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2013 | OriginalPaper | Buchkapitel

49. Adenom-Karzinom-Sequenz in zystischen Pankreasneoplasien

verfasst von : Bence Sipos

Erschienen in: Erkrankungen des Pankreas

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die muzinös-zystischen Neoplasien und die intraduktalen papillär-muzinösen Neoplasien weisen eine morphologisch gut charakterisierte Adenom-Karzinom-Sequenz auf, welche dreistufig eingeteilt wird. Auf dem Boden der dysplastischen Veränderungen in MCN und IPMN entstehen meistens Karzinome vom duktalen Typ. Eine Ausnahme bildet die IPMN vom intestinalen Typ, die meistens mit einem muzinösen (kolloid) Karzinom assoziiert ist. Die meisten bekannten genetischen Veränderungen in MCN und IPMN sind identisch mit denen im duktalen Adenokarzinom, ausgenommen das GNAS-Gen, welches unter den Pankreastumoren ausschließlich in IPMN mutiert ist. Die vier IPMN-Subtypen unterscheiden sich histogenetisch und klinisch markant. Allerdings fehlt uns derzeit das Verständnis für die molekularen Mechanismen, die diesen phänotypischen Unterschieden zugrunde liegen.
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Metadaten
Titel
Adenom-Karzinom-Sequenz in zystischen Pankreasneoplasien
verfasst von
Bence Sipos
Copyright-Jahr
2013
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-37964-2_49

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Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.