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Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 506-511页

作者： Tom florian ulmer Anne Weiland Georg Lurje Christian Klink Anne Andert Hamid Alizai Christoph Heidenhain Ulf Neumann Department of General Visceral and Transplantation Surgery RWTH Aachen University Hospital Aachen Germany Department of Urology Helios Hospital Berlin-Buch Germany

BACKGROUND: Post-hepatectomy liver failure as a result of insufficient liver remnant is a feared complication in liver surgery. Efforts have been made to find new strategies to support liver regeneration. The aim of this study was to investigate the effects of terlipressin versus splenectomy on postoperative liver function and liver regeneration in rats undergoing 70%partial hepatectomy. METHODS: Seventy-two male Wistar rats were randomly assigned into three groups(n=24 in each group): 70% partial hepatectomy as control(PHC), 70% partial hepatectomy with splenectomy(PHS) or 70% partial hepatectomy with a micropump for terlipressin administration(PHT). Eight rats in each group were sacrificed on postoperative day(POD) 1,3 and 7. To assess liver regeneration, immunohistochemical analysis of liver tissue using bromodeoxyuridine(BrdU) and Ki-67 labeling was performed. Portal venous pressure, serum concentrations of creatinine, urea, albumin, bilirubin and prothrombin time as well as liver-, body-weight and their ratio were determined on POD 1, 3 and ***: The liver-, body-weight and their ratio were not statistically different among the groups. On POD 1, 3 and 7 portal venous pressure in the intervention groups(PHT:8.13 ±1.55, 10.38±1.30, 6.25±0.89 cm H2O and PHS: 7.50±0.93,8.88 ±2.42, 5.75±1.04 cm H2O) was lower compared to the control group(PHC: 8.63±2.06, 10.50±2.45, 6.50±2.67 cmH2O). Hepatocyte proliferation in the intervention groups was delayed, especially after splenectomy on POD 1(Brd U: PHS vs PHC, 20.85% ±13.05% vs 28.11%±10.10%; Ki-67, 20.14%±14.10% vs 23.96% ±11.69%). However, none of the differences were statistically ***: Neither the administration of terlipressin nor splenectomy improved liver regeneration after 70% partial hepatectomy in rats. Further studies assessing the regulation of portal venous pressure as well as extended hepatectomy animal models and liver function tests will help to further investigate mechanisms of live

关键词： liver regeneration liver failure terlipressin splenectomy hepatectomy

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Loco-regional hepatocellular carcinoma treatment services as a bridge to liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 228-236页

作者： Sophia Schmitz Georg Lurje florian ulmer Anne Andert Philipp Bruners Maximilian Schulze-Hagen Ulf Neumann Wenzel Schoening Department of General- Visceral- and Transplantation Surgery University Hospital of RWTH Aachen Aachen Germany Department of Diagnostic and Interventional Radiology University Hospital of RWTH Aachen Aachen Germany Department of Surgery Maastricht University Medical Center (MUMC) Maastricht Netherlands Department of Surgery Charité– University Medicine at Berlin Germany

Background: Liver transplantation remains the main curative treatment option for hepatocellular carcinoma(HCC) patients. In the Eurotransplant area Milan criteria are used to assign priority extra points(exceptional MELD, ex MELD) for patients on the waiting list. To prevent patients from tumor progression, loco-regional(neoadjuvant) treatment(LRT) is used. For patients unlikely to timely receive an organ via primary allocation,“extended critera donor(ECD) organs” are used. The present study aimed to investigate the survival after LT with a strategy of minimizing waiting list dropouts by using LRT for bridging and transplanting ECD organs if possible and necessary. Methods: Between October 2010 and May 2015, 50 liver transplants for HCC were included in this retrospective study. Of those, 42(84%) met the Milan criteria according to the preoperative radiological examination. Forty-one patients(82%) received LRT. The waiting time was analyzed according to LRT. Kaplan-Meier curves with log-rank statistics were used for survival analyses. Results: One-and five-year overall survival within Milan criteria was 94.3% and 83.7% compared with 91.7% and 67.9% beyond Milan criteria, though statistical significance was not reached( P = 0.487). LRT had no impact on overall survival( P = 0.629). Median waiting time was shorter if no LRT was performed(4.6 months vs. 1.5 months, P = 0.006) and there were no cases of waiting list dropouts. Using ECD organs had no impact on overall survival( P = 0.663). Conclusions: Patients with an expected waiting time to transplantation of > 6 months could be successfully treated with LRT as a bridge to transplant. Overall and disease-free survival for patients within and beyond Milan criteria was comparable and the use of ECD organs in this cohort of HCC patients proved to be a safe option.

关键词： Hepatocellular carcinoma Liver transplantation Therapeutic embolization Liver neoplasms Organ transplantation

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Grade of donor liver microvesicular steatosis does not affect the postoperative outcome after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 617-623页

作者： Anne Andert Tom florian ulmer Wenzel Schoning Daniela Kroy Marc Hein Patrick Hamid Alizai Christoph Heidenhain Ulf Neumann Maximilian Schmeding Department of General Visceral and Transplant SurgeryUniklinik RWTH Aachen AachenGermany Department of Internal Medicine Uniklinik RWTH Aachen AachenGermany Department of Anaesthesiology Uniklinik RWTH Aachen AachenGermany Department of General and Visceral Surgery Sana Hospital Düsseldorf-Gerresheim Germany

BACKGROUND:The potential effect of graft steatosis on the postoperative liver function is discussed controversially. The present study aimed to evaluate the effect of the donor liver microvesicular steatosis on the postoperative outcome after liver ***:Ninety-four patients undergoing liver transplantation at the University Hospital Aachen were included in this study. The patient cohort was divided into three groups according to the grade of microvesicular steatosis(MiS):MiS 60%(n=26).The outcomes after liver transplantation were evaluated, including the 30-day and 1-year patient and graft survival rates and the incidences of early allograft dysfunction(EAD) and primary nonfunction(PNF). RESULTS:The incidences of EAD and PNF did not differ significantly between the groups. We observed 5 cases of PNF,one occurred in the MiS 60% ***:Microvesicular steatosis of donor livers has no negative effect on the postoperative outcome after liver transplantation.

关键词： liver transplantation liver steatosis microvesicular steatosis early allograft dysfunction

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Impact of body composition on survival and morbidity after liver resection in hepatocellular carcinoma patients

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 28-37页

作者： Andreas Kroh Diane Uschner Toine Lodewick Roman M Eickhoff Wenzel Sch?ning florian T ulmer Ulf P Neumann Marcel Binneb?sel Department of General Visceral and Transplant Surgery University Hospital RWTH Aachen Institute of Medical Statistics University Hospital RWTH Aachen Department of Surgery Maastricht University Medical Center Department of Radiology Zuyderland Medical Centre Department of Radiology Maastricht University Medical Centre

Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma. Methods: A retrospective database analysis of 70 patients who were assigned for liver resection due to hepatocellular carcinoma was conducted. For assessment of sarcopenia and obesity, skeletal muscle surface area was measured at lumbar vertebra 3 level(L3) in preoperative four-phase contrast enhanced abdominal CT scans, and L3 muscle index and body fat percentage were calculated. Results: Univariate analysis comparing the survival curves using the score test demonstrated superior postoperative overall survival for sarcopenic( P = 0.035) and sarcopenic obese( P = 0.048) patients as well as a trend favoring obese( P = 0.130) subjects. Whereas multivariate analysis could not identify significant difference in postoperative survival regarding sarcopenia, obesity or sarcopenic obesity. Only large tumor size, multifocal disease and male gender were risk factors for long-term survival. Conclusions: Sarcopenia, obesity and sarcopenic obesity are indeed no risk factors for poor postoperative survival in this study. Our data do not support the evaluation of sarcopenia, obesity and sarcopenic obesity before liver resection in hepatocellular carcinoma patients.

关键词： Hepatocellular carcinoma Sarcopenia Obesity Sarcopenic obesity Liver resection

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Bayesian inference-based wear prediction method for plain bearings under stationary mixed-friction conditions

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Friction 2024年第6期12卷 1272-1282页

作者： florian KÖNIG florian WIRSING Georg JACOBS Rui HE Zhigang TIAN Ming J.ZUO Institute for Machine Elements and Systems Engineering RWTH Aachen UniversityAachen 52062Germany Department of Mechanical Engineering University of AlbertaEdmonton T6G1H9Canada Qingdao International Academician Park Research Institute Qingdao 266000China

This study introduces a method to predict the remaining useful life(RUL)of plain bearings operating under stationary,wear-critical *** this method,the transient wear data of a coupled elastohydrodynamic lubrication(mixed-EHL)and wear simulation approach is used to parametrize a statistical,linear degradation *** method incorporates Bayesian inference to update the linear degradation model throughout the runtime and thereby consider the transient,system-dependent wear progression within the RUL prediction.A case study is used to show the suitability of the proposed *** results show that the method can be applied to three distinct types of post-wearing-in behavior:wearing-in with subsequent hydrodynamic,stationary wear,and progressive wear *** hydrodynamic operation leads to an infinite lifetime,the method is successfully applied to predict RUL in cases with stationary and progressive wear.

关键词： plain bearings wear modeling remaining useful life prediction Bayesian inference

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Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients

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World Journal of Gastrointestinal Surgery 2021年第1期13卷 19-29页

作者： Daniel Heise Jan Bednarsch Andreas Kroh Sandra Schipper Roman Eickhoff Marielle Coolsen Ronald Van Dam Sven Lang Ulf Neumann florian ulmer Department of Surgery and Transplantation University Hospital RWTH AachenAachen 52074Germany Department of Surgery Maastricht University Medical CenterMaastricht 6229 HXNetherlands

BACKGROUND Laparoscopic liver surgery is currently considered the standard of care for various liver ***,studies focusing on perioperative outcome after laparoscopic hepatectomy(LH)in overweight patients are still sparse and its benefit compared to open hepatectomy(OH)is a matter of *** To analyze postoperative outcomes in overweight[body mass index(BMI)over 25 kg/m²]and obese(BMI over 30 kg/m²)patients undergoing LH and compare postoperative outcome with patients undergoing *** Perioperative data of 68 overweight(BMI over 25 kg/m²)including a subcohort of obese(BMI over 30 kg/m²)patients(n=27)who underwent LH at our institution between 2015 and 2019 were retrospectively analyzed regarding surgical outcome and compared to an equal number of patients undergoing *** The mean BMI was 29.8±4.9 kg/m2 in the LH group and 29.7±3.6 kg/m2 in the OH group with major resections performed in 20.6%(LH)and 26.5%(OH)of cases,*** time(194±88 min vs 275±131 min;P<0.001)as well as intensive care(0.8±0.7 d vs 1.1±0.8 d;P=0.031)and hospital stay(7.3±3.6 d vs 15.7±13.5 d;P<0.001)were significant shorter in the LH ***,overall complications(20.6%vs 45.6%;P=0.005)and major complications(1.5%vs 14.7%,P=0.002)were observed less frequently after *** additional investigation analyzing the subgroup of obese patients who underwent LH(n=27)and OH(n=29)showed a shorter operative time(194±81 min vs 260±137 min;P=0.009)and a reduced length of hospitalization(7.7±4.3 d vs 17.2±17 d;P<0.001)but no difference in postoperative complications or overall *** LH is safe and cost-effective in overweight and obese ***,LH is significantly associated with fewer postoperative complications and reduced hospital stay compared to OH in these patients.

关键词： Laparoscopic hepatectomy Obesity Overweight Morbidity Postoperative outcome Cost

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Mechanically Joined Extrusion Profiles for Battery Trays

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Automotive Innovation 2024年第1期7卷 182-193页

作者： florian Kneuper Stefan Neumann AndréSchulze Mortaza Otroshi A.Erman Tekkaya Gerson Meschut Institute of Forming Technology and Lightweight Components(IUL) TU Dortmund University44227 DortmundGermany Laboratory for Material and Joining Technology(LWF) Paderborn UniversityPaderbornGermany

In the context of electromobility,ensuring the leak tightness of assemblies is of paramount importance,particularly in bat-tery *** battery housings,often featuring base assemblies crafted from extruded aluminum profiles,address the challenge of leak tightness at joints through methods like friction stir welding,a process known for its time and cost *** aim of this study is to develop and implement a new type of extruded profile concept to produce tight base assemblies for battery housings by a longitudinal mechanical single stroke joining *** geometry,the process and the properties of the aluminum profiles are investigated to get a joint that meets the tightness requirements and achieve high load-bearing capacities in agreement with the high homologation requirements set to vehicles with high-voltage *** joint is formed by means of a single stage press stroke,which eliminates the need for complex tool designs that are neces-sary for continuous joining(roll joining).Flat steel contact surfaces are used as joining *** evaluate the joint quality,force curves from the joining process are analyzed and the resulting joint geometries are assessed using *** resulting leak tightness of the linear joints is measured by a helium sniffer leak detector and the load-bearing capacities are investigated by shear lap and bending tests and fatigue strength *** study also explores whether a difference in strength between the two joining partners has a positive effect on the joint properties.

关键词： Joining by plastic deformation Aluminum Leak Tightness

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Foraging valor linked with aggression:selection against completely abandoning aggression in the high-elevation ant Tetramorium alpestre?

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Insect Science 2024年第3期31卷 953-970页

作者： Marie-Luise Contala Patrick Krapf florian M.Steiner Birgit C.Schlick-Steiner Molecular Ecology Group Department of EcologyUniversitat InnsbruckInnsbruckAustria rganismal&Evolutionary Biology Research Programme University of HelsinkiHelsinkiFinland

Aggression has multiple benefits and is often coupled with other behaviors("behavioral syndromes").The level of aggressiveness is influenced by an adaptive benefit-cost ratio suggesting that benefits should outweigh the costs of ***,we assess if several behaviors are coupled in two behaviorally different populations(aggressive,peaceful)of the high-elevation ant Tetramorium *** three weeks,we collected colony fragments and analyzed boldness,exploring,foraging,and risk-taking *** hypothesized that the aggressive population is bolder,more explorative and risk-prone,and forages more food than the peaceful *** test whether(a)the combination of experiments and parameters used yields a good setup,(b)populations differ behaviorally,and(c)populations display behavioral syndromes,we assessed(a)the frequency of repeatable behaviors of each experiment,(b)the behavioral means among populations,and(c)the behavioral repeatability,*** found that(a)boldness and exploring were most repeatable and represent a good experimental setup,(b)the aggressive population was bolder and more explorative and risk-prone than the peaceful population,(c)boldness and exploring behaviors were highly repeatable in both populations,thus corroborating our *** results suggest that boldness,exploring,and risk-taking but not foraging are presumably coupled with aggression and indicate the presence of behavioral syndromes in this *** specific ecological conditions,aggression may be coupled with other behaviors and important for finding *** is probably adaptive in ***,possibly indicating that selection favors aggression at least partially,which may counteract the complete loss of intraspecific aggression.

关键词： adaptive value behavioral syndromes boldness exploration repeatability trade-off

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Mycorrhizal fungi mitigate nitrogen losses of an experimental grassland by facilitating plant uptake and soil microbial immobilization

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Pedosphere 2024年第2期34卷 399-410页

作者： Yangyang JIA Marcel G.A.VAN DER HEIJDEN Alain Y.VALZANO-HELD Markus JOCHER florian WALDER Postdoctoral Mobile Station of Ecology College of Ecology and EnvironmentXinjiang UniversityÜrümqi 830046China Research Group Plant-Soil Interactions AgroscopeZürich 8046Switzerland Research Group Climate and Agriculture AgroscopeZürich 8046Switzerland Department of Plant and Microbial Biology University of ZürichZürich 8008Switzerland Research Group Soil Quality and Soil Use AgroscopeZürich 8046Switzerland

Nitrogen(N)is one of the most limited nutrients of terrestrial ecosystems,whose losses are prevented in tightly coupled cycles in finely tuned *** change-induced N enrichment through atmospheric deposition and application of vast amounts of fertilizer are now challenging the terrestrial N *** mycorrhizal fungi(AMF)are known drivers of plant-soil nutrient fluxes,but a comprehensive assessment of AMF involvement in N cycling under global change is still ***,we simulated N enrichment by fertilization(low/high)in experimental grassland microcosms under greenhouse conditions in the presence or absence of AMF and continuously monitored different N pathways over nine *** found that high N enrichment by fertilization decreased the relative abundance of legumes and the plant species dominating the plant community changed from grasses to forbs in the presence of AMF,based on aboveground *** presence of AMF always maintained plant N:phosphorus(P)ratios between 14 and 16,no matter how the soil N availability *** in plant N:P ratios due to the increased plant N and P uptake might thus be a primary pathway of AMF altering plant community ***,we constructed a comprehensive picture of AMF’s role in N cycling,highlighting that AMF reduced N losses primarily by mitigating N leaching,while N_(2)O emissions played a marginal *** mycorrhizal fungi reduced N_(2)O emissions directly through the promotion of N_(2)O-consuming *** underlying mechanism for reducing N leaching is mainly the AMF-mediated improved nutrient uptake and AMF-associated microbial *** results indicate that synergies between AMF and other soil microorganisms cannot be ignored in N cycling and that the integral role of AMF in N cycling terrestrial ecosystems can buffer the upcoming global changes.

关键词： N cycling N enrichment N uptake N:P ratio plant community structure symbiotic soil fungi

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Femoral Access with Ultrasound-Guided Puncture and Z-Stitch Hemostasis for Adults with Congenital Heart Diseases Undergoing Electrophysiological Procedures

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Congenital Heart Disease 2024年第1期19卷 85-92页

作者： Fu Guan Matthias Gass florian Berger Heiko Schneider Firat Duru Thomas Wolber Arrhythmia and Electrophysiology Division Department of CardiologyUniversity Heart Center ZurichZurichSwitzerland Children’s Research Center Zurich University Children’s HospitalZurichSwitzerland Center for Integrative Human Physiology University of ZurichZurichSwitzerland

Aims:Although the application of ultrasound-guided vascular puncture and Z-stitch hemostasis to manage femoral access has been widely utilized,there is limited data on this combined application in adult congenital heart disease(ACHD)patients undergoing electrophysiological(EP)*** sought to evaluate the safety and efﬁcacy of ultrasound-guided puncture and postprocedural Z-stitch hemostasis for ACHD patients under-going EP *** and Results:The population of ACHD patients undergoing transfemoral EP pro-cedures at the University of Zurich Heart Center between January 2019 and December 2022 was observed and *** the study period,femoral access(left/right,arterial/venous)was performed under real-time ultrasound *** the end of the procedure,a single Z-stitch was performed at the puncture *** eval-uated the incidence of in-hospital complications associated with femoral access puncture in this *** 101 patients who had a total of 147 previous ipsilateral vascular punctures(mean 1.5 per person),100 patients underwent successful femoral vascular access for EP *** median age of the patients was 47±15 years and 34(34%)were male.Z-stitches were performed after the procedure in 100 patients with 303 femoral vascular accesses(mean 3 punctures per person).No patient developed vascular puncture relevant inguinal hematoma,pseudo aneurysm,arteriovenousﬁstula,venous or arterial ***:In ACHD patients undergoing EP procedures,optimal femoral access management can be achieved with ultra-sound-guided puncture and postprocedural Z-stitch hemostasis.

关键词： Congenital heart disease cardiac electrophysiology cardiac catheterization femoral access hemostasis

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