搜索结果：Medizinische Klinik (Munich, Germany : 1983)

At present, long-term results after conservative treatment of morbid obesity (body mass index > 40) are not satisfying, given a relapse rate > 95%. In comparison, surgical treatment is about 10 times more efficient and, thus, more cost-effective. Currently performed surgical interventions to induce weight loss are dominated by two major surgical procedures: (1) Mason's vertical gastroplasty, and (2) the insertion of an adjustable gastric band, developed by Kuzmak in 1983. Essential advantages of gastric banding include the possibility of laparoscopic performance and complete reversibility of the operation. After removal of the gastric band, stomach and upper intestine are left in their anatomic and functional integrity. During a 30-month period, we implanted the adjustable gastric band in 71 patients (65 female and six male patients). All procedures were performed laparoscopically. In none of the cases did intraoperative complications occur. Postoperatively 1.4% of the patients developed a slippage of the gastric band, 2.1% had complications concerning the subcutaneously placed port, and, eventually, the gastric band had to be removed in 1.4%.

In order to test the hypothesis that a dietary supplement of selenium (Se) may reduce cancer risk, 1312 patients with histories of basa/squamous cell carcinomas of the skin were assigned in random, double-blind fashion to daily oral supplements of either Se-enriched yeast (200 micrograms Se/day), or a low-Se yeast placebo. Patients were recruited in 1983 to 1990 and were followed with regular dermatologic examinations through, 1993 for a total of 8269 person-years of observation. Skin cancer diagnoses were confirmed histologically and plasma Se concentration was determined at 6 to 12 months intervals. All deaths and patient-reported illnesses were confirmed and documented by consultation with the patient medical care providers. Results showed that Se-supplementation did not significantly affect the incidences of recurrent basal/squamous cell carcinomas of the skin. However, Se-treatment was associated with reductions in total cancer mortality and in the incidences of lung, colorectal, prostate and total cancers. These effects were consistent over time and between study clinics. The results strongly suggest benefits of Se-supplementation for this cohort of patients and support the hypothesis that supplemental Se can reduce risks to at least some types of cancer.

From March 1983 to June 1986 in 206 patients with acute transmural myocardial infarction, combined intravenous and intracoronary therapy with streptokinase was initiated. After intravenous thrombolysis and randomization in two groups we performed a coronary angiography with selective intracoronary lysis. Infarct related vessels still occluded after intracoronary streptokinase application were opened mechanically in group I. In group II we performed additionally a percutaneous transluminal coronary angioplasty (PTCA) after mechanical recanalisation (occluded vessels) or after thrombolysis (open vessels). In 85 of 87 cases in group II, PTCA could be performed in the acute phase. Elective PTCA was performed in 22 patients of group I (21%) and in nine patients of group II (9%). Up to five years after myocardial infarction, coronary artery bypass grafting (CABG) was necessary in 22 patients (21%) of group I and in 23 patients (22%) of group II. Within four weeks after infarction CABG was performed in 32% and 17% of group I and II respectively. The six-year survival rate was 78% in group I and 82% in group II. Taken all patients together, the six-year survival rate was significantly higher (p = 0.002) for those with early reperfusion (less than or equal to 3.5 h). The survival rates of CABG-patients, PTCA-patients and patients without reperfusion were 91%, 74% and 65% respectively. Streptokinase thrombolysis results, combined with acute or elective PTCA and/or coronary bypass surgery, in a high six-year survival rate after acute transmural myocardial infarction. This rate is about 20% higher than ten years ago.

To describe the incidence of primary bone marrow involvement (BMI) in Hodgkin's disease (HD) and its correlation with clinical and laboratory features present at diagnosis, and to evaluate the prognostic relevance of BMI. Between 1983 and 1991, 2,307 patients with HD were treated according to two trial generations (HD1-3 and HD4-6) of the German Hodgkin's Lymphoma Study Group (GHSG). One hundred thirty-five cases of primary BMI were observed. The incidence of BMI was 4.8% in the HD4-6 study generation, which included all stages. Among stage IV patients, 32% had BMI. Among those with BMI, other organs were also involved in 33%. Among all patients, the presence of BMI was significantly associated with B symptoms, lymph nodes on both sides of the diaphragm, mixed cellularity histologic subtype, leukocytopenia, anemia, thrombocytopenia, lactate dehydrogenase (LDH) level more than 400 U/L, and erythrocyte sedimentation rate (ESR) more than 40 mm/h. BMI was negatively correlated with a large mediastinal tumor (3.7% v 20.0% in non-BMI cases). Eighty-seven of 108 (81%) assessable patients with BMI achieved a complete remission (CR). This compares favorably with the overall CR rate in all stage IIIB/IV patients. Among stage IV patients, BMI has no prognostic relevance with regard to freedom from treatment failure and overall survival. Twenty-one patients with BMI relapsed after having achieved a CR. Only five of these (24%) again had a positive bone marrow biopsy. The prognosis of patients with BMI is not worse than the prognosis of other advanced-stage HD patients. BMI alone does not define a special high-risk group in which a different treatment approach is indicated.

The aim of the study was to analyze the occurrence of primary and secondary glomerulopathies as well as tubulointerstitial nephropathies over time and to assess potential changes in the disease spectrum. The authors retrospectively analyzed all kidney biopsies performed in their institution between 1983 and 2006 as well as the clinical data at the time of biopsy. Between January 1983 and December 2006, 359 native kidney biopsies with sufficient material for histological analysis were performed (218 men, 141 women; mean age 51.8 years). A mean of nine glomeruli per biopsy were obtained. Mean serum creatinine at the time of biopsy was 3.3 mg/dl. The most common indication for biopsy was nephrotic syndrome (31%), followed by renal insufficiency (29%) and proteinuria (14%). Primary glomerulopathies were found in 51%, secondary glomerulopathies in 28%, tubulointerstitial renal diseases in 9%, and vascular renal diseases in 12%. Among the primary glomerulopathies, IgA nephropathy was the most common diagnosis (26%), followed by mesangioproliferative glomerulonephritis (17%), membranous glomerulonephritis (16%), minimal change disease (14%), focal segmental glomerulosclerosis (FSGS; 13%), rapidly progressive glomerulonephritis (RPGN; 8%), and membranoproliferative glomerulonephritis (7%). Among the secondary glomerulopathies, the heterogeneous group of autoimmune diseases (26%) and diabetic nephropathy (25%) dominated. Comparing the period from 1983 to 1994 with 1995 to 2006, a decrease in primary FSGS from 16% to 9% as well as in RPGN from 14% to 1% was noticed, while among the secondary forms, autoimmune diseases with renal involvement increased from 14% to 31%. In the own patient population changes in the spectrum of primary and secondary glomerulopathies can be observed over time. Thereby, the distribution pattern of the various glomerulonephritides largely corresponds to the distribution described for other West European countries. An increase in the incidence of primary FSGS, as observed in non-European countries, could not be demonstrated.

Hemangiopericytomas, rare perivascular tumors, normally tend to be well circumscribed, however, since some have a malignant behavior they are recognized to be potentially malignant. In the case presented here, we report the medical history of a 46-year-old man with a hemangiopericytoma of the nose. In 1983, the tumor was surgically removed, and histological examination revealed no signs of malignancy. In 1987, a local recurrence was removed followed by X-irradiation. In March 1995, the patient presented with multiple hepatic and bone metastases. Chemotherapy with ifosfamide (5 g/m2, day 1) and epirubicin (50 mg/m2, day 1) was performed. After three courses of chemotherapy a tumor stabilization was achieved. In November 1995, however, a massive progression of the hepatic lesions was found. Therefore, six courses of a second-line chemotherapy with dacarbazine (200 mg/m2, day 1 to 5) and adriamycin (60 mg/m2, day 1) were applied. A partial remission was achieved lasting until November 1996. A couple of weeks later the patient died due to hepatic failure. Despite of unacceptably low survival rates in patients with advanced soft tissue sarcomas (especially after pretreatment with ionizing radiation) our report demonstrates that it is also possible to induce long lasting remissions without altered quality of life.

Between 1983 and 1989, 85 patients with either carcinoma of the rectum or a recurrence of a previously diagnosed rectal tumour (47 women and 38 men aged 20 to 87 years) were treated in our pain clinic. In 50 patients, the reason for referral was perineal pain which had been present for one week to two years (median six months, 25%-percentile six weeks, 75%-percentile six months). In some patients this was considered to be due to scar tissue formation by the referring doctors. The pain was classified somatic, visceral and neuropathic in approximately equal numbers of patients, and about half of them described more than one type of pain. The other 35 patients were suffering from pain at other sites. In 40 out of 50 patients with perineal pain, local tumour recurrence was diagnosed. In 29 patients, pain symptoms began with a median of 5.5 months before the tumour recurrence was diagnosed. In a further seven patients, other types of tumour dissemination in the pelvis were considered to be the cause of the perineal pain. In only three patients no evidence of tumour was found in the pelvis. A non-neoplastic cause of perineal pain could be definitely confirmed in only one patient on post-mortem examination. 35 patients reported no perineal pain on admission, although in 19 cases a local cancer recurrence was found. 13 of these patients suffered from pain in the area of sensory innervation of the lumbosacral plexus. From 16 patients without a diagnosis of local recurrence, only four reported pain in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Between 1983 and 1987, there were 24 cases of contact allergy due to bufexamac seen at the Dermatological Hospital of the University of Göttingen. Of these patients, 20 were female und four male. It was noticeable, that the course of disease was particularly protracted and refractory: 16 of 22 patients were hospitalized with an average duration of inpatient treatment of 2.9 weeks. Seven patients had a generalized allergic contact dermatitis. Five patients had used topical preparations containing bufexamac for only one week or less. In 15 of 24 patients, further epidermal sensitization could be found. In all forms of eczematous diseases, especially in patients with chronic eczema, contact allergy to bufexamac should be considered, even if bufexamac preparations were used for only a short time.

In 1983 the antiphospholipid syndrome was first described as an independent clinical entity by Graham Hughes and characterized by thrombosis, thrombocytopenia and recurrent fetal losses. In the following years evidence accumulated from various studies that the thrombotic events in the antiphospholipid syndrome correlate with elevated serum titers of antiphospholipid antibodies. These autoantibodies represent a very heterogeneous group as multiple specificities against various negatively charged phospholipids are found. Most commonly described are antibodies against cardiolipin, but also cross-reactivities between the different phospholipids are observed. Moreover, efficient binding of antiphospholipid antibodies against a phospholipid requires the presence of certain protein-cofactors which on the other hand can be antigens themselves. Although numerous animal models strongly indicate that antiphospholipid antibodies play a causal role in the pathogenesis of the disease, the exact pathogenetic mechanisms are still to be elucidated. There is accumulating evidence from in vitro studies with poly- and monoclonal antiphospholipid antibodies that these autoantibodies are able to interfere with all aspects of the hemostatic balance. Influences of antiphospholipid antibodies on plasmatic processes of the coagulation cascade as well as antithrombotic and fibrinolytic mechanisms are described. Furthermore, antiphospholipid antibodies are able to exert prothrombotic effects on cells participating in hemostasis, mainly platelets and endothelial cells. Therapeutic approaches to the antiphospholipid syndrome today are mainly restricted to the prevention of further thrombosis by permanent anticoagulation. Although 30-50% of all patients, according to the literature, with moderately to highly elevated antiphospholipid antibody titers develop the clinical symptoms of the syndrome, there are only few studies investigating the benefits of a prophylactic anticoagulation of the affected patients. There is an urgent need for prospective clinical studies to clarify this question. Therapy of nonthrombotic manifestations of the antiphospholipid syndrome are scarcely standardized. In obstetrics, treatment with aspirin, heparin and steroids is the main approach. Here also controlled studies are restricted to small numbers of patients and are therefore of limited validity.

Algorithm registers are public-facing databases that display basic information about algorithms employed in public administration. While several such registers exist across Europe and globally, their capacity to deliver meaningful transparency remains contested. In Germany, the landscape is notably fragmented: no federal-level register exists, yet at least five state- and federal-level initiatives publish information about AI systems with varying scopes and objectives. A recent conceptual proposal by Alina Lorenz (2025), outlines technical and governance requirements for a national AI transparency register in Germany. We repurpose this proposal as an audit instrument, extracting structured checklists from the transparency goals and subgoals it formulates. The resulting checklists, translated from German into English, is made publicly available to support practitioners auditing existing registers or designing new ones. We apply this framework to conduct an external audit of the two main existing German transparency initiatives, MaKI and Lernende Systeme, evaluating the extent to which they fulfill the proposed goals. Our audit reveals that several adaptations are likely needed for t

Usutu virus (USUV) is a flavivirus of the Japanese encephalitis complex transmitted between \textit{Culex} mosquitoes and birds, a transmission pattern similar to that of the West Nile virus (WNV). In Germany, the first case of USUV was detected in 2010 in mosquitoes collected in the town of Weinheim, and by 2018 the virus had spread to almost the entire country. Interestingly, the infection front exhibited a clockwise rotational spread pattern throughout the years, a pattern completely different from that of the WNV. This clockwise progression corresponded closely with the spatial temperature gradient, suggesting that warmer regions probably facilitated faster viral amplification and onward transmission. Understanding the drivers that influence the spreading patterns of arboviruses is important as it guides surveillance and implementation of control strategies. In this study, we develop a reaction-diffusion partial differential equation (PDE) model to investigate the spatial spread of USUV in Germany within an extended domain that includes some neighbouring countries (Belgium, the Netherlands, and Luxembourg), thereby capturing cross-border transmission processes. Mosquito paramet

The recent breakthroughs in the distribution of quantum information and high-precision time and frequency (T&F) signals over long-haul optical fibre networks have transformative potential for physically secure communications, resilience of Global Navigation Satellite Systems (GNSS) and fundamental physics. However, so far these capabilities remain confined to isolated testbeds, with quantum and T&F signals accessible, for example in Germany, to only a few institutions. We propose the QTF-Backbone: a dedicated national fibre-optic infrastructure in Germany for the networked distribution of quantum and T&F signals using dark fibres and specialized hardware. The QTF-Backbone is planned as a four-phase deployment over ten years to ensure scalable, sustainable access for research institutions and industry. The concept builds on successful demonstrations of high-TRL time and frequency distribution across Europe, including PTB-MPQ links in Germany, REFIMEVE in France, and the Italian LIFT network. The QTF-Backbone will enable transformative R&D, support a nationwide QTF ecosystem, and ensure the transition from innovation to deployment. As a national and European hub, it w

Modern, data-driven medical research requires the processing of sensitive health data on a large scale. However, this data is subject to special protection under the GDPR, which is why processing regularly raises data protection concerns in practice. These concerns are particularly prevalent when sensitive personal data is processed without informed consent. This article analyses options for data processing in the field of medical research without consent and describes the legal framework for anonymisation under the GDPR, the national Austrian implementation of the research exemption, and their interaction. -- Moderne, datengetriebene medizinische Forschung erfordert die Verarbeitung sensibler Gesundheitsdaten in grossem Ausmass. Diese sind im System der DSGVO jedoch besonders geschützt, weswegen einer rechtssicheren Verarbeitung in der Praxis regelmässig datenschutzrechtliche Bedenken entgegenstehen. Diese Bedenken bestehen insbesondere bei Verarbeitung sensibler personenbezogener Daten ohne informierte Einwilligung. Dieser Beitrag analysiert daher Möglichkeiten zur Datenverarbeitung im Bereich der medizinischen Forschung fernab der Einwilligung und beschreibt hierfür das rechtlic

Using administrative data from Germany, this study provides first evidence on the wage effects of collective bargaining compliance laws. These laws require establishments receiving public contracts to pay wages set by a representative collective agreement, even if they are not formally bound by one. Leveraging variation in the timing of law implementation across federal states, and focusing on the public transport sector -- where regulation is uniform and demand is driven solely by state-level needs -- I estimate dynamic treatment effects using event-study designs. The results indicate that within five years of the law's implementation, wage increases were on average 2.9\% to 4.6\% higher in federal states with such a law compared to those without one -- but only in East Germany. These findings highlight the potential for securing collectively agreed wages in times of declining collective bargaining coverage.

Many documentaries on early house and techno music exist. Here, protagonists from the scenes describe key elements and events that affected the evolution of the music. In the research community, there is consensus that such descriptions have to be examined critically. Yet, there have not been attempts to validate such statements on the basis of audio analyses. In this study, over 9,000 early house and techno tracks from Germany and the United States of America are analyzed using recording studio features, machine learning and inferential statistics. Three observations can be made: 1.) German and US house/techno music are distinct, 2.) US styles are much more alike, and 3.) scarcely evolved over time compared to German house/techno regarding the recording studio features. These findings are in agreement with documented statements and thus provide an audio-based perspective on why techno became a mass phenomenon in Germany but remained a fringe phenomenon in the USA. Observations like these can help the music industry estimate whether new trends will experience a breakthrough or disappear.

The warmer temperatures of global climate change strengthen the water cycle, evaporation and precipitation increase. But the extremes of heavy rain, floods, dry periods and droughts will also increase. How does this fit together? Simple physical considerations show which factors mainly regulate the strength of the water cycle in the Earth system, and how this determines water availability on land. This can be used to interpret the observed changes in the water balance in Germany and explain the increasing dryness in Germany.

Even though many of the experiments leading to the standard model of particle physics were done at large accelerator laboratories in the US and at CERN, many exciting developments happened in smaller national facilities all over the world. In this report we highlight the history of accelerator facilities in Germany.

This study investigates the implementation of semi-on-demand (SoD) hybrid-route services using Shared Autonomous Vehicles (SAVs) on existing transit lines. SoD services combine the cost efficiency of fixed-route buses with the flexibility of on-demand services. SAVs first serve all scheduled fixed-route stops, then drop off and pick up passengers in the pre-determined flexible-route portion, and return to the fixed route. This study addresses four key questions: optimal fleet and vehicle sizes for peak-hour fixed-route services with SAVs and during transition (from drivers to autonomous vehicles), optimal off-peak SoD service planning, and suitable use cases. The methodology combines analytical modeling for service planning with agent-based simulation for operational analysis. We examine ten bus routes in Munich, Germany, considering full SAV and transition scenarios with varying proportions of drivers. Our findings demonstrate that the lower operating costs of SAVs improve service quality through increased frequency and smaller vehicles, even in transition scenarios. The reduced headway lowers waiting time and also favors more flexible-route operation in SoD services. The optimal

The correct detection of dense article layout and the recognition of characters in historical newspaper pages remains a challenging requirement for Natural Language Processing (NLP) and machine learning applications on historical newspapers in the field of digital history. Digital newspaper portals for historic Germany typically provide Optical Character Recognition (OCR) text, albeit of varying quality. Unfortunately, layout information is often missing, limiting this rich source's scope. Our dataset is designed to enable the training of layout and OCR modells for historic German-language newspapers. The Chronicling Germany dataset contains 693 annotated historical newspaper pages from the time period between 1852 and 1924. The paper presents a processing pipeline and establishes baseline results on in- and out-of-domain test data using this pipeline. Both our dataset and the corresponding baseline code are freely available online. This work creates a starting point for future research in the field of digital history and historic German language newspaper processing. Furthermore, it provides the opportunity to study a low-resource task in computer vision