Podcasts about midgut

Embryonic structure from which most of the intestines develop

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Best podcasts about midgut

Latest podcast episodes about midgut

Connecticut Children's Grand Rounds
3.26.24 Pediatric Grand Rounds, "Untwisting the Complexity of Midgut Malrotation and Volvulus Ultrasound", by HaiThuy Nguyen, MD

Connecticut Children's Grand Rounds

Play Episode Listen Later Mar 26, 2024 59:03


Event Objectives:Define the diagnostic performance of US for malrotation and midgut volvulus.Be able to perform and troubleshoot a suboptimal ultrasound.Diagnose malrotation and midgut volvulus on ultrasound.Claim CME Credit Here!

Aging-US
The Anti-aging Effect of Vitamin D and its Receptor in Drosophila Midgut

Aging-US

Play Episode Listen Later Feb 27, 2024 3:24


BUFFALO, NY- February 27, 2024 – A new #research paper was #published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 3, entitled, “The anti-aging effect of vitamin D and vitamin D receptor in Drosophila midgut.” Adult stem cells are pivotal for maintaining tissue homeostasis, and their functional decline is linked to aging and its associated diseases, influenced by the niche cells' environment. Age- and cancer-related reduction of vitamin D and its receptor levels are well documented in human clinical studies. However, the mechanisms through which the vitamin D/vitamin D receptor (VitD/VDR) pathway contributes to anti-aging and extends life expectancy are not well understood. In this new study, researchers Joung-Sun Park, Hyun-Jin Na and Yung-Jin Kim from Pusan National University and Korea Food Research Institute aimed to determine the protective role of the vitamin D/vitamin D receptor pathway in differentiated enterocytes (ECs) during intestinal stem cell (ISC) aging. “This study aimed to determine the protective role of VitD/VDR in differentiated ECs during ISC aging using the adult Drosophila intestine model.” By utilizing a well-established Drosophila midgut model for stem cell aging biology, the researchers revealed that vitamin D receptor knockdown in ECs induced ISC proliferation, EC death, ISC aging, and enteroendocrine cell differentiation. Additionally, age- and oxidative stress-induced increases in ISC proliferation and centrosome amplification were reduced by vitamin D treatment. In conclusion, this study provides direct evidence of the anti-aging role of the VitD/VDR pathway, involving protecting ECs during aging, and provides valuable insights for exploring the molecular mechanisms underlying enhanced healthy aging in Drosophila. “Our findings suggest a direct evidence of the anti-aging role of the vitamin D/vitamin D receptor pathway and provides insights into the molecular mechanisms underlying healthy aging in Drosophila.” DOI - https://doi.org/10.18632/aging.205518 Corresponding author - Joung-Sun Park - dreamjs78@pusan.ac.kr Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.205518 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, Drosophila, vitamin D, vitamin D receptor, anti-aging, intestinal stem cell About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

CME Anytime - Emergency Medicine
Pediatric Altered Mental Status

CME Anytime - Emergency Medicine

Play Episode Listen Later Sep 14, 2021 21:19


The Center for Medical Education's new course title EMCert Module Mastery has been designed to guarantee participants a passing grade on the new MyEMCert exams from ABEM.  This episode comes from the Neurology Module and discusses Pediatric AMS.Differential Diagnosis: Epilepsy (active seizures or post‐ictal state), CNS infection: meningitis, encephalitis, Intussusception, midgut malrotation, Nonaccidental trauma, BRUE, Inborn errors of metabolism, Endocrine (new onset DKA), Electrolyte disturbance, Obstructed VP shunt, Toxicologic causes.To learn more, visit https://ccme.org/emcertmodule

Cracking The Anatomical Myth
Development of midgut

Cracking The Anatomical Myth

Play Episode Listen Later Feb 19, 2021 15:14


Midgut rotation, physiological hernia, VID

NETs Neuroendocrine Expert Talks
A Multidisciplinary Approach to NETs

NETs Neuroendocrine Expert Talks

Play Episode Listen Later Feb 19, 2020 18:48


Dr. Robert Ramirez, a member of the American Society of Clinical Oncology (ASCO), and NET nurse navigator Pam Ryan discuss the importance of the multidisciplinary team, building trust, and creating positive treatment experiences for patients with gastrointestinal and pancreatic NETs (GEP-NETs). (c) 2020 Ipsen Biopharmaceuticals, Inc. January 2020 SMD-US-003644

Premed Memory Training
Medical Students Memory Training with Alex Mullen and Cathy

Premed Memory Training

Play Episode Listen Later Sep 7, 2019 74:37


AEMind.com | Medical Students Cathy and Alex Mullen on Memory Techniques in Med School Free Better Memory Now Guide ▶ www.BetterMemoryGuide.com Mullen Memory ▶ www.MullenMemory.com // Follow AE Mind | Luis Angel // Subscribe: www.youtube.com/aemind Podcast: www.aemind.com/podcast Like @ www.facebook.com/aemind1 Follow @ www.twitter.com/aemind IG: www.instagram.com/AE.Mind // Notes// Alex Mullen and Cathy Mullen on Memory Techniques in School They met in pre-school in Mississippi. How they’ve worked together in other projects prior to Mullen Memory, such as the science fair. Cathy went to Princeton and Alex went to John Hopkins. They are now medical students at the University of Mississippi. They weren’t as successful with applying the memory techniques to their studies in the beginning. They both made refinements in order to help them apply the memorization skills to learning their class material while at med school. Take notes on how they’re memorizing the information in university. Now they think through the concepts first before applying a memory technique. The memory palace helps them with their critical thinking. Even when using memory techniques, you still need to review the information while studying. How Cathy and Alex Mullen use the memory techniques when memorizing Anatomy Digestive Tract – Foregut, Midgut, Hindgut They stored and encoded the foregut references on the ceiling. Celiac Nerve = ceiling. Vagus Nerve = Vegas Sign on ceiling. Foregut = the number 4 or a forearm. We talked about creating memory palaces and how to use locations in order to memorize the school material to make studying easier. We discussed whether or not they reuse locations and memory palaces to learn new information along the same path that they’ve created associations for already using that path. In continuation with the Digestive tract. Midgut: Superior Mesenteric Artery = Lionel Messi Celebrating. HindGut: Inferior Mesenteric Artery = Messi injured. How they memorize pharmacology material. Pelvic Nerve = Elvis (pelvic thrust) Do they ever reuse images for other things that might have similar sounding words associated with the med terms. Pharmacology Examples - Penicillin: Amoxicillin = Ammo Shells. Side effects for Penicillin - Hypersensitivity reaction = Donald Trump Bio-Chemistry Medical Terminology – Aspartate, Glycine, Glutamine, THF (Tetrahydrofolate) Aspartate = Asphalt Glycine = Ice Glutamine = Glutes THF = Four Foals (horses) Spaced repetition study software: Anki – http://www.AnkiSRS.net Quizlet – http://www.Quizlet.com Great Time Management and Productivity Method: Pomodoro Technique This study tip technique requires the student to study for a set period of time without distractions and then take a break for about 5 minutes in which Alex recommends that you reward yourself during that time. He likes to read a book or watch videos during his breaks. After a few homework study times and breaks sets, you want to then take an extended break for about 15 minutes before starting the cycle over again. Another tip for success in Med School is to create and keep a consistent daily schedule. Find out more about Cathy and Alex Mullen’s Memory Training and Education programs at: http://www.MullenMemory.com Stay Up! Keep Learning Keep Growing Achieve and Accelerated and Empowered Mind -Luis Angel Echeverria Your AE Mind Memory Coach --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/premed/support

AE Mind Academy
Medical Students Cathy and Alex Mullen on Memory Techniques in Med School

AE Mind Academy

Play Episode Listen Later Sep 1, 2019 74:02


AEMind.com | Medical Students Cathy and Alex Mullen on Memory Techniques in Med School Free Better Memory Now Guide ▶ www.BetterMemoryGuide.com Mullen Memory ▶ www.MullenMemory.com // Follow AE Mind | Luis Angel // Subscribe: www.youtube.com/aemind Podcast: www.aemind.com/podcast Like @ www.facebook.com/aemind1 Follow @ www.twitter.com/aemind IG: www.instagram.com/AE.Mind // Notes// Alex Mullen and Cathy Mullen on Memory Techniques in School They met in pre-school in Mississippi. How they've worked together in other projects prior to Mullen Memory, such as the science fair. Cathy went to Princeton and Alex went to John Hopkins. They are now medical students at the University of Mississippi. They weren't as successful with applying the memory techniques to their studies in the beginning. They both made refinements in order to help them apply the memorization skills to learning their class material while at med school. Take notes on how they're memorizing the information in university. Now they think through the concepts first before applying a memory technique. The memory palace helps them with their critical thinking. Even when using memory techniques, you still need to review the information while studying. How Cathy and Alex Mullen use the memory techniques when memorizing Anatomy Digestive Tract – Foregut, Midgut, Hindgut They stored and encoded the foregut references on the ceiling. Celiac Nerve = ceiling. Vagus Nerve = Vegas Sign on ceiling. Foregut = the number 4 or a forearm. We talked about creating memory palaces and how to use locations in order to memorize the school material to make studying easier. We discussed whether or not they reuse locations and memory palaces to learn new information along the same path that they've created associations for already using that path. In continuation with the Digestive tract. Midgut: Superior Mesenteric Artery = Lionel Messi Celebrating. HindGut: Inferior Mesenteric Artery = Messi injured. How they memorize pharmacology material. Pelvic Nerve = Elvis (pelvic thrust) Do they ever reuse images for other things that might have similar sounding words associated with the med terms. Pharmacology Examples - Penicillin: Amoxicillin = Ammo Shells. Side effects for Penicillin - Hypersensitivity reaction = Donald Trump Bio-Chemistry Medical Terminology – Aspartate, Glycine, Glutamine, THF (Tetrahydrofolate) Aspartate = Asphalt Glycine = Ice Glutamine = Glutes THF = Four Foals (horses) Spaced repetition study software: Anki – http://www.AnkiSRS.net Quizlet – http://www.Quizlet.com Great Time Management and Productivity Method: Pomodoro Technique This study tip technique requires the student to study for a set period of time without distractions and then take a break for about 5 minutes in which Alex recommends that you reward yourself during that time. He likes to read a book or watch videos during his breaks. After a few homework study times and breaks sets, you want to then take an extended break for about 15 minutes before starting the cycle over again. Another tip for success in Med School is to create and keep a consistent daily schedule. Find out more about Cathy and Alex Mullen's Memory Training and Education programs at: http://www.MullenMemory.com Stay Up! Keep Learning Keep Growing Achieve and Accelerated and Empowered Mind -Luis Angel Echeverria Your AE Mind Memory Coach

AE Mind Academy
How to Memorize Anatomy with Medical Students

AE Mind Academy

Play Episode Listen Later Aug 26, 2019 14:33


MedStudentMastery.com | How to Memorize Human Anatomy w/ Medical Students, Cathy and Alex Mullen http://www.MullenMemory.com | Med School Terminology Mnemonics Full Video: http://www.AEMind.com/Mullen1 //Follow AE Mind// Memory Training ▶ http://www.AEMind.com Subscribe: http://www.youtube.com/aemind Podcast: http://www.aemind.com/podcast Like @ http://www.facebook.com/aemind1 Follow @ http://www.twitter.com/aemind IG: http://www.instagram.com/AE.Mind //Follow Alex and Cathy Mullen// Website: http://www.MullenMemory.com YT: https://www.youtube.com/ajmullen7 FB: https://www.facebook.com/mullenmemory/ //Notes from the Interview// Alex Mullen (2x World Memory Champion) and Cathy Mullen on Memory Techniques in School How Cathy and Alex Mullen use the memory techniques when memorizing Anatomy Digestive Tract – Foregut, Midgut, Hindgut They stored and encoded the foregut references on the ceiling. Celiac Nerve = ceiling. Vagus Nerve = Vegas Sign on ceiling. Foregut = the number 4 or a forearm. We talked about creating memory palaces and how to use locations in order to memorize the school material to make studying easier. We discussed whether or not they reuse locations and memory palaces to learn new information along the same path that they've created associations for already using that path. In continuation with the Digestive tract. Midgut: Superior Mesenteric Artery = Lionel Messi Celebrating. HindGut: Inferior Mesenteric Artery = Messi injured. How they memorize pharmacology material. Pelvic Nerve = Elvis (pelvic thrust) Do they ever reuse images for other things that might have similar sounding words associated with the med terms. Stay Up! Keep Learning Keep Growing Achieve and Accelerated and Empowered Mind -Luis Angel Echeverria Your AE Mind Memory Coach Memory Training for Students, Professionals, Business People, Mental Athletes, and Everyone Else: http://www.aemind.com

NETs Neuroendocrine Expert Talks
Patient With Carcinoid Syndrome

NETs Neuroendocrine Expert Talks

Play Episode Listen Later Jun 3, 2019 24:48


Dr. Daneng Li, co-director of the neuroendocrine tumor program at City of Hope National Medical Center, offers his expertise and insight on diagnosis, treatment, and dietary practices for a patient with carcinoid syndrome. Patient on this episode is an actor, and represents a hypothetical case. Dr. Li is a paid consultant for Ipsen. ©2019 Ipsen Biopharmaceuticals, Inc. May 2019. SMD-US-002859

cancer patients syndrome nets li tumors metastatic symptomatic ipsen hope national medical center carcinoid midgut
NETs Neuroendocrine Expert Talks
Patient With Midgut NET

NETs Neuroendocrine Expert Talks

Play Episode Listen Later Jun 3, 2019 12:00


Dr. Jonathan Strosberg, associate professor at Moffitt Cancer Center, discusses a hypothetical patient with symptomatic carcinoid midgut NET. Dr. Strosberg provides his specific insights on practice considerations for patients having disease progression. Patient on this episode is an actor, and represents a hypothetical case. Dr. Strosberg is a paid consultant for Ipsen. ©2019 Ipsen Biopharmaceuticals, Inc. May 2019. SMD-US-002964

Herpetological Highlights
025 Return of the Invertebrates

Herpetological Highlights

Play Episode Listen Later Apr 17, 2018 57:48


We back for another invertebrate versus amphibian episode. But this time we’re focusing on carabid beetles and their relentless consumption all amphibian life. They have managed to turn the tables on their would be predator in a remarkable case of role-reversal. Species of the Bi-week is a beautiful frog with a fittingly macabre name. FULL REFERENCE LIST AVAILABLE AT: herphighlights.podbean.com Main Paper References: Wizen, G., and A. Gasith. 2011. “Predation of amphibians by carabid beetles of the genus Epomis found in the central coastal plain of Israel.” Zookeys 100: 181–191. Wizen, G., and A. Gasith. 2011. “An unprecedented role reversal: Ground beetle larvae (Coleoptera: Carabidae) lure amphibians and prey upon them.” PLoS One 6: 1–6. Species of the Bi-Week: Dias, I. R., C. F. B. Haddad, A. J. S. Argôlo, and V. G. D. Orrico. 2017. “The 100th: An appealing new species of Dendropsophus (Amphibia: Anura: Hylidae) from northeastern Brazil R. Castiglia.” PLoS One 12: e0171678. Other Mentioned Papers/Studies: Barkai A, McQuaid C (1988) Predator–prey role reversal in marine benthic ecosystems. Science 242: 62–64. Beckmann, C, and R Shine. 2011. “Toad’s Tongue for Breakfast: Exploitation of a Novel Prey Type, the Invasive Cane Toad, by Scavenging Raptors in Tropical Australia.” Biological Invasions 13 (6): 1447–55. Brodie Jr., ED. 1977. “Hedgehogs Use Toad Venom in Their Own Defence.” Nature 268 (5621): 627–28. Choh, Y., Takabayashi, J., Sabelis, M. W., & Janssen, A. (2014). Witnessing predation can affect strength of counterattack in phytoseiids with ontogenetic predator–prey role reversal. Animal Behaviour, 93, 9-13. Escoriza, D., L. Mestre, G. Pascual, and J. Buse. 2017. “First case of attack of an adult Bufo spinosus Daudin, 1803 by a carabid beetle larva of Epomis circumscriptus (Duftschmid, 1812).” Bol. Asoc. Herpetol. Esp. 28: 2006–2008. Petschenka, G, S Fandrich, N Sander, V Wagschal, M Boppré, and S Dobler. 2013. “Stepwise Evolution of Resistance to Toxic Cardenolides via Genetic Substitutions in the Na+/K+-ATPase of Milkweed Butterflies (Lepidoptera: Danaini).” Evolution 67 (9): 2753–61. Scudder, GGE, and J Meredith. 1982. “The Permeability of the Midgut of Three Insects to Cardiac Glycosides.” Journal of Insect Physiology 28 (8): 689–94. Ujvari, B, NR Casewell, K Sunagar, K Arbuckle, W Wüster, N Lo, D O’Meally, et al. 2015. “Widespread Convergence in Toxin Resistance by Predictable Molecular Evolution.” Proceedings of the National Academy of Sciences 112 (38): 11911–11916. Wilson, NJ, AN Stokes, GR Hopkins, ED Brodie, Jr., and CR Williams. 2014. “Functional and Physiological Resistance of Crayfish to Amphibian Toxins: Tetrodotoxin Resistance in the White River Crayfish (Procambarus Acutus).” Canadian Journal of Zoology 92 (11): 939–45. Voyles, J, DC Woodhams, V Saenz, AQ Byrne, R Perez, G Rios-sotelo, MJ Ryan, et al. 2018. “Shifts in Disease Dynamics in a Tropical Amphibian Assemblage Are Not due to Pathogen Attenuation.” Science 359: 1517–19. Other Links/Mentions: Epomis circumscriptus attacking and preying upon Bufo viridis – http://www.youtube.com/watch?v=wFJ_CXJ0qPo Epomis circumscriptus attacking and preying upon Hyla savignyi – http://www.youtube.com/watch?v=RMkFb5n97cU Trophic interactions between Epomis adults and Triturus vittatus –  http://www.youtube.com/watch?v=JA46dbEpluI Videos from Wizen and Gasith 2011 PLoS One  – http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0025161 Photos from paper two: http://www.tau.ac.il/lifesci/departments/zoology/Amphibia/new.html Rats vs toads: https://www.facebook.com/groups/ukargs/permalink/2092225931007478/ Music: Intro/outro – Treehouse by Ed Nelson Other Music – The Passion HiFi, www.thepassionhifi.com

This Week in Parasitism
TWiP 141: Paratransgenesis

This Week in Parasitism

Play Episode Listen Later Oct 31, 2017 89:27


The TWiP Wataalamu solve the case of the One Year Old From Kenya With Moving Skin Lesions, and describe how to make mosquitoes refractory to Plasmodium with engineered symbiotic bacteria. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Become a patron of TWiP. Links for this episode: Engineered Serratia make mosquitoes refractory to Plasmodium (Science) Operation Sea Spray (Wikipedia) Photo credit Letters read on TWiP 141 Case Study for TWiP 141 A 59 yo Spanish speaking female on Long Island originally from Guatemala. Goes to ER after returning from 10 day trip to visit friends and relatives in Guatemala and El Salvador with fever, cough, diffuse muscle aches, fatigue, chills. Respiratory pathogen panel done, positive for rhinovirus. Told that it's just a virus, go home. 5 days later returns with fever and chills, pain in upper belly, feels constipated. Admitted. No past med/surg, no allergies, no significant family history, no meds. Works cleaning houses. Travel: spends most time in and around big cities, lots of exposure to animals, ate all local fare; conch ceviche, fresh eggs, flattened chicken dish. Elevated white count left shifted, neutrophils increased, eosinophils cleared; cultured Salmonella from blood. IV antibiotics given, gets better, about to go out the hospital door, when results of stool O&P comes back from initial admission. Observed: Entamoeba coli; Endolimax nana; Blastocystis hominis. Released to home, 2 weeks later feels fine. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

This Week in Microbiology
TWiM #69: Bacterial DNA in the human genome

This Week in Microbiology

Play Episode Listen Later Nov 27, 2013 69:42


Vincent, Elio, Jo, and Michele review evidence for bacterial DNA integrated into the human genome, and control of the symbiont population in an insect midgut.

School of Surgery
right hemicolectomy for cancer explained

School of Surgery

Play Episode Listen Later Jun 28, 2013 15:11


Jon Lund, colorectal surgeon in DIvision of Medical Sciences, University of Nottingham, Royal Derby Hospital UK, explains in a video podcast important principles of colonic blood supply, colectomy for cancer and right hemicolectomy. Produced for medical students and core trainees (junior residents) in surgery. In association with East Midlands LETB Surgical training.

This Week in Parasitism
TWiP 50: Antagonism in the mosquito midgut

This Week in Parasitism

Play Episode Listen Later Feb 16, 2013 71:05


Hosts: Vincent Racaniello and Dickson Despommier Vincent and Dickson reveal how malaria parasites avoid lysis by complement in the mosquito. Links for this episode: Malaria parasites co-opt factor H (Cell Host Microbe) Complement system (Wikipedia) Letters read on TWiP 50 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv

Medizin - Open Access LMU - Teil 20/22
The Novel Somatostatin Receptor 2/Dopamine Type 2 Receptor Chimeric Compound BIM-23A758 Decreases the Viability of Human GOT1 Midgut Carcinoid Cells

Medizin - Open Access LMU - Teil 20/22

Play Episode Listen Later Jan 1, 2013


The majority of neuroendocrine tumors (NETs) of thegastro-enteropancreatic system coexpress sornatostatin receptors (SSTRs)and dopamine type 2 receptors (D2R), thus providing a rationale for theuse of novel SSTR2/D2R chimeric compounds in NET disease. Here weinvestigate the antitumor potential of the SSTR2/D2R chimeric compoundsBIM-23A760 and BIM-23A758 in comparison to the selective SSTR2 agonistBIM-23023 and the selective D2R agonist BIM-53097 on human NET celllines of heterogeneous origin. While having only minor effects on humanpancreatic and bronchus carcinoid cells (BONI and NCI-H727), BIM-23A758induced significant antitumor effects in human midgut carcinoid cells(GOT1). These effects involved apoptosis induction as well as inhibitionof mitogen-activated protein kinase and Akt signaling. Consistent withtheir antitumor response to BIM-23A758, GOT1 cells showed relativelyhigh expression levels of SSTR2 and D2R mRNA. In particular, GOT1 cellshighly express the short transcript variant of D2R. In contrast toBIM-23A758, the SSTR2/D2R chimeric compound BIM-23A760 as well as theindividual SSTR2 and D2R agonistic compounds BIM-23023 and BIM-53097induced no or only minor antitumor responses in the examined NET celllines. Taken together, our findings suggest that the novel SSTR2/D2Rchimeric compound BIM-23A758 might be a promising substance for thetreatment of NETs highly expressing SSTR2 and D2R. In particular, asufficient expression of the short transcript variant of DR2 might playa pivotal role for effective treatment.

Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 13/19
Untersuchung zur Sensitivität des Tumormarkers Chromogranin A im Serum bei Patienten mit neuroendokrinen Tumoren des GastroEnteroPankreatischen Systems

Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 13/19

Play Episode Listen Later Nov 24, 2011


Ziel dieser Arbeit war es, die Sensitivität des Tumormarkers Chromogranin A (CgA) für neuroendokrine Tumoren (NETs) des gastroenteropankreatischen Systems (GEP) bei dem von uns verwendeten Assay zur Bestimmung von CgA zu berechnen und mit Daten anderer Zentren zu vergleichen. Hierfür analysierten wir die CgA-Serumwerte von 110 Patienten mit neuroendokrinen Tumoren (Midgut-NET n=62, Pankreas-NET n=48) in einer retrospektiven Studie mit den Daten unserer Klinik. Die CgA-Werte wurden durch einen kommerziell verfügbaren immunoradiometrischen Assay (IRMA, CIS-bio) bei Patienten der Medizinischen Klinik II, Campus Großhadern der Ludwig-Maximilian- Universität München, in den Jahren von 2000 – 2009 (Cutoff-Level: CgA < 98 ng/ml) bestimmt. In der gesamten Studienpopulation lag die CgA-Sensitivität für Patienten mit einem Midgut-NET höher als bei Patienten mit einem Pankreas-NET (68 % bzw. 54 %). Für beide Gruppen (Midgut- und Pankreas-NETs) konnte bei Patienten mit Lebermetastasen eine höhere CgA-Sensitivität als bei Patienten ohne Lebermetastasen nachgewiesen werden (Midgut: 77 % versus 40 %; Pankreas 63 % versus 31 %). Es zeigten sich außerdem signifikant höhere mediane CgA-Werte bei Patienten mit Lebermetastasen (n = 82; Median ± Standardabweichung: 389 ± 38103 ng/ml) als bei den Patienten ohne hepatische Metastasierung (n = 28; Median ± Standardabweichung: 65 ± 181 ng/ml) (p < 0,0001). Bei Patienten, die neben den Lebermetastasen noch weitere Metastasenherde (Knochen, Peritoneum oder Lunge) aufwiesen, zeigten sich sogar noch deutlich höhere CgA-Werte (n = 29; Median ± Standardabweichung: 1011 ± 63224 ng/ml) als bei Patienten die neben den Leberherden nur noch Lymphknotenbefall aufwiesen (n = 53; Median ± Standardabweichung: 196 ± 4427 ng/ml) (p = 0,005). Wir evaluierten außerdem die Sensitivität für 5-Hydroxy-Indolessigsäure, gemessen im 24-Stundensammelurin bei 51 Midgut-NET-Patienten und konnten hier eine Gesamtsensitivität von 69 % nachweisen. In der Untergruppe der Patienten mit hepatisch metastasiertem Midgut-NETs zeigte sich eine deutlich höhere Sensitivität 48 von 87,5 %. Außerdem konnten wir eine signifikante Korrelation zwischen den medianen CgA- und 5-HIES-Werten nachweisen (r = 0,752; p < 0,0001). Die alkalische Phosphatase (AP) zeigte nur eine niedrige Sensitivität für Pankreas- und Midgut-NETs von 42 % bzw. 26 %. Eine etwas höhere Sensitivität von 49 % bzw. 32 % konnte für die Untergruppe der hepatisch metastasierten Pankreas- und Midgut-NETs nachgewiesen werden. Zwischen den CgA- und AP-Werten konnte weder für die Pankreas-NET-Gruppe (r = 0,362) noch für die Midgut-NET-Gruppe (r = 0,208) eine signifikante Korrelation gefunden werden. Nach unseren Ergebnissen sowie den Ergebnissen bestehender Literatur hängt die CgA-Sensitivität von dem zur Messung verwendeten Assay, dem verwendeten Cutoff-Level, der Lokalisation des Tumorprimarius sowie von der Tumorlast ab. Chromogranin A scheint aufgrund der geringen Sensitivität im nicht metastasierten Stadium nicht zur primären Tumorsuche bzw. zum Screening geeignet, sondern sollte primär bei Patienten mit bereits bekanntem neuroendokrinen Tumor zur Tumornachsorge bzw. Verlaufskontrolle eingesetzt werden.

UCLA Radiology - UCLA Radiology
Midgut Volvulus Malrotation

UCLA Radiology - UCLA Radiology

Play Episode Listen Later Jul 19, 2009 7:51


volvulus malrotation midgut