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Die Pharmakogenetik ist ein wichtiger Baustein in der Individualisierung von Therapien. Eine pharmakogenetische Diagnostik findet jedoch bislang noch wenig Anwendung in der medizinischen Praxis. Eine konsequente Berucksichtigung individueller Patientenfaktoren in der Arzneimitteltherapie kann helfen, diese sicherer und effektiver zu gestalten. Es wird ein kurzer Uberblick uber Strukturen und Auswirkungen von genetischen Varianten auf Arzneimittelwirkungen gegeben. Einige haufig verordnete Medikamente werden exemplarisch herausgegriffen. Des Weiteren wird die Durchfuhrbarkeit von pharmakogenetischer Diagnostik und Dosisanpassungen beschrieben. Die European Medicines Agency (EMA) als europaische Zulassungsbehorde hat bereits uber 70, die U.S. Food and Drug Administration (FDA) sogar uber 150 Arzneimittelinformationen um Angaben zu Biomarkern erweitert. Dies ist ein entscheidender Schritt in Richtung gezielte Therapie. Internationale Leitlinien fur die Dosis- und Therapieanpassung basieren auf einer systematischen Datenauswertung der klinischen Evidenz beispielsweise durch das Clinical Pharmacogenetics Implementation Consortium des Pharmacogenomics Research Network. Wesentlich fur den Erfolg einer Arzneimitteltherapie ist auch die Berucksichtigung individueller Risikofaktoren der Patienten. Eine pharmakogenetische Diagnostik muss von konkreten Dosierungs- und Therapieempfehlungen begleitet werden, um einen Beitrag zur Individualisierung und zur Verbesserung der Sicherheit und Effizienz der Arzneimitteltherapie leisten zu konnen.

Pharmacogenetics are an important component in the individualization of treatment; however, pharmacogenetic diagnostics have so far not been used to any great extent in clinical practice. A consistent consideration of individual patient factors, such as pharmacogenetics may help to improve drug therapy and increase individual safety and efficacy aspects.A brief summary of structures and effects of genetic variations on drug efficacy is presented. Some frequently prescribed pharmaceuticals are specified. Furthermore, the feasibility of pharmacogenetic diagnostics and dose recommendations in the clinical practice are described.The European Medicines Agency (EMA) as the European approval authority has already extended the drug labels of more than 70 pharmaceuticals by information on pharmacogenetic biomarkers and the U.S. Food and Drug Administration (FDA) more than 150. This is a crucial step towards targeted medicine. Guidelines on dose and therapy adjustments are provided by the Clinical Pharmacogenetics Implementation Consortium of the Pharmacogenomics Research Network.It is fundamental to consider individual patient factors for successful drug therapy. Dose and therapy recommendations based on pharmacogenetic diagnostics are highly important for individualization as well as improvement of safety and efficiency of drug therapy.

Purpose In the past, virtual endoscopies have been performed for planning of endoscopic interventions or for diagnostic purposes in various organ systems with increasing frequency. This study evaluates the ability of virtual ventricular endoscopy to depict anatomical structures and the use for planning of real endoscopy. Materials and methods In a prospective study, 4 volunteers and 8 patients were examined with MRI. In 3 of the patients endoscopy was performed by our neurosurgeons thereafter. The calculation of the virtual endoscopy was based on 1 mm sagittal T2-weighted images. Comparison of surface rendering and volume rendering was made by means of video sequencing of individual views, and these were compared with the intraoperative endoscopic videos concerning the depictability of anatomical landmarks. Results The reconstructions using volume rendering were more significant and easier to calculate than those based on surface rendering. Virtual endoscopy in the transparent mode allowed visualization of hazardous structures outside the ventricular system such as the basilar artery tip. Transparent 3D images of the ventricles gave a good overview on the depicted structures and enabled a better orientation during the virtual camera flight than surface rendered views. Conclusion MR-based virtual endoscopy of the ventricular system can be obtained on the basis of surface- and volume-rendered views of sagittal T2-weighted thin sections. Preoperative utilization of this method simplifies the planning of endoscopy by visualization of anatomical structures.

In the past, virtual endoscopies have been performed for planning of endoscopic interventions or for diagnostic purposes in various organ systems with increasing frequency. This study evaluates the ability of virtual ventricular endoscopy to depict anatomical structures and the use for planning of real endoscopy.In a prospective study, 4 volunteers and 8 patients were examined with MRI. In 3 of the patients endoscopy was performed by our neurosurgeons thereafter. The calculation of the virtual endoscopy was based on 1 mm sagittal T2-weighted images. Comparison of surface rendering and volume rendering was made by means of video sequencing of individual views, and these were compared with the intraoperative endoscopic videos concerning the depictability of anatomical landmarks.The reconstructions using volume rendering were more significant and easier to calculate than those based on surface rendering. Virtual endoscopy in the transparent mode allowed visualization of hazardous structures outside the ventricular system such as the basilar artery tip. Transparent 3D images of the ventricles gave a good overview on the depicted structures and enabled a better orientation during the virtual camera flight than surface rendered views.MR-based virtual endoscopy of the ventricular system can be obtained on the basis of surface- and volume-rendered views of sagittal T2-weighted thin sections. Preoperative utilization of this method simplifies the planning of endoscopy by visualization of anatomical structures.