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World Journal of Gastroenterology 2007年第45期13卷 6090-6093页

作者： Doris Schacherer Martina Zeitoun Roland Büttner Cornelia Gelbmann Aiman Obed Hans-Jürgen schlitt Jürgen Schlmerich Gabi I Kirchner Department of Internal MedicineⅠ University of Regensburg Regensburg 93042 Germany Department of Surgery University of Regensburg Regensburg 93042 Germany

We describe the first case of sirolimus-induced drug fever in a female liver transplant recipient, with a history of hepatitis C-induced end-stage liver cirrhosis in 1999. In 2005, six years after transplantation, she developed calcineurin inhibitor-induced renal function impairment. Immunosuppression was switched from tacrolimus to sirolimus. Two days after the intake of sirolimus, she developed daily fever spikes, but no infectious focus was found. Antibiotic therapy had no influence on the fever. After fourteen days, sirolimus was switched back to tacrolimus and the fever disappeared. In history, the patient developed ciclosporin-induced generalized seizures eleven days after liver transplantation, followed by the development of a motoric speech disorder. Magnetic resonance imaging (MRI) findings were consistent with leucoencephalopathy, therefore immunosuppressive therapy was changed from ciclosporin to tacrolimus and the neurologic symptoms improved significantly. Our case is the first reported case of sirolimus-induced drug fever. In addition, the patient showed the rare occurrence of ciclosporin-induced leukencephalopathy with seizures.

关键词： Liver transplantation Immunosuppression Side effects

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本期导读

中华消化外科杂志 2024年第7期23卷 I0003-I0003页

作者：董家鸿全志伟沈锋周俭吕国悦杨扬徐骁朱志军孟文勃 Hans J schlitt 陈志宇耿智敏冯晓彬王健东伍路黄登潘熊熊田明国张辉李小争不详

胆道疾病是外科常见病和多发病。近年来,随着新技术和新理念的不断涌现,胆道外科取得了长足进步。为展示该领域最新研究成果,总结和分享相关临床经验,规范和推动学科的进一步发展,本期重点选题为“胆道疾病”。

关键词：胆道疾病胆道外科重点选题最新研究成果临床经验外科常见病新理念多发病

Ileo-right hemi-colonic cervical pull-up on a non-supercharged ileocolic arterial pedicle: A technical and case report

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World Journal of Gastroenterology 2016年第14期22卷 3869-3874页

作者： Andreas RR Weiss Christina Hackl Yorick Soeder Hans J schlitt Marc-H Dahlke Department of Surgery University Medical Center Regensburg

Esophageal reconstruction can be challenging when stomach and colon are not anatomically intact and their use as esophageal substitutes is therefore limited. Innovative individual approaches are then necessary to restore the intestinal passage. We describe a technique in which a short stump of the right hemicolon and 25 cm of ileum on a long, non-supercharged, fully mobilized ileocolic arterial pedicle were used for esophageal reconstruction to the neck. In this case, a 65 year-old male patient had accidentally indigested hydrochloric acid which caused necrosis of his upper digestive tract. An emergency esophagectomy, gastrectomy, duodenectomy, pancreatectomy and splenectomy had been performed in an outside hospital. A cervical esophagostomy and a biliodigestive anastomosis had been created and a jejunal catheter for enteral feeding had been placed. After the patient had recovered, a reconstruction of his food passage via the left and transverse colon failed for technical reasons due to an intraoperative necrotic demarcation of the colon. Our team then faced the situation that only a short stump of the right hemi-colon was left in situ when the patient was referred to our center. After intensified nutritional therapy, we reconstructed this patient's food passage with the right hemicolonapproach described herein. After treatment of a postoperative pneumonia, the patient was discharged from hospital on the 26 th postoperative day in a good clinical condition on an oral-only diet. In conclusion, individual approaches for long-segment reconstruction of the esophagus can be technically feasible in experienced hands. They do not always require arterial supercharging or free intestinal transplantation.

关键词： Esophageal cancer Esophageal trauma Esophageal reconstruction Gastric pull-up Colonic interposition

Current developments in pediatric liver transplantation

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World Journal of Hepatology 2015年第11期7卷 1509-1520页

作者： Christina Hackl Hans J schlitt Martin Loss Birgit Knoppke Michael Melter Department of Surgery University Hospital Regensburg KUNO-Children’s University Hospital Regensburg

In 1953, the pioneer of human orthotopic liver transplantation(LT), Thomas E Starzl, was the first to attempt an orthotopic liver transplant into a 3 years old patient suffering from biliary atresia. Thus, the first LT in humans was attempted in a disease, which, up until today, remains the main indication for pediatric LT(p LT). During the last sixty years, refinements in diagnostics and surgical technique, the introduction of new immunosuppressive medications and improvements in perioperative pediatric care have established LT as routine procedure for childhood acute and chronic liver failure as well as inherited liver diseases. In contrast to adult recipients, p LT differs greatly in indications for LT, allocation practice, surgical technique, immunosuppression and postoperative life-long aftercare. Many aspects are focus of ongoing preclinical and clinical research. The present review gives an overview of current developments and the clinical outcome of p LT, with a focus on alternatives to full-size deceased-donor organ transplantation.

关键词： Pediatric liver transplantation Deceasedorgan donation Living donor liver transplantation Splitliver transplantation Biliary atresia

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肾脏移植

德国医学 1998年第1期15卷 45-47页

作者： R.Brunkhorst H.-J.schlitt 朱学海 Abteilung Nephrologie der Medizinischen Hochschule Konstanty-Gutschow-StraβeD-30623 HannoverGermany 同济医科大学附属同济医院

1992年底德国有24000名透析患者,肾移植是大部分透析者的唯一可提高生活质量的治疗方法。 1994年德国40个移植中心共行1894例肾移植。而等候移植者多达9092人,且还在持续增多,其中大于65岁的老人和糖尿病者占的比例越来越大。透析人群... 详细信息

1992年底德国有24000名透析患者,肾移植是大部分透析者的唯一可提高生活质量的治疗方法。 1994年德国40个移植中心共行1894例肾移植。而等候移植者多达9092人,且还在持续增多,其中大于65岁的老人和糖尿病者占的比例越来越大。透析人群中冠心病、中央与外周血管病、肿瘤及阻塞性肺病发病率亦增高。所以在移植前要仔细全面评价病情及危险因素,移植后要精心治疗。

关键词：肾移植免疫抑制剂供体

Therapeutic options for peritoneal metastasis arising from colorectal cancer

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第3期7卷 343-352页

作者： Gabriel Glockzin Hans J schlitt Pompiliu Piso Department of Surgery Staedtisches Klinikum Muenchen GmbH Department of Surgery University Hospital Regensburg Department of Surgery Hospital of the Order of St. John of God

Peritoneal metastasis is a common sign of advanced tumor stage, tumor progression or tumor recurrence in patients with colorectal cancer. Due to the improvement of systemic chemotherapy, the development of targeted therapy and the introduction of additive treatment options such as cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC), the therapeutic approach to peritoneal metastatic colorectal cancer(pm CRC) has changed over recent decades, and patient survival has improved. Moreover, in contrast to palliative systemic chemotherapy or best supportive care, the inclusion of CRS and HIPEC as inherent components of a multidisciplinary treatment regimen provides a therapeutic approach with curative intent. Although CRS and HIPEC are increasingly accepted as the standard of care for selected patients and have become part of numerous national and international guidelines, the individual role, optimal timing and ideal sequence of the different systemic, local and surgical treatment options remains a matter of debate. Ongoing and future randomized controlled clinical trials may help clarify the impact of the different components, allow for further improvement of patient selection and support the standar-dization of oncologic treatment regimens for pm CRC. The addition of further therapeutic options such as neo-adjuvant intraperitoneal chemotherapy or pressurized intraperitoneal aerosol chemotherapy, should be investig-ated to optimize therapeutic regimens and further improve the oncological outcome.

关键词： Peritoneal metastasis Colorectal cancer Systemic chemotherapy Intraperitoneal chemotherapy Cytoreductive surgery

帕金森患者全关节置换术:生存率、结果和失败原因分析

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临床骨科杂志 2017年第6期20卷 738-738页

作者： Rondon A J Tan T L schlitt P K 胡孔足

由于步态不稳、肌肉痉挛,帕金森患者进行关节置换术的疗效受到影响。作者回顾性分析了123例全关节置换术患者资料（52例髋,71例膝）。平均随访5.3年,23.6%患者需要进行翻修术。最常见的膝关节翻修原因是假体周围感染,最常见的髋关节翻... 详细信息

由于步态不稳、肌肉痉挛,帕金森患者进行关节置换术的疗效受到影响。作者回顾性分析了123例全关节置换术患者资料（52例髋,71例膝）。平均随访5.3年,23.6%患者需要进行翻修术。最常见的膝关节翻修原因是假体周围感染,最常见的髋关节翻修原因是假体周围骨折和脱位。术后第2、5、10年假体生存率分别为94.9%、87.9%、72.3%。

关键词：全关节置换术患者资料生存率帕金森原因分假体周围感染髋关节翻修假体周围骨折

直接经皮抽吸并溶栓术治疗急性栓塞性肠系膜上动脉闭塞

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国际医学放射学杂志 2011年第1期34卷 101-页

作者： P.Heiss B.Loewenhardt C.Manke A.Hellinger K.H.Dietl H.J.schlitt 郑昊宇 Department of Radiology University Medical Center Regensburg

目的评估急性栓塞性肠系膜上动脉(SMA)闭塞病人,采用直接经皮穿刺行血运重建的成功率及临床效果。方法通过3个医学中心放射信息系统数据库。

关键词：肠系膜血管阻塞经皮介入栓塞抽吸溶栓治疗