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Cancer risk in IBD: How to diagnose and how to manage DALM and ALM

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World Journal of Gastroenterology 2011年第27期17卷 3184-3191页

作者： Helmut Neumann Michael Vieth cord langner Markus F Neurath Jonas Mudter Department of Medicine 1 Department of SurgeryUniversity of Erlangen-Nuremberg Ulmenweg 1891054 ErlangenGermany Institute of Pathology Klinikum Bayreuth GmbHPreuschwitzer Str. 10195445 BayreuthGermany Institute of Pathology Medical University of GrazAuenbruggerplatz 25A-8036 Graz Austria

The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemented to identify these lesions. The main issue is that colitisassociated neoplasms often occurs in flat mucosa, often being detected on taking random biopsies rather than by identification of these lesions via endoscopic imaging. The standard diagnostic procedure in long lasting UC is to take four biopsies every 10 cm. Image enhancement methods, such as chromoendoscopy and virtual histology using endomicroscopy, have greatly im- proved neoplasia detection rates and may contribute toreduced random biopsies by taking targeted "smart" biopsies. Chromoendoscopy may effectively be performed by experienced endoscopists for routine screening of UC patients. By contrast, endomicroscopy is often only available in selected specialized endoscopic centers. Importantly, advanced endoscopic imaging has the poten- tial to increase the detection rate of neoplasia whereas the interplay between endoscopic experience and interpretation of histological biopsy evaluation allows the physician to make a proper diagnosis and to find the appropriate therapeutic approach. Colitis-associated intraepithelial neoplasms may occur in flat mucosa of endoscopically normal appearance or may arise as dysplasia-associated lesion or mass (DALM), which may be indistinguishable from sporadic adenomas in healthy or non-colitis mucosa [adenoma-like mass (ALM)]. The aim of this review was to summarize endoscopic and histological characteristics of DALM and ALM in the context of therapeutic procedures.

关键词： Inflammatory bowel disease Crohn’s dis- ease Endoscopy Colitis Dysplasia-associated lesion or mass Adenoma-like mass Endomicroscopy Ulcerative colitis Endomicroscopy Confocal laser endomicroscopy Probe-based confocal laser endomicroscopy Integrated confocal laser endomicroscopy Endoscope-based confocal laser endomicroscopy Narrow band imaging Chromoendoscopy Cancer Dysplasia

Dual Targeting of a Mitochondrial Protein： The Case Study of Cytochrome C1

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Molecular Plant 2011年第4期4卷 679-687页

作者： Anja Rodiger Bianca Baudisch Uwe langner Ralf Bernd Klosgen Institute of Biology--Plant Physiology Martin Luther University Halle-Wittenberg Weinbergweg 10 06120 Halle/Saale Germany

As a result of the endosymbiotic gene transfer, the majority of proteins of mitochondria and chloroplasts is encoded in the nucleus and synthesized in the cytosol as precursor molecules carrying N-terminal transit peptides for the transport into the respective target organelle. In most instances, transport takes place into either mitochondria or chloroplasts, although a few examples of dual targeting into both organelles have been described. Here, we show by a combination of three different experimental strategies that also cytochrome c1 of potato, a component of the respiratory electron transport chain, is imported not only into mitochondria, but also into plastids. In organello import experiments with isolated mitochondria and chloroplasts, which were analyzed in both single and mixed organelte assays, demonstrate that the processing products accumulating after import within the two endosymbiotic organelles are different in size. Dual targeting of cytochrome c1 is observed also in vivo, after biolistic transformation of leaf epidermal cells with suitable reporter constructions. Finally, Western analyses employing cytochrome c1-specific antiserum provide evidence that the protein accumulates in significant amounts in mitochondria and chloroplasts of both pea and spinach. The possible consequences of our findings on the relevance of the dual targeting phenomenon are discussed.

关键词： Protein transport dual targeting cytochrome c1 mitochondria chloroplast.

Long term follow-up after liver transplantation from a JAK2 mutation positive donor

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Hepatobiliary Surgery and Nutrition 2019年第2期8卷 189-191页

作者： Alejandro Lazo-langner Peter Ainsworth Vivian McAlister Department of Medicine Division of HematologyWestern UniversityLondonONCanada Department of Epidemiology and Biostatistics Western UniversityLondonONCanada Department of Oncology Western UniversityLondonONCanada Department of Pathology and Laboratory Medicine Western UniversityLondonONCanada Department of Surgery Western UniversityLondonONCanada

Introduction Philadelphia-negative myeloproliferative neoplasms(MPN),including polycythemia vera(PV),essential thrombocythemia(ET),and primary myelofibrosis(PMF),are characterized by the presence of mutations involving the Janus Kinase 2(JAK2),calreticulin(CALR)or myeloproliferative leukemia virus oncogene(MPL)genes(1).Of these,the JAK2 V617F gain-of-function mutation is the most frequently found and is present in>95%of patients with PV and in about 60%of those with ET or PMF whereas JAK2 exon 12 mutations are found in the remaining PV patients(2).JAK2 V617F somatic mutations have been detected in granulocytes and platelets and therefore they could potentially be transmitted to recipients of solid organ transplants(3)and in fact the presence of the JAK2 V617F mutation has been detected in otherwise healthy blood donors(4,5).

关键词： JAK2 neoplasms patients

Polymer nanofibre composite nonwovens with metal-like electrical conductivity

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npj Flexible Electronics 2018年第1期2卷 29-34页

作者： Steffen Reich Matthias Burgard Markus langner Shaohua Jiang Xueqin Wang Seema Agarwal Bin Ding Jianyong Yu Andreas Greiner Macromolecular Chemistry Bavarian Polymer InstituteUniversity of BayreuthBayreuth 95440Germany College of Materials Science and Engineering Nanjing Forestry UniversityNanjing 210037China Key Laboratory of Textile Science&Technology Ministry of EducationCollege of TextileDonghua UniversityShanghai 201620China Innovation Center for Textile Science and Technology Donghua UniversityShanghai 20051China

Bendable and breathable polymer nanofibre nonwovens with metal-like electrical conductivity are required for lightweight electrodes and electric shielding design with applications in batteries,functional textiles,sensors,cars,aerospace,constructions,mobile phones,and medical ***-like conductivity in polymer nonwovens has not been achieved till now due to the limitation of the existing processing *** show here,the metal-like electrical conductivity of 750,000 S/m in polyacrylonitrile(PAN),poly(ε-caprolactone)(PCL)nonwoven using very low content of silver nanowires(AgNW;3.35 vol%).The key to the high conductivity was the homogenous distribution of AgNW in nonwoven made by wet-laid process using short electrospun fibre and AgNW *** a threshold of 0.36 vol%AgNW,the conductivity of the nonwoven increased by seven orders of magnitude,which we attribute to the onset of percolation of the *** nonwoven-AgNW composites show fast heating and cooling within a few seconds at a voltage of 1.1 V,which is in the range of portable *** composites are also breathable and *** electrical conductivity was independent of the bending angle of the composite,which is important for applications mentioned above and would help other scientists to design new conductive materials in the future.

关键词： composite composites conductivity

Weight stigma mitigating approaches to gender-affirming genital surgery

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Plastic and Aesthetic Research 2022年第1期9卷 295-307页

作者： Elijah Castle Gaines Blasdel Nabeel A.Shakir Lee C.Zhao Rachel Bluebond-langner Department of Urology New York University Langone Medical CenterNew YorkNY 10017USA Vattikuti Urology Institute Henry Ford Health SystemDetroitMI 48202USA Hansjörg Wyss Department of Plastic Surgery New York University Langone Medical CenterNew YorkNY 10017USA

The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been *** BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause *** is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical *** article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight *** factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital *** patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight *** impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.

关键词： Gender-affirming surgery weight stigma phalloplasty vaginoplasty metoidioplasty body mass index

Spinal fusion is an aerosol generating procedure

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World Journal of Orthopedics 2023年第5期14卷 340-347页

作者： Joanna Lind langner Nicole Segovia Pham Ann Richey Yousi Oquendo Shayna Mehta John Schoeneman Vorhies Pediatric Orthopaedic Surgery Stanford UniversityPalo AltoCA 94304United States Orthopaedic Surgery Hospital for Special SurgeryNew YorkNY 10021United States

BACKGROUND Transmission of severe acute respiratory syndrome coronavirus 2 can occur during aerosol generating *** steps in spinal fusion may aerosolize blood but little data exists to quantify the risk this may confer upon *** particles containing infectious coronavirus are typically 0.5-8.0μ*** To measure the generation of aerosols during spinal fusion using a handheld optical particle sizer(OPS).METHODS We quantified airborne particle counts during five posterior spinal instrumentation and fusions(9/22/2020-10/15/2020)using an OPS near the surgical *** were analyzed by 3 particle size groups:0.3-0.5μm/m^(3),1.0-5.0μm/m^(3),and 10.0μm/m^(3).We used hierarchical logistic regression to model the odds of a spike in aerosolized particle counts based on the step in progress.A spike was defined as a>3 standard deviation increase from average baseline *** Upon univariate analysis,bovie(P<0.0001),high speed pneumatic burring(P=0.009),and ultrasonic bone scalpel(P=0.002)were associated with increased 0.3-0.5μm/m^(3)particle counts relative to ***(P<0.0001)and burring(P<0.0001)were also associated with increased 1-5μm/m^(3)and 10μm/m^(3)particle *** drilling was not associated with increased particle counts in any of the size ranges *** logistic regression model demonstrated that bovie(OR=10.2,P<0.001),burring(OR=10.9,P<0.001),and bone scalpel(OR=5.9,P<0.001)had higher odds of a spike in 0.3-0.5μm/m^(3)particle ***(OR=2.6,P<0.001),burring(OR=5.8,P<0.001),and bone scalpel(OR=4.3,P=0.005)had higher odds of a spike in 1-5μm/m^(3)particle ***(OR=0.3,P<0.001)and drilling(OR=0.2,P=0.011)had significantly lower odds of a spike in 10μm/m^(3)particle counts relative to *** Several steps in spinal fusion are associated with increased airborne particle counts in the aerosol size *** research is warranted to determine if such particles have the potential to con

关键词： Optical particle sizers Aerosol COVID-19 Orthopaedic procedures Spinal fusion SARS-CoV-2

Different antibiotic susceptibility between antrum and corpus of the stomach,a possible reason for treatment failure of Helicobacter pylori infection

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World Journal of Gastroenterology 2014年第43期20卷 16245-16251页

作者： Michael Selgrad Ina Tammer Cosima langner Jan Bornschein Julia Mei?le Arne Kandulski Mariya Varbanova Thomas Wex Dirk Schlüter Peter Malfertheiner Department of Gastroenterology Hepatology and Infectious DiseasesOtto-von-Guericke-University of Magdeburg39120 MagdeburgGermany Institute of Medical Microbiology Otto-von-Guericke-University of Magdeburg39120 MagdeburgGermany

AIM: To assess whether antibiotic resistance varies between the antrum and corpus of the stomach of patients that are either Helicobacter pylori (H. pylori) therapy-naive or pre-treated.

关键词： Helicobacter pylori treatment Antibiotic susceptibility Heteroresistance Antibiotic susceptibility

Effectiveness of an early operating room start time in managing pediatric trauma

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World Journal of Orthopedics 2023年第7期14卷 516-525页

作者： Dan Kym Japsimran Kaur Nicole Segovia Pham Eric Klein Joanna Lind langner Ellen Wang John Schoeneman Vorhies Department of Orthopaedic Surgery Stanford University School of MedicinePalo AltoCA 94304United States Lucile Packard Children’s Hospital Palo AltoCA 94304United States Department of Anesthesiology Pain and Perioperative MedicineStanford University School of MedicinePalo AltoCA 94304United States

BACKGROUND The timing of operative treatment for pediatric supracondylar humerus fractures(SCHF)and femoral shaft fractures(FSF)remains *** fractures previously considered to be surgical emergencies,such as SCHF and open fractures,are now commonly being treated the following *** presented with an urgent fracture overnight needing operative treatment,the on-call surgeon must choose whether to mobilize resources for a late-night case or to add the case to an elective schedule of the following *** To describe the effect of a program allowing an early operating room(OR)start for uncomplicated trauma prior to an elective day of surgery to decrease wait times for surgery for urgent fractures admitted *** Starting in October 2017,patients were eligible for the early slot in the OR at the discretion of the surgeon if they were admitted after 21:00 the previous night and before 05:*** compared demographics and timing of treatment of SCHF and FSF treated one year before and after implementation as well as the survey responses from the surgical *** Of the 44 SCHF meeting inclusion criteria,16 received treatment before imple mentation while 28 were treated *** implementation,the mean wait time for surgery decreased by 4.8 h or 35.4%(13.4 h vs 8.7 h;P=0.001).There were no significant differences in the operative duration,time in the post anesthesia care unit,and wait time for *** results demonstrated decreased popularity of the program among nurses and anesthesiologists relative to *** 57%of the surgeons believed that the program was effective,only 9%of anesthesiologists and 16%of nurses *** program was ultimately discontinued given the *** Our findings demonstrate significantly reduced wait times for surgery for uncomplicated SCHF presenting overnight while discussing the importance of shared decision-making with the *** the program produced promisi

关键词： Pediatrics Trauma Supracondylar humerus fractures Operating room

Furazolidone-based triple therapy for H pylori gastritis in children

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World Journal of Gastroenterology 2006年第34期12卷 5544-5549页

作者： Elisabete Kawakami Rodrigo Strehl Machado Silvio Kazuo Ogata Marini langner Erika Fukushima Anna Paula Carelli Vania Cláudia Guimares Bonucci Francy Reis Silva Patrício Peptic Diseases Outpatient Clinic Pediatric Gastroenterology Division Department of Pediatric Universidade Federal de So Paulo/Escola Paulista de Medicina So Paulo SP Brazil Department of Pathology Universidade Federal de So Paulo/Escola Paulista de Medicina S?o Paulo SP Brazil

AIM： To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastdtis. METHODS： A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms sufficiently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive ^13C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone （100 mg, 200 mg if over 30 kg） twice daily. Eradication of H pylori was assessed two months after treatment by histology and ^13C-urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS： Thirty-eight patients （24 females, 14 males） were included. Their age ranged from 4 to 17.8 （mean 10.9 ± 3.7） years. On intent-to-treat analysis （n = 38）, the eradication rate of H pylori was 73.7% （95% CI, 65.2%-82%） whereas in per-protocol analysis （n = 33） it was 84.8% （95% CI, 78.5%-91%）. All the patients with duodenal ulcer （n = 7） were successfully treated （100% vs 56.2% with antral nodularity）. Side effects were reported in 26 patients （68.4%）, mainly vomiting （14/26） and abdominal pain （n = 13）. Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of Hpylori-positive patients after six months of treatment. CONCLUSION： Triple therapy with furazolidone achieves moderate efficacy in H pylori treatment. The eradication rate seems to be higher in patients with duodenal ulcer.

关键词： Furazolidone H pylori treatment Gastritis Children