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Validity of studies suggesting preoperative chemotherapy for resectable thoracic esophageal cancer:A critical appraisal of randomized trials

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World Journal of Gastrointestinal Oncology 2020年第1期12卷 113-123页

作者： Giulia Manzini Ursula Klotz doris henne-bruns Michael Kremer Department of General and Visceral Surgery University of UlmUlm 89081Germany Department of General and Visceral Surgery Hospital of AarauAarau 5000Switzerland

BACKGROUND In 2015,Kidane published a Cochrane review and meta-analysis to summarise the impact of preoperative chemotherapy versus surgery alone on survival for resectable thoracic esophageal *** authors concluded that preoperative chemotherapy improved overall survival(OS).AIM The aim of this article was to assess the validity of the three most powerful studies included in the Cochrane review and the meta-analysis supporting the advantage of preoperative chemotherapy and to investigate the impact of an exclusion of these three studies on the result of the *** OS was selected as the endpoint of *** the ten included papers which analysed this endpoint,we identified the three publications with the highest weights influencing the final *** validity of these papers was analysed using the CONSORT checklist for randomized controlled *** performed a new meta-analysis without the three studies to assess their impact on the general result of the original *** The three analysed studies revealed several *** answers were found in up to one third of the items of the CONSORT *** information about sample-size calculation and power,unclear or inadequate randomisation,and missing blinded set-up were the most common *** the three criticized studies were excluded in the meta-analysis,preoperative chemotherapy showed no benefit in *** The three most powerful publications in the Cochrane review show substantial *** the exclusion of these studies from the meta-analysis,preoperative chemotherapy does not seem to result in an advantage in *** suggest a more critical appraisal regarding the validity of single studies.

关键词： Esophageal cancer Assessment of validity Meta-analysis CONSORT Overall survival

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Perioperative chemotherapy for advanced gastric cancer - results from a tertiary-care hospital in Germany

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World Journal of Gastrointestinal Oncology 2020年第5期12卷 559-568页

作者： Katrin Bauer Giulia Manzini doris henne-bruns Peter Buechler Department for General VisceralThoracic and Paediatric SurgeryClinic of KemptenKempten 87439Germany Department of General and Visceral Surgery University Hospital of UlmUlm 89081Germany

BACKGROUND Neoadjuvant/perioperative chemotherapy is the recommended treatment for advanced stages of gastric cancer(>T2,N+)before tumour resection in many European ***,there is no consensus as to whether perioperative chemotherapy is as effective in distal as in proximal tumours,in addition to a relevant uncertainty concerning appropriate treatment modalities for elderly *** To investigate the role of perioperative chemotherapy in advanced gastric cancer in patients from a German tertiary clinic with respect to efficacy,localisation,and *** We performed a retrospective analysis of 158 patients from our clinic with adenocarcinoma of the stomach or the gastroesophageal junction who underwent resection between 2008 and *** data were evaluated particularly in relation to patient age,tumour site,and perioperative *** Administration of perioperative chemotherapy did not lead to a significant survival advantage in our study *** 5-year survival rates were 40%for patients who received perioperative chemotherapy and 29%for the group without perioperative chemotherapy(P=0.125).Our patients were on average distinctly older than patients in most of the published randomised controlled *** elder than 75 years received perioperative chemotherapy far less *** with a proximal tumour received perioperative chemotherapy much more *** This analysis reconfirms our previous data concerning the effectiveness of perioperative chemotherapy for advanced gastric *** is reasonable doubt that the quality of the existing randomized controlled trials is sufficient to generally justify perioperative chemotherapy in patients with advanced gastric cancer independent of tumour localization or age.

关键词： Gastric cancer Perioperative Chemotherapy Tumour localisation Age distribution Validity

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Multiple gastrointestinal stromal tumors and bilateral pheochromocytoma in neurofibromatosis

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World Journal of Gastroenterology 2007年第24期13卷 3384-3387页

作者： Klaus Kramer Cornelia Hasel Andrik J Aschoff doris henne-bruns Peter Wuerl Department of Surgery University Hospitals of Ulm Ulm Germany Department of Pathology University Hospitals of Ulm Ulm Germany Department of Diagnostic and Interventional Radiology University Hospitals of Ulm Ulm Germany

The coincidence of a gastrointestinal stromal tumor (GIST) and a neuroendocrine tumor (NET) in neurofibromatosis type 1 (NF1) is described only five times within the literature. We report on a 63 year old Caucasian female with the rare condition of neurofibromatosis type 1 coinciding with recurrent gastrointestinal stromal tumor plus bilateral pheochromocytoma (PCC). After a history of palpitations and dizziness that lasted for years, a left adrenal mass was detected by CT. Laparotomy revealed a pheochromocytoma of the left adrenal gland while an ileoterminal GIST was found incidentally intraoperatively. After six months contralateral PCC and multiple recurrent GIST were resected again. After four years the patient is doing well without any signs of further recurrent tumors. Discussion includes review of the literature.

关键词： Gastrointestinal stromal tumor Neuroendocrine tumor Neurofibromatosis Pheochromocytoma Coincidence

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Adjuvant chemotherapy in curatively resected rectal cancer: How valid are the data?

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World Journal of Gastrointestinal Oncology 2020年第4期12卷 503-513页

作者： Giulia Manzini Fabius Hapke Ian N Hines doris henne-bruns Michael Kremer Department of General and Visceral Surgery University of UlmUlm 89081Germany Department of Nutrition Science College of Allied Health SciencesEast Carolina UniversityGreenvilleNC 27834United States Department of General and Visceral Surgery Hospital of AarauAarau 5000Switzerland

BACKGROUND According to the result of the Cochrane review published in 2012,postoperative adjuvant chemotherapy(CTx)is associated with a survival benefit for rectal cancer patients operated for cure in comparison to patients who underwent only the surgical *** To analyze the quality of the data supporting the advantage of adjuvant CTx after surgery for rectal *** the times of increasing health care costs,it is imperative to offer the patient an evidence-based therapy that justifies potential side effects as well as *** Overall survival was selected as endpoint of *** the 21 included papers which analyzed this endpoint,we identified those three publications which have the highest weights to influence the final *** validity of these papers was analyzed using the CONSORT checklist for randomized controlled *** performed a second meta-analysis excluding the three analyzed studies(n=18)in order to assess their impact on the overall result of the original ***,we performed a third meta-analysis excluding all studies(n=16)which showed a statistically improved overall *** The detailed analysis of the three most relevant RCTs according to the items of the CONSORT checklist showed several *** up to 47%of the items,inappropriate answers were ***,a lack of information regarding therandomization procedure as well as the absence of allocation concealment,blinded set-up,of intention-to-treat analysis and omission of sample size calculation were common problems of the analyzed *** exclusion of these three studies from the meta-analysis did not affect the general result of the meta-analysis,still confirming a survival advantage after adjuvant *** exclusion of single studies with a statistically significant outcome improvement,the meta-analysis of the remaining 16 studies again shows a statistically significant result due in part to a large remaining sample size.C

关键词： Rectal cancer Validity Meta-analysis CONSORT checklist Postoperative chemotherapy Overall survival

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Follow-up in hepatic alveolar echinococcosis under benzimidazole therapy using computed tomography

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Chinese Medical Journal 2020年第12期133卷 1507-1509页

作者： Tilmann Graeter Rong Shi Hai-Hua Bao Wolfgang Kratzer Thomas F.E.Barth Andreas Hillenbrand doris henne-bruns Julian Schmidberger Beate Gruener Wei-Xia Li 无 Department of Diagnostic and Interventional Radiology University Hospital UlmUlm 89081Germany Qinghai University Qinghai University Affiliated HospitalXiningQinghai 810001China Department of Internal Medicine I University Hospital UlmUlm 89081Germany Institute of Pathology University Hospital UlmUlm 89081Germany Department of General and Visceral Surgery University Hospital UlmUlm 89081Germany Comprehensive Infectious Diseases Centre University Hospital UlmUlm 89081Germany for the Echinococcosis Study Group Ulm

To the Editor:Alveolar echinococcosis(AE),caused by infection with Echinococcus multilocularis,is regarded as the most dangerous parasitic zoonosis in the temperate climate zones of the northern hemisphere,particularly across Central Europe and large parts of North-/Central *** untreated,AE has a very high mortality *** liver is the organ most commonly affected showing complex,often infiltrative *** lesions cannot be resected in curative intention,long-term parasitostatic pharmacotherapy with benzimidazoles is indicated to inhibit further extension.[1]

关键词： echinococcosis mortality hepatic

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Long-lived lunar volcanism sustained by precession-driven core-mantle friction

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National Science Review 2024年第2期11卷 114-123页

作者： Shuoran Yu Xiao Xiao Shengxia Gong Nicola Tosi Jun Huang doris Breuer Long Xiao Dongdong Ni State Key Laboratory of Lunar and Planetary Sciences Macau University of Science and Technology Planetary Science Institute State Key Laboratory of Geological Processes and Mineral Resources School of Earth Sciences China University of Geosciences CAS Key Laboratory of Planetary Sciences Shanghai Astronomical Observatory Institute of Planetary Research German Aerospace Centre(DLR)

Core-mantle friction induced by the precession of the Moon's spin axis is a strong heat source in the deep lunar mantle during the early phase of a satellite's evolution, but its influence on the long-term thermal evolution still remains poorly explored. Using a one-dimensional thermal evolution model, we show that core-mantle friction can sustain global-scale partial melting in the upper lunar mantle until ～3.1 Ga, thus accounting for the intense volcanic activity on the Moon before ～3.0 Ga. Besides, core-mantle friction tends to suppress the secular cooling of the lunar core and is unlikely to be an energy source for the long-lived lunar core dynamo. Our model also favours the transition of the Cassini state before the end of the lunar magma ocean phase(～4.2 Ga), which implies a decreasing lunar obliquity over time after the solidification of the lunar magma ocean. Such a trend of lunar obliquity evolution may allow volcanically released water to be buried in the lunar regolith of the polar regions. As a consequence, local water ice could be more abundant than previously thought when considering only its accumulation caused by solar wind and comet spreading.

关键词： Moon precession orbit volcanism

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The Pichia pastoris enzyme production platform:From combinatorial library screening to bench-top fermentation on residual cyanobacterial biomass

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Journal of Bioresources and Bioproducts 2024年第1期9卷 43-57页

作者： Korbinian Sinzinger Ulrike Obst Samed Güner Manuel Döring Magdalena Haslbeck doris Schieder Volker Sieber Chair of Chemistry of Biogenic Resources Campus Straubing for Biotechnology and SustainabilityTechnical University of MunichStraubing 94315Germany Catalysis Research Center Technical University of MunichGarching 85748Germany SynBiofoundry@TUM Technical University of MunichStraubing 94315Germany School of Chemistry and Molecular Biosciences The University of QueenslandSt.Lucia 4072Australia

The demand for industrial enzymes is continually rising,fueled by the growing need to shift towards more sustainable industrial ***,making efficient enzyme production strains and identifying optimal enzyme expression conditions remains a ***,the production of the enzymes themselves comes with unavoidable impacts,e.g.,the need to utilize secondary ***,we take a more holistic view of bioprocess development and report an integrative approach that allows us to rapidly identify improved enzyme expression and secretion conditions and make use of cyanobacterial waste biomass as feed for supporting Pichia pastoris *** demonstrate these capabilities by producing a phytase secreted by *** that is grown on cyanobacterium hydrolysate and buffered glycerol-complex(BMGY)medium,with genetic expression conditions identified by high-throughput screening of a randomized se-cretion *** our best-performing strain is grown in a fed-batch fermentation on BMGY,we reach over 7000 U/mL in three days.

关键词： Protein secretion Phytase Cyanobacterial biomass Fed-batch fermentation Pichia pastoris

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Mechanical upper bowel obstruction caused by a large trichobezoar in a young woman: A very unusual case report

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World Journal of Clinical Cases 2024年第4期12卷 777-781页

作者： Magdalena Scherrer Peter Kornprat Robert Sucher Johanna Muehlsteiner doris Wagner Department of Surgery Division for GeneralVisceral and Transplantation SurgeryMedical University of GrazGraz 8036Austria Department of Surgery Clinic RohrbachRohrbach 4150Austria

BACKGROUND Bezoars usually compile human fibers and debris.A special form of bezoar in case of psychologically altered individuals is the *** consists of voluntarily swallowed hair bulks and is normally removed via *** leading to ileus have rarely been *** SUMMARY A 24-year-old female patient presented to the emergency room with abdominal pain,nausea,and vomiting for 3 *** previous medical and psychiatric history was *** analysis showed iron deficiency anemia,leukocytosis,and elevated liver *** abdominal CT scan revealed a dense structure in the patients’stomach which turned out to be a huge trichobezoar completely obstructing the *** trichobezoar had to be removed *** her postoperative course,a subcutaneous seroma *** a single puncture,the rest of the recovery process was unremarkable,and the patient recovered *** A mechanical bowel obstruction is a potentially life-threatening event for every *** our case a young female was suffering from severe symptoms of an obstruction which might have resulted in serious harm without successful surgical management.

关键词： Rapunzel syndrome Hair ingestion Gastroscopy Bezoar Case report

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Growth differentiation factor-15 serum concentrations reflect disease severity and anemia in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2024年第13期30卷 1899-1910页

作者： Ante Tonkic Marko Kumric Ivna Akrapovic Olic doris Rusic Piero Marin Zivkovic Daniela Supe Domic Zeljko Sundov Ivan Males Josko Bozic Biology of Neoplasms University of Split School of MedicineSplit 21000Croatia Department of Pathophysiology University of Split School of MedicineSplit 21000Croatia Department of Gastroenterology University Hospital of SplitSplit 21000Croatia Department of Pharmacy University of Split School of MedicineSplit 21000Croatia Department of Medical Laboratory Diagnostics University Hospital of SplitSplit 21000Croatia Department of Health Studies University of SplitSplit 21000Croatia Department of Internal Medicine University of Split School of MedicineSplit 21000Croatia Department of Surgery University Hospital of SplitSplit 21000Croatia

BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and ***-differentiation factor-15(GDF-15)is often overexpressed under stress conditions,such as inflammation,malignancies,heart failure,myocardial ischemia,and many *** To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple *** additional aim was to determine possible associations between GDF-15 and multiple clinical,anthropometric and laboratory parameters in patients with *** This cross-sectional study included 90 adult patients diagnosed with IBD,encompassing both Crohn’s disease(CD)and ulcerative colitis(UC),and 67 healthy age-and sex-matched *** patients underwent an extensive workup,including colonoscopy with subsequent histopathological *** activity was assessed by two independent gastroenterology consultants specialized in IBD,employing well-established clinical and endoscopic scoring ***-15 serum concentrations were determined following an overnight fasting,using electrochemiluminescence *** In patients with IBD,serum GDF-15 concentrations were significantly higher in comparison to the healthy controls[800(512-1154)pg/mL vs 412(407-424)pg/mL,P<0.001],whereas no difference in GDF-15 was found between patients with CD and UC[807(554-1451)pg/mL vs 790(509-956)pg/mL,P=0.324].Moreover,multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age,sex,and C-reactive protein levels(P=0.016 and P=0.049,respectively).Finally,an association between GDF-15 and indices of anemia was ***,negative correlations were found between GDF-15 and serum iron levels(r=-0.248,P=0.021),as well as GDF-15 and hemoglobin(r=-0.351,P=0.021).Accordingly,in comparison to I

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Growth-differentiation factor-15 Anemia Extraintestinal manifestations

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Orthotopic transplantation model of human gastrointestinal cancer and detection of micrometastases

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World Journal of Gastroenterology 2001年第3期7卷 381-386页

作者： Jun Hui Cui~1 Uwe Krueger~2 doris henne-bruns~2 Bemd Kremer~2 Holger Kalthoff~2 ~1Department of General Surgery,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China ~2Department of General Surgery,Christian-Albrechts-University,Kiel,GermanyDr.Jun Hui Cui graduated from Zhejiang Medical University in 1984,earned master degree in 1990,studied in the Surgical Department of Kiel University and worked in the Lab of Molecular Oncology of Kiel University from 1994-1997achieved M.D.from Kiel University.Germany,now associate professor of surgery,specialized in colorectal oncology.Adviser of graduated student for master degree,having 20 publications published in key Chinese or English journals. Department of General Surgery First Affiliated Hospital College of Medicine Zhejiang University 79 Qingchun Road Hangzhou 310003 Zhejiang ProvinceChina. Cjhui@***

AIM: To establish a relevant animal model of human gastrointestinal cancer, which can be used for repetitive investigations, so as to improve our understanding and management of carcinogenesis and cancer metastasis. METHODS: Intact tissues of human colorectal and pancreatic cancers were transplanted in nude mice. The biological characteristics of the original and the corresponding transplanted tumors were investigated by HE staining, PAS staining and immunostaining. The metastases in the livers and lungs of nude mice were investigated by immunostaining with biotinylated mab KL-1 and by RT-PCR using CK20 specific primers. RESULTS: There were totally 9 of 16 surgical specimens growing in nude mice subcutaneously and/or orthotopically (4 of 6 colorectal and 5 of 10 pancreatic cancer). Tumor cell content of the specimens and freezing of tissue specimens are important factors influencing the growth of transplanted tumor. In the group of fresh tumor tissues with greater than 50% tumor cell content, the success rate of the transplantation was 100% (3 cases of pancreatic cancer and 3 cases of colorectal cancer). The orthotopically trans-planted tumors resemble the original tumor morphologically and biologically, including TAA expression such as CEA by immunohistochemistry, and CEA level in the serum of mice. Ki-67 labeling index and the expression of TAA especially K-ras, 17-1A and RA-96, are associated with the potential of tumor growth in nude mice. Micrometastases in the lungs and livers of tumor bearing mice can be detected by immunostaining with biotinylated mab KL-1 and CK20-specific RT-PCR. CONCLUSION: An orthotopic transplantation model for human colon and pancreatic cancer in nude mice has been set up. We have also established sensitive detection methods with CK-immunohistochemistry and CK20-RT-PCR to study xenotransplanted human cancer and its metastatic cancer cells in the liver and lung of nude mice. This study may be helpful in understanding the mechanism of ca

关键词： Animals Disease Models, Animal Female Gastrointestinal Neoplasms Humans Male Mice Mice, Nude Neoplasm Seeding Neoplasm Transplantation Research Support, Non-U.S. Gov't Transplantation, Heterologous

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