrequency ablation is equally distributed between patients with persistent and paroxysmal atrial fibrillation. Conclusion: Based on multi-center and multi-national data the FREEZE-cohort study will provide important information on long-term efficacy, clinical effectiveness, complication rates and procedural differences between atrial fibrillation patients treated with either cryoablation or radiofrequency ablation.
文摘Circumscribed palmar or plantar hypokeratosis is a new entity recently described by Perez et al in 2002. It seems to be underdiagnosed or clinically it is often misdiagnosed as Bowen’ s disease or porokeratosis. Obviously the number of case reports of circumscribed palmar or plantar hypokeratosis has increased since the first publication by Perez et al. The histopathological hallmarks of this condition are a stair- like configuration with an abrupt thinning of the stratum corneum from uninvolved to involved skin with a central hypokeratotic area. There are no atypical keratinocytes or cornoid lamellation. We describe two new patients with circumscribed palmar hypokeratosis. In one case there were additional histopathological features including the loss of granular cell layer in the center of the lesion and an overlying compact thin parakeratotic layer.
文摘Background/Aims: The natural course of the hepatitis C virus genotype 1b (HCV-1b) infection is still unclear but important for therapeutic decisions. There are few unbiased long-term follow-up studies with known dates of infection. Methods: Between August 1978 and March 1979, 14 HCV-1b contaminated batches of anti-D immunoglobulin had been administered to 2867 women for prophylaxis of rhesus isoimmunization throughout East Germany. We reexamined 1980 women, representing 70% of the total cohort of 15 centers. Results: After application of the contaminated anti-D, 93% of the recipients developed an acute hepatitis C. After 25 years, 86% of the 1833 affected women still tested positive for hepatitis C virus antibodies and 46% for HCV RNA. Only nine (0.5% ) had overt liver cirrhosis, 30 women (1.5% ) developed precirrhotic stages and one HCC was diagnosed. Ten (0.5% ) died of HCV related complications, half of these related to additional comorbidity. In the last 5 years, a continuous, but low increase of fibrotic scores was observed. Conclusions: Young women without comorbidity may clear HCV (1b) infection in more than half of the cases, or develop mild chronic hepatitis C. We confirmed the low risk of progression to cirrhosis in this cohort within 25 years.
文摘Background. Despite widespread use of anti-inflammatory drugs the morbidity of asthma in the paediatric age group is still increasing. Los acceptance of therapy may be a reason for this. Methods. A validated questionnaire was administered into 101 children and 109 of their parents in personal interviews and to 102 paediatriicians in telephone interviews. Results.The majority of the children and their parents expressed dissatisfaction with the current asthma management. Children and their parents expressed very similar judgments, but the answers given by the paediatricians differed notably from those of both other groups. The physicians underestimated the time taken up by the therapy, and overestimated the patients’ anxiety about asthma drugs. New types of inhalers (dry powder inhalers; DPIs) were not rated at all highly, “classic”MDIs(metered dose inhalers) being preferred by children and their parents, followed by tablets or capsules. Physicians imagined patients would prefer DPIs,as they themselves thought these were superior for inhalation therapy. In addition, children and their parents reported more frequently than the paediatricians imagined that they would like more information on the disease and the medication available, Especially if this were presented in a group situation or through the new media. Conclusion. It will not be possible to improve compliance in asthma management unless the frequency of drug administration is reduced and better communication between doctor and patient is achieved.
文摘Objectives: Patients with hyperhidrosis suffer from an extreme perspiration that cannot be aligned with natural or situational standards. Endoscopic sympathectomy is a meaningful option for palmar and axillary hyperhidrosis. A standardized method of monitoring the immediate intraoperative success has not been established yet. The presented investigation shows one proposed sollution by monitoring skin surface temperature. The main aspect is to demonstrate a significant rise in temperature with utility for monitoring the immediate success of surgery. Methods: Twenty patients with primary hyperhidrosis were observed and treated in a standardized setting against a control group (n = 10). We obtained diverse data that permit determination of a point of time of measurement of surface temperature and definition of a degree of temperature variance. Results: After 5 minutes a significant change of 0.5? Celcius was noted on the palms;after 10 minutes on average 1.2? Celcius. Axillary temperature had significantly changed after 10 minutes with a mean temperature variation of 0.8? Celcius on the right side and 0.6? Celcius on the left side. Conclusions: Under consideration of appropriate time intervals of measurement and determined changes in surface temperature an early control of correct clip application in ETS is possible. In the palmar aspect an increase of 0.5? Celcius at an 5 minutes interval, and more than 1? Celcius at 10 minutes after placement of the clip as compared to basic values before application of the clip can be proposed.
文摘We report the case of a 68- year- old female with reactive angioendotheliomatosis (RAE). This case highlights the benign course of this condition and suggests that this entity might be an intravascular histiocytosis.
文摘《2015年St.Gallen早期乳腺癌国际专家共识》在外科手术领域做出了若干更新,指出最小可接受保乳切缘为"无浸润性肿瘤或导管原位癌(ductual carcinoma in situ,DCIS)印染";只要切缘达到"无浸润性肿瘤或DCIS印染"标准以及有计划行术后放疗,小叶组织来源、广泛导管内成分、年轻病人、多灶或多中心和不良生物学亚型的早期乳腺癌同样可行保乳手术;ACOSOG Z0011的结果在临床实践中推广是可行的。
