Non-operative treatment of femoral neck fractures is a treatment option, but only in well-selected cases. The majority of secondary displacements were associated with initial misdiagnosis using the Garden classification. For Garden II, primary surgical treatment is likely a better option, and therefore careful application of the Garden classification in this context is essential.

MAPK and p42/44MAPK could also be observed in the presence of cholecystokinin (CCK), which also causes activation of cPLA 2 . ACh-and CCK-induced Ca 2؉ waves were slowed down when p38 MAPK (4,5). The speed of Ca 2ϩ waves depends on the type of agonist used for stimulation and to some extent also on the agonist concentration (6). The propagation rate can be modified by application of arachidonic acid (AA) or by activation of protein kinase C (PKC) with phorbol esters (6, 7). Both application of AA and activation of PKC leads to inhibition of CICR and thereby slows down spreading of Ca 2ϩ signals. Analysis of the propagation rate of secretagogueevoked Ca 2ϩ waves in pancreatic acinar cells can therefore be used to investigate coupling of hormone receptors to intracellular signal cascades that lead to endogenous production of AA and/or to activation of PKC. In previous studies we could demonstrate that in mouse pancreatic acinar cells bombesin receptors couple to phospholipase D (7), which produces diacylglycerol and thereby activates PKC, whereas high affinity CCK receptors couple to cytosolic phospholipase A 2 (cPLA 2 ) (6), an enzyme that leads to release of AA from membrane phospholipids. Bombesin-induced activation of PKC via phospholipase D-dependent diacylglycerol production, as well as CCK-induced formation of AA by cPLA 2 , takes place within the very first seconds after hormone application, before or during development of the initial inositol 1,4,5-trisphosphate-induced Ca 2ϩ signal in the luminal cell pole.In the present study we investigated the role of cPLA 2 in ACh-and bombesin-evoked Ca 2ϩ signaling. Our data indicate that in pancreatic acinar cells activation of cPLA 2 is an early event in ACh-but not in bombesin-evoked intracellular signaling. ACh-and CCK-induced activation of cPLA 2 involves MAP kinase activation. Furthermore, we demonstrate that secretagogue-induced Ca 2ϩ signaling in pancreatic acinar cells is modified by AA itself and not by metabolites of AA. MATERIALS AND METHODSCell Preparation-Adult male CD-1 mice (35-40 g) were sacrificed by cervical dislocation. The pancreas was removed and transferred into a "preparation buffer" consisting of (in mM): 130 NaCl, 4.7 KCl, 1.3 CaCl 2 , 1 MgCl 2 , 1.2 KH 2 PO 4 , 10 glucose, 0.2% (w/v) albumin, 0.01% (w/v) trypsin inhibitor, 10 HEPES, pH 7.4. Single acinar cells were isolated by enzymatic digestion with collagenase type V (30 units/ml, 10 min, 37°C; Sigma) as described previously (8). Enzymatic digestion was followed by mechanical dissociation of cells by gentle pipetting. The resulting cell suspension was centrifuged, and the cells were washed twice in preparation buffer without collagenase.Confocal Microscopy-Freshly prepared acinar cells were loaded with 4 M fluo-3/AM for 30 min at room temperature and then stored at 4°C. Experiments were performed within 4 h after cell isolation. For measurement of cytosolic Ca 2ϩ signals, cells were transferred to a perfusion chamber and were allowed to adhere to the glass coverslip for several minut...

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Einleitung Gastrointestinale Lipome gehören neben Adenomen und Leiomyomen zu den gutartigen Darmtumoren [1]. Lipome werden im gesamten Gastrointestinaltrakt beobachtet [2, 3]. Häufig werden diese Veränderungen zufällig entdeckt und sind asymptomatisch [4]. Selten verursachen sie leichte Abdominalschmerzen, gastrointestinale Blutungen [5] oder Ileussymptomatik [6]. Wir berichten über eine 59-jährige Patientin, bei der ein exulzerierendes Lipom eine subakute intestinale Obstruktion verursacht hat. Die Patientin wurde unter Karzinomverdacht operiert. Fallbeschreibung Anamnese Eine 59-jährige Patientin stellte sich zur Abklärung von seit 4 Wochen bestehenden periumbilikalen und rechtsseitigen Abdominalschmerzen, Übelkeit und Inappetenz vor. Seit einigen Zusammenfassung Eine 59-jährige Patientin stellt sich mit Abdominalschmerzen, Durchfällen und Gewichtsverlust vor. In der Koloskopie wird eine große exulzerierte polypöse Raumforderung an der rechten Kolonflexur gesehen. Unter der Verdachtsdiagnose Kolonkarzinom erfolgt eine Rechtshemikolektomie. Die endgültige Diagnose wird histologisch am Operationspräparat gestellt. Es handelt sich um ein submukosales Lipom. In seltenen Fällen finden sich bei symptomatischen Kolontumoren Lipome, die ein Kolonkarzinom vortäuschen können. Schlüsselwörter Lipom · chronische Diarrhö · AbdominalschmerzenAbstract A 59-year-old woman was admitted to hospital with abdominal pain, diarrhia and losing weight. In colonoscopy was seen a large exulcerated, polypoid lesion obstructing the bowel lumen in the right flexura. The presumption diagnosis was colorectal cancer and right hemicolectomie was performed. The lesion was confirmed to be a submucosal lipoma of the colon. Symptomatic colon tumors are rarely lipomas, they imitate a carcinoma. Kasuistik 80Heruntergeladen von: WEST VIRGINIA UNIVERSITY. Urheberrechtlich geschützt.