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Pancreatic Castleman disease treated with laparoscopic distal pancreatectomy

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Hepatobiliary & Pancreatic Diseases International 2013年第3期12卷 332-334页

作者： Filip ecka Alexander Ferko Bohumil Jon Zdeněk ubrt petra Kaparová Rudolf Repák Department of Surgery Faculty of Medicine and University Hospital Hradec Králové Department of Field Surgery Military Health Science Faculty Hradec Králové Defence University Brno Fingerland Department of Pathology Faculty of Medicine and University Hospital Hradec Králové Second Department of Internal Medicine Faculty of Medicine and University Hospital Hradec Králové

BACKGROUND: Castleman disease is an uncommon lympho-proliferative disorder most frequently occurring in the mediastinum. Abdominal forms are less frequent, with pancreatic localization of the disease in particular being extremely rare. Only seventeen cases have been described in the world literature. METHOD: This report describes an interesting and unusual case of pancreatic Castleman disease treated with laparoscopic resection. RESULTS: A 48-year-old woman presented with epigastric pain. CT scan showed a well-encapsulated mass on the ventral border of the pancreas. Endosonography with fine needle aspiration biopsy was performed. Biopsy showed lymphoid elements and structures of a normal lymph node. The patient was treated with laparoscopic distal pancreatectomy. The pancreas was transected with a Ligasure device and the pancreatic stump was secured with a manual suture. One year after surgery the patient was complaint-free and showed no signs of recurrence of the disease. CONCLUSIONS: Laparoscopic distal pancreatectomy is a feasible and safe method for the treatment of lesions in the body and tail of the pancreas. Transection of the pancreas with a Ligasure device offers the advantages of low bleeding and low risk of pancreatic fistula.

关键词： Castleman disease pancreas laparoscopic distal pancreatectomy Ligasure

Patient age and duration of colonoscopy are predictors for adenoma detection in both proximal and distal colon

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World Journal of Gastroenterology 2015年第2期21卷 525-532页

作者： Peter Klare Stefan Ascher Alexander Hapfelmeier petra Wolf Analena Beitz Roland M Schmid Stefan von Delius Ⅱ.Medizinische Klinik Klinikum rechts der IsarTechnischen Universit?t München81675 MunichGermany Institut für Medizinische Statistik und Epidemiologie Klinikum rechts der IsarTechnische Universit?t München81675 MunichGermany

AIM: To investigate the relation of patient characteristics and procedural parameters to the endoscopic detection rate of colonic adenomas. Further to study,which factors may be capable to predict the localization of adenomatous ***: We used the data base of a prospective randomized colonoscopy study(The Colo Cap trial) to identify patients being diagnosed with colon adenoma. Logistic regression analysis was conducted to reveal predictors for adenoma detection in the entire colon and also with respect to the proximal and distal part. Covariates including age, gender, duration of colonoscopy and comorbidities were defined to determine association between predictors and adenoma ***: Equal numbers of adenomas were detected in the proximal and distal side of the splenic flexure [126(57%) vs 94(43%), P = 0.104]. Simultaneous occurrence of adenomas in both sides of the colon was rare. The appearance of both proximal and distal adenoma was associated with increasing age(P = 0.008 and P = 0.024) and increasing duration of colonoscopy(P < 0.001 and P = 0.001). Male gender was a predictor for adenoma detection in the proximal colon(P = 0.008) but statistical significance was slightly missed with respect to the distal colon(P = 0.089). Alcohol abuse was found to be a predictor for the detection of distal adenoma(P = 0.041). CONCLUSION: Increasing age and longer duration of colonoscopy are factors with a strong impact on adenoma detection both in the proximal and distal colon. Since proximal adenomas occurred in absence of distal adenomas, complete colonoscopy should be performed for screening.

关键词： Adenoma Colorectal carcinoma Distal Colonoscopy Pr

Colorectal cancer screening:20 years of development and recent progress

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World Journal of Gastroenterology 2014年第14期20卷 3825-3834页

作者： Miroslav Zavoral Stepan Suchanek Ondrej Majek Premysl Fric petra Minarikova Marek Minarik Bohumil Seifert Ladislav Dusek Department of Medicine 1st Faculty of MedicineMilitary University HospitalCharles University Institute of Biostatistics and Analyses Masaryk University Genomac Research Institute Centre for Applied Genomics of Solid Tumors Institute of General Medicine 1st Faculty of MedicineCharles University

Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily *** trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screening programs across Europe have experienced considerable improvements(fecal occult blood testing;transition from opportunistic to population based program settings).The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality *** year,approximately 8000 people are diagnosed with CRC and some 4000 die from this *** years ago,the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal Cancer Screening Program in ***,this program was based on the guaiac fecal occult blood test(FOBT)offered by general practitioners,followed by colonoscopy in cases of FOBT *** program has continuously evolved,namely with the implementation of immunochemical FOBTs and screening colonoscopy,as well as the involvement of *** the establishment of the Czech CRC Screening Registry in 2006,2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening *** overall program expanded to cover 25.0%of the target population by ***,stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation,which is currently being prepared.

关键词： Colorectal cancer Population-based screening program Colonoscopy Fecal occult blood test

Implementing BIM in the German Architecture, Engineering and Construction Market---A Survey about the Potentials and Barriers

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Journal of Civil Engineering and Architecture 2013年第7期7卷 812-820页

作者： petra von Both Building Lifecycle Management Department Karlsruhe Institute of Technology Karlsruhe 76131 Germany

The research project ＂BIM--Potentials and Barriers＂ aims to analyze existing BIM practice and the barriers to the implementation of the approach in Germany. overseen by an ＂advisory board＂ with high-profile field, public-authority and AEC （architecture, engineering and construction market） association representatives, a set of hypotheses has been drawn up and subjected to evaluation by means of a detailed survey. The survey, having identified the relevant stakeholders, first attempts to discover how BIM （building information modeling） is currently used. The potentials of the application of BIM in the different processes and target groups are also determined, as well as the barriers and constraints. Enhancement of the considered areas is an important project solution approach： Besides technological aspects, the analysis also focuses on contracting, norms and processes, as well as education, knowledge and role perception.

关键词： BIM survey collaborative engineering virtual engineering product modelling.

Hepatic phenotypes of HNF1B gene mutations:A case of neonatal cholestasis requiring portoenterostomy and literature review

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World Journal of Gastroenterology 2015年第8期21卷 2550-2557页

作者： Radana Kotalova petra Dusatkova Ondrej Cinek Lenka Dusatkova Tomas Dedic Tomas Seeman Jan Lebl Stepanka Pruhova Department of Pediatrics 2nd Faculty of Medicine Charles University in Prague and University Hospital Motol

Hepatocyte nuclear factor 1-β(HNF1B)defects cause renal cysts and diabetes syndrome(RCAD),or HNF1B-maturity-onset diabetes of the ***,the hepatic phenotype of HNF1B variants is not well *** present a female neonate born small for her gestational age[birth weight 2360 g;-2.02standard deviations(SD)and birth length 45 cm;-2.40 SD at the 38th gestational week].She developed neonatal cholestasis due to biliary atresia and required surgical intervention(portoenterostomy)when 32-d *** the operation,icterus resolved,but laboratory signs of liver dysfunction *** had hyperechogenic kidneys prenatally with bilateral renal cysts and pancreatic hypoplasia postnatally that led to the diagnosis of an HNF1B *** represents the most severe hepatic phenotype of an HNF1B variant recognized thus far.A review of 12 published cases with hepatic phenotypes of HNF1B defects allowed us to distinguish three severity levels,ranging from neonatal cholestasis through adult-onset cholestasis to noncholestatic liver impairment,all of these are associated with congenital renal cysts and mostly with diabetes later in *** conclude that to detect HNF1B variants,neonates with cholestasis should be checked for the presence of renal cysts,with special focus on those who are born small for their gestational ***,patients with diabetes and renal cysts at any age who develop cholestasis and/or exocrine pancreatic insufficiency should be tested for HNF1B variants as the true etiological factor of all disease *** observations are needed to confirm the potential reversibility of cholestasis in infancy in HNF1B mutation/deletion carriers.

关键词： Hepatocyte nuclear factor 1-β Renal cysts and diab

Risk factors for carotid plaque progression after optimising the risk factor treatment: substudy results of the Atherosclerotic Plaque Characteristics Associated with a Progression Rate of the Plaque and a Risk of Stroke in Patients with the carotid Bifurcation Plaque Study (ANTIQUE)

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Stroke & vascular Neurology 2022年第2期7卷 132-139页

作者： David Školoudik petra Kešnerova Tomaš Hrbač David Netuka Jaroslav Vomačka Kateřina Langova Roman Herzig Tomaš Belšan Center for Health Research Faculty of MedicineUniversity of OstravaOstravaCzech Republic Department of Neurology University Hospital OstravaOstravaCzech Republic Department of Neurology Second Faculty of MedicineCharles UniversityPrahaCzech Republic Department of Neurology Motol University HospitalPrahaCzech Republic Department of Neurosurgery Faculty of MedicineUniversity of OstravaOstravaCzech Republic Department of Neurosurgery University Hospital OstravaOstravaCzech Republic Department of Neurosurgery Military University Hospital PraguePrahaCzech Republic Department of Radiological Assistance Faculty of Health SciencesPalacky University OlomoucOlomoucCzech Republic Deaprtment of Radiology University Hospital OlomoucOlomoucCzech Republic Department of Biophysics Faculty of MedicinePalacky University OlomoucOlomoucCzech Republic Department of Neurology University Hospital Hradec KrálovéHradec KraloveCzech Republic Department of Neurology Faculty of Medicine in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic Department of Radiology Military University Hospital PraguePrahaCzech Republic

Background and aim Carotid plaque progression contributes to increasing stroke *** study aims to identify factors influencing carotid plaque thickness progression after changing the preventive treatment to the‘treating arteries instead of risk factors’strategy,that is,change in treatment depending on the progression of *** The study participants who completed sonographic controls over the course of 3 years were enrolled to the *** sonography of cervical arteries was performed in 6-month intervals with measurement of carotid plaque *** thickness measurement error(σ)was set as 3 *** evidently stable and progressive plaques(defined as plaque thickness difference between initial and final measurements of˂σand>2σ,respectively)were included to *** and multivariate logistic regression analysis was performed to identify factors influencing plaque *** A total of 1391 patients(466 males,age 67.2±9.2 years)were enrolled in the *** plaque in at least one carotid artery was detected in 255(18.3%)*** age,male sex,greater plaque thickness,coronary heart disease,vascular surgery/stenting history and smoking were more frequently present in patients with progressive plaque(p˂0.05 in all cases).Multivariate logistic regression analysis identified only the plaque thickness(OR 1.850 for left side,95%CI 1.398 to 2.449;and OR 1.376 for right side,95%CI 1.070 to 1.770)as an independent factor influencing plaque *** Carotid plaque thickness corresponding to stenosis severity is the only independent risk factor for plaque thickness progression after optimising the prevention treatment.

关键词： prevention treatment Duplex

Contrast-enhanced ultrasonography in the evaluation of incidental focal liver lesions: A cost-effectiveness analysis

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World Journal of Gastroenterology 2016年第38期22卷 8605-8614页

作者： Miriama Smajerova Hana petrasova Jirina Little petra ovesna Tomas Andrasina Vlastimil valek Eva Nemcova Barbora Miklosova Department of Radiology University Hospital Brno Faculty of Medicine Masaryk University Institute of Biostatistics and Analyses Masaryk University

AIM To determine whether contrast-enhanced ultrasonography(CEUS) as the first-line method is more costeffective in evaluating incidentally discovered focal liver lesions(FLLs) than is computed tomography(CT) and magnetic resonance imaging(MRI). METHODS Between 2010 and 2015, our prospective study enrolled 459 patients with incidentally found FLLs. The biological nature of FLLs was assessed by CEUS in all patients. CT or MRI examinations were added in unclear cases. The sensitivity and specificity of CEUS were calculated. The total costs of CEUS examinations and of the added examinations performed in inconclusive cases were calculated. Afterwards, the theoretical expenses for evaluating incidentally discovered FLLs using CT or MRI as the first-line method were calculated. The resultswere compared. RESULTS The total cost of the diagnostic process using CEUS for all enrolled patients with FLLs was 75884 USD. When the expenses for additional CT and MRI examinations performed in inconclusive cases were added, the total cost was 90540 US dollar(USD). If all patients had been examined by CT or MR as the first-line method, the costs would have been 78897 USD or 384235 USD, respectively. The difference between the cost of CT and CEUS was 3013 USD(4%) and that between MRI and CEUS was 308352 USD(406.3%). We correctly described 97.06% of benign or malignant lesions, with 96.99% sensitivity and 97.09% specificity. Positive predictive value was 94.16% and negative predictive value was 98.52%. In cases with 4 and more lesions, malignancy is significantly more frequent and inconclusive findings significantly less frequent(P valuating FLLs are comparable, CEUS examination is far more costeffective in comparison to MRI.

关键词： Contrast-enhanced ultrasonography Focal liver lesion Computed tomography Magnetic resonance imaging Economic analysis

Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity

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Hepatobiliary Surgery and Nutrition 2021年第5期10卷 610-622,I0004-I0007页

作者： Magdalena Eilenberg petra Munda Judith Stift Felix BLanger Gerhard Prager Michael Trauner Katharina Staufer Division of General Surgery Department of SurgeryMedical University of ViennaViennaAustria Department of Visceral Surgery and Medicine InselspitalUniversity Hospital BernBernSwitzerland Division of Gastroenterology&Hepatology Department of Internal Medicine IIIMedical University of ViennaViennaAustria Clinical Institute of Pathology Medical University of ViennaViennaAustria Division of Transplantation Department of SurgeryMedical University of ViennaViennaAustria

Background:Vibration controlled transient elastography(VCTE)and controlled attenuation parameter(CAP™)have shown reliable performance predicting fibrosis and steatosis in normal-to overweight patients but have not been validated in severe to morbid *** study aimed at determining the accuracy of VCTE,CAP™and the composite score FibroScan-AST(FAST)in patients with a body mass index(BMI)of≥35 kg/m^(2).Methods:Patients scheduled for bariatric-metabolic surgery underwent preoperative VCTE/CAP™measurement,and intraoperative liver *** feasibility and accuracy of VCTE,CAP™and the composite score FAST were retrospectively analysed to evaluate fibrosis,steatosis and active fibrotic non-alcoholic steatohepatitis[NASH+non-alcoholic fatty liver disease(NAFLD)activity score≥4+fibrosis grade≥2]using per protocol(PP)and intent to diagnose(ITD)***:In total,170 patients(median BMI 44.4 kg/m²)were included in the *** biopsy showed NASH,simple steatosis,and normal livers in 60.6%(n=103),28.8%(n=49),and 10.6%(n=18),*** and CAP™delivered reliable results in 90.6%(n=154/170)and 90.5%(n=134/148).The AUC(PP)of VCTE,CAP™,and FAST were 0.687(≥F2),0.786(≥F3),0.703(≥S2),0.738(S3),and 0.780(active fibrotic NASH).The AUC increased to 0.742(≥F2),0.842(≥F3),0.712(≥S2),0.780(S3),and 0.836(active fibrotic NASH)in patients below the median BMI of 44.4 kg/m².Conclusions:VCTE,CAP™and FAST show acceptable accuracy for the detection of fibrosis,steatosis and NASH in a real-life cohort of patients with *** improves in patients with a BMI<44.4 kg/m^(2).

关键词： Transient elastography controlled attenuation parameter(CAP™) FibroScan-AST score(FAST score) obesity non-alcoholic fatty liver disease(NAFLD)

Clones or no clones：genetic structure of riparian Populus euphratica forests in Central Asia

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Journal of Arid Land 2018年第5期10卷 750-766页

作者： Katja KRAMP Thomas SCHMITT petra LANG Michael JESCHKE Philipp SCHAFERI Dustin KULANEK ZHANG Ximing YU Ruide Frank M THOMAS Senckenberg German Entomological Institute Eberswalder StraBe 90 Muncheberg 15374 Germany Department of Zoology Faculty Natural Sciences I Institute of Biology Martin Luther University Halle-Wittenberg Halle (SaMe) 06099 Germany Faculty of Regional and Environmental Sciences University of Trier Campus II BehringstraBe 21 Trier 54296 Germany Xinjiang Institute of Ecology and Geography Chinese Academy of Sciences Urumqi 830011 China Sino-German Joint Research Center for the Management of Ecosystems and Environmental Changes in Arid Lands (MEECAL) Urumqi 830011 China

Many riparian（Tugai） forests growing along rivers in arid and hyper-arid regions of Central Asia are dominated by the Euphrates poplar（Populus euphratica）. Besides generative reproduction, which is only possible upon flooding events and at a distance to the groundwater of less than 2 m, this phreatophytic tree species also reproduces vegetatively by forming clones that can cover land surface areas of several hectares. Along a gradient of groundwater distances, we investigated whether the fraction of clones in P. euphratica stands（1） increases with increasing distance to the water table;（2） is higher if supplied with water via river cut-offs; and（3） approaches 100% at a short distance to the groundwater, but at high salt concentrations in the upper soil layers, which would prevent germination and establishment of seedlings. AFLP（Amplified Fragment Length Polymorphism） analyses were conducted on leaf samples taken from mature P. euphratica trees growing at the fringes of the Taklimakan Desert in stands with different distances（2–12 m） to the groundwater at two plots at the middle and the lower reaches of the Tarim River and in a stand close to Ebinur Lake, Xinjiang, China. Genetic diversity was large among plots, but considerably smaller within plots. We found the highest genetic diversity（caused by regeneration from seeds） at plots that have a short distance to the groundwater or are supplied with additional water. There was no significant relationship between groundwater distance and clonal fraction. All investigated trees at the saline Ebinur Lake site belonged to one single clone. Our results demonstrate that the genetic pattern of this widespread species is not easily predictable even over small distances as it is a result of a complex interplay of stand history and dispersal of propagules（pollen, seeds, and vegetative diaspores） by wind and water. In conservation and restoration schemes, P. euphratica stands with a high genetic diversity and stands that grow at

关键词： clonality floodplain forest ground water phreatophyte population genetics rejuvenation salinity