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The incidence and severity of post-hepatectomy bile leaks is affected by surgical indications,preoperative chemotherapy,and surgical procedures

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Hepatobiliary Surgery and Nutrition 2019年第2期8卷 101-110页

作者： Vinzent N.Spetzler Marlene Schepers Hans O.Pinnschmidt lutz fischer Bj?rn Nashan Jun Li Department of Hepatobiliary Surgery and Visceral Transplantation University Medical Center Hamburg-EppendorfHamburgGermany Department of Medical Biometry and Epidemiology University Medical Center Hamburg-EppendorfHamburgGermany

Background:Bile leaks are one of the most common complications after liver *** International Study Group of Liver Surgery(ISGLS)established a uniform bile leak definition including a severity ***,a risk factor assessment according to ISGLS grading as well as the clinical implications has not been studied sufficiently so ***:The incidence and grading of bile leaks according to ISGLS were prospectively documented in 501 consecutive liver resections between July 2012 and December 2016.A multivariate regression analysis was performed for risk factor *** with other surgical complications,90-day mortality as well as length of hospital stay(LOS)was ***:The total rate of bile leaks in this cohort was 14.0%:2.8%grade A,8.0%grade B,and 3.2%grade C bile leaks were *** chemotherapy or biliary intervention,diagnosis of hilar cholangiocarcinoma,colorectal metastasis,central minor liver resection,major hepatectomy,extended hepatectomy or two-stage hepatectomy,were some of the risk factors leading to bile *** multivariate regression analysis revealed that preoperative chemotherapy,major hepatectomy and biliodigestive reconstruction remained significant independent risk factors for bile *** C bile leaks were associated not only with surgical site infection,but also with an increased 90-day mortality and prolonged ***:The preoperative treatment as well as the surgical procedure had significant influence on the incidence and the severity of bile *** C bile leaks were clinically most relevant,and led to significant increased LOS,rate of infection,and mortality.

关键词： Bile leakage post-operative complication liver resection International Study Group of Liver Surgery(ISGLS) Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy(ALPPS)

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High incidence of periodontitis in patients with ascitic decompensated cirrhosis

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World Journal of Hepatology 2023年第12期15卷 1325-1332页

作者： Sven Pischke Mohamad Motee Ashouri Ulrike Peters Anita Shiprov Julian Schulze Zur Wiesch Martina Sterneck Frank fischer Peter Huebener Maria Mader lutz fischer Thorben Fründt G Aarabi Thomas Beikler First Department of Medicine University Medical Centre Hamburg-EppendorfHamburg 20246Germany First Department of Medicine University Hospital Hamburg-EppendorfHamburg 20246Germany Periodontics Preventive and Restorative DentistryUniversity Hospital Hamburg-EppendorfHamburg 20246Germany Department of Periodontics Preventive and Restorative DentistryUniversity Medical Center Hamburg-EppendorfHamburg 20246Germany Department of Visceral Transplantation University Hospital Hamburg-EppendorfHamburg 20246Germany

BACKGROUND Periodontitis has been associated with various liver ***,the relevance of periodontitis in the progression of decompensated cirrhosis remains *** particular,it is unclear whether the common periodontitis pathogens,Porphyromonas gingivalis(***)and Actinobacillus actinomycetemcomitans(***),can be detected not only in the oral mucosa but also in ascites and *** To investigate the significance of periodontitis,***,and *** in cirrhosis patients with ascitic *** This prospective study was conducted at the University Hospital Hamburg Eppendorf,a tertiary center in Northern Germany.A cohort of 27 patients with ascitic decompensated liver cirrhosis underwent dental examinations to assess the association between periodontitis and various clinical parameters of cirrhosis,as well as patient *** was used to test gingival samples,ascites,and stool for the presence of *** and *** samples were collected by probing the deepest gum pocket of a sextant and wiping them on a cotton *** Periodontitis was diagnosed in 22 out of 27(82%)ascite patients,which is significantly more common than in a control cohort of 100 unselected patients(59%,P=0.04).*** was detected in the gingiva of six patients,and one of them also had *** in their ***,*** was not found in the ascites of any *** out of six patients with *** had periodontitis(83%).*** was not detected in any *** without periodontitis had a significantly higher mortality rate compared to those with periodontitis,and survival(Kaplan-Meier analysis)was longer in patients with periodontitis(P=0.02).Transplantfree survival was also more common in patients with periodontitis compared to those without(63%vs 0%,P=0.02).CONCLUSION Decompensated cirrhotic patients frequently suffer from perio

关键词： Cirrhosis Ascites Decompensation Periodontitis Survival Gingiva

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Factors associated with long-term survival after liver transplantation:A retrospective cohort study

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World Journal of Hepatology 2017年第8期9卷 427-435页

作者： Sven Pischke Marie C Lege Moritz von Wulffen Antonio Galante Benjamin Otto Malte H Wehmeyer Uta Herden lutz fischer Bjorn Nashan Ansgar W Lohse Martina Sterneck Department of Medicine I University Medical Center Hamburg-Eppendorf Department of Hepatobiliary and Transplant Surgery University Medical Center Hamburg-Eppendorf

AIM To identify predictive factors associated with long-term patient and graft survival(> 15 years) in liver transplant *** Medical charts of all de novo adult liver transplant recipients(n = 140) who were transplanted in Hamburg between 1997 and 1999 were retrospectively *** total,155 transplantations were identified in this time period(15 re-transplantations).Twenty-six orthotopic liver transplant(OLT) recipients were early lost to followup due to moving to other places within 1 year after *** remaining 114 patients were included in the *** following recipient factors were analysed:Age,sex,underlying liver disease,pre-OLT body mass index(BMI),and levels of alanine aminotransferase(ALT),bilirubin,creatinine and gammaglutamyltransferase(gamma-GT),as well as warm and cold ischemia ***,the following donor factors were assessed:Age,BMI,cold ischemia time and warm ischemia *** surviving patients were followed until December *** divided patients into groups according to their underlying diagnosis:(1) hepatocellularcarcinoma(n = 5,4%);(2) alcohol toxic liver disease(n = 25,22.0%);(3) primary sclerosing cholangitis(n = 6,5%);(4) autoimmune liver diseases(n = 7,6%);(5) hepatitis C virus cirrhosis(n = 15,13%);(6) hepatitis B virus cirrhosis(n = 21,19%);and(7) other(n = 35,31%).The group "other" included rare diagnoses,such as acute liver failure,unknown liver failure,stenosis and thrombosis of the arteria hepatica,polycystic liver disease,Morbus Osler and Caroli *** The majority of patients were male(n = 70,61%).Age and BMI at the time point of transplantation ranged from 16 years to 69 years(median:53 years) and from 15 kg/m^2 to 33 kg/m^2(median:24),***-six OLT recipients(58%) experienced a follow-up of 15 years after ***'s age(P = 0.009) and BMI(P = 0.029) were identified as risk factors for death by χ~***-Meier analysis confirmed BMI or age ab

关键词： Liver transplantation Age Body mass index Long-term survival Hepatitis B

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Gluon number fluctuations and diffusive scaling effect

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Frontiers of physics 2011年第1期6卷 100-105页

作者： Wolfgang fischer Department of Physics Bielefeld University of Applied Sciences Bielefeld 33615 Germany

The diffusive scaling is studied based on pomeron loop equations in the fixed coupling case. At Y 〉〉 YDS, the gluon number fluctuations become important, the geometric scaling is replaced by the diffusive scaling. In the diffusive scaling regime, the deep inelastic scattering （DIS） total scattering cross-section is a function of single variable ln[1/（r^2Qs^2（z））]. We show that the deep inelastic scattering experimental data lie on a single curve, which seems to indicate the existence of the diffusive scaling phenomenology in the deep inelastic scattering.

关键词： gluon number fluctuations proton structure function pomeron loop

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Geometric Bone Modeling:From Macro to Micro Structures

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Journal of Computer Science & Technology 2010年第3期25卷 614-622页

作者： Oded Zaideman Anath fischer Laboratory for Computer Aided Design & Life Cycle Engineering Faculty of Mechanical Engineering Technion Israel Institute of Technology

There is major interest within the bio-engineering community in developing accurate and non-invasive means for visualizing, modeling and analyzing bone micro-structures. Bones are composed of hierarchical bio-composite materials characterized by complex multi-scale structural geometry. The process of reconstructing a volumetric bone model is usually based upon CT/MRI scanned images. Meshes generated by current commercial CAD systems cannot be used for further modeling or analysis. Moreover, recently developed methods are only capable of capturing the micro-structure for small volumes （biopsy samples）. This paper examines the problem of re-meshing a 3D computerized model of bone micro- structure. The proposed method is based on the following phases： defining sub-meshes of the original model in a grid-based structure, remeshing each sub-mesh using the neural network （NN） method, and merging the sub-meshes into a global mesh. Applying the NN method to micro-structures proved to be quite time consuming. Therefore, a parallel, grid-based approach was applied, yielding a simpler structure in each grid cell. The performance of this method is analyzed, and the method is demonstrated on real bone micro-structures. Furthermore, the method may be used as the basis for generating a multi-resolution bone geometric model.

关键词： bone modeling micro-structures micro CT (#CT) scanning technology

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Micro-site Conditions of Epiphytic Orchids in a Human Impact Gradient in Kathmandu Valley, Nepal

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Journal of Mountain Science 2012年第3期9卷 331-342页

作者： Yagya Prasad ADHIKARI Anton fischer Hagen Siegfried fischer Geobotany Department of Ecology and Ecosystem Management Technische Universitt München Hans-Carl-von-Carlowitz-Platz 2 D-85354 Freising Germany

We studied distribution and site conditions of epiphytic orchids in a gradient of human interference in Kathmandu valley, central Nepal. The aim was to understand the recent distribution pattern of epiphytic orchids, with respect to (i) the micro-site conditions and (ii) the type and intensity of land use. The occurrence of epiphytic orchids was recorded for a grid with 1.5 km cell size. The cells represent different types and intensities of human impact. Site factors such as bark rugosity, bark pH, diameter at breast height (dbh; 1.3 m) of host trees, exposure to wind and sunlight intensity were recorded. With regard to the species richness and abundance of epiphytic orchids, we compared different human impact categories from very strong human impact (settlement area) to very low human impact (national park). Remote sensing was used for a supervised classification of land cover. Ficus religiosa turned out to be the most important host species for orchids in urban areas, while Schima wallichii and Alnus nepalensis significantly host orchids in the other categories. Both species richness and abundance of epiphytic orchids were significantly higher under very low human impact (forest in national park) and also some remaining patches of primary forest than the other regions. Micro-climate is crucial for orchid populations. Host bark pH, bark rugosity, sunlight intensity and host exposure were significantly different for all human impact categories in order to harbour epiphytic orchid species. Habitats with a mixture of mature trees are suitable and essential for the conservation of viable populations of epiphytic orchids in settled areas. The study reveals that to improve the population size of orchids it is essential for future urban forestry to: (i) Protect old trees as carriers of existing epiphytic orchid diversity, (ii) protect medium old trees to ensure that they may become old trees, (iii) plant new host trees for the future, (iv) plant in groups instead of sing

关键词： Human impact Host tree Micro-climate Epiphytic orchids Remote sensing Conservation Nepal

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Epiphytic orchids and their ecological niche under anthropogenic influence in central Himalayas,Nepal

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Journal of Mountain Science 2016年第5期13卷 774-784页

作者： ADHIKARI Yagya Prasad fischer Anton fischer Hagen Siegfried Geobotany Department of Ecology and Ecosystem ManagementTechnische Universit?t München

The survival chance of epiphytie orchids today not only depends on the natural site conditions required by the orchids but also on anthropogenic changes in site conditions. This study answers two questions：（1） What is the ecological niche of the different epiphytic orchid species？（2） What are the ecological factors that threaten epiphytic orchid＇s population under anthropogenic disturbances？ Our study area was the Kathmandu valley, Nepal, with its subtropical forest. We established 156 systematically selected sampling points in the Kathmandu area covering different types of ecosystems under human impacts such as densely populated area, agricultural land, mixed agricultural and settled area, old tree patches, and a natural forest in a national park. The ecological niche of the orchid species was analyzed with a principal component analysis （PCA）. The correlations between the different site factors were statistically significant. Spearman＇s rank correlation matrices showed that the variables land-use intensities with altitude, and height with diameter in breast height （dbh） of host had the highest significant positive correlation coefficient （0.67 and 0.64 respectively）. On the other hand, host bark pH and altitude as well as land use had a significantly strong negative correlation coefficient （-0.80 and -0.61, respectively）. Different epiphytic orchid species interact differently with the given set of environmental factors： for occurrence of Vanda cristata there is no single environmental factor of special influence, while for Rhynehostylis retusa high bark pH and high light availability are important. First two axis of the PCA explained more than 50% of the total variance. Most orchid species occupy a specific, narrow niche in this ecological space. The main causes of anthropogenie influence of orchid population in the Kathmandu Valley are loss of adequate host trees （species and size） and increasing air pollution, resulting in increasing host bark pH.

关键词： Host characteristics Epiphytic orchids Anthropogenic disturbances Canopy ecosystem Ecological niche Himalayas

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Liquid-phase epitaxy of metal organic framework thin films

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Science China Chemistry 2011年第12期54卷 1851-1866页

作者： fischer Roland A. Organometallics and Materials Chemistry Ruhr-Universitt Bochum

Metal-organic framework(MOF) thin films are multilayer materials ranging from nanometers to micrometers in thickness,physically or chemically adhesive to a(functionalized) substrate and,in an ideal case,exhibiting low roughness and high *** innovative approaches have been developed for MOF thin film *** these advanced materials,surface-attached metal-organic frameworks(SURMOFs) are an important class of MOF ***,fabricated in a step-by-step liquid phase epitaxial(LPE) fashion by alternating deposition of metal and organic linker precursors on a functionalized substrate,for example,thiolate-based self-assembled monolayers(SAMs),have already exhibited their utility in both research and potential *** combine surface science and the chemistry of MOFs,possessing the following unique advantages that cannot be accessed through other methods:(i) precisely controlling thickness,roughness and homogeneity as well as growth orientation,(ii) studying of MOF growth mechanism,(iii) modifying/tailoring MOFs' structures during the SURMOF growth and thus creating customizable properties,and(iv) existing in the form of thin film/membrane for direct applications,for example,as *** review discusses the oriented and crystalline SURMOFs fabricated by LPE approach,covering their preparation,growth mechanism,and characterization methodology as well as applications based upon the most newly updated knowledge.

关键词： coordination chemistry metal-organic frameworks (MOFs) liquid phase epitaxy step-by-step approach surface science thin film

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SOME ALMOST ALL RESULTS CONCERNINGTHE PJATECKII-SAPIRO PRIME NUMBERS

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Chinese Annals of Mathematics,Series B 1996年第3期17卷 279-288页

作者： fischer,D. ZHANTAO InstituteofMathematics Albert-LudwigsUniversityAlbertstrasse23bD-W-7800FreiburgGermany. InstituteofMathematics ShandongUniversityJinan250100China.

The distribution of the Pjateckii-Sapiro prime numbers in arithmetic progressions is investigated, and a Bombier i- Vinogr adov typ e mean- value t heorem and anot her almost all resultconcerning this problem are esta... 详细信息

关键词： Pjateckii-Sapiro prime number Arithmetic progression Bombieri-Vinogradov type mean-value theorem

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The essence of bidirectional programming

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Science China(Information Sciences) 2015年第5期58卷 76-96页

作者： fischer Sebastian HU ZhenJiang PACHECO Hugo Department of Computing Science Christian-Albrechts-University of Kiel Information Systems Architecture Research Division National Institute of Informatics Department of Informatics The Graduate University for Advanced Studies (SOKENDAI) School of Electronics Engineering and Computer Science Peking University Department of Computer Science Cornell University

Bidirectional transformations(BXs), programs with a forward transformation and a backward transformation that maintain consistency between input and output, are routinely written in ways that do not let programmers specify their behavior completely. Several bidirectional programming languages exist to aid programmers in writing BXs with increased maintainability but decreased expressiveness. Such languages allow programmers to write BXs as one program for both directions, which is easier to maintain than separate programs for each direction. However, the maintainability provided by existing bidirectional languages comes at the cost of expressiveness because the ambiguity of synchronization is solved by default strategies which are hidden from programmers. The programmers’ inability to influence synchronization strategies has led to the proposal of a vast number of approaches that consider tailor-made synchronization strategies for particular *** this paper, we argue that such ambiguity is essential for BX and advocate that the synchronization strategy should not be hidden from programmers but considered from the start. We propose a novel approach to specifying so-called well-behaved bidirectional programs by their backward transformations, capable of expressing all aspects of a BX while retaining maintainability. Soundness of our approach results from a systematic analysis, based on existing mathematical concepts, of the instrumental laws of well-behaved BXs. We show that well-behaved BXs are uniquely determined by their backward transformations and corresponding forward transformations can be obtained for free.

关键词： bidirectional transformation software adaption and coevolution bidirectional programming

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