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Endoscopic approach to achalasia

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World Journal of Gastrointestinal Endoscopy 2013年第8期5卷 379-390页

作者： michaela müller Alexander J Eckardt Till Wehrmann Department of Gastroenterology German Diagnostic Clinic

Achalasia is a primary esophageal motor disorder. The etiology is still unknown and therefore all treatment options are strictly palliative with the intention to weaken the lower esophageal sphincter (LES). Current established endoscopic therapeutic options include pneumatic dilation (PD) or botulinum toxin injection. Both treatment approaches have an excellent symptomatic short term effect, and lead to a reduction of LES pressure. However, the long term success of botulinum toxin (BT) injection is poor with symptom recurrence in more than 50% of the patients after 12 mo and in nearly 100% of the patients after 24 mo, which commonly requires repeat injections. In contrast, after a single PD 40%-60% of the patients remain asymptomatic for ≥ 10 years. Repeated on demand PD might become necessary and long term remission can be achieved with this approach in up to 90% of these patients. The main positive predictors for a symptomatic response to PD are an age > 40 years, a LES-pressure reduction to mmHg and/ or an improved radiological esophageal clearance post-PD. However PD has a significant risk for esophageal perforation, which occurs in about 2%-3% of cases. In randomized, controlled studies BT injection was inferior to PD and surgical cardiomyotomy, whereas the efficacy of PD, in patients > 40 years, was nearlyequivalent to surgery. A new promising technique might be peroral endoscopic myotomy, although long term results are needed and practicability as well as safety issues must be considered. Treatment with a temporary self expanding stent has been reported with favorable outcomes, but the data are all from one study group and must be confirmed by others before definite recommendations can be made. In addition to its use as a therapeutic tool, endoscopy also plays an important role in the diagnosis and surveillance of patients with achalasia.

关键词： Achalasia Pneumatic dilation Botulinum toxin injection Per oral endoscopic myotomy Dys-phagia Laparoscopic cardiomyotomy

A combined computational pipeline to detect circular RNAs in human cancer cells under hypoxic stress

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Journal of molecular Cell Biology 2019年第10期11卷 829-844页

作者： Antonella Di Liddo Camila de Oliveira Freitas machado Sandra Fischer Stefanie Ebersberger Andreas WHeumliller Julia EWeigand michaela muller-mcNicoll Kathi Zarnack Buchmann Institute for molecular Life Sciences Goethe University FrankfurtFrankfurt am MainGermany Institute of Cell Biology and Neuroscience Goethe University FrankfurtFrankfurt am MainGermany Institute for Cardiovascular Regeneration Goethe University FrankfurtFrankfurt am MainGermany Department of Biology Technical University DarmstadtGermany Institute of molecular Biology(ImB) MainzGermany

Hypoxia is associated with several diseases,including *** that are deprived of adequate oxygen supply trigger tran-scriptional and post-transcriptional responses,which control cellular pathways such as angiogenesis,proliferation,and metabolic *** RNAs(circRNAs)are a novel class of mainly non-coding RNAs,which have been implicated in multiple cancers and attract increasing attention as potential ***,we characterize the circRNA signatures of three different cancer cell lines from cervical(HeLa),breast(mCF-7),and lung(A549)cancer under *** order to reliably detect circRNAs,we integrate available tools with custom approaches for quantification and statistical analysis?Using this consolidated computational pipeline,we identify?12000 circRNAs in the three cancer *** molecular characteristics point to an involvement of complementary RNA sequences as well as trans-acting factors in circRNA biogenesis,such as the RNA-binding protein HNRNPC-Notably,we detect a number of circRNAs that are more abundant than their linear *** addition,64 circRNAs significantly change in abundance upon hypoxia,in most cases in a cell type-specific *** summary,we present a comparative circRNA profiling in human cancer cell lines,which promises novel insights into the biogenesis and function of circRNAs under hypoxic stress.

关键词： circular RNA computational pipeline differential expression cancer cells hypoxia RNA-Seq

Endoscopic findings in patients with Schatzki rings:Evidence for an association with eosinophilic esophagitis

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World Journal of Gastroenterology 2012年第47期18卷 6960-6966页

作者： michaela müller Alexander J Eckardt Annette Fisseler-Eckhoff Susanne Haas Ines Gockel Till Wehrmann Department of Gastroenterology German Diagnostic ClinicD-65191 WiesbadenGermany Department of Pathology Dr.Horst-Schmidt-Kliniken65199 WiesbadenGermany Department of General and Abdominal Surgery University Medical CenterThe Johannes Gutenberg University55131 MainzGermany

AIm:To investigate endoscopic findings in patients with Schatzki rings(SRs) with a focus on evidence for eosinophilic esophagitis(EoE).mETHODS:We consecutively approached all adult patients scheduled for elective outpatient upper endoscopy for a variety of indications at the German Diagnostic Clinic,Wiesbaden,Germany between July 2007 and July *** patients with endoscopically diagnosed SRs,defined as thin,symmetrical,mucosal structures located at the esophagogastric junction,were prospectively *** endoscopic findings,clinical information and histopathological findings with a focus on esophageal eosinophilia(≥ 20 eosinophils/high power field) were *** criteria for active EoE were defined as:(1) eosinophilic tissue infiltration ≥ 20 eosinophils/hpf;(2) symptoms of esophageal dysfunction;and(3) exclusion of other causes of esophageal *** reflux disease was excluded by proton pump inhibitor treatment prior to *** presence of ≥ 20 eosinophils/hpf in esophageal biopsies in patients that did not fulfil the criteria of EoE was defined as esophageal ***:A SR was diagnosed in 171(3.3%;128 males,43 females,mean age 66 ± 12.9 years) of the 5163 patients that underwent upper *** of the 116 patients(17%) from whom esophageal biopsies were obtained showed histological hypereosinophilia(≥ 20 eosinophils/hpf).Nine of these patients(8 males,1 female,mean age 49 ± 10 years) did not fulfill all diagnostic criteria of EoE,whereas in 11(9%) patients with ≥ 20 eosinophils/hpf,a definite diagnosis of EoE was *** of the 11 patients(27%) with definite EoE had no suspicious endoscopic features of *** contrast,in the 25 patients in whom EoE was suspected by endoscopic features,EoE was only confirmed in 7(28%) *** with EoE were younger(mean age 41.5 ± 6.5 vs 50.5 ± 11.5 years,P = 0.012),were more likely to have a history of allergies(73% vs 29%,P = 0.007

关键词： Schatzki ring Dysphagia Esophageal eo-sinophilia Eosinophilic esophagitis Food impaction

Is the schatzki ring a unique esophageal entity?

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World Journal of Gastroenterology 2011年第23期17卷 2838-2843页

作者： michaela müller Ines Gockel Philip Hedwig Alexander J Eckardt Kathrin Kuhr Jochem Knig Volker F Eckardt Department of Gastroenterology German Clinic for Diagnostics Wiesbaden65191 WiesbadenGermany Department of General and Abdominal Surgery University Medical Center of the Johannes Gutenberg University Mainz55131 MainzGermany Institute of medical Statistics Informatics and EpidemiologyUniversity of Cologne50924 CologneGermany Institute of medical Biostatistics Epidemiology and InformaticsUniversity Medical Center of the Johannes Gutenberg University Mainz55131 MainzGermany

AIm： To study, whether the association of Schatzki rings with other esophageal disorders support one of the theories about its etiology. mETHODS： From 1987 until 2007, all patients with newly diagnosed symptomatic Schatzki rings （SRs） were prospectively registered and followed. All of them underwent structured interviews with regards to clinical symptoms, as well as endoscopic and/or radiographic examinations. Endoscopic and radiographic studies determined the presence of an SR and additional morp- hological abnormalities. RESULTS： One hundred and sixty-seven patients （125 male, 42 female） with a mean age of 57.1±14.6 years were studied. All patients complained of intermittent dysphagia for solid food and 113 （79.6%） patients had a history of food impaction. Patients experienced symptoms for a mean of 4.7± 5.2 years before diagnosis. Only in 23.4% of the 64 patients who had endoscopic and/or radiological examinations before their first presentation to our clinic, was the SR previously diagnosed. At presentation, the mean ring diameter was 13.9 4- 4.97 mm. One hundred and sixty-two （97%） patients showed a sliding hiatal hernia. Erosive reflux esophagitis was found in 47 （28.1%） patients. Twenty-six （15.6%） of 167 patients showed single or multiple esophageal webs; five （3.0%） patients exhibited eosinophilic esophagitis; and four （2.4%） had esophageal diverticula. Four （7%） of 57 patients undergoing esophageal manometry had non- specific esophageal motility disorders. CONCLUSION： Schatzki rings are frequently associated with additional esophageal disorders, which support the assumption of a multifactorial etiology. Despite typical symptoms, SRs might be overlooked.

关键词： Schatzki ring Dysphagia Food impaction Gastroesophageal reflux disease Esophageal web

Treatment of colonic varices and gastrointestinal bleeding by recanalization and stenting of splenic-vein-thrombosis:A case report and literature review

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World Journal of Gastroenterology 2023年第24期29卷 3922-3931页

作者： Lisa-michaela Füssel Rene müller-Wille Patrick Dinkhauser Walter Schauer Harald Hofer Department of Internal medicine Ⅰ Gastroenterology and HepatologyKlinikum Wels-GrieskirchenWels 4600Austria Department of Radiology Klinikum Wels-GrieskirchenWels 4600Austria Department of Abdominal Surgery Klinikum Wels-GrieskirchenWels 4600Austria

BACKGROUND Splenic vein thrombosis is a known complication of *** can lead to increased blood flow through mesenteric *** segmental hypertension may result in the development of colonic varices(CV)with a high risk of severe gastrointestinal *** clear guidelines for treatment are lacking,splenectomy or splenic artery embolization are often used to treat *** vein stenting has been shown to be a safe *** SUmmARY A 45-year-old female patient was admitted due to recurrent gastrointestinal *** was anemic with a hemoglobin of 8.0 g/*** a source of bleeding,CV were *** tomography scans revealed thrombotic occlusion of the splenic vein,presumably as a result of a severe acute pancreatitis 8 years *** a selective angiography,a dilated mesenterial collateral leading from the spleen to enlarged vessels in the right colonic flexure and draining into the superior mesenteric vein could be *** hepatic venous pressure gradient was within normal *** an interdisciplinary board,transhepatic recanalization of the splenic vein via balloon dilatation and consecutive stenting,as well as coiling of the aberrant veins was discussed and successfully *** evaluation revealed complete regression of CV and splenomegaly as well as normalization of the red blood cell count during *** Recanalization and stenting of splenic vein thrombosis might be considered in patients with gastrointestinal bleeding due to ***,a multidisciplinary approach with a thorough workup and discussion of individualized therapeutic strategies is crucial in these difficult to treat patients.

关键词： Pancreatitis-induced splenic vein thrombosis Gastrointestinal hemorrhage Colonic varices Splenic vein stenting Segmental/sinistral hypertension Case report

Fuel cell development for New Energy Vehicles (NEVs) and clean air in China

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Progress in Natural Science:materials International 2018年第2期28卷 113-120页

作者： michaela Kendall midlands Fuel Cell and Hydrogen Network (mFCHN) and Business Forum Birmingham City University

This paper reviews the background to New Energy Vehicles(NEV) policies in China, and the key scientific and market challenges that need to be addressed to accelerate fuel cells(FCs) in the rapidly developing NEV *** global significance of the Chinese market, key players, core FC technologies and future research priorities are discussed.

关键词： New energy vehicle(NEV) Electric vehicle(EV) Hybrid vehicle(HV) Battery electric vehicle(BEV) Fuel cell vehicle(FCV) Fuel cell bus Range extender Polymer electrolyte membrane fuel cell(PEm FC) Solid oxide fuel cell(SOFC) Hydrogen Clean air in China

Topological Transformation during Normal Grain Growth

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Journal of materials Science & Technology 2004年第5期20卷 601-604页

作者： ChaogangLOU michaela.PLayer SchoolofElectronicEngineering SoutheastUniversitvNanjing210018China DepartmentofEngineering UniversityofAberdeenAberdeen-AB243UEUK

This paper investigates topological transformation during normal grain growth by carrying out a computer vertex simulation. Results show that topological correlation agrees with the models proposed by Blanc et al. and Weaire. Topological transformation occurs more often on grains with some topological classes instead of equal probability on each boundary. This can be qualitatively explained by topological correlation.

关键词： Topological transformation Normal grain growth Simulation

A numerical study of prestressed high strength steel tubular members

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Frontiers of Structural and Civil Engineering 2020年第1期14卷 10-22页

作者： michaela GKANTOU marios THEOFANOUS Charalampos BANIOTOPOULOS Department of Civil Engineering Liverpool John Moores UniversityLiverpool L33AFUK Department of Civil Engineering University of BirminghamBirmingham B152TTUK

The structural behavior of prestressed high strength steel(HSS)tubular members is investigated through the execution of advanced finite element *** models are developed and validated against published experimental data on HSS tubular members subjected to different levels of initial prestress and loaded either in tension or *** effect of the presence or absence of grouting on the strength and ductility of the members is also *** numerically replicate the structural response recorded in the tests,some key modeling features including the employed numerical solver,the adopted material models and the element types warrant careful *** developing of the finite element models,the numerically generated ultimate loads,the corresponding failure modes and the full load-deformation curves are compared to the experimental ones,indicating a successful *** anticipated,prestressing enhances the load-bearing capacity for the tensile members,whereas it is detrimental for the compressive ones.A series of parametric studies is performed to assess the influence of key factors on the structural response of prestressed HSS members and the obtained results are *** guidance for tensile and compressive prestressed tubular members is also provided.

关键词： finite element prestressing tubular members grout high strength steel

Tissue engineering approaches for dental pulp regeneration:The development of novel bioactive materials using pharmacological epigenetic inhibitors

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Bioactive materials 2024年第10期40卷 182-211页

作者： Ross m.Quigley michaela Kearney Oran D.Kennedy Henry F.Duncan Division of Restorative Dentistry&Periodontology Dublin Dental University HospitalTrinity College Dublin(TCD)University of DublinLincoln PlaceDublinIreland Department of Anatomy and Regenerative medicine and Tissue Engineering Research GroupRoyal College of Surgeons in Ireland(RCSI)University of Medicine and Health SciencesDublinIreland The Trinity Centre for Biomedical Engineering(TCBE)and the Advanced materials and Bioengineering Research Centre(AmBER) Royal College of Surgeons in Ireland(RCSI)and Trinity College Dublin(TCD)DublinIreland

The drive for minimally invasive endodontic treatment strategies has shifted focus from technically complex and destructive root canal treatments towards more conservative vital pulp ***,novel approaches to maintaining dental pulp vitality after disease or trauma will require the development of innovative,biologicallydriven regenerative medicine *** example,cell-homing and cell-based therapies have recently been developed in vitro and trialled in preclinical models to study dental pulp *** approaches utilise natural and synthetic scaffolds that can deliver a range of bioactive pharmacological epigenetic modulators(HDACis,DNmTis,and ncRNAs),which are cost-effective and easily applied to stimulate pulp tissue ***,many biological factors hinder the clinical development of regenerative therapies,including a lack of blood supply and poor infection control in the necrotic root canal *** challenges include a need for clinically relevant models and manufacturing challenges such as scalability,cost concerns,and regulatory *** review will describe the current state of bioactive-biomaterial/scaffold-based engineering strategies to stimulate dentine-pulp regeneration,explicitly focusing on epigenetic modulators and therapeutic pharmacological *** will highlight the components of dental pulp regenerative approaches,describe their current limitations,and offer suggestions for the effective translation of novel epigenetic-laden bioactive materials for innovative therapeutics.

关键词： Epigenetics Regenerative medicine Regenerative endodontics Biocompatible materials Tissue engineering