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Fragestellung/Zielsetzung: Die professionelle Persönlichkeitsentwicklung ist neben dem Erwerb von medizinischen Kompetenzen ein wichtiger Teil der ärztlichen Ausbildung. Um passende curriculare Unterstützungsangebote zu implementieren, ist es notwendig zu verstehen, wie Medizinstudierende [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Poster-Abstract

Poster-Abstract

It is the aim of this thesis to shed light on and gain a more nuanced understanding of the negotiation of the political and constitutional order at the German Imperial Diet and the Polish-Lithuanian Sejm in the crisis-ridden seventeenth century. Both assemblies had to reach collectively-binding decisions on questions of institutional and procedural development in order to keep the constitutional order intact and functional and to process the challenges and changes occurring in the late sixteenth and the seventeenth centuries. The question of this thesis is how the scope for necessary institutional and procedural adjustments was enabled or constrained by political languages and rhetoric which key actors used in the deliberations at the two central estate assemblies. Why do we have an institutional standstill and comparative decline in Poland-Lithuania until the reform period in the eighteenth century, and a stabilization and gradual institutional adjustment until the 1720s in the Holy Roman Empire? This question is answered by analyzing the communication about the scope of politics in its concrete historical context and institutional setting. Through the analysis the thesis comes to a new interpretation of the role and impact of orality and writing in both assemblies. Establishing socially relevant meaning depended on the means of communication and on the relationship between different media in the process of political decision-making and how they formed communication, in this case oral and written communication. The central claim of the thesis is that political culture and material culture were intricately linked in both imperial systems as the available media in the political process shaped the sayable, and the sayable shaped the doable.

The anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody is specifically associated with dermatomyositis (DM). Nevertheless, anti-MDA5(+)-patients experience characteristic symptoms distinct from classic DM, including severe signs of extramuscular involvement; however, the clinical signs of myopathy are mild or even absent. The morphological and immunological features are not yet described in adulthood. Data concerning the pathophysiology of anti-MDA5 DM are sparse; however, the importance of the interferon (IFN) type I pathway involved in DM has been shown. Our aim was to define morphological alterations of the skeletal muscle and the intrinsic immune response of anti-MDA5-positive DM patients. Immunohistological and RT-PCR analysis of muscle biopsy specimens from anti-MDA5 and classic DM were compared. Those with anti-MDA5 DM did not present the classic features of perifascicular fiber atrophy and major histocompatibility complex class I expression. They did not show significant signs of capillary loss; tubuloreticular formations were observed less frequently. Inflammation was focal, clustering around single vessels but significantly Less intense. Expression of IFN-stimulated genes was up-regulated in anti-MDA5 DM; however, the IFN score was significantly lower. Characteristic features were observed in anti-MDA5 DM and not in classic DM patients. Only anti-MDA5 DM showed numerous nitric oxide synthase 2-positive muscle fibers with sarcoplasmic colocalization of markers of regeneration and cell stress. Anti-MDA5-positive patients demonstrate a morphological pattern distinct from classic DM.

Objectives: Dermatomyositis (DM) can occur in both adults and children with considerable clinical differences. The links between immune-mediated mechanisms and vasculopathy with respect to development of perifascicular atrophy are incompletely understood. We investigated skeletal muscle from newly diagnosed[for full text, please go to the a.m. URL], 60th Annual Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN)

In this retrospective study the results of surgical biopsy of suspected breast cancer in 319 outpatients are reported. In 113 cases (35.4%) the lesion was palpable, in 206 cases (64.6%) it was not. Concerning the nonpalpable esions, mammography was performed in 98 patients (47.6%) for work-up of fibrocystic changes, in 41 patients (19.9%) for initial participation in a breast cancer prevention program,and in 33 patients (16.0%) for surveillance after breast conservation therapy. Prior to operation, 84.0% (n=173) of the nonpalpable lesions were detected by mammography, 11.2% (n=23) by sonography, and 4.8% (n=10) by magnetic resonance imaging. Intra-operative specimen mammography was carried out in every case detected by mammography.In 19.4% (n=40) of 206 nonpalpable lesions a malignant tumor was found.Twenty-five percent (n=10) of all marked tumors were diagnosed and treated as in-situ stage tumors, while 65% (n=26) were diagnosed and treated as tumors in the pT1 stage.As regards the nodal stage, 85% (n=34) of the tumors were diagnosed and treated as pNO tumors, and 100% (n=40) were found to be free from any distant metastases. Consequently, for improving prognosis and, at the same time, for reducing the rate of breast amputations as a means of curative therapy of breast cancer, regular screening in defined risk groups is necessary. Surgical treatment of patients with small and nonpalpable findings should be reserved for departments with marking and quick-freezing facilities.

BACKGROUND In order to optimize regional utilization of transplantable thoracic organs, the seven university hospitals in North-Rhine-Westfalia have formed a transplant cooperation meanwhile approved by Eurotransplant. METHODS Heart transplant and organ donation activities of the cooperating hospitals in the year before the foundation of the cooperation (period A, 7/95 - 6/96) and in the year thereafter (period B, 7/96 - 6/97) were retrospectively analysed. RESULTS In period A, a total of 39 heart transplants and 74 heart donations were performed, whereas in period B 67 heart transplantations and 78 heart donations could be achieved. The regional utilization of the donor organs increased from 4% to 30% with a significantly shorter ischemia time of regionally or locally allocated donor hearts than of nationally or internationally allocated ones. CONCLUSIONS A high rate of regional or local heart transplant procedures with short ischemia times clearly demonstrate the benefits of a regionalization of heart transplant medicine for medical as well as economical reasons.