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Severe acute pancreatitis: Clinical course and management

World Journal of Gastroenterology 2007年第38期13卷 5043-5051页

作者： Hans G Beger bettina m rau Department of General Surgery Department of Viszeralsurgery University of Ulm (1982-2001) Donau-Klinikum Neu-Ulm Germany Department of General Viszeral Vascular and Pediatric Surgery Universit?tsklinikum des Saarlandes Homburg/ Saar Germany

Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically. Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (mOFS) occurs in the later course after the first week. To predict sepsis, mOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the Sepsis- Related Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.

关键词： Severe acute pancreatitis multiorgan failure syndrome Infected necrosis Fluid replacement Enteral feeding Surgical and interventional debridement

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Correlation of IL-8 with induction, progression and metastatic potential of colorectal cancer

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World Journal of Gastroenterology 2007年第37期13卷 4996-5002页

作者： Claudia Rubie Vilma Oliveira Frick Sandra Pfeil mathias Wagner Otto Kollmar Berit Kopp Stefan Grber bettina m rau martin K Schilling Department of General Visceral Vascular and Paediatric Surgery University of the Saarland Homburg 66421 Germany Institute of Pathology University of the Saarland Homburg 66421 Germany Institute of medical Biometrics Epidemiology and Medical Informatics University of the Saarland Homburg 66421 Germany

AIm： To investigate the expression profile of IL-8 in inflammatory and malignant colorectal diseases to evaluate its potential role in the regulation of colorectal cancer （CRC） and the development of colorectal liver metastases （CRLm）.mETHODS： IL-8 expression was assessed by quantitative real-time PCR （Q-RT-PCR） and the enzyme-linked immunosorbent assay （ELISA） in resected specimens from patients with ulcerative colitis （UC, n = 6） colorectal adenomas （CRA, n = 8）, different stages of colorectal cancer （n = 48） as well as synchronous and metachronous CRLm along with their corresponding primary colorectal tumors （n = 16）.RESULTS： IL-8 mRNA and protein expression was significantly up-regulated in all pathological colorectal entities investigated compared with the corresponding neighboring tissues. However, in the CRC specimens IL-8 revealed a significantly more pronounced overexpression in relation to the CRA and UC tissues with an average 30-fold IL-8 protein up-regulation in the CRC specimens in comparison to the CRA tissues. moreover, [L-8 expression revealed a close correlation with tumor grading. most interestingly, IL-8 up-regulation was most enhanced in synchronous and metachronous CRLm, if compared with the corresponding primary CRC tissues. Herein, an up to 80-fold IL-8 overexpression in individual metachronous metastases compared to normal tumor neighbor tissues was found.CONCLUSION： Our results strongly suggest an association between IL-8 expression, induction and progression of colorectal carcinoma and the development of colorectal liver metastases.

关键词： Interleukin-8 Gene expression profiling RNA and protein expressioni Colorec cal cancer Colorectalliver metastases

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Can mouse models mimic sporadic Alzheimer’s disease?

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Neural Regeneration Research 2020年第3期15卷 401-406页

作者： bettina m.Foidl Christian Humpel Laboratory of Psychiatry and Experimental Alzheimer’s Research Medical University of Innsbruck

Alzheimer’s disease(AD)is a progressive neurodegenerative disorder and the most common form of dementia *** age is the main risk factor,>97%of all AD cases are of sporadic origin,potentiated by various risk factors associated with life style and starting at an age>60 ***mutations in the amyloid precursor protein or Presenilins 1 or 2,and symptoms already start at an agemouse models are *** far many transgenic mouse models have been developed and used,with mutations in the APP or presenilin or combinations(3×Tg,5×Tg).However,such transgenic mouse models more likely mimic the genetic form of AD and no information can be given how sporadic forms *** risk genes,such as Apolipoprotein E4 and TREm-2 enhance the risk of sporadic AD,but also many risk factors associated with life style(e.g.,diabetes,hypercholesterolemia,stress)may play a *** this review we discuss the current situation regarding AD mouse models,and the problems to develop a sporadic mouse model of AD.

关键词： Alzheimer’s disease beta-amyloid cerebral amyloid angiopathy cognitive impairment sporadic and genetic mouse models tau vascular risk factors

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Chemokine expression in hepatocellular carcinoma versus colorectal liver metastases

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World Journal of Gastroenterology 2006年第41期12卷 6627-6633页

作者： Claudia Rubie Vilma Oliveira Frick mathias Wagner Christina Weber Bianca Kruse Katja Kempf Jochen Knig bettina rau martin Schilling Department of General- Visceral-Vascular-and Paediatric SurgeryUniversity of the SaarlandHomburg/Saar 66421Germany Institute of Pathology University of the SaarlandHomburg/Saar 66421Germany Institute of medical Biometrics Epidemiologyand Medical InformaticsUniversity of the SaarlandHomburg/ Saar 66421Germany

AIm： To evaluate and compare the expression profiles of CXCL12 （SDF-1）, CCL19 （mIP-3β）, CCL20 （mIP-3a） and CCL21 （6Ckine, Exodus2） and their receptors on RNA and protein levels in hepatocellular carcinoma （HCC） versus colorectal liver metastases （CRLm） and to elucidate their impact on the carcinogenesis and progression of malignant liver diseases. mETHODS： Chemokine expression was analyzed by RT-PCR and ELISA in 11 cases of HCC specimens and in 23 cases of CRLm and corresponding adjacent nontumorous liver tissues, respectively. Expressions of their receptors CXCR4, CCR6 and CCR7 were analyzed by RT- PCR and Western blot analysis in the same cases of HCC and CRLm. RESULTS： Significant up-regulation for CCL20/CCR6 was detected in both cancer types. moreover, CCL20 demonstrated significant overexpression in CRLm in relation to the HCC tissues. Being significantly up-regulated only in CRLm, CXCR4 displayed an aberrant expression pattern with respect to the HCC tissues. CONCLUSION： Correlation of CXCR4 expression with CRLm suggests CXCR4 as a potential predictive factor for CRLm. High level expression of CCL20 and its receptor CCR6 in HCC and CRLm with marked up-regulation of CCL20 in CRLm in relation to HCC tissues indicates involvement of the CCL20/CCR6 ligand-receptor pair in the carcinogenesis and progression of hepatic malignancies.

关键词： Chemokines Chemokine receptors Gene expression Hepatocellular carcinoma Colorectal liver metastases

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Longitudinal monitoring and prediction of long-term outcome of scar stiffness on pediatric patients

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Burns & Trauma 2021年第1期9卷 196-206页

作者： bettina müller Edoardo mazza Clemens Schiestl Julia Elrod Institute for mechanical Systems Department of Mechanical and Process EngineeringETH ZurichLeonhardstrasse 218092 ZurichSwitzerland Empa Swiss Federal Laboratories for Materials Science and TechnologyUeberlandstrasse 1298600 DübendorfSwitzerland Burn Center Division of Plastic and Reconstructive SurgeryUniversity Children’s Hospital ZurichSteinwiesstrasse 758032 ZürichSwitzerland Children’s Research Center(CRC) University Children’s Hospital ZurichSteinwiesstrasse 758032 ZürichSwitzerland

Background:Hypertrophic scarring after burn injury is one of the greatest unmet challenges in patients with burn injuries.A better understanding of the characteristics of scar maturation and early prediction of the long-term outcome of scarring are prerequisites for improving targeted therapies and pivotal for patient ***:Repeated measurements of scar stiffness in 11 pediatric patients were performed over the course of 1 year using 2 suction devices,the Cutometer and the *** addition,the observer pliability score of the Patient and Observer Scar Assessment Scale was *** longitudinal study allowed quantification of the ability of each of the measured parameters to reflect scar maturation,as indicated by change in skin pliability/stiffness,over time(using linear regression);the ability to distinguish individual patients(intraclass correlation coefficient(ICC));the correlation of the devices(Spearman correlation coefficient);and the ability to predict longterm scar maturation based on early scar assessment(using receiver operating characteristic).Results:All the tools used showed significant longitudinal decrease of scar stiffness from 3 months until 12 months after the *** Nimble(ICC_(patient)^(Nimble)=0.99)and the Cutometer(ICC_(patient)^(Cuto)=0.97)demonstrated an excellent ability to distinguish between individual *** Nimble seemed to be able to predict the 12-month pliability of scars based on early(3-month)measurements(area under the curve(AUC)_(12m)^(POSAS)=0.67;AUC_(12m)^(C)=0.46;AUC_(12m)^(N)=0.79).Conclusions:The results of this preliminary study suggest that all 3 tools provide suitable means to quantify alterations in scar stiffness over *** evidence suggests the Nimble is most favorable for predicting changes in stiffness associated with long-term scar *** studies with a larger sample size are required to validate tissue suction as a clinical tool for analysis of changes of scar stiffne

关键词： Pediatric burns Scar maturation POSAS Cutometer Nimble

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Role of colectomy in preventing recurrent primary sclerosing cholangitis in liver transplant recipients

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World Journal of Gastroenterology 2018年第28期24卷 3171-3180页

作者： bettina m Buchholz Panagis m Lykoudis Reena Ravikumar Joerg m Pollok Giuseppe K Fusai Department of HPB Surgery and Liver Transplantation Royal Free Hospital London

AIm To study the published evidence on the impact of colectomy in preventing recurrent primary sclerosing cholangitis(r PSC). mETHODS An unrestricted systematic literature search in Pub med, EmBASE, medline Ovid SP, ISI Web of Science, Lista(EBSCO) and the Cochrane library was performed on clinical studies investigating colectomy in liver transplantation(LT) recipients with and without r PSC in the liver allograft. Study quality was evaluated according to a modification of the methodological index for non-randomized studies(mINORS) criteria. Primary endpoints were the impact of presence, timing and type of colectomy on r PSC. Overall presence of inflammatory bowel disease(IBD), time of IBD diagnosis, posttransplant IBD and immunosuppressive regimen were investigated as secondary *** The literature search yielded a total of 180 publications. No randomized controlled trial was identified. Six retrospective studies met the inclusion criteria of which 5 studies were graded as high quality articles. Reporting of IBD was heterogenous but in four publications, either inflammatory bowel disease, ulcerative colitis or in particular active colitis post-LT significantly increased the risk of r PSC. The presence of an intact(i.e., retained) colon at LT was identified as risk factor for r PSC in two of the high quality studies while four studies found no effect. Type of colectomy was not associated with r PSC but this endpoint was underreported(only in 33% of included studies).Neither tacrolimus nor cyclosporine A yielded a significant benefit in disease recurrence of primary sclerosing cholangitis(PSC).CONCLUSION The data favours a protective role of pre-/peri-LT colectomy in r PSC but the current evidence is not strong enough to recommend routine colectomy for r PSC prevention.

关键词： Recurrent primary sclerosing cholangitis Risk factor Ulcerative colitis Colectomy Liver transplantation

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Spontaneous elimination of hepatitis C virus infection: A retrospective study on demographic, clinical, and serological correlates

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World Journal of Gastroenterology 2007年第31期13卷 4224-4229页

作者： Perdita Wietzke-Braun Larissa bettina mnhardt Albert Rosenberger Angela Uy Giuliano Ramadori Sabine mihm Department of Gastroenterology and Endocrinology Robert-Koch-Str.40 37075 Gttingen Germany Department of Genetic Epidemiology Humboldtallee 32 Gttingen 37073 Germany Department of microbiology Kreuzbergring 57 Gttingen Georg-August-Universitt Gttingen 37075 Germany

To find correlates to spontaneous clearance of hepatitis C virus （HCV） infection, this study compared individuals with self-limited and chronic infection with regard to clinical, demographic, and serological pa- rameters. mETHODS： Sixty-seven anti-HCV positive and repeatedly HCV RNA negative individuals were considered to have resolved HCV infection spontaneously. To determine the viral genotype these patients had been infected with HCV serotyping was performed. For comparison reasons, 62 consecutive patients with chronic hepatitis C were enrolled. Cases and controls were compared stratified for age and sex. RESULTS： Retrospective analysis showed （1） a lower humoral reactivity to HCV in patients with self-limited compared to chronic HCV-infection and （2） that younger age, history of iv drug use, and acute/post-acute hepatitis A or B co-infections, but not viral genotypes, are independent correlates for spontaneous HCV clearance. CONCLUSION： The stronger humoral reactivity to HCV in patients with persistent infections and in those with a history of iv drug use is supposed to be due to continuous or repeated contact（s） to the antigen. metachronous hepatitis A or hepatitis B infections might favor HCV clearance.

关键词： Hepatitis C virus Hepatitis Self-limitedinfection Anti-HCV antibodies Co-infection HCVserotype

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Factors influencing the drug release from calcium phosphate cements

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Bioactive materials 2022年第1期7卷 341-363页

作者： marco Fosca Julietta V.rau Vuk Uskokovi Istituto di Struttura della materia Consiglio Nazionale delle Ricerche(ISM-CNR)Via del Fosso del Cavaliere 10000133RomeItaly I.m.Sechenov First moscow State medical University Institute of PharmacyDepartment of AnalyticalPhysical and Colloid ChemistryTrubetskaya 8build.2119991MoscowRussia Advanced materials and Nanobiotechnology Laboratory TardigradeNano LLCIrvineCA 92604United States

Thanks to their biocompatibility,biodegradability,injectability and self-setting properties,calcium phosphate cements(CPCs)have been the most economical and effective biomaterials of choice for use as bone void *** have also been extensively used as drug delivery carriers owing to their ability to provide for a steady release of various organic molecules aiding the regeneration of defective bone,including primarily antibiotics and growth *** review provides a systematic compilation of studies that reported on the controlled release of drugs from CPCs in the last 25 *** chemical,compositional and microstructural characteristics of these systems through which the control of the release rates and mechanisms could be achieved have been *** doing so,the effects of(i)the chemistry of the matrix,(ii)porosity,(iii)additives,(iv)drug types,(v)drug concentrations,(vi)drug loading methods and(vii)release media have been distinguished and discussed *** specificities of in vivo release of drugs from CPCs have been reviewed,*** the kinetic and mechanistic correlations between the CPC properties and the drug release is a prerequisite for the design of bone void fillers with drug release profiles precisely tailored to the application area and the clinical *** goal of this review has been to shed light on these fundamental correlations.

关键词： Calcium phosphate cements Drug release Release rate Antibiotics release Bone fillers

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急性胰腺炎的外科治疗

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中华外科杂志 2001年第4期39卷 329-331页

作者： Hans Guenther Beger bettina rau Rainer Isenmann Jens mayer 刘斌吴在德 Professor of Surgery 同济医科大学同济医院

100年前,波士顿的Reginald　Fitz　认为,急性胰腺炎的严重程度主要取决于炎症及其相关形态学变化的程度。急性胰腺炎的病程涉及几个相关器官及其临床、病理、放射学、生化和细菌学检查结果,每种变化都要求有特殊的治疗方法。临床表现包... 详细信息

100年前,波士顿的Reginald　Fitz　认为,急性胰腺炎的严重程度主要取决于炎症及其相关形态学变化的程度。急性胰腺炎的病程涉及几个相关器官及其临床、病理、放射学、生化和细菌学检查结果,每种变化都要求有特殊的治疗方法。临床表现包括轻度的局限性疾病、感染形成及由此所致的严重的局限性和全身性并发症。相应的病理变化包括限制性肠性水肿，至胰腺及周围组织坏死,直至累及远处器官。　　　　

关键词：急性胰腺炎外科手术感染病死率

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Ex vivo limb perfusion for traumatic amputation in military medicine

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military medical Research 2020年第4期7卷 489-496页

作者： Alexander Kaltenborn Nicco Krezdorn Sebastian Hoffmann AndréGutcke Kirsten Haastert-Talini Peter m.Vogt Axel Haverich bettina Wiegmann Department of Trauma and Orthopedic Surgery PlasticHand and Reconstructive SurgeryArmed Forces Hospital WesterstedeWesterstedeGermany Department of Plastic AestheticHand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany Institute of Neuroanatomy and Cell Biology Hannover Medical SchoolHannover and Center for Systems Neuroscience(ZSN)WesterstedeGermany Department of Cardiothoracic Transplantation and Vascular SurgeryHannover Medical SchoolHannoverGermany

Background:Limb loss has a drastic impact on a patient’s *** trauma to the extremities is common in current military *** other aspects,"life before limb"damage control surgery hinders immediate replantation within the short post-traumatic timeframe,which is limited in part by the ischemic time for successful *** vivo limb perfusion is currently being researched in animal models and shows promising results for its application in human limb replantation and *** of the hypothesis:The current lack of replantation possibilities in military operations with high rates of amputation can be addressed with the development of a portable ex vivo limb perfusion device,as there are several opportunities present with the introduction of this technique on the *** hypothesize that ex vivo limb perfusion will enable overcoming the critical ischemic time,provide surgical opportunities such as preparation of the stump and limb,allow for spare-part surgery,enable rigorous antibiotic treatment of the limb,reduce ischemiareperfusion injuries,enable a tissue function assessment before replantation,and enable the development of large limb transplant *** the hypothesis:Data from in vivo studies in porcine models are limited by the relatively short perfusion time of 24 *** the military setting,notably longer perfusion times need to be ***,future animal studies must focus especially on long-term perfusion,since this represents the military setting,considering the time for stabilization of the patient until evacuation to a tertiary treatment *** of the hypothesis:The development and clinical introduction of ex vivo limb perfusion in the military setting could lead to a drastic reduction in the number of limb amputations among service *** vivo limb perfusion enables replantation surgery in Role 4 facilities and changes the clinical setting from a highly urgent,lifethreatening s

关键词： Ex vivo limb perfusion traumatic amputation ischemia and reperfusion-related injuries hypothesis

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