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Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

World Journal of Gastroenterology 2005年第8期11卷 1182-1186页

作者： Ahmed Madisch Stephan Miehike Ekkehard Bayerdoerffer Birgit Wiedemann David Antos anke sievert Michael Vieth Manfred Stolte Heinrich Schulz Medical Department Ⅰ Department of Hematology and Oncology Institute of Medical Statistics and Biometry Clinic for Pediatric Diseases Gastroenterologist in private practice Institute of Pathology

AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma. METHODS: In 70 patients with historically proven non neoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion. RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P= 0.0004). CONCLUSION: The long-term relapse rate of non neoplastic BE following complete ablation with high-power APC is low (3% per year).

关键词： Barrett's esophagus Argon plasma coagulation Esophageal adenocarcinoma

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Voles and weasels in the boreal Fennoscandian small mammal community:what happens if the least weasel disappears due to climate change?

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Integrative Zoology 2019年第4期14卷 327-340页

作者： Hannu YLÖNEN Marko HAAPAKOSKI Thorbjörn sievert Janne SUNDELL Department of Biological and Environmental Science and Konnevesi Research Station University of JyväskyläJyväskyläFinland Lammi Biological Station University of HelsinkiLammiFinland

Climate change,habitat loss and fragmentation are major threats for populations and a challenge for individual behavior,interactions and ***-prey interactions are modified by climate *** the northern latitudes,strong seasonality is changing and the main predicted feature is shortening and instability of win*** populations in the boreal Fennoscandia exhibit multiannual *** amplitude peak numbers of voles and dramatic population lows alternate in 3-5-year cycles shortening from North to *** key factor,or driver,promoting the population crash and causing extreme extended lows,is suggested to be predation by the least *** review the arms race between prey voles and weasels through the multiannual density fluctuation,affected by climate change,and especially the changes in the duration and stability of snow *** ground-dwelling small mammals,snow provides thermoregulation and shelter for nest sites,and helps them hide from *** increases in the instability of winter forms a major challenge for species with coat color change between brown summer camouflage and white winter *** of these is the least weasel,Mustela nivalis *** vulnerability of wrong-colored weasels to predation affects vole populations and may have dramatic effects on vole *** may have cascading effects on other small rodent-predator interactions and even on plant-animal interactions and forest dynamics.

关键词： cascading effects climate change least weasel population cycles predator-prey

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完全可吸收封堵器——结构性和先天性心脏病治疗的关键进展?

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Science Bulletin 2023年第16期68卷 1733-1734页

作者： Kerstin Piayda Stefan Bertog Kolja sievert Horst sievert CardioVascular Center Frankfurt Frankfurt 60389Germany Department of Cardiology and Angiology Universitätsklinikum Gieûen und MarburgGieûen 35391Germany

Over the past decades,transcatheter therapy has become the primary option for the treatment of simple congenital heart diseases with the advantages of minimal invasiveness and rapid ***,currently used metal occluders may cause nickel allergies,inflammation,and *** the treatment of ventricular septal defects(VSD),due to the close proximity of the electrical conduction tissue,implantation of conventional occluders may cause conduction *** atrioventricular block can occur in up to 2%of patients undergoing percutaneous perimembranous VSD closure with conventional devices[1].The timing of this event varies,ranging from immediate/intraprocedural to years after the *** commonly,it is observed within the first five days[1],however,late-onset atrioventricular block is fairly *** this reason,no perimembranous VSD closure device has been approved by the US Food and Drug Administration[2].The complicated anatomical structure of VSDs and its anatomical relationship to the atrioventricular node complicates device design and *** this context,bioresorbable occluders have potential *** is conceivable that,due to implant degradation over time and native cardiac tissue coverage,surrounding tissue compression and persistent arrhythmias are less prevalent.

关键词：先天性心脏病 closure conduction

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cytoplasmic domain of tissue factor promotes liver fibrosis in mice

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World Journal of Gastroenterology 2017年第31期23卷 5692-5699页

作者： Virginia Knight Dinushka Lourensz Jorge Tchongue Jeanne Correia Peter Tipping William sievert Centre for Inflammatory Diseases Department of MedicineSchool of Clinical SciencesMonash University Gastroenterology and Hepatology Unit Monash Health

To evaluate the role of tissue factor (TF) and protease activated receptor (PAR)-2 in liver fibrosis. METHODSUsing CCl4 administration for eight weeks, we induced hepatic fibrosis in wild-type C57BL/6 mice and in mice with deletion of the cytoplasmic signalling domain of TF (TF§CT/§CT), deletion of PAR-2 (PAR-2-/-) and combined deletion of TF signalling domain and PAR-2 (TF§CT/§CT/PAR-2-/-). Hepatic fibrosis area was assessed by quantitative imaging of picrosirius red staining. Hepatic collagen content was assessed by hydroxyproline levels. Hepatic stellate cells (αSMA positive) and hepatic macrophages (CD68 positive) were identified by immunohistochemistry. Hepatic gene expression was determined by PCR and liver TGFβ1 content by ELISA. RESULTSCCl4 treated mice with deletion of the PAR-2 gene (PAR-2-/-) and the cytoplasmic domain of TF (TF§CT/§CT) developed significantly less hepatic fibrosis, characterised by reduced liver fibrosis area and hydroxyproline content, compared to control wildtype mice treated with CCl4. The observed reduction in histological fibrosis was accompanied by a significant decrease in the hepatic content of TGFβ, the prototypic fibrogenic cytokine, as well as fewer activated hepatic stellate cells and hepatic macrophages. Deletion of the TF cytoplasmic signalling domain reduced hepatic fibrosis to levels similar to those observed in mice lacking PAR-2 signalling but combined deletion provided no added protection against fibrosis indicating a lack of mutual modulating effects that have been observed in other contexts such as angiogenic responses. CONCLUSIONTissue factor cytoplasmic domain is involved in TF-PAR-2 signalling initiating hepatic fibrosis and is a potential therapeutic target, as its deletion would not impact coagulation.

关键词： Tissue factor Protease activated receptor Hepatic stellate cell Liver fibrosis Macrophage

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Factors Which Influence Intraluminal Temperature during Ho:YAG-Laser Exposure at an In-Vitro URS

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Open Journal of Urology 2015年第4期5卷 34-41页

作者： Jens Cordes Felix Nguyen Karl-Dietrich sievert Clinic of Urology University Medical Center Schleswig-Holstein Campus Lübeck Lübeck Germany

Introduction: The Ho:YAG-Laser is categorized as a potentially dangerous lithotripsy device (DIN: Class 4) for perforation which is mainly caused by the photonic energy the laser emits. Long time complications like ureteral strictures seem to be directed by thermal and mechanical injury. In this study different energy settings a) are being investigated, a DJ (double J stent) is placed beside the laser to simulate a therapy of a forgotten stent with reduction of the lumen b) due to the volume exploitation of the DJ, and direct contact between the laser fiber and the DJ in the ureter c) is simulated during laser exposure. Materials and Methods: We used the Ho:YAG-laser (Vera PulseTM, Coherent, Santa Clara USA) with a 365 μm diameter laser fiber. The settings of the laser were 0.6 J and 1 J pulse energy with a frequency of 5 Hz. The experimental setup was closely aligned with the clinical situation. The tip of the thermometer was attached inside the catheter through a puncture. The laser fiber was guided by means of a rigid URS video device (11.5 Ch). We had four different settings for a), b) and c) during the measurement: 1) Distance of 0.5 cm between the laser and the thermometer;without irrigation, 2) Distance of 0.5 cm between the laser and the thermometer;with irrigation, 3) Distance of 1 cm between the laser and the thermometer;without irrigation, 4) Distance of 1 cm between the laser and the thermometer;with irrigation. Results: The temperature in an empty ureter rises approximately by 5°C, when the laser energy is increased from 0.6 J to 1 J. When a DJ is inserted in the artificial ureter there is surprisingly almost no difference in the maximum temperature between the lower energy level (0.6 J) and the high energy level (1 J). However the time needed to reach the maximum temperature is noticibly less when using high energy levels. The reduction involume based on the placement of the DJ leads to a higher maximum temperature for the low energy setting. The third

关键词： YAG-Laser URS Laser Fiber DJ Ureteral

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First Intraluminal Temperature Measurement during Ho:YAG-Laser Exposure at an <i>In-Vitro</i>URS

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Open Journal of Urology 2015年第1期5卷 1-5页

作者： Jens Cordes Felix Nguyen Karl-Dietrich sievert Clinic of Urology University Medical Center Schleswig-Holstein Lübeck Germany

Introduction: The laser is a high energy instrument which can melt metals like nitinol. So it is very important to know under which conditions it is dangerous to perform an endourologic lithotripsy. We measure the temperature increase during laser exposure in an underwater in-vitro ureter model. For comparison, temperatures with and without irrigation and with different distances from the laser fiber to the thermometer are measured. Materials and Methods: We used the Ho:YAG-laser (Vera PulseTM, Coherent) with a 365 μm laser fiber. The settings of the laser were 0.6 J with a frequency of 5 Hz which is the minimum setting for that type of laser. The experimental setup was closely aligned with the clinical situation. A metal container was filled with 0.9% sodium chloride (NaCl) solution (Temp. 36.8°) and a catheter with an inner diameter of 4 mm was attached to the rim of the container. The tip of the thermometer was attached inside the catheter through a waterproof hole. The laser fiber was guided by means of a rigid URS video device (11.5 F). We had four different settings during the measurement: 1) Distance of 0.5 cm between the laser and the thermometer;without irrigation, 2) Distance of 0.5 cm between the laser and the thermometer;with irrigation, 3) Distance of 1 cm between the laser and the thermometer;without irrigation, 4) Distance of 1 cm between the laser and the thermometer;with irrigation. Results: The maximum overall temperature was recorded in the 1) and 3) setting, both featuring no irrigation. The maximum temperature was ~50°C in both settings, with the 1) setting reaching the maximum temperature after 50 seconds and hence approximately twice as fast as the 3) setting. During measurements with a NaCl solution flow we couldn’t detect any noticeable increase in temperature, neither at short nor at long distance between the laser fiber and the thermometer. Conclusion: There is a relevant heating in the ureter beside an endourologic lithotripsy. In our mod

关键词： YAG-Laser Exposure Intraluminal Irrigation Laser Fiber

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电工钢片磁性的计量问题

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中国计量学院学报 2008年第2期19卷 91-97页

作者： Johannes sievert 刘亚丕德国联邦物理技术研究院中国计量学院

综述了电工钢片计量的当前水平和最新进展,重点讨论了在交变场中的标准测试方法:Epstein方圈法和单片(SST)法.所讨论的相关条款是有关磁通密度控制、数据获取和数据计算的最新电子方法,以及磁路设计对这两种方法的准确性和精度特性的影... 详细信息

综述了电工钢片计量的当前水平和最新进展,重点讨论了在交变场中的标准测试方法:Epstein方圈法和单片(SST)法.所讨论的相关条款是有关磁通密度控制、数据获取和数据计算的最新电子方法,以及磁路设计对这两种方法的准确性和精度特性的影响,也讨论了系统误差来源、再现特性和经济因素等.

关键词：电工钢片磁性计量问题

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根据差异量热比色法测定支链淀粉链的缔合

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绵阳农专学报 1996年第1期13卷 66-71页

作者： D.sievert P.WURSCH 黄建华

直链淀粉和类脂化合物是通过采用差异量热比色法（DSC），在过量的水中把玉蜀黍淀粉、豌豆、玉米、小麦、马铃薯、蜡质种玉米从20℃加热到180℃，然后冷却到4℃，最后再加热至180℃除去淀粉而形成的。直链淀粉和软化淀粉的冷却曲线显示... 详细信息

直链淀粉和类脂化合物是通过采用差异量热比色法（DSC），在过量的水中把玉蜀黍淀粉、豌豆、玉米、小麦、马铃薯、蜡质种玉米从20℃加热到180℃，然后冷却到4℃，最后再加热至180℃除去淀粉而形成的。直链淀粉和软化淀粉的冷却曲线显示了放热期（＜70℃）是由直链淀物链组成的原理．覆盖范围0～95％的直链淀粉和支链淀粉混合物类似于被加热和被冷却．直链糖链淀物链的缔合被支链淀粉所限制．

关键词：直链淀粉支链淀粉淀粉差异量热比色法

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经下直肌后退术治疗的眼肌炎症后周期性垂直斜视1例

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世界核心医学期刊文摘(眼科学分册) 2006年第3期 39-40页

作者： Bau V sievert M Roggenkmper P Zierz S. 王大江 Universittsklinik und Poliklinik f¨ur Augenheilkunde Martin-Luther-Universitt Halle-Wittenberg Ernst-Grube-Strasse 40 06097 Halle Saale Germany

Background: Cyclic strabismus is a rare disorder in which strabismus and orthotropia regularly alternate over a period of mostly 48 h. It may occur spontaneously, upon squint surgery, or in association with lesions of the central nervous system. In most cases the deviations are convergent. Methods: Clinical case report. Results: A 34-year-old woman with bilat eral recurrent ocularmyositis for 2 years had developed cyclic vertical deviation 6 months after clinical remission. A hypotropia of the left eye alternatedwith an orthotropia, following a 48-h rhythm. Three months after recession of the inferior rectus muscle the alternating squint had disappeared. Discussion: The aetiology of cyclic eye deviations, most of them occurring in a constant rhythm, is not known. The association with lesions of the central nervous system indicates a primary central dysregulation of a “biological clock”. Their well-known occurrence, however, after squint surgery and, as in the present case, after orbital myositis, suggests that alteration of peripheral structures may contribute to a central dysregulation. Squint surgery seems to be the treatment of choice, even in rare cases with vertical deviations.

关键词：垂直斜视周期性下直肌炎症病理

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在阻塞冠状动脉近端和捕获栓子物质期间Proxis系统标示逆向冠状动脉血流的安全性和有效性

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世界核心医学期刊文摘（心脏病学分册） 2005年第3期1卷 14-15页

作者： sievert H. Wahr D.W. Schuler G. 郝广华

The Feasibility And Safety Trial for its embolic protection device during transluminal intervention in coronary vessels: a European Registry (FASTER)was designed to demonstrate that (1) the Proxis embolic protection system can control anterograde flow and reverse blood flow in native coronary arteries and saphenous vein grafts; and (2) this system can capture embolic debris. Percutaneous coronary intervention on stenotic coronary lesions revolutionized treatment of coronary disease, but is associated with the risk of major adverse cardiac events. This prospective, nonrandomized, multicenter clinical feasibility and safety study enrolled 40 patients with 51 lesions at 4 centerswho underwent treatment of stenotic lesions with proximal emboli protection (Proxis system). Proxiswas successfully used 95%of the time, and embolic debris was qualitatively identified in all cases. Major adverse cardiac events occurred in 2 patients (5.0%): 1 late in-stent thrombosis resulting in death and 1 non-Q-wave infarction when a lesion was crossed before deployment of the Proxis system. Mean vessel occlusion time was 4.3±2.4 minutes. Native flow reversal was sufficient in 31 patients, with a mean aspirate volume of 11.8±6.5 ml. When the infusion catheter was used to augment reflow, mean occlusion time was 4.6 minutes. In conclusion, this trial is the first to demonstrate that retrograde blood flow can be achieved during proximal occlusion and that the Proxis system can be used safely during intervention of saphenous vein grafts and native coronary arterial lesions to capture embolic material.

关键词：冠状动脉血流 Proxis 近端隐静脉移植物安全性试验心脏不良事件腔内介入血管阻塞支架内血栓保护装置

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